Child Health in America: Making a Difference through Advocacy

307 Pages·2006·1.24 MB·English

by  Judith S. Palfrey

Child Health in America
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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
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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
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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-
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