Community social pediatrics is a model of integrated social medicine developed by Dr. Gilles Julien that targets the child’s needs and focuses on the strengths of the child, the extended family and the community. It brings together expertise from the medical, legal and social science fields in order to detect, reduce or eliminate sources of toxic stress or risk factors that affect the development and well-being of children from disadvantaged backgrounds.
- Eisenberg D. (2002). À l’aube d’une médecine intégrée. Congrès international sur la science du touché, Montreal. Interview with Christian Lamontagne on PasseportSanté.net. Retrieved July 10, 2013.
- Julien G., Trudel H. (2009). Tous responsables de nos enfants : Un appel à l’action. Montreal: Bayard Canada.
- Julien G. (2004). A Different Kind of Care: The Social Pediatrics Approach. Montreal: McGill-Queen’s University Press.
- Julien G. (2004). Soigner différemment les enfants : méthodes et approches, 2nd ed. Québec City: Les Éditions Logiques.
- Lindström B., Spencer N. (eds.) (1995). Social Paediatrics. New York: Oxford University Press.
- Lynam M.J., Loock C., Scott L., Wong S. (2010). Social Pediatrics Initiative, Enacting a ‘RICHER’ Model, A report to the British Columbia Medical Services Foundation and the Canadian Nurses Foundation. Vancouver, BC.
- Garner A.S., Shonkoff J.P., Siegel B.S., Dobbins M.I., Earls M.F., McGuinn L., Pascoe J., Wood D.L. Early Childhood Adversity, Toxic Stress, and the Role of the Pediatrician: Translating Developmental Science Into Lifelong Health. Pediatrics, 129 (1): e224-231.
- Social Medicine (2007). Abstracts from the Social Medicine Session at the 2006 Annual Meeting of the American Association of Medical Colleges, Seattle 2(1): 56-64.
Community social pediatrics takes a holistic approach to health. Although it is fundamentally a medical approach, it incorporates other disciplines into its practice, such as social sciences and the law. This leads to a better understanding of the overall context and the sources of stress that affect a child’s development and well-being. The approach relies on collective know-how to come up with a clear diagnosis as time goes on that depends on everyone’s participation, including the children and their extended families. Information is shared by everyone around the table in a friendly, informal and non-judgemental atmosphere. This collective know-how promotes a common understanding of the situation and better coordination between everyone involved, thereby ensuring that service delivery is adapted to each child’s particular situation. It also encourages children and their families to engage in the decision-making process.References
- Bertrand M-A. et al. (2002). L’interdisciplinarité et la recherche sociale appliquée, réflexions sur des expériences en cours. Montreal: Université de Montréal.
- Darbellay F. (2005). Interdisciplinarité et transdisciplinarité en analyse des discours : complexité des textes, intertextualité et transtextualité. Geneva: Slatkine.
- Solar O. et al. (2009). Moving Forward to Equity in Health: What Kind of Intersectoral Action Is Needed? An Approach to an Intersectoral Typology. Presented at the 7th Global Conference on Health Promotion, “Promoting Health and Development: Closing the Implementation Gap”, Oct. 26-30, Nairobi, Kenya.
1750s – Philosophy of the Enlightenment
During the 18th century, many physicians – such as Rosen Von Rosenstein, Des Essarts and George Armstrong – start to express concerns about children’s health and diseases. Several textbooks addressing childhood diseases, which include chapters on breastfeeding, vaccination, and maternal and child education, are published.
1767 – Launch of the social pediatrics movement
George Armstrong opens the first clinic for children of poor families in London.
1840 – First proof of the influence of poverty on children’s growth
Father of social medicine Louis-René Villermé publishes epidemiological data documenting a differential in children’s growth correlated to their socio-economic status. He notes an increased risk of child mortality in poor families and those with low socio-professional status.
1848 – Social medicine progresses across Europe
In France, Jules Guérin creates the heading “Médecine sociale” [Social Medicine] in La Gazette médicale de Paris. At the same time in Germany, Czerny promotes hygiene and adequate nutrition for children.
1884 – Creation of the Society for the Prevention of Cruelty to Children in London
1894 – Advancement of children’s rights in France
Children’s living conditions in France slowly improve when factories are prohibited from hiring children under the age of 8 and children’s work hours are reduced. This same year, the government announces that children will no longer be allowed to work in mines.
1901 – Services for disadvantaged children
Some obstetricians – such as Budin in Paris – decide, on their own initiative, to offer free services to disadvantaged children in specific clinics and create free milk distribution centres.
1919 – Creation of “L’Œuvre nationale de l’Enfance”
“L’Œuvre nationale de l’Enfance” is founded in Belgium to assist disabled children by providing medical, social and educational activities for their families and supporting research in this field. Other similar organizations are created across Europe between the two world wars.
1946 – Creation of UNICEF
As child mortality continues to increase, UNICEF is created in 1946 by the United Nations to provide food, clothing and health care to children who are victims of war.
1959 – Declaration of the Rights of the Child
The Declaration of the Rights of the Child is adopted by the United Nations General Assembly. It includes children’s right to protection, education, health care, shelter and good nutrition.
1962 – First definition of social pediatrics
At the Congress of Pediatrics, social pediatrics is defined for the first time as follows: “From the moment a collective action is taken – either local, national or international – pediatrics becomes a social issue.” – Robert Debré “Social pediatrics considers the child – either healthy or ill – in the context of the social group that he/she belongs to and grows up in.”– Nathalie Masse
1972 – First textbooks on social pediatrics
The authors Manciaux, Mande and Masse publish the first textbooks on social pediatrics that outline recent advances in the field.
1989 – Convention on the Rights of the Child
The Convention on the Rights of the Child is adopted in 1989 by the United Nations General Assembly and comes into force in September 1990.
Dr. Julien turns to partners working with children at risk in disadvantaged communities and develops a clinical social pediatrics model.
The first community social pediatrics centre called “Assistance aux Enfants en Difficulté” (AED) opens in Hochelaga-Maisonneuve. It receives 50% of its initial funding from the Fondation Lucie et André Chagnon.
A second community social pediatrics centre opens in the multicultural neighbourhood of Côte-des-Neiges. Incorporated under the name “Centre de services préventifs à l’enfance” (CSPE), it receives 100% of its funding from the Fondation Lucie et André Chagnon.
2003 to the present —
The general public gives increasingly positive support to Dr. Julien’s social pediatrics approach.
Dr. Julien publishes A Different Kind of Care: The Social Pediatrics Approach, which describes his approach. The International Society for Social Pediatrics and Child Health’s (ISSOP) first symposium is held in Montreal.
The FPPS is created to ensure the sustainability of the social pediatrics movement, to support the two social pediatrics centres and to protect and promote children’s rights in disadvantaged communities.
2005 to the present —
The first two social pediatrics centres are recognized as centres of expertise and training for McGill University and Université de Montréal.
Members of the community approach Dr. Julien to develop their own CSPCs.
A partnership is set up with MFC to develop continuing medical education in social pediatrics, including a component designed to raise awareness of the issue among doctors. Medical interest groups in community social pediatrics are formed.
2008 to date —
Beginning of the CSPC Movement, mainly in Quebec.
The Fondation pour la promotion de la pédiatrie sociale (FPPS) changes its name to the Fondation du Dr Julien (FDJ). Publication of Dr Julien and Hélène (Sioui) Trudel book « Tous responsables de nos enfants : un appel à l’action ».
The FDJ receives three-year funding from the government of Québec (one million dollars annually).
A three-year evaluation is undertaken by the Fonds de recherche sur la société et la culture (FQRSC) in collaboration with the Ministère de la Santé et des Services sociaux [Québec Ministry of Health and Social Services]. The study examines the specific features and impacts of the community social pediatrics model and its integration into the current health and social services system of the province of Québec.
Avenir d’enfants funds a project entitled “Acquisition et transfert de connaissances en pédiatrie sociale en communauté ” [Acquiring and Transferring Knowledge in Community Social Pediatrics] to document and share knowledge on community social pediatrics practice.
Québec government funds the FDJ for a five-year period. The FDJ receives five-year funding from the Québec government to help the organization reach 20,000 children at risk between 2015 and 2020. The Dr Julien/Marcelle and Jean Coutu Foundation Chair in Community Social Pediatrics is set up at Université de Montréal, and the Nicolas Steinmetz – Gilles Julien Chair in Community Social Pediatrics is created at McGill University. The Fondation de l’Ordre des infirmières et infirmiers du Québec grants funding to the Fondation du Dr Julien to support nurses’ training and inclusion in community social pediatrics.