Addressing Parent Employment as an Essential Issue in Child Health.

* Abbreviations: CSHCN — : child with special health care needs FFE — : foregone family employment SDOH — : social determinant of health In this issue of Pediatrics , Foster et al1 address the often unseen and pressing reality of the economic impact that having a child with special health care needs (CSHCN) has on families. Using data from the 2016–2017 National Survey of Children’s Health, the authors specifically address foregone family employment (FFE) and lost earnings. The numbers reported are sobering: FFE occurs in 14.5% of employed families of CSHCNs and skyrockets to 40.9% for those who have children with intellectual disability, seeming to correlate to the number of hours families raising CSHCNs must dedicate to caring for their child. Viewed through an equity lens, the authors’ findings become even more pointed. Those who have public insurance, are of Hispanic ethnicity, or whose children are younger, have functional limitations, or medical complexity seem particularly vulnerable. We know from the existing literature, well referenced by the authors, that social determinants of health (SDOHs), including family income, can directly impact health outcomes for a child.2,3 The estimated annual household loss of $18 000 among families … Address correspondence to Laurie Glader, MD, Section Chief, Division of Complex Care, Nationwide Children’s Hospital, 700 Children’s Dr, Suite E6A, Columbus, OH 43205 E-mail: laurie.glader{at}nationwidechildrens.org