Starting Points: Meeting the Needs of Our Youngest Children

As a general pediatrician in the Bronx, I see the dire health and social problems facing young children and families living in poverty. A dearth of decent-paying jobs, lack of affordable and adequate housing, limited availability of quality child care, and deficient educational opportunities have contributed to increased social disparities in our community. Widespread addiction has exacerbated family and community violence and child neglect. Health care is fragmented and inaccessible to many. In the United States, rates of low birth weight, immunizations, and teen pregnancy compare unfavorably with other industrialized nations. Young urban children of color have been notable victims of these circumstances. In 1991, the Carnegie Corporation of New York established a Task Force on Meeting the Needs of Young Children with the assignment of providing scientific knowledge and offering an "action agenda to ensure the healthy development of children before birth to age three," with a particular emphasis