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Special Communication
December 2014

Children and US Federal Policy on Health and Health Care: Seen but Not Heard

Author Affiliations
  • 1Division of General Pediatrics, Department of Pediatrics, The University of Texas Southwestern Medical Center, Dallas
  • 2Division of General Pediatrics, Children’s Medical Center, Dallas, Texas
  • 3First Focus and First Focus Campaign for Children, Washington, DC
JAMA Pediatr. 2014;168(12):1155-1163. doi:10.1001/jamapediatrics.2014.1701

Children account for 73.5 million Americans (24%), but 8% of federal expenditures. Data on health and health care indicate that child well-being in the United States has been in decline since the most recent recession. Childhood poverty has reached its highest level in 20 years, 1 in 4 children lives in a food-insecure household, 7 million children lack health insurance, a child is abused or neglected every 47 seconds, and 1 in 3 children is overweight or obese. Five children are killed daily by firearms, 1 in 5 experiences a mental disorder, racial/ethnic disparities continue to be extensive and pervasive, and major sequester cuts and underfunding of pediatric research have damaged our global leadership in biomedical research and hobbled economic growth. In this analysis, we identify 10 urgent priorities for the health and health care of US children, including poverty, food insufficiency, lack of health insurance, child abuse and neglect, overweight and obesity, firearm deaths and injuries, mental health, racial/ethnic disparities, immigration, and research. Overwhelming, bipartisan support by voters exists for enhancing our nation’s investments in children’s health and well-being. Federal policy action steps are proposed to successfully address these priorities and ensure a healthy, productive future for US children and the nation.

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