The Issue. Advocacy on behalf of children who are medically underserved and the pediatricians who care for them has been a long-standing core commitment of the Royal College of Paediatrics and Child Health and the American Academy of Pediatrics. Although different in etiology, barriers to adequate health care exist in both nations. In the United States, almost 18 million children have either no health insurance or inadequate coverage, whereas in the United Kingdom, parents can, in most cases, readily enroll their youngsters in a universal health insurance program that is not dependent on employers or employment.1 However, despite universal access to health care in the United Kingdom, as in the United States, there are infants and children who do not regularly use or otherwise connect to available health care delivery systems. Many of these families are not participants in other social systems (eg, church, school, voting, employment, property ownership/rental) and therefore are not known to governments, agencies, authorities, or health care professionals. Both nations have citizens living in extreme poverty with its associated environmental and health hazards and tendencies to health risk behaviors. Both the Royal College of Paediatrics and Child Health and the American Academy of Pediatrics have strategies and programs to address these issues and to support pediatricians who work in their communities to improve the lives of children. The following describes the American Academy of Pediatrics Community Access to Child Health infrastructure that supports practicing community pediatricians in these efforts and opportunities to develop collaborative international endeavors to advance the practice of community pediatrics.
