We are being inundated with political commercials these days. These TV ads hope to appeal to our selfish interests often, that folks will vote for candidate A or B because they will give me what I want. I understand the motivating force behind these ads but worry about the underrepresented segment of our population that gets ignored in this process every election cycle – children. One day after this post, our country will engage in the 2024 election, for local, state and national offices. And they all matter for children., and they cannot vote.

My professional organization, the American Academy of Pediatrics, takes the responsibility of advocating for children quite seriously. The AAP is nonpartisan but definitely pro-children and pro-families. Make no mistake, pediatricians are unapologetically pro-children and will speak out as needed since children and their needs are all too often pushed to the side as adults squabble.
The AAP recently issued a call to action for pediatricians to ask incumbents or would-be office holders their stances on a variety of issues.1 I would like to ask you to consider these questions below posed by the AAP for their members and put children and their needs at the top of our lists. We are seeking health equity for children. Health equity means that everyone, regardless of their background, has the opportunity to live to their full health potential; this means that race, class, gender, or other social circumstances should not systematically make it more difficult to attain good health.2 Policies enacted by legislation or other deliberative bodies are what makes a difference in the lives of children. The questions, in quotes, are (with my additional comments in italics; they do not represent AAP opinion or policies) –
- Health care. “Since the COVID-19 public health emergency ended last year, millions of children have lost their health care coverage through programs like Medicaid and CHIP. What is your plan to protect children’s health coverage and ensure they can access the care and services they need to be healthy?” The only political action committee solely devoted to children notes that Medicaid (often confused with Medicare) offers insurance for low-income Americans.3 It doesn’t just help provide financial security for people in need of basic care, it provides access to medicine and care that is preventive. For children, access to the right care at the right time means they can live healthier, fuller, and more productive lives. Cutting Medicaid funding will likely impact 73 million Americans, including 50% of America’s children. States that have not expanded Medicaid funding under the Affordable Care Act have demonstrably poorer health outcomes for children. Unfortunately, my now home state of South Carolina is one of those.
- Firearm violence. “In 2020, firearm violence overtook motor vehicle accidents as the leading cause of death for children in the United States. What is your plan to end the epidemic of firearm injuries and deaths among children and teens in our country?” Common sense gun regulation should be a no-brainer, but we refuse to adopt solutions that will protect our children. More resource officers might sound like a reasonable approach, but I see it as bailing water out of a canoe with a hole in it. Let’s get the water out of the canoe AND fix the canoe.
- Social media. “As a pediatrician, one of the top questions families ask me about is social media and its impact on their children’s mental health. What is your plan to make sure kids are able to benefit from a digital environment that is safe and healthy for them?” The Surgeon General has rightfully identified social media as a health hazard to our children. Policy makers cannot bury their heads in the sand, nor can they pass draconian laws that will not be adhered to. This is a unique problem in today’s society and will not go away without sane and rational approaches.
- Poverty. “11 million children live in poverty in this country, and its impacts on children’s health can be severe and lifelong. How do you propose to help lift children and families out of poverty?” Poverty is a great injustice for too many children – an injustice of housing, an injustice of hunger, an injustice of health care, an injustice of transportation, an injustice of climate change, an injustice of the environment, an injustice of education, an injustice of voting.5 Tangible solutions exist but, as a society, we do not have the social will to find them. When children are the pawns of power brokers and the downtrodden are seen as freeloaders, children suffer from the injustices of a society that values wealth over justice.6,7
- Mental health. “Nearly three years ago, pediatricians, child and adolescent psychiatrists and children’s hospitals declared a national emergency in youth mental health. While there has been some policy progress, there is so much more we need to do to support young people. How do you plan to address and support youth mental health?” Too many children are not getting the support and services that they need to cope. As parents will need to be conscious of the mental state of their children and society needs to be conscious of its inadequate responses to the current problem.8
- Vaccines. “During the COVID-19 pandemic, our nation saw a drop in vaccine rates among children. While vaccine rates have increased since the end of the pandemic, we still have not quite reached pre-pandemic vaccine levels. What will you do to help promote vaccines and ensure that our community is protected against measles, polio, whooping cough and other infectious diseases?” One of greatest public health triumphs in my lifetime has been use of so many vaccines to prevent serious injury or death.9,10 Seeing the decline in vaccines and spread of misinformation/disinformation about vaccines is a social tragedy in my estimation. Public servants need to be the primary promoters of public health with vaccines at the forefront.
- Climate change. “Children are uniquely vulnerable to the impacts of climate change. As a pediatrician, I see these impacts in my practice daily—a child’s asthma may be harder to manage because of poor air quality, camps keep kids indoors because of increasingly hot temperatures, and wildfires and hurricanes are becoming more common and more severe, impacting housing and health. What would your administration do to protect children from the health effects of climate change?” The hurricanes in the southeast and wildfires in the west were particularly impactful on children because they exposed them to numerous health conditions and totally disrupted their lives. To ignore the ongoing effects of climate change is to put the needs of children in the background and not care about generations to come.
- Investment in children. “Children are 25% of the U.S population and 100% of the future. How do you propose to provide for the future by investing in children?” This question is the crux of this series of questions. If children matter, we should be actively investing in children in meaningful ways. All too often we invest in some children and not in others. I don’t know how this became acceptable. All of the children are our children, and to dispute that only serves to create an us vs. them (my kids vs. those kids) mentality.

For all of the reasons above, I fervently hope that you will vote for the children. If you have already voted and didn’t ask the questions above, please do so next time. Elections are the hallmark of a democratic society and the way tangible change occurs. Please be a part of this change – for the children.
- https://www.aap.org/en/advocacy/election-vote-kids/candidate-questions-for-the-2024-election/
- https://www.aap.org/en/advocacy/election-vote-kids/the-basics-what-is-health-equity/
- https://www.theirfutureourvote.org
- https://www.hhs.gov/about/news/2023/05/23/surgeon-general-issues-new-advisory-about-effects-social-media-use-has-youth-mental-health.html
- https://mychildrenschildren.com/the-injustices-of-poverty/
- https://eji.org/bryan-stevenson/
- Saul R. Mercy. GHS Proc May 2016. 1(1):70.
- https://mychildrenschildren.com/could-my-child-do-that/
- https://mychildrenschildren.com/i-embrace-science-you-should-also/
- https://mychildrenschildren.com/vaccines-in-children-december-15-2023/