L. Brotman, Spring R. Dawson-McClure, Dana M. Rhule, Katherine Rosenblatt, K. Hamer, D. Kamboukos, M. Boyd, Michelle Mondesir, Isabel Chau, Erin C Lashua-Shriftman, Vanessa Rodriguez, R. G. Barajas-Gonzalez, K. Huang
{"title":"Scaling Early Childhood Evidence-Based Interventions through RPPs","authors":"L. Brotman, Spring R. Dawson-McClure, Dana M. Rhule, Katherine Rosenblatt, K. Hamer, D. Kamboukos, M. Boyd, Michelle Mondesir, Isabel Chau, Erin C Lashua-Shriftman, Vanessa Rodriguez, R. G. Barajas-Gonzalez, K. Huang","doi":"10.1353/FOC.2021.0002","DOIUrl":"https://doi.org/10.1353/FOC.2021.0002","url":null,"abstract":"","PeriodicalId":51448,"journal":{"name":"Future of Children","volume":"31 1","pages":"57-74"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1353/FOC.2021.0002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66360919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"法学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Strambler, Joanna L. Meyer, C. Irwin, George A. Coleman
{"title":"Seeking Questions from the Field: Connecticut Partnership for Early Education Research","authors":"M. Strambler, Joanna L. Meyer, C. Irwin, George A. Coleman","doi":"10.1353/FOC.2021.0008","DOIUrl":"https://doi.org/10.1353/FOC.2021.0008","url":null,"abstract":"","PeriodicalId":51448,"journal":{"name":"Future of Children","volume":"31 1","pages":"21-38"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1353/FOC.2021.0008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66361041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"法学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Summary:Children from low-income backgrounds are less likely to have economically successful role models and mentors in their own families and neighborhoods, and are more likely to spend time with media. In this article, Melissa Kearney and Phillip Levine review the theoretical and empirical evidence on how these external forces can influence children’s development. The authors also document income-based differences in exposure to social influences. They show that well-designed programs involving role models, mentors, and the media can be deployed deliberately, effectively, and often inexpensively to improve children’s social and economic outcomes.After highlighting the theoretical reasons why role models, mentors, and the media could alter a child’s life trajectory, the authors report a descriptive analysis showing differences over time and across income class in exposure to these influences. They show that compared to children four decades ago, today’s children spend much more time in school and with media, and less time with parents, peers, and other adults. They also show that young children with low socioeconomic status (SES) spend considerably more time exposed to media and considerably less time in school, as compared to higher-SES children, and encounter very different role models in their neighborhoods.Kearney and Levine focus on large-scale analyses that credibly claim that a specific intervention had a causal impact on children’s outcomes. The beneficial impact of role models is evident in teachers’ ability to positively influence the educational performance and career decisions of students who share the teacher’s gender or race. Children who participate in formal mentoring programs see improvements in their school performance and are more likely to avoid the criminal justice system. Exposure to specific media content with positive messaging can lead to improved social outcomes. The authors conclude that interventions designed to improve the social influences encountered by children can make an important contribution toward the goal of increasing rates of upward mobility for children in low-income homes in the United States.
{"title":"Role Models, Mentors, and Media Influences","authors":"Melissa S. Kearney, P. Levine","doi":"10.1353/foc.2020.0006","DOIUrl":"https://doi.org/10.1353/foc.2020.0006","url":null,"abstract":"Summary:Children from low-income backgrounds are less likely to have economically successful role models and mentors in their own families and neighborhoods, and are more likely to spend time with media. In this article, Melissa Kearney and Phillip Levine review the theoretical and empirical evidence on how these external forces can influence children’s development. The authors also document income-based differences in exposure to social influences. They show that well-designed programs involving role models, mentors, and the media can be deployed deliberately, effectively, and often inexpensively to improve children’s social and economic outcomes.After highlighting the theoretical reasons why role models, mentors, and the media could alter a child’s life trajectory, the authors report a descriptive analysis showing differences over time and across income class in exposure to these influences. They show that compared to children four decades ago, today’s children spend much more time in school and with media, and less time with parents, peers, and other adults. They also show that young children with low socioeconomic status (SES) spend considerably more time exposed to media and considerably less time in school, as compared to higher-SES children, and encounter very different role models in their neighborhoods.Kearney and Levine focus on large-scale analyses that credibly claim that a specific intervention had a causal impact on children’s outcomes. The beneficial impact of role models is evident in teachers’ ability to positively influence the educational performance and career decisions of students who share the teacher’s gender or race. Children who participate in formal mentoring programs see improvements in their school performance and are more likely to avoid the criminal justice system. Exposure to specific media content with positive messaging can lead to improved social outcomes. The authors conclude that interventions designed to improve the social influences encountered by children can make an important contribution toward the goal of increasing rates of upward mobility for children in low-income homes in the United States.","PeriodicalId":51448,"journal":{"name":"Future of Children","volume":"30 1","pages":"106 - 83"},"PeriodicalIF":0.0,"publicationDate":"2020-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1353/foc.2020.0006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47470683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"法学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Summary:Beliefs about socioeconomic mobility have important consequences, writes Mesmin Destin, especially for young people. Moreover, research by psychologists shows that such beliefs are malleable, based on the information and circumstances people encounter.The consequences of beliefs about mobility can be quite positive. When young people perceive that they have opportunities and financial resources to help them reach their goals, they are more likely to take the steps that can lead to upward socioeconomic mobility. But the consequences can also be negative. Overemphasizing opportunities while de-emphasizing systematic barriers and inequality, Destin writes, makes it less likely that people will take collective action against discrimination and address inequality’s structural roots.Destin proposes several ways that policymakers and others could navigate this tension. One, for example, is to convey a more balanced notion to young people: that opportunities are available, but unfair barriers exist that particularly affect members of certain groups. In the end, though, he concludes, perhaps the most effective way to shape people’s perceptions of opportunity is to expand the pathways to upward socioeconomic mobility and make them more accessible to all young people.
{"title":"The Double-Edged Consequences of Beliefs about Opportunity and Economic Mobility","authors":"Mesmin Destin","doi":"10.1353/foc.2020.0001","DOIUrl":"https://doi.org/10.1353/foc.2020.0001","url":null,"abstract":"Summary:Beliefs about socioeconomic mobility have important consequences, writes Mesmin Destin, especially for young people. Moreover, research by psychologists shows that such beliefs are malleable, based on the information and circumstances people encounter.The consequences of beliefs about mobility can be quite positive. When young people perceive that they have opportunities and financial resources to help them reach their goals, they are more likely to take the steps that can lead to upward socioeconomic mobility. But the consequences can also be negative. Overemphasizing opportunities while de-emphasizing systematic barriers and inequality, Destin writes, makes it less likely that people will take collective action against discrimination and address inequality’s structural roots.Destin proposes several ways that policymakers and others could navigate this tension. One, for example, is to convey a more balanced notion to young people: that opportunities are available, but unfair barriers exist that particularly affect members of certain groups. In the end, though, he concludes, perhaps the most effective way to shape people’s perceptions of opportunity is to expand the pathways to upward socioeconomic mobility and make them more accessible to all young people.","PeriodicalId":51448,"journal":{"name":"Future of Children","volume":"30 1","pages":"153 - 163"},"PeriodicalIF":0.0,"publicationDate":"2020-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1353/foc.2020.0001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42469599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"法学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"How Cultural Factors Shape Economic Outcomes: Introducing the Issue","authors":"Melissa S. Kearney, Ron Haskins","doi":"10.1353/foc.2020.0005","DOIUrl":"https://doi.org/10.1353/foc.2020.0005","url":null,"abstract":"","PeriodicalId":51448,"journal":{"name":"Future of Children","volume":"30 1","pages":"3 - 8"},"PeriodicalIF":0.0,"publicationDate":"2020-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1353/foc.2020.0005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48411690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"法学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Summary:Religious institutions can provide spiritual guidance and hope, a sense of belonging, and material support during periods of hardship. Daniel Hungerman reviews the evidence on the roles that religious institutions play in individuals’ lives and how engagement with those institutions shapes individuals’ economic wellbeing.First, he describes patterns and trends in religious social service provision, and in religiosity, across places and over time. The United States features prominently in this discussion, although he includes work in other countries as well. Next, he provides an overview of key aspects of the large interdisciplinary body of research that associates religious participation with other outcomes and channels by which religious groups affect outcomes, giving special attention to the empirical challenges facing work of this nature.Overall, he writes, religious groups are an important and understudied source of social services and wellbeing. Despite the challenges of studying the effects of religion, many rigorous studies on the topic confirm that religion has important causal beneficial effects on wellbeing. Together, these results raise important policy questions concerning how to provide social services to the disadvantaged.
{"title":"Religious Institutions and Economic Wellbeing","authors":"Daniel M. Hungerman","doi":"10.1353/foc.2020.0003","DOIUrl":"https://doi.org/10.1353/foc.2020.0003","url":null,"abstract":"Summary:Religious institutions can provide spiritual guidance and hope, a sense of belonging, and material support during periods of hardship. Daniel Hungerman reviews the evidence on the roles that religious institutions play in individuals’ lives and how engagement with those institutions shapes individuals’ economic wellbeing.First, he describes patterns and trends in religious social service provision, and in religiosity, across places and over time. The United States features prominently in this discussion, although he includes work in other countries as well. Next, he provides an overview of key aspects of the large interdisciplinary body of research that associates religious participation with other outcomes and channels by which religious groups affect outcomes, giving special attention to the empirical challenges facing work of this nature.Overall, he writes, religious groups are an important and understudied source of social services and wellbeing. Despite the challenges of studying the effects of religion, many rigorous studies on the topic confirm that religion has important causal beneficial effects on wellbeing. Together, these results raise important policy questions concerning how to provide social services to the disadvantaged.","PeriodicalId":51448,"journal":{"name":"Future of Children","volume":"30 1","pages":"28 - 9"},"PeriodicalIF":0.0,"publicationDate":"2020-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1353/foc.2020.0003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45180626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"法学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Summary:In this article, Melanie Wasserman reviews the latest evidence about the causal link between family structure and children’s economic and social outcomes. Going beyond the question of whether family structure affects child outcomes—a topic that’s already been covered at length, including in previous Future of Children volumes—she examines how family structure differentially affects children. One important finding from recent studies is that growing up outside a family with two biological, married parents yields especially negative consequences for boys as compared to girls, including poorer educational outcomes and higher rates of criminal involvement.Wasserman describes mechanisms that may link family structure to children’s outcomes, in terms of both the main effect and the differences between effects on boys and on girls. These include same-gender role models in the household and in the neighborhood, parental resources (including money, time, and more), parenting quantity and quality (with attention to how parents allocate their time to children of different genders), and the differences in how boys and girls respond to parental inputs, among other hypotheses.What can be done to ameliorate the effects of family structure on children’s outcomes? Wasserman encourages policy makers to supplement the educational, parental, and emotional resources available to those children who are most at risk of experiencing the negative effects of nontraditional family structures.
{"title":"The Disparate Effects of Family Structure","authors":"M. Wasserman","doi":"10.1353/foc.2020.0008","DOIUrl":"https://doi.org/10.1353/foc.2020.0008","url":null,"abstract":"Summary:In this article, Melanie Wasserman reviews the latest evidence about the causal link between family structure and children’s economic and social outcomes. Going beyond the question of whether family structure affects child outcomes—a topic that’s already been covered at length, including in previous Future of Children volumes—she examines how family structure differentially affects children. One important finding from recent studies is that growing up outside a family with two biological, married parents yields especially negative consequences for boys as compared to girls, including poorer educational outcomes and higher rates of criminal involvement.Wasserman describes mechanisms that may link family structure to children’s outcomes, in terms of both the main effect and the differences between effects on boys and on girls. These include same-gender role models in the household and in the neighborhood, parental resources (including money, time, and more), parenting quantity and quality (with attention to how parents allocate their time to children of different genders), and the differences in how boys and girls respond to parental inputs, among other hypotheses.What can be done to ameliorate the effects of family structure on children’s outcomes? Wasserman encourages policy makers to supplement the educational, parental, and emotional resources available to those children who are most at risk of experiencing the negative effects of nontraditional family structures.","PeriodicalId":51448,"journal":{"name":"Future of Children","volume":"30 1","pages":"55 - 81"},"PeriodicalIF":0.0,"publicationDate":"2020-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1353/foc.2020.0008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46672573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"法学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Summary:People don’t base decisions about their economic life solely on their own individually formed ideas and preferences. Rather, they’re influenced by the experiences of their peers and by social group norms. Gordon Dahl reviews the various ways family and neighborhood peer groups influence decisions to participate in the workforce and in government social assistance programs.These social spillover effects are hard to estimate because of the problems that economists refer to as reflection, correlated unobservables, and endogenous group membership. Dahl explains how researchers have overcome these challenges to produce credible estimates of the effects of family and peer groups on work and program participation. He reviews the most rigorous evidence to date and discusses possible mechanisms.Understanding neighborhood and family group influences is critical to thinking about policy, Dahl writes. The spillover effects on children, siblings, and neighbors can be just as important as the direct impact on parents and directly targeted peers, due to social multiplier effects.
{"title":"Peer and Family Effects in Work and Program Participation","authors":"Gordon B. Dahl","doi":"10.1353/foc.2020.0000","DOIUrl":"https://doi.org/10.1353/foc.2020.0000","url":null,"abstract":"Summary:People don’t base decisions about their economic life solely on their own individually formed ideas and preferences. Rather, they’re influenced by the experiences of their peers and by social group norms. Gordon Dahl reviews the various ways family and neighborhood peer groups influence decisions to participate in the workforce and in government social assistance programs.These social spillover effects are hard to estimate because of the problems that economists refer to as reflection, correlated unobservables, and endogenous group membership. Dahl explains how researchers have overcome these challenges to produce credible estimates of the effects of family and peer groups on work and program participation. He reviews the most rigorous evidence to date and discusses possible mechanisms.Understanding neighborhood and family group influences is critical to thinking about policy, Dahl writes. The spillover effects on children, siblings, and neighbors can be just as important as the direct impact on parents and directly targeted peers, due to social multiplier effects.","PeriodicalId":51448,"journal":{"name":"Future of Children","volume":"30 1","pages":"107 - 126"},"PeriodicalIF":0.0,"publicationDate":"2020-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1353/foc.2020.0000","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43851874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"法学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Summary:In this article, economists Kevin Lang and Ariella Kahn-Lang Spitzer take up the expansive issue of discrimination, examining specifically how discrimination and bias shape people’s outcomes. The authors focus primarily on discrimination by race, while acknowledging that discrimination exists along many other dimensions as well, including gender, sexual orientation, religion, and ethnicity. They describe evidence of substantial racial disparities in the labor market, education, criminal justice, health, and housing, and they show that in each of these domains, such disparities at least partially reflect discrimination.Lang and Kahn-Lang Spitzer note that the disparities we see are both causes and results of discrimination, and that they reinforce each other. For instance, harsher treatment from the criminal justice system makes it more difficult for black people to get good jobs, which makes it more likely they’ll live in poor neighborhoods and that their children will attend inferior schools.The authors argue that simply prohibiting discrimination isn’t effective, partly because it’s hard to prevent discrimination along dimensions that are correlated with race. Rather, they write, policies are more likely to be successful if they aim to eliminate the statistical association between race and many other social and economic characteristics and to decrease the social distance between people of different races.
摘要：在这篇文章中，经济学家Kevin Lang和Ariella Kahn Lang Spitzer讨论了歧视的广泛问题，特别研究了歧视和偏见如何影响人们的结果。作者主要关注种族歧视，同时承认歧视还存在许多其他方面，包括性别、性取向、宗教和种族。他们描述了劳动力市场、教育、刑事司法、健康和住房方面存在巨大种族差异的证据，并表明在每一个领域，这种差异至少部分反映了歧视。Lang和Kahn Lang Spitzer指出，我们看到的差异既是歧视的原因，也是歧视的结果，而且它们相互强化。例如，刑事司法系统的更严厉待遇使黑人更难找到好工作，这使他们更有可能生活在贫困社区，他们的孩子也更有可能就读于较差的学校。作者认为，仅仅禁止歧视是无效的，部分原因是很难防止与种族相关的歧视。相反，他们写道，如果政策旨在消除种族与许多其他社会和经济特征之间的统计关联，并减少不同种族之间的社会距离，那么政策更有可能取得成功。
{"title":"How Discrimination and Bias Shape Outcomes","authors":"K. Lang, Ariella Kahn-Lang Spitzer","doi":"10.1353/foc.2020.0007","DOIUrl":"https://doi.org/10.1353/foc.2020.0007","url":null,"abstract":"Summary:In this article, economists Kevin Lang and Ariella Kahn-Lang Spitzer take up the expansive issue of discrimination, examining specifically how discrimination and bias shape people’s outcomes. The authors focus primarily on discrimination by race, while acknowledging that discrimination exists along many other dimensions as well, including gender, sexual orientation, religion, and ethnicity. They describe evidence of substantial racial disparities in the labor market, education, criminal justice, health, and housing, and they show that in each of these domains, such disparities at least partially reflect discrimination.Lang and Kahn-Lang Spitzer note that the disparities we see are both causes and results of discrimination, and that they reinforce each other. For instance, harsher treatment from the criminal justice system makes it more difficult for black people to get good jobs, which makes it more likely they’ll live in poor neighborhoods and that their children will attend inferior schools.The authors argue that simply prohibiting discrimination isn’t effective, partly because it’s hard to prevent discrimination along dimensions that are correlated with race. Rather, they write, policies are more likely to be successful if they aim to eliminate the statistical association between race and many other social and economic characteristics and to decrease the social distance between people of different races.","PeriodicalId":51448,"journal":{"name":"Future of Children","volume":"30 1","pages":"165 - 186"},"PeriodicalIF":0.0,"publicationDate":"2020-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1353/foc.2020.0007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44375619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"法学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-01DOI: 10.1353/foc.2020.a807755
A. Schickedanz, N. Halfon
Summary:Health care reaches more children under age three in the United States than any other family-facing system and represents the most common entry point for developmental assessment of and services for children. In this article, Adam Schickedanz and Neal Halfon examine how well the child health care system promotes healthy child development early in life. They also review children’s access to health care through insurance coverage, the health care system’s evolution in response to scientific and technical advances, and the shifting epidemiology of health and developmental risk.The authors find that the health care system is significantly underperforming because it is constrained by antiquated conventions, insufficient resources, and outmoded incentive structures inherent in the traditional medical model that still dominates pediatric care. These structural barriers, organization challenges, and financial constraints limit the system’s ability to adequately recognize, respond to, and, most importantly, prevent adverse developmental outcomes at the population level.To achieve population-level progress in healthy child development, Schickedanz and Halfon argue that pediatric care will need to transform itself and go beyond simply instituting incremental clinical process improvement. This will require taking advantage of opportunities to deliver coordinated services that bridge sectors and focusing not only on reducing developmental risk and responding to established developmental disability but also on optimizing healthy child development before developmental vulnerabilities arise.New imperatives for improved population health, along with the growing recognition among policy makers and practitioners of the social and developmental determinants of health, have driven recent innovations in care models, service coordination, and coverage designs. Yet the available resources and infrastructure are static or shrinking, crowded out by rising overall health care costs and other policy priorities. The authors conclude that child health systems are at a crossroads of conflicting priorities and incentives, and they explore how the health system might successfully respond to this impasse.
{"title":"Evolving Roles for Health Care in Supporting Healthy Child Development","authors":"A. Schickedanz, N. Halfon","doi":"10.1353/foc.2020.a807755","DOIUrl":"https://doi.org/10.1353/foc.2020.a807755","url":null,"abstract":"Summary:Health care reaches more children under age three in the United States than any other family-facing system and represents the most common entry point for developmental assessment of and services for children. In this article, Adam Schickedanz and Neal Halfon examine how well the child health care system promotes healthy child development early in life. They also review children’s access to health care through insurance coverage, the health care system’s evolution in response to scientific and technical advances, and the shifting epidemiology of health and developmental risk.The authors find that the health care system is significantly underperforming because it is constrained by antiquated conventions, insufficient resources, and outmoded incentive structures inherent in the traditional medical model that still dominates pediatric care. These structural barriers, organization challenges, and financial constraints limit the system’s ability to adequately recognize, respond to, and, most importantly, prevent adverse developmental outcomes at the population level.To achieve population-level progress in healthy child development, Schickedanz and Halfon argue that pediatric care will need to transform itself and go beyond simply instituting incremental clinical process improvement. This will require taking advantage of opportunities to deliver coordinated services that bridge sectors and focusing not only on reducing developmental risk and responding to established developmental disability but also on optimizing healthy child development before developmental vulnerabilities arise.New imperatives for improved population health, along with the growing recognition among policy makers and practitioners of the social and developmental determinants of health, have driven recent innovations in care models, service coordination, and coverage designs. Yet the available resources and infrastructure are static or shrinking, crowded out by rising overall health care costs and other policy priorities. The authors conclude that child health systems are at a crossroads of conflicting priorities and incentives, and they explore how the health system might successfully respond to this impasse.","PeriodicalId":51448,"journal":{"name":"Future of Children","volume":"30 1","pages":"143 - 164"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43653932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"法学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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