Poverty and Cardiac Disease in Children

Almost 80 million children live in the United States. At least eight of every 1000 infants born each year have congenital heart defects.1When mortality and spontaneous defect improvement are factored into live birth data, Roberts and Cretin2estimated that by 1995 there will be 300 000 children under the age of 21 years with congenital heart disease; 38% will have had one or more surgical procedures. Other children will develop acquired heart disease, such as cardiomyopathies, rheumatic fever, acquired immunodeficiency syndrome with its myocarditis, Kawasaki disease, and arrhythmias. The projected incidence estimate for supraventricular tachycardia alone is between one and four per 1000.3Familial hypercholesterolemia will affect the future of an unknown but probably large number of children. Therefore, at least one-half million children in the United States have some form of cardiac problem. One quarter to one third4,5of the more than 4 million