Division of General Pediatrics, Department of Pediatrics, The University of Texas Southwestern Medical Center, Dallas2Division of General Pediatrics, Children's Medical Center, Dallas, Texas.
First Focus and First Focus Campaign for Children, Washington, DC.
JAMA Pediatr. 2014 Dec;168(12):1155-63. doi: 10.1001/jamapediatrics.2014.1701.
Children account for 73.5 million Americans (24%), but 8% of federal expenditures. Data on health and health care indicate that child well-being in the United States has been in decline since the most recent recession. Childhood poverty has reached its highest level in 20 years, 1 in 4 children lives in a food-insecure household, 7 million children lack health insurance, a child is abused or neglected every 47 seconds, and 1 in 3 children is overweight or obese. Five children are killed daily by firearms, 1 in 5 experiences a mental disorder, racial/ethnic disparities continue to be extensive and pervasive, and major sequester cuts and underfunding of pediatric research have damaged our global leadership in biomedical research and hobbled economic growth. In this analysis, we identify 10 urgent priorities for the health and health care of US children, including poverty, food insufficiency, lack of health insurance, child abuse and neglect, overweight and obesity, firearm deaths and injuries, mental health, racial/ethnic disparities, immigration, and research. Overwhelming, bipartisan support by voters exists for enhancing our nation's investments in children's health and well-being. Federal policy action steps are proposed to successfully address these priorities and ensure a healthy, productive future for US children and the nation.
儿童占美国总人口的 73.5%（24%），但仅占联邦支出的 8%。健康和医疗保健数据表明，自最近一次经济衰退以来，美国儿童的福利一直在下降。儿童贫困率达到 20 年来的最高水平，1/4 的儿童生活在粮食不安全的家庭中，700 万儿童没有医疗保险，每 47 秒就有一名儿童受到虐待或忽视，1/3 的儿童超重或肥胖。每天有 5 名儿童被枪支杀害，1/5 的儿童患有精神障碍，种族/族裔差异继续广泛存在且普遍存在，重大的预算削减和儿科研究资金不足损害了我们在生物医学研究方面的全球领导地位，并阻碍了经济增长。在这项分析中，我们确定了美国儿童健康和医疗保健的 10 项紧急优先事项，包括贫困、食物不足、缺乏医疗保险、儿童虐待和忽视、超重和肥胖、枪支死亡和伤害、心理健康、种族/族裔差异、移民和研究。选民对加强美国对儿童健康和福祉的投资表示压倒性的两党支持。我们提出了联邦政策行动步骤，以成功解决这些优先事项，并确保美国儿童和国家拥有健康、富有成效的未来。
