WELFARE-REFORM AND CHILDRENS HEALTH

During the ongoing national discussion of proposals to reform health c are financing, effects on the health status of children emerged as a s pecial concern. Public attention has shifted away from comprehensive r eform of the health care system and toward reform of the welfare syste m (primarily the Aid to Families with Dependent Children [AFDC] progra m), but this debate with its focus on parental behavior has not attend ed to the effects of reform on children's health and well-being. Yet t he changes proposed will have a profound effect on the lives of childr en. Children's health status is determined by a multiplicity of factor s, among which social and economic factors are especially important.(1 ,2) Children living in poverty have poorer health than their more affl uent peers,(1-16) consequently, welfare system reform carries great im plications for children's health, Welfare system reforms that reduce r esources for low-income families will lead to a predictable increase i n adverse health outcomes for children in low-income homes. Pediatrici ans and other children's health professionals must view this process w ith great concern. This commentary addresses the associations of pover ty and children's health, the potential adverse consequences for child ren's health with the welfare system reform measures currently being e nacted, and the subject of welfare system reform as human experimentat ion.