So Dependent, So Poorly Cared For

More bad news about the youngest users of the American health system:

-- Progress in reducing infant mortality has virtually halted as the United States has slipped to 20th place among the developed nations of the world, according to the National Commission to Prevent Infant Mortality.

-- None of the surgeon general’s goals for 1990 for prenatal care and immunization have been met, says a joint report from the National Assn. of Children’s Hospitals and Related Institutions and the American Academy of Pediatrics.

In fact, matters have been getting worse: The proportion of young children without basic immunizations has increased; the percentage of women receiving delayed or no prenatal care has also increased.

“These trends provide a strong indicator that infant mortality will worsen in the years ahead, especially as more communities feel the impact of increased poverty among children, drugs and fewer health care providers serving high-risk families,” the National Commission to Prevent Infant Mortality warns.

Particularly troubling is the “unconscionable gap” between white and black children. Compared with whites, black babies are twice as likely to die in their first year and three times more likely to have a birth weight under 3 1/4 pounds.

The findings are not surprising, given a situation in which children are one-third of the37 million Americans without health insurance. Half of the children living at poverty level have no insurance.

And the prospects for improvement in child health in the future are dimmed by the fact that immunization is falling behind, protecting, for example, only 57% of non-whites from polio.

Nor is there an easy solution. Some in Congress have responded to the commission report with proposals to extend Medicare coverage. California has already done this for pregnant mothers and infants, with the promise of improving prenatal care at least. But the Medicare system is so underfunded that it is, in any case, an inadequate response to a problem that probably can only be solved effectively by an as-yet undefined system of universal health care.