‘Rules for radicals’: a subversive's guide to putting social paediatrics into practice

  • Guddi Singh
    Guddi Singh BA MB BChir MPH MRCPCH EADTM&H, Consultant in Neurodevelopmental and Social Paediatrics, King's College London, United Kingdom. Conflicts of interest: none declared
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Published:January 11, 2022DOI:https://doi.org/10.1016/j.paed.2021.12.005


      Paediatricians witness the social determinants of health in action in their clinical practice every day. By pushing hundreds of thousands of children into poverty, the global coronavirus pandemic has only made the link between social justice and health inequalities in the UK clearer and more relevant than ever. Yet paediatricians face a glaring dearth of opportunities to meaningfully engage with the issue, and lack the resources with which to learn what can be done about it. Using real-life examples from the author's own professional experience, this article demonstrates how ordinary paediatricians can apply a theoretical framework to clinical practice to move from why paediatricians ought to orient their practice towards the social determinants of health, to how. Rather than waiting for institutions to lead the way, this article provides ‘rules for radicals’ and makes a call for bottom-up, grassroots organizing around social justice and developing the knowledge and tools to fight it, including the exciting new initiatives of the ‘social tool kit’ and the ‘social incubator’.


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        • Singh G.
        • Zhu H.
        Poverty in practice: using quality improvement in paediatrics to improve identification and support of families living in poverty.
        Arch Dis Child Educ Pract. 2020; 106: 306-309
        • Singh G.
        • Damarell A.
        Co-producing a social determinants of health questionnaire for an urban population in community child health.
        Arch Dis Child Educ Pract. 2021; 1: 1-6https://doi.org/10.1136/archdischild-2020-319940

      Further reading

        • Mitchell P.
        • Cribb A.
        • Entwistle V.
        • Singh G.
        Pushing poverty off limits: quality improvement and the architecture of healthcare values.
        BMC Med Ethics. 2021; 22: 1-13
        • Singh G.
        • Cribb A.
        Aligning quality improvement with better child health for the 21st century.
        Arch Dis Child Educ Pract. 2020;
        • Singh G.
        • Owens J.
        • Cribb A.
        Practising ‘social paediatrics’: what do the social determinants of child health mean for professionalism and practice?.
        Paediatr Child Health. 2018; 28: 107-113
        • Singh G.
        • Zhu H.
        • Cheung C.R.
        Public health for paediatricians: fifteen-minute consultation on addressing child poverty in clinical practice.
        Arch Dis Child Educ Pract. 2020;

      Online resources

      1. British Association for Child and Adolescent Public Health - Child poverty campaign: http://www.bacaph.org.uk/advocacy/child-poverty-introduction.

      2. Dr Julie-Ann Maney’s blog: https://medium.com/rcpch-insight/im-a-paediatrician-and-i-see-the-impact-of-poverty-and-childhood-hunger-486b5629b9fc.

      3. Free Open Access Medical Education (FOAMed):

      4. - Call to Arms: Fighting Child Poverty Together Part 1: https://www.paediatricfoam.com/2021/03/call-to-arms-fighting-child-poverty-together-part-1/.

      5. - Call to Arms: Fighting Child Poverty Together Part 2: https://www.paediatricfoam.com/2021/03/call-to-arms-fighting-child-poverty-together-part-2/.

      6. “Listen Up!” from Dr Najette Ayadi O'Donnell and company: https://www.youtube.com/watch?v=xnuSodDeWsQ.

      7. MedAct - Health professionals for a safer, fairer, better world: https://www.medact.org/.

      8. Wellbeing and Health Action Movement (WHAM): A movement to unite, inform and inspire healthcare providers fighting inequality in child health. https://www.whamproject.co.uk/.