Rich country, poor children

12 World Healtll • November-lle<ember 1992

Rich country, poor children

Nationwide, one in every five homeless persons is a child.

D

improvements in the general economy, the child poverty rate in the USA reached 19.6% in 1989; this means that 12.6 million children now live below the poverty line, an increase of more than 2.5 million from a decade ago. Falling earnings and more families headed only by the mother are the key underlying causes ofthis phenomenon.

A national health survey carried out by the government in 1988 highlighted the correlation between poverty and health in children.

• Children aged under five living in the poorest families are one-third less likely than children in more

For many children, the street is their home.

affluent families to be in excellent health.

• Poor 5-17-year-olds are about half as likely to be in excellent health as their more affluent counterparts.

• The poorest 5-17-year olds lose 1.5 times more schooling because of acute or chronic health conditions.

• Poor children are twice as likely as affluent children to have physical or mental disabilities or other chronic health conditions that impair daily activity.

Perhaps the most dramatic situations are those facing homeless children, whose numbers increased in the 1980s. Nationwide, one in every five homeless persons today is a child.

In one study of New York City's barrack-style shelters for the

homeless, 42% of parents interviewed said that they or their children, or both, suffered from diarrhoea for more than three years. Another study found that homeless children were twice as

likely as poor children with homes to have elevated blood lead levels, a condition associated with

developmental retardation. In Los Angeles, 23% of homeless parents interviewed said that their children were often or always hungry.

Children's vulnerability manifests itself in different ways:

- abused and neglected children:

2.4 million reported in 1989;

- children born drug-exposed:

375 000 each year;

- children with emotional disorders:

12% of children under 18 in 1989;

- runaway children: 450 700 in 1988;

- homicide victims: homicide is now the second leading cause of death among all adolescents and young adults, and the leading cause among black youths. •

From The state of America's children 1991, Children's Defense Fund. Washington DC,

1991, quoted in Health dimensions of economic reform, WHO, Geneva, 1992.