Dr. Mark Schuster was the lead author of a study that looked at inequities in health among 5,119 randomly selected fifth-graders attending public schools in and around Birmingham, Ala., Houston and Los Angeles.
The study found significant racial and ethnic disparities - many of them tied to poverty - in factors that determined children's health.
For example, black and Latino children were much less likely than white children to wear seat belts or bike helmets and reported a significantly lower level of physical activity.
"When I think of health, I don't just think of healthcare," said Schuster, chief of the division of general pediatrics and vice chair for health policy in the department of medicine at Boston Children's Hospital. "I think of any factors that affect health."
As a physician, Schuster regularly talks about the importance of seat belts and bike helmets with his patients, but he can't make them comply.
"If everyone had access to healthcare and to well visits and to preventive care, I would hope that there would be some improvements to these kinds of indicators," Schuster said. "But I don't want to suggest the pediatrician is the major player in whether kids wear seat belts, whether they wear bike helmets."
Schuster and other experts say these "social determinants" of health are a critical component, perhaps even more important than health care or health insurance. Many of these health issues are discussed in the I-News at Rocky Mountain PBS special report Losing Ground.