Miller C A, Coulter E J, Schorr L B, Fine A, Adams-Taylor S
Int J Health Serv. 1985;15(1):95-134. doi: 10.2190/8C7U-7AB2-UJL7-VPA2.
This is a review of the United States experience with issues of child health and services as they relate to changes in economic trends. No existing data systems are entirely adequate for reporting on the current health status of children. An important consideration for the monitoring of children's health in the United States is the status of subgroups such as those who are disadvantaged for reasons of poverty, discrimination or geographic isolation. Ample evidence confirms that children living in poverty suffer adverse health consequences and that the proportion of children living in poverty in the United States has increased steadily since 1975 and dramatically since 1981. Most measures of health status and health risks for children show steady improvements throughout the 1970s. The exercise of public responsibility for financing and providing essential services and supports held constant or improved during this period, especially during the recession of 1974-75. The health status and risks for children since 1981 appear to be adversely affected which must be attributed to a combination of circumstances that include serious recession, increased poverty rates for households with children and diminished health benefits and social support services. These findings suggest that when either local or widespread economic reversals are anticipated, health services and social supports for children need to be expanded rather than contracted.
这是一篇关于美国儿童健康及服务问题与经济趋势变化相关情况的综述。现有的数据系统都不足以全面报告儿童当前的健康状况。在美国监测儿童健康时，一个重要的考量因素是诸如因贫困、歧视或地理隔离等处于不利地位的亚群体的状况。大量证据证实，生活贫困的儿童健康会受到不良影响，并且自1975年以来，美国生活贫困的儿童比例稳步上升，自1981年以来更是急剧增加。20世纪70年代，大多数儿童健康状况和健康风险指标都呈现稳步改善。在此期间，尤其是在1974 - 1975年经济衰退期间，政府在为基本服务和支持提供资金方面履行的公共责任保持不变或有所改善。自1981年以来，儿童的健康状况和面临的风险似乎受到了不利影响，这必须归因于多种因素的综合作用，包括严重的经济衰退、有子女家庭贫困率上升以及健康福利和社会支持服务减少。这些研究结果表明，当预计会出现局部或广泛的经济衰退时，儿童的健康服务和社会支持需要扩大而非缩减。
