Health care reaches more children under age three in the United States than any other family-facing system and represents the most common entry point for developmental assessment of and services for children. In this article, Adam Schickedanz and Neal Halfon examine how well the child health care system promotes healthy child development early in…

It might seem strange to ask whether increasing access to medical care can improve children's health. Yet Lindsey Leininger and Helen Levy begin by pointing out that access to care plays a smaller role than we might think, and that many other factors, such as those discussed elsewhere in this issue, strongly influence children's health.…

Few people would disagree that children with disabilities need adequate health insurance. But what kind of health insurance coverage would be optimal for these children? Peter Szilagyi surveys the current state of insurance coverage for children with special health care needs and examines critical aspects of coverage with an eye to helping policy…

Much attention has aided measurement and improvement in the quality of health care during the past two decades, with new ways to define and measure quality, recognition that doing so can identify strategies to enhance care, and systematic efforts by both government and private insurers to apply these principles. In this article, James Perrin…

Technological innovation is transforming the prevalence and functional impact of child disability, the scale of social disparities in child disability, and perhaps the essential meaning of disability in an increasingly technology-dominated world. In this article, Paul Wise investigates several specific facets of this transformation. He begins by…

Poor childhood health contributes to lower socioeconomic status in adulthood. Subsequently, low socioeconomic status among parents contributes to poor childhood health outcomes in the next generation. This cycle can be particularly pernicious for vulnerable and low-income minority populations, including many children of immigrants. And because of…

Children from low-income families are more likely than other children to have serious health problems. And, as Anne Case and Christina Paxson show, childhood health problems can prevent poor children from achieving economic success as adults. Income-related disparities in childhood health are evident at birth or even before, and the disparities…

This issue of "The Future of Children" focuses on efforts to provide publicly funded health insurance to low-income children in the United States through Medicaid and the State Children's Health Insurance Program (SCHIP). The articles summarize current knowledge and research about which children are uninsured and why, discuss ways to…

The staff of the Center for the Future of Children analyzes policies to make the U.S. health care system more responsive to the needs of children and pregnant women focusing on (1) efficiency; (2) access; and (3) affordability. Recommendations are made in each of these areas. (SLD)

Identifies health risks and other factors that determine the need for health care services among children and adolescents. Recommendations are made to develop reforms through a coordinated care program rather than through competing systems of services. Models for community-based health care monitoring and coordination exist in other industrialized…

Analyzes annual medical expenditures for childhood (conception through age 18 years). A decline in the relative share of children's medical expenditures means that their health care will become more affordable compared to other groups. The least budget impact will result from expanding insurance coverage for 3- to 12-year-old children. (SLD)

Summarizes the private health insurance market, focusing on recent trends. Efforts should be made to preserve the current private health insurance system through comprehensive reforms that reduce cost and shift from public programs; control costs by competition, managed care, and global spending limits; and guarantee coverage for all groups. (SLD)

Provides an overview of the major federal and state health care programs serving children and pregnant women, including (1) Medicaid; (2) the Maternal and Child Health Block Grant Program; (3) the Community and Migrant Health Center Program; and (4) the Special Supplemental Food Program for Women, Infants, and Children. (SLD)

Examines changes in children's health insurance status and utilization of health services in the past decade, using 1977 National Medical Care Expenditure Survey data and 1987 National Medical Expenditure Survey data. Policies that could reduce the number of uninsured children (mandated employment-related coverage and incremental Medicaid…

Discusses nonfinancial barriers to receiving medical care, including legal restrictions, geographic isolation and provider shortages, provider practices and policies, and personal circumstances. Suggests ways to reduce these barriers. These efforts should not wait for health care financing reforms, because nonfinancial barriers will continue even…