Prather Pediatric and Allergy Center - Ask Doctor Brent

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Title: Children's Health Needs and Congress in 1991

Category: Access To Children's Health Care


In 1990, children were well represented by the 101st Congress with improvements in child funding of the medicaid program, reorganization of Headstart and a few other child care programs which were supported. With this Congressional legislation in the present budget which is being studied, the American Academy of Pediatrics is encouraging new legislation in several other areas for children. A few of these that are considered very important in preventing unnecessary suffering and death include lead poisoning, immunizations, child abuse, health insurance, pediatric AIDS and family leave.

The first critical area is to try to reduce children's exposure to lead. An estimated three to four million American children under six have blood lead levels that might impair their development. Approximately 400,000 fetuses are also estimated to have high blood lead levels. Studies have shown that these levels previously considered harmless can impair a child's central nervous system and result in problems with learning, reduced I.Q. and even slowed growth and impaired hearing. Many of these changes are irreversible and so the best method is by preventing the lead poisoning in the first place. Since this is completely preventable and is considered the most serious environmental cause of neurologic disease of children in the United States today, the American Academy of Pediatrics is working hard with concerned legislators to enact legislation to clean up the old lead paint facilities where many of these children and their mothers are living. It will require the support of Congress and doctors and concerned citizens throughout the country to begin bringing about this overdue needed change in our country.

The next area of urgent child care legislation includes recent epidemics and infectious diseases which can be prevented by new vaccines. Also the need for greater federal support for the funding for these immunizations. At present, over one- fourth of American children are not properly immunized against measles, rubella, polio, mumps, diphtheria and tetanus. Last year studies show that by immunizing young children, even as early as two months, against Hemophilus influenza B meningitis, we could begin to wipe out this dreaded disease as well. There is not enough funding even in the state of Louisiana to provide these HiB vaccines to young infants before 15 months of age. The tragedy here is that the first year when they most need it, they cannot get it unless they can afford to get it by their private doctor. This is occurring throughout many other areas of the country as well. We need a more comprehensive vaccine policy whereby all needy children can receive these vaccines as well as the second vaccine of MMR to protect against the recent rise in measles, and any future possible vaccines including one against chicken pox which may be licensed in 1991. If legislation and work between Health Units, American Academy of Pediatrics and the U.S. Public Health organization is not coordinated then we will become a country whereby one class of children will get vaccines who can afford it and poor children will not. We must work together to prevent this two class system.

The third area of important child care legislation is to prevent and begin to reverse the rampant increase in child abuse. This would call for a new national neighborhood based child care protection strategy. We must prevent and decrease the tremendous amount of child abuse that goes on in our society. Between 1979 and 1989, the incidence of child abuse reporting increased by 140%. In 1989 there were 2.4 million cases of abuse and neglect reported. In 1985 the number of child abuse fatalities increased by almost 40%. We must develop an intelligent child abuse prevention and treatment act. We must update the 1990 child abuse and prevention and treatment act and work together to help the victims of the abuse as well as to prevent the abuse and work with the struggling families in which it occurs.

Three other areas of importance in child care legislation in 1991 include the need for more health insurance for poor children across the country, a need to address the growing pediatric AIDS problem and the need for greater family leave for sick infants and children, adoptee and newborns.