The state of US children's health and recommendations for improvement are reported. The 1st table identifies youth as risk, i.e., at the current rate, 1 in 10 women will give birth by the time they turn 18. Among black children, white children 1-4 years, and blacks 15-24 years, death rates actually increased from 1985 to 1987. Injuries, particularly due to violence, have replaced communicable diseases as the primary cause of death among adolescents. Since 1976, immunization has deteriorated. There is a refusal to recognize sexually active adolescents, in spite of 2.5 million cases of sexually transmitted disease. The 6 strategies discussed intervention begin with providing high quality preschool education programs for all children. The 2nd urges educational programs from kindergarten through 12th grade that help children make healthy choices, improve their self-esteem, and accept as much responsibility for their own lives as possible. Parenting education, as the 3rd strategy, promotes the education and support of parents, especially for young and poor parents. The 4th strategy involves male responsibility and instruction on obligations in pregnancy and parenthood, including a requirement of financial commitment from fathers and identification of the father by Social Security number on an infant's birth certificate. The 5th strategy is the provision for school-based health services, including family life counseling and contraceptive services for adolescents. The 6th strategy is to provide free college tuition and books at a state supported school for students with at least a B average, good citizenship record, and a family income of $20,000. It is cheaper to offer children opportunity than to pay the costs of the consequences of poverty.

作者：M J, Elders

来源：North Carolina medical journal 1991 年 52卷 5期