As pediatric historian Tom Cone, Jr, has pointed out, at the beginning of the 20th century "health supervision of children—if it existed at all—consisted of a cursory examination to detect contagious disease. Physicians confined their efforts to the child when sick rather than the child when well."1 Of course, there has been much progress since the early 1900s. Today, for example, the childhood mortality rate is nearly 25 times less than it was in 1900, when the principal cause of death was infection. While many of the serious childhood diseases have all but disappeared as the chief causes of death in the United States, we have come to appreciate what Robert Haggerty termed the "new morbidity" largely resulting from social, behavioral, economic, psychosocial, and contextual influences.
- Received February 10, 1993.
- Accepted February 10, 1993.
- Copyright © 1993 by the American Academy of Pediatrics