Published online April 1, 2005
PEDIATRICS Vol. 115 No. 4 April 2005, pp. 1129-1133 (doi:10.1542/peds.2004-2825D)
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SUPPLEMENT ARTICLE

Successes and Missed Opportunities in Protecting Our Children's Health: Critical Junctures in the History of Children's Health Policy in the United States

Howard Markel, MD, PhD* and Janet Golden, PhD{ddagger}

* Center for the History of Medicine, Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, Michigan
{ddagger} Department of History, Rutgers University, Camden, New Jersey

This article revisits several turning points in the history of child health policy for the purpose of understanding why many current health needs of children have not been addressed. We demonstrate how the rupture of ties between child medical and child welfare leaders, as well as the fault lines between various health care professionals, led to difficulties in establishing programs for children in the early 20th century. We note how wartime mobilizations helped to make the needs of the nation's youth apparent to political leaders and observe that programs begun in response to these discoveries often were ended in peacetime. Finally, we discuss how politics shaped the situation wherein maternal and child health programs, including Medicaid, are need based, severely underfunded, and administered by the states, whereas benefit programs for the elderly, including Medicare and Social Security, are general entitlements administered at the federal level.


Key Words: medical history • child health • health policy • politics • child welfare • Progressive Era • Sheppard-Towner Maternity and Infancy Act • New Deal • Social Security Act • Great Society • Medicaid

Abbreviations: AMA, American Medical Association • APS, American Pediatric Society • SSA, Social Security Act


Accepted Dec 22, 2004.


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