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April 1996

Welfare Reform and Children's Health

Author Affiliations

From the Department of Pediatrics, Boston University and Boston City Hospital (Drs Geltman, Meyers and Zuckerman), and the Family Advocacy Program, Department of Pediatrics, Boston City Hospital (Mr Greenberg), Boston, Mass.

Arch Pediatr Adolesc Med. 1996;150(4):384-389. doi:10.1001/archpedi.1996.02170290050008

During the ongoing national discussion of proposals to reform health care financing, effects on the health status of children emerged as a special concern. Public attention has shifted away from comprehensive reform of the health care system and toward reform of the welfare system (primarily the Aid to Families with Dependent Children [AFDC] program), but this debate with its focus on parental behavior has not attended to the effects of reform on children's health and well-being. Yet the changes proposed will have a profound effect on the lives of children. Children's health status is determined by a multiplicity of factors, among which social and economic factors are especially important.1,2 Children living in poverty have poorer health than their more affluent peers,1-16 consequently, welfare system reform carries great implications for children's health. Welfare system reforms that reduce resources for low-income families will lead to a predictable increase in adverse