Roles
Clinical Professor, Pediatrics
Director, Population Health Ethics
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Biography
Dr. Brosco completed an M.D. and a Ph.D. at the University of Pennsylvania. He served as chief resident after training in pediatrics at the University of Miami/Jackson Memorial Hospital, and he is board-certified in Pediatrics and in Developmental-Behavioral Pediatrics. He has practiced general pediatrics for 30 years at the University of Miami, and he also helps direct an interprofessional developmental pediatrics service that focuses on children with autism and other learning and behavioral disorders.
Dr. Brosco’s teaching responsibilities include ethics, public policy, cultural humility, population health, and developmental-behavioral pediatrics for medical students, nurses and nursing students, and residents in pediatrics, family medicine, medicine-pediatrics. He is active in continuing medical education for practicing clinicians and in faculty development for members of the Departments of Pediatrics and Medical Education.
Dr. Brosco’s research focuses on three broad areas: the organization of health care services for children with special health care needs, the education of professionals in family-centered, interprofessional practice, and public policy regarding newborn screening programs. He has over 100 publications and with Diane Paul, he is the author The PKU Paradox: A Short History of a Genetic Disease (Johns Hopkins Press, 2013). Dr. Brosco has served on the editorial board of JAMA Pediatrics and the Bulletin of the History of Medicine; he has also been on the NIH Review Panel for Grants in Scholarly Works in Biomedicine and Health; National Library of Medicine more than a dozen times.
At the University of Miami, Dr Brosco served as Associate Director of the Mailman Center for Child Development and Associate Chair for Population Health, UM Department of Pediatrics. He is the Director of Population Health Ethics in UM’s Institute for Bioethics and Public Policy, and chaired the Pediatric Bioethics Committee, Holtz Children’s Hospital, Jackson Health System.
Dr. Brosco has also served in some capacity in Florida state government for the last 20 years, including as Deputy Secretary of Health, Children’s Medical Services (2016-18). He is currently Florida’s Title V Director for Children and Youth with Special Health Care Needs. Other roles include membership in the Part C Early Intervention Autism Spectrum Disorders Workgroup, Florida’s Task Force on Autism Spectrum Disorder (Gov. Crist), and Florida Joint Work Group on Guardianship and the Developmentally Disabled (Gov. Bush).
At the national level, Dr. Brosco has been a member of more than two dozen health policy groups, including the Advisory Committee on Heritable Disorders in Newborns and Children (Department of Health and Human Services), the National Workgroup on Standards for Systems of Care for Children and Youth with Special Health Care Needs (Association of Maternal and Child Health Programs/National Academy for State Health Policy), and the Steering Committee, Newborn Screening Translational Research Network (NIH), American College of Medical Genetics, 2014-2016. In 2019 he was awarded a Maternal and Child Health Bureau Director’s Award for noteworthy national level contributions to the health of infants, mothers, children, adolescents, and children with special health care needs. From 2022-25, Dr. Brosco was Director, Division of Services for Children with Special Health Needs in the federal Maternal Child Health Bureau (HRSA). -
Education & Training
Education
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Honors & Awards
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Teaching Interests
Over the last 3 decades Dr. Brosco has worked with colleagues to develop courses in a wide variety of fields. In ethics and public policy, for example, he created the core course clinical ethics for medical students, a quarterly ethics series for the Department of Pediatrics, and ad hoc ethics sessions for clinicians and students across an array of disciplines. In the University of Miami’s NextGenMD curriculum, population health and a focus on cultural humility are core components of longitudinal required coursework; Dr. Brosco led the effort of dozens of faculty, students, and staff to create a culture of belonging and real-world skills in address health equity. Dr. Brosco created the core rotation in developmental-behavioral pediatrics for pediatric and medicine-pediatric residents, which is also available to medical students, graduate-level nurses, and fellows in child psychiatry. For a decade he directed the Leadership Education in Neurodevelopmental Disabilities training program at the Mailman Center for Child Development, which has been continuously funded by the federal Maternal Child Health Bureau for three decades. -
Research Interests
Children with developmental disabilities and other special health care needs
The health care system for children in the US evolved in response to acute, deadly illnesses. Today, child deaths are rare and relatively few children have serious medical conditions, such as cancer or metabolic disorders, which affect their everyday lives. Developmental-behavioral conditions such as ADHD and learning disabilities are more prevalent and have a significant impact on child function. Toxic stress during childhood and conditions such as obesity are even more common, have profound affects on adult health and well-being, and require attention to prevention and population-level interventions. The training, daily practice, and payment mechanisms of child health professionals are only slowly adapting to this new morbidity of childhood. Dr. Brosco contributes to decisions on how to design training programs and implement policy to best meet the needs of children and their families through his historical research and participation in state and national advisory positions regarding children with special health care needs, especially developmental disabilities. Dr. Brosco argues that broad public policy approaches to population-level child health and well-being have had a greater impact on child morbidity and overall child well-being than specific medical interventions.
Family-center, interprofessional education in neurodevelopmental disabilities
Educating health and education professionals to work together—and to include individuals with disabilities and their families as part of the team—has become an increasing critical component of improving health. Family-centered, interprofessional teamwork is essential whether the issue is improving adherence to a specific intervention, continuous quality improvement of programs, or devising policies that meld evidence-base and broader values such as autonomy and privacy. In his scholarship and organizational roles, Dr. Brosco is contributing to broader efforts to ensure that professionals, individuals with disabilities, and family members have the knowledge, skills, and attitudes to address health issues at the individual and population level.
Newborn screening
State newborn screening programs (NBS) are among the most successful public health initiatives of the past 100 years. Thousands of lives have been saved, and tens of thousands have avoided significant morbidity because of early detection and treatment. Expansion of NBS programs, however, is high controversial. How do we decide which new conditions to add to state screening panels? How do we gather the research necessary to inform these decisions? NBS is done under state-mandated public health programs for every newborn, and the resulting blood spots are a unique and necessary resource for research on rare conditions, yet some argue that privacy trumps public health needs. Dr. Brosco has contributed to these debates by investigating the history of PKU and NBS as well as serving in leadership roles in NIH- and HRSA-sponsored advisory groups. Dr. Brosco has argued that the universal nature of NBS must be maintained to reduce health disparities, that opt-out consent for parents is ethically justified in NBS research, and that expansion of NBS is necessarily a political endeavor requiring scientific evidence to inform but not decide public policy. -
Publications
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