Child health disparities in terms of access to high-quality physical and behavioral health services and social needs supports are rampant and pernicious in the United States. These disparities reflect larger societal health inequities (social injustice in health) and lead to preventable population-specific differences in wellness outcomes with marginalized children facing substantial and systematically disproportionate health burdens. Primary care, and specifically the pediatric patient-centered medical home (P-PCMH) model, is a theoretically well-positioned platform to address whole-child health and wellness needs, yet often does so in a way that is inequitable for marginalized populations. This article delineates how the integration of psychologists within the P-PCMH can advance child health equity. This discussion emphasizes roles (i.e., clinician, consultant, trainer, administrator, researcher, and advocate) that psychologists can undertake with explicit intentionality toward promoting equity. These roles consider structural and ecological drivers of inequities and emphasize interprofessional collaboration within and across child-serving systems of care using community-partnered shared decision-making approaches. Owing to the multiple intersecting drivers implicated in health inequities-ecological (e.g., environmental and social determinants of health), biological (e.g., chronic illness, intergenerational morbidity), and developmental (e.g., developmental screening, support, and early intervention)-the ecobiodevelopmental model is used as an organizing framework for psychologists' roles in promoting health equity. This article aims to advance the platform of the P-PCMH to address and promote policy, practice, prevention, and research in child health equity and the important role of psychologists within this model. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

中文翻译：

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儿童健康公平和初级保健。

在获得高质量的身体和行为健康服务以及社会需求支持方面，儿童健康方面的差异在美国十分猖獗且有害。这些差异反映了更大的社会健康不公平（健康方面的社会不公正），并导致健康结果中可预防的特定人群差异，边缘化儿童面临着巨大和系统性的不成比例的健康负担。初级保健，特别是儿科患者为中心的医疗之家 (P-PCMH) 模型，在理论上是一个定位良好的平台，可以解决整个儿童的健康和保健需求，但这样做的方式往往对边缘化人群不公平。本文描述了心理学家在 P-PCMH 中的整合如何促进儿童健康公平。此讨论强调角色（即，临床医生、顾问、培训师、管理人员、研究人员和倡导者），心理学家可以明确地致力于促进公平。这些角色考虑了不平等的结构和生态驱动因素，并强调使用社区合作共享决策方法在儿童服务系统内部和之间进行跨专业合作。由于涉及健康不公平的多重交叉驱动因素——生态（例如，健康的环境和社会决定因素）、生物（例如，慢性病、代际发病率）和发展（例如，发育筛查、支持和早期干预）——生态生物发展模型被用作心理学家在促进健康公平方面的作用的组织框架。本文旨在推进 P-PCMH 的平台，以解决和促进儿童健康公平方面的政策、实践、预防和研究，以及心理学家在该模型中的重要作用。（PsycInfo 数据库记录 (c) 2023 APA，保留所有权利）。