Johns Hopkins pediatric pulmonologist Christy Sadreameli advocates for public policies aimed at protecting vulnerable young lungs — and urges her colleagues to do the same. “We’re the ones who really understand the impact that climate change, air pollution, smoking and vaping, and the unavailability of lifesaving drugs have on children,” she says. “So if we don’t fight for them, who will?” Some key takeaways from her recent paper, “Advocacy and Health Equity: The Role of the Pediatric Pulmonologist,” in Chest Medicine:

1.

Pediatric pulmonologists should be aware of how environmental and social factors can drive health inequities and lead to poor health outcomes. Among the most urgent threats to children’s lung health, Sadreameli cites climate change, poor air quality and environmental injustice; policies resulting in historical and contemporary neighborhood divestment; tobacco exposure and vaping; lack of health insurance; lack of emergency albuterol in schools; and the digital divide in telemedicine access.

2.

Take actions to address these factors in clinical encounters and in broader advocacy activities within society — and work to educate colleagues and other health professionals. Actions could include organizing grand rounds or inviting speakers to local professional organization meetings. During patient visits, Sadreameli recommends screening for housing concerns (mold, dampness, pests, unvented gas stoves, tobacco exposure) and connecting families with local resources or education, including tobacco cessation supports for youth.

3.

Partner with nonprofits, lawmakers and other advocacy groups to help achieve policy goals (including the passage of stock albuterol laws). Stocking emergency bronchodilators (i.e., albuterol) in schools is a priority that may help many children with asthma. In many states that have passed or are currently working on such legislation, pediatric pulmonologists have played a major role by partnering with lawmakers and providing expert testimony, she notes.

4.

Lobby academic institutions to encourage advocacy activities and provide academic credit for this work. Sadreameli believes that pediatric pulmonology programs should count advocacy activities toward faculty promotion at the institutional level. She recommends that fellows be encouraged to develop advocacy skills and experience (in the form of health-related media interviews, community education and spoken testimony to legislative bodies) during their training periods and beyond.