- AAP —
- American Academy of Pediatrics
In a tumultuous and unpredictable election year, Americans selected Donald Trump as our 45th president. Mr Trump’s approach to policymaking is still unknown, and his positions on certain issues do not follow the typical partisan patterns within American politics. However, Mr Trump has expressed support for family-oriented policies, including paid family leave and child care subsidies. His administration may present an opportunity to continue working on efforts to provide children with the essential elements needed to lead healthy and productive lives. The priorities and policy decisions President Trump takes will have a lasting impact on our nation’s future.
To help guide these decisions, in advance of the election, the American Academy of Pediatrics (AAP) laid out a comprehensive plan for the federal government to give children, families, communities, and the nation a solid foundation for the future.
The Academy’s plan, Blueprint for Children: How the Next President Can Build a Foundation for a Healthy Future, is grounded in the belief that society’s health depends on its children’s well-being.1 It reflects the AAP’s commitment to programs and policies that improve the lives of children and families so they can achieve their full potential. The Blueprint contains a high-level policy vision as well as many specific administrative and legislative recommendations relevant to 24 federal agencies and departments that can influence the health and well-being of children and families. It was developed in consultation with AAP leaders and reviewed by numerous colleague organizations, 11 of which endorsed it (the Academic Pediatric Association, the American Pediatric Society, America’s Promise Alliance, the Association of Medical School Pediatric Department Chairs, the Children’s Partnership, Family Voices, the National Association of Pediatric Nurse Practitioners, the Pediatric Policy Council, the Society for Adolescent Health and Medicine, the Society for Pediatric Research, and ZERO TO THREE). The Blueprint was presented last September at a panel discussion featuring a range of thought-leaders. The archived event webcast is available at aap.org/blueprint, along with the complete document.1
Almost half of children in the United States live in poverty or near poverty.2 Lifting families out of poverty and ameliorating its impact on children is critical for the future of our country. The federal government has existing programs that move millions of children out of poverty, as well as protect them from the negative effects of poverty on their health and well-being.3–5 These programs must be maintained, strengthened, and expanded.
Childhood is a critical time of rapid physical, cognitive, emotional, and social development that sets the stage for good health and successful learning and relationships. Early childhood relationships and experiences—positive and negative—significantly affect individual health, educational, and economic outcomes through adolescence and into adulthood.6 Supporting children as they develop, rather than trying to identify and remediate intractable problems later in life, is critical to building healthy adults. Comprehensive and long-term investments in early life experiences that promote resilience and provide a strong start yield significant returns and save money on increased health care expenses and other societal costs.
The Blueprint calls for the federal government to invest in, coordinate, and focus on 4 key themes: promoting healthy children, supporting secure families, building strong communities, and ensuring the United States is a leading nation for children.
Child health is a strong predictor of adult health. Lack of access to health care threatens the physical, mental, and social well-being of children and their caregivers. The next administration should ensure that all children, regardless of immigration status, have access to high-quality health care, including specialty care. Almost half of US children receive health insturance from Medicaid and the Children's Health Insurance Program (CHIP). Therefore, the next administration must ensure that Medicaid is not subject to payment caps, block grants, or other structural harms, and CHIP is reauthorized and strengthened. Among other recommendations, the Blueprint calls for health plans to offer comprehensive, well-defined, pediatric-specific essential health benefits packages. It also calls for support for programs that promote maternal and reproductive health such as comprehensive prenatal care, the Title X Family Planning program, the Teen Pregnancy Prevention Program, and confidential access to contraception for adolescents.
A safe, nurturing environment that includes steady income, stable housing, adequate nutrition, and social-emotional support helps children thrive. The next administration should embrace a multigeneration perspective that values the formation of stable, responsive, and nurturing relationships. The Blueprint recommendations include strengthening several effective federal programs that lift families out of poverty, including minimum wage increases, job training, family-friendly benefits, and tax credits (such as the Earned Income Tax Credit and the Child Tax Credit).7 It also calls for increased support for social programs that provide nutrition, housing, child care, and parenting support to families in need.
Communities play a vital role in safeguarding public health, mitigating social disparities, and fostering a resilient society. The next administration should ensure that all children and families are safe in their communities and have equal access to opportunities, regardless of race, ethnicity, or income. The Blueprint recommendations include policies to reduce the dangers of violence, environmental toxins, and preventable infectious diseases; to make sure every child has access to high-quality early learning programs; and to improve the built environment.8
A Leading Nation for Children
The next administration should maintain the United States’ role as a leading nation for children by advancing child health not only within our country but internationally. The Blueprint recommends increased efforts to address climate change, protect civil rights and human rights, and promote maternal and child health globally. It also calls for comprehensive immigration reform, expanded investments in pediatric research to improve child well-being, and the development of innovative therapies for pediatric diseases.
This nation has made progress in protecting and nurturing children and expanding opportunities for all. President Trump must preserve these successes, build on them, and create the strongest possible foundation for future generations. Achieving the Blueprint’s goals will require creating new programs, enhancing existing policies, and coordinating federal programs that affect children and families. That is why the Blueprint calls on the next administration, in its first 100 days, to direct all federal agencies to review how their activities can proactively work together to improve children’s lives. Children deserve a bold agenda that prioritizes their needs and places them at the center of our federal policy decisions. The Blueprint offers such a plan, and it is up to us to help our nation’s leaders put it into practice.
- Accepted October 28, 2016.
- Address correspondence to Benard P. Dreyer, MD, 564 1st Ave, Apt 23 E, New York, NY 10016-6469. E-mail:
FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.
FUNDING: No external funding.
POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.
- American Academy of Pediatrics
- Proctor BD,
- Semega JL,
- Kollar MA
- ↵Federal Low-Income Programs: Multiple Programs Target Diverse Populations and Needs. Washington, DC: US Government Accountability Office; 2015. Available at: www.gao.gov/assets/680/671779.pdf. Accessed October 27, 2016
- Marr C,
- Huang CC,
- Sherman A, et al
- Center on Budget and Policy Priorities
- AAP Council on Community Pediatrics
- Council on Environmental Health
- Copyright © 2017 by the American Academy of Pediatrics