Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

The reading gap: Too small to fail or too big to care?

Claire McCarthy, MD
Physician
November 14, 2014
Share
Tweet
Share

At the national conference of the American Academy of Pediatrics (AAP), I got to hear Hillary Clinton talk about the AAP’s partnership with her Too Small to Fail campaign. It made me happy — and sad.

The partnership is a great idea. It’s all about improving early childhood literacy, which is way more crucial than most people realize. It’s not just about an income gap when we talk about the fact that 1 in 5 U.S. children live in poverty. It’s also about the word gap.

Kids who grow up in low-income households hear fewer words than kids who grow up in more affluent ones. Millions fewer, actually (30 million by kindergarten). This makes a difference, because kids who hear more words have bigger vocabularies at age 3 — and not just do better in school, but have higher IQs. The word gap turns into an achievement gap which leads to an income gap which leads to a word gap … you can see where this is going: The divide between rich and poor gets bigger and bigger.

When they’ve looked closely at this word gap thing, it turns out that all families have roughly the same amount of “business talk”: Come here, don’t hit your brother, eat your vegetables, do your homework, and other such communication. Where the word gap lies is in the “non-business” talk: the chatting, the encouragement, the singing — and the reading.

Did you know (Clinton told us this) that in middle income neighborhoods, there are an average of 13 books for every child — while in low-income neighborhoods, there are 300 children for every one book?

While the amount of time spent meeting the physical needs of children (like changing their diapers or feeding them) has remained the same over the years, the amount of Goodnight Moon time has dropped — especially among low-income children. That’s where this campaign and partnership comes in, by helping pediatricians encourage parents to read and interact with their kids (and helped by a big book donation from Scholastic Books).

It’s wonderful. But as I sat there listening, I felt a bit sad.

I’ve been a pediatrician for 23 years, working with many low-income families. I’ve been lucky that our hospital is part of the Reach Out and Read program, meaning that I’ve been able to give books to families when they come for well-child visits, and talk with parents about the importance of reading and talking to children. I’ve been doing this for years.

I’m sure I’ve helped. But the lives of my patients haven’t gotten appreciably better. As Clinton herself pointed out, the number of children living in poverty is higher now than it was in 2000.

The thing is, there’s so much a book and a pep talk from me can’t do. They can’t teach a parent to read. They can’t make it so that a parent is home at bedtime, instead of working the evening cleaning shift while an older sibling or neighbor watches the child. They can’t get rid of the toxic stress that pervades every family interaction.

This is a lovely campaign. I’m happy it exists and I wish it all the best. But kids don’t vote, the parents of poor kids don’t contribute to campaigns (and many of them don’t vote), and the fruits of “Too Small to Fail,” if any, won’t be seen until long after the next election cycle or tenure of any current captain of industry. We are a society that is all about its wallets — and its politics.

Jim Steyer, the founder and CEO of Common Sense Media and Clinton’s partner in Too Small to Fail spoke at the AAP earlier the same day as Clinton. He pointed out that we are investing trillions in Iraq and Afghanistan, but not in our children.

“The underinvestment in young people in this country is morally wrong and economically stupid,” he said. I couldn’t agree more.

ADVERTISEMENT

But when it comes to those who are too small to fail, are we perhaps too big to care?

Claire McCarthy is a pediatrician at Boston Children’s Hospital. She blogs at the Huffington Post, where this article originally appeared, and at Boston.com as MD Mama.

Prev

Physician suicide 101: Secrets, lies and solutions

November 13, 2014 Kevin 266
…
Next

Oncologists have one of the lowest burnout rates. Why?

November 14, 2014 Kevin 2
…

Tagged as: Pediatrics

Post navigation

< Previous Post
Physician suicide 101: Secrets, lies and solutions
Next Post >
Oncologists have one of the lowest burnout rates. Why?

ADVERTISEMENT

More by Claire McCarthy, MD

  • Sometimes, talking to strangers is necessary

    Claire McCarthy, MD
  • Maybe God made teenagers difficult so we can let them go

    Claire McCarthy, MD
  • 4 mistakes parents make in the pediatrician’s office

    Claire McCarthy, MD

More in Physician

  • The moral injury of “not medically necessary” denials

    Arthur Lazarus, MD, MBA
  • Is physician unionization the answer to a broken health care system?

    Allan Dobzyniak, MD
  • The decline of professionalism in medicine: a structural diagnosis

    Patrick Hudson, MD
  • The patchwork era of medical board certification

    Brian Hudes, MD
  • How neurodiversity in relationships shapes communication

    Farid Sabet-Sharghi, MD
  • Why lifestyle matters more than BPC-157 and semaglutide

    Shiv K. Goel, MD
  • Most Popular

  • Past Week

    • How environmental justice and health disparities connect to climate change

      Kaitlynn Esemaya, Alexis Thompson, Annique McLune, and Anamaria Ancheta | Policy
    • A physician father on the Dobbs decision and reproductive rights

      Travis Walker, MD, MPH | Physician
    • Examining the rural divide in pediatric health care

      James Bianchi | Policy
    • Will AI replace primary care physicians?

      P. Dileep Kumar, MD, MBA | Tech
    • How CAR-NK cancer therapy could be safer than CAR-T

      Cliff Dominy, PhD | Meds
    • The moral injury of “not medically necessary” denials

      Arthur Lazarus, MD, MBA | Physician
  • Past 6 Months

    • Why patient trust in physicians is declining

      Mansi Kotwal, MD, MPH | Physician
    • Is primary care becoming a triage station?

      J. Leonard Lichtenfeld, MD | Physician
    • How environmental justice and health disparities connect to climate change

      Kaitlynn Esemaya, Alexis Thompson, Annique McLune, and Anamaria Ancheta | Policy
    • The blind men and the elephant: a parable for modern pain management

      Richard A. Lawhern, PhD | Conditions
    • Is tramadol really ineffective and risky?

      John A. Bumpus, PhD | Meds
    • Psychiatrists are physicians: a key distinction

      Farid Sabet-Sharghi, MD | Physician
  • Recent Posts

    • The moral injury of “not medically necessary” denials

      Arthur Lazarus, MD, MBA | Physician
    • What is palliative medicine and why is it so misunderstood?

      Patricia M. Fogelman, DNP | Conditions
    • Capping student loans destroys the rural medical pipeline [PODCAST]

      The Podcast by KevinMD | Podcast
    • Is physician unionization the answer to a broken health care system?

      Allan Dobzyniak, MD | Physician
    • Will AI replace primary care physicians?

      P. Dileep Kumar, MD, MBA | Tech
    • The decline of professionalism in medicine: a structural diagnosis

      Patrick Hudson, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 8 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • How environmental justice and health disparities connect to climate change

      Kaitlynn Esemaya, Alexis Thompson, Annique McLune, and Anamaria Ancheta | Policy
    • A physician father on the Dobbs decision and reproductive rights

      Travis Walker, MD, MPH | Physician
    • Examining the rural divide in pediatric health care

      James Bianchi | Policy
    • Will AI replace primary care physicians?

      P. Dileep Kumar, MD, MBA | Tech
    • How CAR-NK cancer therapy could be safer than CAR-T

      Cliff Dominy, PhD | Meds
    • The moral injury of “not medically necessary” denials

      Arthur Lazarus, MD, MBA | Physician
  • Past 6 Months

    • Why patient trust in physicians is declining

      Mansi Kotwal, MD, MPH | Physician
    • Is primary care becoming a triage station?

      J. Leonard Lichtenfeld, MD | Physician
    • How environmental justice and health disparities connect to climate change

      Kaitlynn Esemaya, Alexis Thompson, Annique McLune, and Anamaria Ancheta | Policy
    • The blind men and the elephant: a parable for modern pain management

      Richard A. Lawhern, PhD | Conditions
    • Is tramadol really ineffective and risky?

      John A. Bumpus, PhD | Meds
    • Psychiatrists are physicians: a key distinction

      Farid Sabet-Sharghi, MD | Physician
  • Recent Posts

    • The moral injury of “not medically necessary” denials

      Arthur Lazarus, MD, MBA | Physician
    • What is palliative medicine and why is it so misunderstood?

      Patricia M. Fogelman, DNP | Conditions
    • Capping student loans destroys the rural medical pipeline [PODCAST]

      The Podcast by KevinMD | Podcast
    • Is physician unionization the answer to a broken health care system?

      Allan Dobzyniak, MD | Physician
    • Will AI replace primary care physicians?

      P. Dileep Kumar, MD, MBA | Tech
    • The decline of professionalism in medicine: a structural diagnosis

      Patrick Hudson, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

The reading gap: Too small to fail or too big to care?
8 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...