Pollitt E
Department of Pediatrics, School of Medicine, University of California, Davis 95616.
Child Dev. 1994 Apr;65(2 Spec No):283-95.
Data from low-income countries are helpful in understanding the effects of poverty on child development in the U.S. Illustrative are 3 public health issues: (1) In the U.S., among poor African-American and Hispanic babies anemia is as high as 20%-24%, while in low-income countries, iron deficiency anemia (IDA) causes poor performance on mental and motor tests among babies and children. These data suggest that IDA is a major public health problem among poor minority children that requires prompt attention. (2) In 1993 the U.S. government appropriated $2.86 billion for the Special Supplemental Food Program for Women, Infants, and Children (WIC). Evaluations of WIC, however, have failed to yield conclusive information on the benefits of the program. In low-income countries, nutritional supplements targeted to at-risk groups have resulted in developmental benefits. Thus, WIC is likely to buffer intellectual development against the adverse effects of malnutrition observed among poor children. (3) Evidence from developing countries suggests that concurrent illnesses and poor nutrition interfere with schooling. However, in the U.S., attention to such issues has declined, while common illnesses have increased among the poor. A reappraisal of this issue is warranted to meet the education and health goals proposed for the year 2000 in the U.S.
来自低收入国家的数据有助于理解贫困对美国儿童发育的影响。有3个公共卫生问题可作例证:(1)在美国,贫困的非裔美国人和西班牙裔婴儿中贫血率高达20% - 24%,而在低收入国家,缺铁性贫血(IDA)导致婴儿和儿童在智力和运动测试中表现不佳。这些数据表明,IDA是贫困少数族裔儿童中的一个主要公共卫生问题,需要立即引起关注。(2)1993年,美国政府拨款28.6亿美元用于妇女、婴儿和儿童特别补充食品计划(WIC)。然而,对WIC的评估未能得出关于该计划益处的确切信息。在低收入国家,针对高危群体的营养补充剂已带来了发育方面的益处。因此,WIC可能会缓冲智力发育,使其免受贫困儿童中观察到的营养不良的不利影响。(3)来自发展中国家的证据表明,并发疾病和营养不良会干扰学业。然而,在美国,对这类问题的关注减少了,而穷人中常见疾病却增加了。有必要重新评估这个问题,以实现美国为2000年提出的教育和健康目标。