Hopscotch, baseball, lemonade—some may remember childhood as a relatively simple and carefree time, removed from the pressures of adulthood. But it has its own unique stresses, dangers and concerns. And while certain childhood health challenges have been dealt with successfully—think polio, for instance—others have risen to take their place.

Dr. Bruce Ellsweig is a family physician for Crystal Run Healthcare, based in Rock Hill, NY. He also chairs the Professional Advisory Committee for the Sullivan County Public Health Services Department. The River Reporter spoke with him recently about what he sees as the critical challenges to family medicine in the Upper Delaware.

“Preventive care. That’s one of the most important things we do here,” he said. “We offer extensive ‘anticipatory guidance’ to children and parents—letting them know what is likely to come up in the next stage of growth, what they should watch out for, and how they can prepare.”

Preventive care is particularly important in family medicine, says Dr. Ellsweig, because the health habits formed in childhood are important to avoiding health problems later in adulthood. For example, avoiding tobacco usage—including the growing phenomenon of vaping—dramatically reduces the likelihood of developing respiratory and other illnesses. Exposure to second-hand smoke is also a factor in children’s health—so Crystal Run offers smoking cessation programs as well.

Nutrition support forms another part of preventive care. “We are always on the lookout for signs of childhood obesity,” Dr. Ellsweig says. “Access to healthy food is frequently an issue in lower-income rural areas such as ours. Food that is affordable is not always the most nutritious, and malnutrition doesn’t always mean hunger.” Family physicians can share advice and suggestions regarding diet and exercise.

Dr. Ellsweig also emphasized the importance of proper dental care. “Not all families have access to dentists,” he points out. “We can do some things—we can provide fluoride treatments, for example—but fortunately there are other agencies that reach out to underserved populations with a broader spectrum of dental services.”

Many childhood diseases have been successfully controlled, and in some cases practically eradicated, by the use of vaccines. Dr. Ellsweig expressed concern about the amount of misinformation about vaccines that spreads across social media. “We’ve seen a leveling off in the number of people expressing misgivings about vaccines based on anecdotal or unscientific information,” he says. “We do need, however, to make sure that parents understand the facts, and education in this regard is crucial.”

As a practitioner involved with public health, Dr. Ellsweig is also concerned with the delivery of health care. “The difficulty in obtaining insurance coverage is a big problem for many people in our area,” he says. The resulting lack of adequate coverage has longer-term costs for the system, as it means people may avoid seeking help early on, leading to higher medical costs later on. “It’s much better—and much cheaper—to be able to catch or prevent problems early.” He approves of the transition to value-based care, but notes that it’s only one part of a much broader process of healthcare reform.

In the final analysis, healthcare is both a personal and social responsibility. He has some simple and straightforward recommendations for maintaining individual and family health. “Own your health care,” he says. “Be a partner, be responsible and listen. Emphasize safety and prevention, eat well and exercise, and pursue spiritual and emotional wellbeing.”