Pediatric Grand Rounds (RECORDING) Applying a Health Disparities Lens to a Career in Pediatrics

This presentation is a recording of a Stanford Pediatric Grand Rounds Session.  World-renowned experts will present the latest research, practice guidelines, and treatment protocols to advance best practices in the care of pediatric patients. These online recordings will provide pediatricians and family physicians with up-to-date clinical information on a wide range of clinical issues encountered in daily pediatric practice. 

In this session, Dr. Fuentes-Afflick reviews her contributions to health disparities research in perinatal epidemiology and shares her engagement in departmental, institutional, and organizational efforts to promote diversity, equity, and inclusion.

  Release Date: June 15, 2022
  Expiration Date: June 15, 2023
  Estimated Time to Complete: 1.0 hours 
  Registration Fee: FREE
 *Originally recorded 03/11/2022.

1. Critically apply diagnostic and treatment principles addressed in the American Academy of Pediatrics guideline to the management of children with acute otitis media.
2. Highlight departmental, institutional, and organizational approaches to advancing diversity, equity, and inclusion.

In support of improving patient care, Stanford Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. 

Credit Designation 
American Medical Association (AMA) 
Stanford Medicine designates this Enduring Material for a maximum of 1.00 AMA PRA Category 1 Credits^TM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Accessibility Statement
 Stanford University School of Medicine is committed to ensuring that its programs, services, goods and facilities are accessible to individuals with disabilities as specified under Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Amendments Act of 2008.  If you have needs that require accommodations, please contact the CME Conference Coordinator.

Cultural and Linguistic Competency
The planners and speakers of this CME activity have been encouraged to address cultural issues relevant to their topic area for the purpose of complying with California Assembly Bill 1195. Moreover, the Stanford University School of Medicine Multicultural Health Portal contains many useful cultural and linguistic competency tools including culture guides, language access information and pertinent state and federal laws.  You are encouraged to visit the Multicultural Health Portal: https://laneguides.stanford.edu/multicultural-health

References/Bibliography

Abraído-Lanza, A. F., Armbrister, A. N., Flórez, K. R., & Aguirre, A. N. (2006). Toward a theory-driven model of acculturation in public health research. American journal of public health, 96(8), 1342–1346. https://doi.org/10.2105/AJPH.2005.064980

Bell, J. F., Zimmerman, F. J., Almgren, G. R., Mayer, J. D., & Huebner, C. E. (2006). Birth outcomes among urban African-American women: a multilevel analysis of the role of racial residential segregation. Social science & medicine (1982), 63(12), 3030–3045. https://doi.org/10.1016/j.socscimed.2006.08.011

Delgado, J. L. (2022). Beyond Diversity Time for New Models of Health. The New England Journal of Medicine, 386:503-505. https://doi.org/10.1056/NEJMp2115149

Diez Roux A. V. (2012). Conceptual approaches to the study of health disparities. Annual review of public health, 33, 41–58. https://doi.org/10.1146/annurev-publhealth-031811-124534

Flores, G., Mendoza, F. S., DeBaun, M. R., Fuentes-Afflick, E., Jones, V. F., Mendoza, J. A., Raphael, J. L., & Wang, C. J. (2019). Keys to academic success for under-represented minority young investigators: recommendations from the Research in Academic Pediatrics Initiative on Diversity (RAPID) National Advisory Committee. International journal for equity in health, 18(1), 93. https://doi.org/10.1186/s12939-019-0995-1

Fuentes-Afflick, E. (2015). Updating the Academic Playbook. JAMA Pediatrics
2015;169(10):889–890. https://doi.org/10.1001/jamapediatrics.2015.1830

Fuentes-Afflick, E., & Hessol, N. A. (2009). Immigration status and use of health services among Latina women in the San Francisco Bay Area. Journal of women's health (2002), 18(8), 1275–1280. https://doi.org/10.1089/jwh.2008.1241

Fuentes-Afflick, E., & Hessol, N. A. (2000). Interpregnancy interval and the risk of premature infants. Obstetrics and gynecology, 95(3), 383–390. https://doi.org/10.1016/s0029-7844(99)00583-9

Fuentes-Afflick, E., Hessol, N. A., & Pérez-Stable, E. J. (1998). Maternal birthplace, ethnicity, and low birth weight in California. Archives of pediatrics & adolescent medicine, 152(11), 1105–1112. https://doi.org/10.1001/archpedi.152.11.1105

Fuentes-Afflick, E., & Lurie, P. (1997). Low birth weight and Latino ethnicity. Examining the epidemiologic paradox. Archives of pediatrics & adolescent medicine, 151(7), 665–674. https://doi.org/10.1001/archpedi.1997.02170440027005

Goldenberg, R. L., Culhane, J. F., Iams, J. D., & Romero, R. (2008). Epidemiology and causes of preterm birth. Lancet (London, England), 371(9606), 75–84. https://doi.org/10.1016/S01406736(08)60074-4

Hessol, N. A., & Fuentes-Afflick, E. (2005). Ethnic differences in neonatal and postneonatal mortality. Pediatrics, 115(1), e44–e51. https://doi.org/10.1542/peds.2004-0478

Hessol, N. A., & Fuentes-Afflick, E. (2000). The perinatal advantage of Mexican-origin Latina women. Annals of epidemiology, 10(8), 516–523. https://doi.org/10.1016/s1047-2797(00)00073-9

Markides, K. S., & Coreil, J. (1986). The health of Hispanics in the southwestern United States: an epidemiologic paradox. Public health reports (Washington, D.C. : 1974), 101(3), 253–265. https://pubmed.ncbi.nlm.nih.gov/3086917/

Martin, J. A. et al. (2016). Births: Final Data for 2016. National Vital Statistics Reports, vol. 67
No. 1. https://www.cdc.gov/nchs/data/nvsr/nvsr67/nvsr67_01.pdf

National Center for Health Statistics. Image. Ethnic disparities in infant mortality: 1940-1995.

National Center for Health Statistics. Image. US Infant mortality rate, by ethnicity: 1995-2009. National Center for Health Statistics. (2013). Image. Infant mortality rate, by ethnicity and birthplace: US 2009.

Powell-Griner, E., & Streck, D. (1982). A closer examination of neonatal mortality rates among the Texas Spanish surname population. American journal of public health, 72(9), 993–999. https://doi.org/10.2105/ajph.72.9.993

Selby, M. L., Lee, E. S., Tuttle, D. M., & Loe, H. D.. (1984). Validity of the Spanish surname infant mortality rate as a health status indicator for the Mexican American population.
American Journal of Public Health 74, 998-1002. https://doi.org/10.2105/AJPH.74.9.998

University of Michigan. (1972-2002). Integrated Premedical-Medical Program (University of Michigan) Records: 1976-2002. Bentley Historical Library. https://quod.lib.umich.edu/b/bhlead/umich-bhl-9620?rgn=main;view=text

Wong, W. F., LaVeist, T. A., & Sharfstein, J. M. (2015). Achieving health equity by design. The Journal of the American Medical Association, 313(14), 1417–1418. https://doi.org/10.1001/jama.2015.2434

Zolitschka, K. A., Miani, C., Breckenkamp, J., et al. (2019). Do social factors and country of origin contribute towards explaining a “Latina paradox” among immigrant women giving birth in Germany?. BMC Public Health 19, 181. https://doi.org/10.1186/s12889-019-6523-9

For CME general questions, please contact 
     Email: [email protected]

Mitigation of Relevant Financial Relationships

Stanford Medicine adheres to the Standards for Integrity and Independence in Accredited Continuing Education. 

There are no relevant financial relationships with ACCME-defined ineligible companies for anyone who was in control of the content of this activity, except those listed in the table below. All of the relevant financial relationships listed for these individuals have been mitigated.

Faculty Member Information

Role in activity

Name of Ineligible Company(s) / Nature of Relationship(s)

Alan Ross Schroeder, MD
Clinical Professor
Stanford University

Co-Course Director and Reviewer

Nothing to disclose

Elena Fuentes-Afflick, MD, MPH
Professor and Vice Dean
University of California, San Francisco

Faculty

Nothing to disclose

Debra Babcock, MD
Stanford Childrens (PCHA)

Planner

Nothing to disclose

Caitlin Billingham, MD, MPH
Chief Resident
Stanford Pediatrics

Planner

Nothing to disclose

Lisa Jo Chamberlain, MD
Associate Professor of Pediatrics – General Pediatrics
Stanford Children's Health

Planner

Nothing to disclose

Olja Marsenic Couloures, MD
LPCH

Planner

Nothing to disclose

Lane Francis Donnelly, MD
Chief Quality Officer, Packard Childrens Hospital at Stanford
Stanford University

Planner

Nothing to disclose

Baraka Dechelle Floyd, MD, MSc
Clinical Assistant Professor and Associate Chair for Diversity, Equity, and Inclusion
Stanford University School of Medicine

Planner

Nothing to disclose

Ingrid Garnica, BA
Stanford Pediatrics

Planner

Nothing to disclose

Charles Gawad, MD, PhD
Associate Professor
Stanford

Planner

Ownership-BioSkryb Genomics

Allison Guerin, EdD
Stanford

Planner

Nothing to disclose

Mary Beth Leonard, MD, MSCE
Professor and Chair, Department of Pediatrics
Stanford Medicine

Planner

Nothing to disclose

Stephen J Roth, MD, MPH
Attending, Cardiovascular ICU
Lucile Packard Children's Hospital Stanford

Planner

Nothing to disclose

Sarina Tom, BA
Education Operations Manager
Stanford Pediatrics

Planner

Nothing to disclose

Ke-You Zhang, MD
Stanford University

Planner

Nothing to disclose