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 View From Washington

Brent Ewig

Taking the Long View on Child Health

By Brent Ewig, MHS
Director of Public Policy & Government Affairs, AMCHP  

Those of us in public health are sometimes guilty of dwelling only on the negative. We whine about how no one understands what we do, and are sometimes perceived as constantly complaining about inadequate resources. So before I do all that (again) I want to start with the good news and bold proclamation that children in America are healthier today than at any time in history.  

This may be hard to believe considering the constant headlines we see about challenges in MCH. In just the past week we’ve seen headlines declaring that fewer than half of U.S. children receive comprehensive, quality health care. Another prominent study found the number of children in the United States identified with developmental disabilities has increased by 17 percent in just over the past decade.  

We are all too familiar with the childhood obesity epidemic, and frustrated by the lack of progress in improving infant mortality over the past decade. We know the United States ranks a dismal 30 in infant mortality rates and 41 in maternal mortality. Perhaps most appalling is the tolerance of persistent and inexcusable racial and ethnic disparities across most of key MCH measures.  

And now we are facing the most serious threats to public health budgets we have seen in our lifetime.    

And yet we have it so much better than any previous cohort of public health professionals. If you doubt that, just consider this: would you rather be responsible for a child born today or a child born 100 years ago? At the beginning of the last century, approximately 100 children out of every 1,000 died before their first birthday. Today, it’s less than seven per 1,000 – a stunning 90 percent reduction. A hundred years ago there was no penicillin, no vaccines, no NICUs, no organized family planning, and no newborn screening. As MCH professionals, would you rather have these tools or the kit from 100 years ago? 

My point is that when focused on the short term it is easy to get overwhelmed and downright depressed by the daunting challenges, critical un-met needs, and divisive budget politics. But taking the long view, we can see the immense progress we have to build upon. We can appreciate the tools we have today that our foremothers in MCH labored without. We can be inspired to rejuvenate the can-do spirit that will be necessary to survive these temporary dark days and be ready to re-ignite progress when circumstances improve. 

It was with this can-do spirit that we collectively stared down and reversed a proposed $210 million cut to the Title V Maternal and Child Health Services Block Grant. We showed that working together, mobilizing our friends, documenting the harm cuts would inflict, and stressing the cost effectiveness of MCH services that our advocacy can make a difference in the face of immense budget pressures. We survived round one, but round two is about to start. We’ll need to stand together to weather the storms sure to come, but taking the long-view we can be assured we will prevail.