During routine checkups, pediatricians talk to parents about their child's diet, sleep patterns, vaccinations and TV time.

But as nearly half of children in the United States live in poverty or close to the line, new guidelines from the American Academy of Pediatrics recommend doctors add another question to their checklist: "Do you have difficulty making ends meet?"

The AAP's policy statement said poverty is a factor that can significantly harm the health of children, and it is strongly associated with lifelong hardship.

"Poverty is everywhere. It affects children of all backgrounds and in all communities," said Dr. Benard Dreyer, the president of the AAP.

Statistics in the U.S. reveal that one in every five children younger than 18 years old lives in poverty. When families classified as poor, near poor or low-income are included, the poverty rate goes up to 43 percent, or more than 31.5 million, the AAP said.

So as part of the new guidelines, families who answer yes to the question will be directed to appropriate community resources.

"Pediatricians are dedicated to preventing illness in children and intervening early when there is a problem," said Dr. James Duffee, one of the authors of the new policy statement.

Previous studies have shown that living in poverty can impair a person's immune function, foster cardiovascular disease, and contribute to behavioral or emotional disorders.

Among low-income families, poverty can cause major health problems such as infant death, elevated risk of asthma and injuries, and poor language development. In fact, a past study in the United Kingdom found that children in low-income families are thrice as likely to be overweight or obese as their rich counterparts.

Dr. John Pascoe, the policy's lead author, said poverty-related conditions can take a lasting toll on children and families, but there are effective ways to intervene and help buffer the effects. Such interventions would include the promotion of strong family relationships, which can cause positive changes in the body's stress response system and the developing brain, he said.

The AAP also called for the expansion of federal and state anti-poverty and safety net programs.

The policy statement listed a wide range of programs focused on alleviating the effects of poverty and increasing access to social services and care. Among those programs are the following:

- Medicaid
- Children's Health Insurance Program
- Women, Infants and Children (WIC) Program
- Temporary Assistance for Needy Families
- A home-visiting program for parents of babies and young children, which is established under the Affordable Care Act

The AAP also urged doctors to support policies that increase access to healthy food, health care and safe, affordable housing.

The policy statement and the accompanying technical report are featured in the journal Pediatrics.

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