When you have over 40 million people without any health insurance at all – and another 70 million with limited and poor coverage – while suffering is widespread, some categories of people are at greater risk. A recent report released by the prestigious Commonwealth Fund found that, “Despite a number of noted successes, American children largely don’t get the quality of health care they should, with up to three-quarters of children and adolescents not receiving care scientifically proven or recommended.”

It is an internationally agreed-upon standard that you can judge a country’s humanity by the way it treat its old and young. We just witnessed the Bush administration’s attempt to gut the Medicare bill. And now this report.

‘Healthiest part of life’

The Fund’s report was based on research conducted at the University of North Carolina School of Public Health, whose report was, in turn, based on a literature search of 500 studies. In other words, this a report that is beyond reproach.

What makes the report all the more compelling is that kids and adolescents are supposed to be at the healthiest point of their lives. This may be why so little attention is paid to their health status.

The principal researcher of the Fund’s study, Sheila Leatherman, stated, “The report shows dangerous lapses in patient safety, substantial shortcomings in providing effective and recommended care, persistent racial and ethnic disparities in care, and widespread failure to provide needed preventive services to teens.”

The report points to the lack of any systematic approach to family medical needs. Of course, this is only a reflection of a health system in the United States which emphasizes payment for services over the quality and effectiveness of the same services.

Asthma crisis

Two-thirds of children who need asthma-control medications do not receive them, according to the report. This is totally preventable. Chlamydia is another totally preventable condition, yet up to 75 percent of sexually active adolescents are not tested. Furthermore, five key vaccines recommended by medical and public health professionals are not administered on time. For example, in Massachusetts, only 14 percent of kids receive their needed vaccines in time. In Colorado, only 37 percent receive them. The lack of federal requirements, and enforcement policies which leave these extremely important vaccine programs to the states, make this disaster possible.

Mental health deficiencies

Among young people, mental health problems are extremely important. Being able to make an early diagnosis of a mental health problem can be a life and death issue for these kids. But the report finds that 79 percent of kids diagnosed with severe mental health problems did not get needed follow up. An estimated 7.5 million children don’t get the mental health care they require.

Additional problems cited by the report include extremely poor prenatal care in the first trimester of pregnancy and poor quality of care in hospitals.

Racism and disparities in care

While high percentages of all children face major health problems, poor, minority and urban young children are less likely than non-poor, white and suburban young children to receive timely immunizations. Black and Latino children with asthma are less likely to be using the proper inhalation medications than their counterparts, although they have more severe asthma than white children.

Roads to improvement

The report showed that with proper national monitoring programs, pediatric infection rates have been reduced. Statewide lead-screening programs, such as Rhode Island’s, reduced lead poisoning for kids. Community and migrant health centers have significantly improved adolescent health among populations they serve; and, where community outreach programs were initiated, flu shots increased and problems with asthma were reduced. Fewer hospitals and emergency room visits were required.

National policy makers, especially politicians in this election year, can be approached with information from this important report with the message to make the health status of kids, their parents and communities the priority over the profits of the industry.

The author can be reached at pww@pww.org.