Health Affairs, 26, no. 2 (2007): 314 doi: 10.1377/hlthaff.26.2.314 © 2007 by Project HOPE	New Online   Pay Cuts For Medicare Docs   Access To Care Woes   Public Coverage More Efficient   Empowering Consumers

This Article Extract Reprint (PDF) Submit a response to this article Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services E-mail this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to My Personal Archive Download to Citation Manager Reprints & Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Search for Related Content Related Collections Health Reform Insurance Coverage - Children Health Spending

Health Care

PROLOGUE

Children’s Health And Health Care

Neal Halfon, director of the Center for Healthier Children, Families, and Communities at the University of California, Los Angeles (UCLA), and his UCLA colleagues, Helen DuPlessis and Moira Inkelas, lay out a critique of our current system characterized by fragmentation, shot through with holes in its safety net, and designed to meet twentieth-century needs of infectious disease. Halfon and colleagues then take readers on a ride toward the envisioned future. They start the discussion of transformation: How do we move to a twenty-first-century design based on the emerging science of health, one that can align multiple service sectors and funding streams?

One of the key concepts used in a new understanding of how health, childhood, and environment interact is the measure of social determinants of health. Janet Currie, an economist at Columbia University, and Wanchuan Lin, a colleague of Currie’s previously at UCLA, revisit one of the vexing issues of how we measure these determinants. Why do poor children do worse even when income is accounted for? Scholars have yet to comprehensively measure how limiting ill health, and poor mental health in particular, is for all children—especially low-income children—as they try to become productive members of society.

Daniel Eisenberg and Gary Freed of the University of Michigan take another tack at how poorly we value children. As a society, we badly underestimate how highly we value children’s potential good health and lifespans by the way we measure cost-effectiveness. They look at an issue of particular interest in children’s health care: the costs of vaccination. To get at the true measure of good health, we need to rethink how we measure its costs and potential.

All of the papers, in their unique ways, demonstrate that we have the science and the knowledge to do better by our children and our country’s health care. What they all ultimately ask is, Do we have the will?

                      What's this?