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Discover Pediatric Collections on COVID-19 and Racism and Its Effects on Pediatric Health

American Academy of Pediatrics
Pediatrics Perspective

Protecting the American Dream: a Pediatric Imperative

Arvin Garg, Michelle Lopez and Jean L. Raphael
Pediatrics February 2021, 147 (2) e20200370; DOI: https://doi.org/10.1542/peds.2020-0370
Arvin Garg
aDivision of General Academic Pediatrics, Department of Pediatrics, Boston Medical Center and School of Medicine, Boston University, Boston, Massachusetts;
bDepartment of Pediatrics, University of Massachusetts Medical School, Worcester, Massachusetts; and
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Michelle Lopez
bDepartment of Pediatrics, University of Massachusetts Medical School, Worcester, Massachusetts; and
dCenter for Child Health Policy and Advocacy, Baylor College of Medicine, Houston, Texas
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Jean L. Raphael
cDepartment of Pediatrics and
cDepartment of Pediatrics and
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  • Abbreviations:
    AAP —
    American Academy of Pediatrics
    VVN —
    Vital Village Network
  • The American dream is a fundamental ethos of the nation passed from generation to generation. In 1931, James Truslow Adams coined the term as “that dream of a land in which life should be better and richer and fuller for everyone.” Most Americans across all incomes still believe their children and grandchildren will achieve the American dream.1 Yet, in reality, it is out of most children’s reach. The American dream is intrinsically tied to the capacity for upward mobility, whereby children can grow up to surpass their parent’s income level. The groundbreaking work of Harvard Professor of Public Economics Dr Raj Chetty reveals that there is less upward mobility in the United States today than at any other time, likely because of lower overall economic growth and greater inequality in its distribution. Specifically, Chetty et al2 found that, since 1940, the fraction of children who earn more than their parents has fallen from >90% to ∼50%. However, the decline in the American dream is not equally distributed across the United States. Chetty et al3 has revealed great variation in upward mobility, with significant differences even among neighborhoods within the same city. Higher–upward-mobility areas are associated with less residential segregation and income inequality and greater …

    Address correspondence to Arvin Garg, MD, MPH, Department of Pediatrics, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655. E-mail: Arvin.Garg{at}umassmemorial.org

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    Pediatrics
    Vol. 147, Issue 2
    1 Feb 2021
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    Protecting the American Dream: a Pediatric Imperative
    Arvin Garg, Michelle Lopez, Jean L. Raphael
    Pediatrics Feb 2021, 147 (2) e20200370; DOI: 10.1542/peds.2020-0370

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    Protecting the American Dream: a Pediatric Imperative
    Arvin Garg, Michelle Lopez, Jean L. Raphael
    Pediatrics Feb 2021, 147 (2) e20200370; DOI: 10.1542/peds.2020-0370
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      • Reducing Child Poverty and Poverty-Related Social Determinants of Health
      • Supporting Immigrant Families and Their Children
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    • Child Care During the COVID-19 Pandemic: A Bad Situation Made Worse
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