A poor report for children

December 28, 1992

Immunizations represent one of the simplest and mos cost-effective of all public health measures. Especially for children, for whom a measles, rubella or smallpox vaccination can mean the difference between life and death, immunization rates also say a lot about a country's standard of living -- and about the priority that the country places on its most precious natural resource. According to two reports issued earlier this month, the United States has little reason for pride in its recent record of caring for the health of its children.

The annual "State of the World's Children" report from the United Nations Children's Fund (UNICEF) found that a 10-year campaign to improve children's health in developing nations had raised immunization rates for infants from 15 percent in 1981 to more than 80 percent in 1991, saving about 3 million lives each year.

In this country, however, the past decade has seen a disturbing erosion in childhood immunization rates. According to the Children's Defense Fund's annual report on the state of America's children, rates in the United States have fallen so that in most states fewer than 60 percent of 2-year-olds are fully immunized.

Why? The reasons range from increasing rates of poverty and lack of access to medical care to skyrocketing costs. In the case of immunizations, "skyrocketing" translates into a rise of more than $200 in the price of fully immunizing a child in the United States. In 1977, full immunization against preventable diseases cost just under $11; now the price tag is about $230. In many cases, insurance doesn't cover the expense, and Medicaid only reimburses providers for a fraction of the cost.

The results are obvious: Since 1988, more than 60,000 Americans, most of them young children, have contracted measles. In about 8,000 cases hospitalization was required, and 130 people died.

Immunization rates reflect another disturbing trend in America -- the increasing numbers of children growing up in poverty. Contrary to stereotypes, most of these poor children are white and living with a working parent in rural or suburban areas. In itself, poverty, with all its grinding manifestations in daily life, poses a threat to the health of children and their ability to fulfill their potential.

Marian Wright Edelman, president of the Children's Defense Fund, neatly pinpointed the issue: "Every American needs to ask why there are more poor children in rich America than there are citizens in famine-stricken Somalia."

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