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Child Health in America: Making a Difference through Advocacy PDF

307 Pages·2006·1.24 MB·English
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Child Health in America This page intentionally left blank Judith S. Palfrey Child Health in America Making a Difference through Advocacy The Johns Hopkins University Press baltimore © 2006 The Johns Hopkins University Press All rights reserved. Published 2006 Printed in the United States of America on acid-free paper 1 2 3 4 5 6 7 8 9 The Johns Hopkins University Press 2715 North Charles Street Baltimore, Maryland 21218-4363 www.press.jhu.edu Library of Congress Cataloging-in-Publication Data Palfrey, Judith S. Child health in America : making a difference through advocacy / Judith S. Palfrey. p. ; cm. Includes bibliographical references and index. ISBN 0-8018-8452-7 (hardcover : alk. paper) — ISBN 0-8018-8453-5 (pbk. : alk. paper) 1. Child health services—United States. [DNLM: 1. Child Advocacy—United States. 2. Adolescent Health Services—United States. 3. Child Health Services—United States. 4. Child Welfare—United States. 5. Infant Welfare—United States. WA 320 P159c 2006] I. Title. RJ102.P348 2006 362.198(cid:118)9200973—dc22 2006005263 A catalog record for this book is available from the British Library. in memoriam Anne E. Dyson This page intentionally left blank Contents Acknowledgments / ix Introduction / xiii chapter one Child Health Advocacy / 1 chapter two A History of Child Health Advocacy / 18 chapter three The Current Status of Child Health / 51 chapter four Clinical Advocacy / 89 chapter five Group Advocacy / 121 chapter six Legislative Advocacy / 144 chapter seven Professional Advocacy / 182 chapter eight Political Will / 209 Appendix: Resources Online / 241 Notes / 243 Index / 275 This page intentionally left blank Acknowledgments Nearly ten years ago, my friend Anne Dyson and I took a long walk through the streets of San Francisco. Up one hill, we talked about our families. Down another, we talked about children. Huffi ng a bit, we mused about how unfair life can be. Easing up on a level street, we won- dered about how child health professionals could attack the big problems confronting American children. Annie wanted to do something to make a difference. She had a vision that she wanted to share. We talked and walked and thought about all sorts of things. One of them was writing a book like this. We talked of the fun it would be to do together. Anne Dyson was an extraordinary person—a pediatrician, a business- woman, and a philanthropist. She was convinced that pediatrics needed a fundamental realignment to address child health problems in the com- munity. She believed that child health professionals could do a great deal of good through advocacy and that many of the young child health pro- fessionals were just waiting for the chance to speak and to act on behalf of children. As president of the Dyson Foundation, she worked to design a large experiment in pediatric resident education. Unfortunately, in Oc- tober 1999, just as the national solicitation for proposals for the program was going out, she learned that she had an advanced, aggressive form of breast cancer. Even so, Anne never stopped plowing forward, positive in her beliefs and ardent in her efforts to improve the life chances and the health of children. She died almost exactly one year after the solicita- tion and one month after we celebrated the launch of the program: the Anne E. Dyson Community Pediatrics Training Initiative. After Annie died, I decided that, to honor her and to fulfi ll her vision, I must write the book we had planned. I began work on the manuscript in the summer of 2003, drawing on the child health literature and the wealth of data available as a result of the 2000 census from government agencies and foundation projects. Although I was working hard on the book, it was not until January 2005, listening to a student rendition of the song “Smile Though Your Heart Is Aching,” that I understood that writing this book was my at- ix

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Who will speak for the children? is the question posed by Judith S. Palfrey, a pediatrician and child advocate who confronts unconscionable disparities in U.S. health care -- a system that persistently fails sick and disabled children despite annual expenditures of $1.8 trillion.In Child Health in A
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