Abstract
By the traditional measures of health status-mortality rates- the health of children in the United States has greatly improved. Fom 1970 to 1979 the infant mortality rate declined from 20.0 to 13.0 per 1,000 live births. The mortality rate per 100,000 children ages 1-4 years declined from 84 to 63. The decline in mortality appears to have been accomplished without a rise in morbidity. Despite the impressive achievements, 10 years after the implementation of Medicaid poor children were still in poorer health than children in families with more money and were still receiving less medical care relative to need. The differentials that existed before the Medicaid program had decreased, but they had not disappeared. If the ideal is that all parents will report that their children are in excellent health and are not limited in activity by any chronic condition, 2 out of 5 children and youths under 18 years of age did not have ideal health in the mid-1970s. Less than half the children in poor or poorly educated families, black children, or children living without fathers in the household achieved that ideal. If a goal for medical care is that children under age 2 have had a contact with a physician within 6 months, children ages 2-5 within a year, and children ages 6-17 within 2 years, 14 percent of U.S. children and youths did not achieve that relatively modest goal. About a quarter of the children in poorly educated families or families with six or more members had not had a contact with a physician that recently. Tooth decay is one of the most prevalent problems of childhood, yet in 1975-76, 38 percent of the children ages 4-17 had not seen a dentist within a year. More than half the children in poorly educated families, black children, or children in low-income families had not seen a dentist that recently.
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Selected References
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