Behavioral and Developmental Components of Child Health Promotion: How Can They Be Accomplished?

Child health supervision has been a service highly valued both by the consumer and by pediatricians. In addition to improved public health practices, nutrition, housing, and other environmental factors, pediatric health promotion has made a major contribution to the improved health status of children which has occurred in recent decades in the United States. Although the current preoccupation with cost containment might suggest otherwise, the present question is not how we can do less in health promotion but how we can do more, and with better effectiveness, especially in relation to behavior and development. The potential for child and family health promotion in these areas remains largely unrealized. We live in a society characterized by rapid change. By 1 990, one fourth of the children in the United States will spend part or all of their lives in one-parent families. Today, most mothers work outside the home. Parental divorce, separation, and remarriage are events now frequently experienced by children. Many upwardly mobile families are postponing parenthood and having few children or none. In our highly migratory society, grandparents and other relatives are less available to provide emotional and other support, especially for young parents and children. NEED FOR NEW MODELS In view of all this, the model of pediatric practice that has gradually envolved over the decades to provide care, in the beginning for infants with nutritional and acute infectious disorders, requires constant reevaluation and renewal if it is to remain responsive to emerging health promotion needs, particularly in relation to behaviour and development.