Youngsters from poor families are more likely to be mentally retarded and suffer lifelong learning disabilities because the nation's system of preventing those illnesses for the poor is in disarray, a report to the president concludes.
The report, which is to be presented to the President's Committee on Mental Retardation next week, challenges federal and state governments to improve access to adequate health care for all.
"Our health-care system . . . is highly discriminatory against children -- particularly minority and poor children -- and should be restructured," said Albert A. Baumeister, one of the authors of the report.
The 220-page report by Baumeister, a Vanderbilt University professor and researcher, and three colleagues seeks to link the prevention of mental retardation and developmental disabilities with an array of other health issues related to unfavorable socioeconomic conditions, including infant mortality, low birth weight, pediatric AIDS and fetal alcohol syndrome.
"Ours is a piecemeal system of public health practice that does not quickly and reliably connect with those who are at greatest risk" for a host of interrelated health problems, including mental retardation, the report says.
"By recent comparison with other Western nations, our public health services are inadequate and poorly organized for addressing the health needs of the poor, minority groups and families at risk."
Among its recommendations is the expansion of Medicaid to make prenatal care available to all low-income, high-risk women. Under the present system, pregnancy must occur and be diagnosed before the process of Medicaid enrollment can begin, thus discouraging early prenatal care, the report says.
The report also contains a section on early-intervention strategies gleaned from nine states that responded to a request for mental-retardation prevention plans. According to Baumeister, Virginia, New Jersey, New York, Iowa, Florida and California have the most sophisticated plans.
The report says the fundamental difficulty in achieving those goals is "the failure to implement comprehensive and socially relevant policies" that would apply existing knowledge to existing problems.