Pediatric News Updates

The state of children's health care

Last month, the indications that all is not well with children's health care in this country were piling up. At any one time in the US, approximately 9 million children are without health insurance. More and more voters are coming to feel that the consequences for children's health status are unacceptable. Straws in the wind:

According to Dr. Neal Halfon, Director of the Center for Healthier Children, Families and Communities at UCLA's School of Public Health, the problems go deeper than questions of insurance alone. What we need, Halfon and colleagues say in the March issue of Health Affairs, is comprehensive health care coverage for all children that is responsive to their unique developmental needs, includes health promotion as well as disease prevention, and addresses the physical, mental, behavioral, and developmental needs of the whole child. Most pediatricians would say, "Amen."

It isn't what their parents dreamed of when they send their offspring off to get a college education: Campuses where 49% of the full-time students (3.8 million young people) indulge in binge drinking and abuse of prescription and illegal drugs. Unfortunately, that's what parents find themselves paying for, according to a report from Columbia University's National Center on Addiction and Substance Abuse (CASA). CASA's report, Wasting the Best and the Brightest: Substance Abuse at America's Colleges and Universities, is a summary of four years of research, surveys, interviews, and focus group studies ( http://www.casacolumbia.org/).

The situation is even worse now than it was a few years ago. Students are binge drinking more frequently, as well as using marijuana and other illegal and prescription drugs more heavily. Almost 23% meet medical criteria for substance abuse and dependence, the number of alcohol-related arrests is up 21%, 97,000 students were victims of alcohol-related rape or sexual assault in 2001, and 696,000 students were assaulted in 2001 by a fellow student on an alcoholic binge. Says Joseph Califano, CASA's president, the situation is the result of a college culture of alcohol and drug abuse linked to poor academic performance, depression, anxiety, suicide, vandalism, fights, and a host of medical problems. Califano calls the college presidents, deans, and trustees who accept this culture "Pontius Pilates whose acceptance of...rampant alcohol and other drug abuse puts the best and the brightest-and the nation's future-in harm's way." To turn that culture around will require a concerted effort involving parents, alumni, students, fraternities, athletic organizations, and government.