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to more than 20 percent, creating the prospect that the current generation could be less healthy than their parents.

“The most common diseases of the past were acute illnesses or infections, but today’s children and youth face more chronic conditions that will impact them for the rest of their lives — diseases like asthma, diabetes and mental health problems like ADHD and depression,” Halfon said. “These emerging health needs are simply not being addressed.”

The authors call for ground-up reforms to the U.S. child care system that include:
? making transformation of the child health system a national priority.
? improving overall system performance by consolidating the fragmented array of programs scattered across various federal departments and agencies into a new national child health development agency that can take the lead in advancing the child health agenda.
? ensuring that all children have health care coverage that is responsive to their unique developmental health needs; that coverage is comprehensive and includes health promotion, as well as disease prevention services; and that coverage addresses the whole child, including physical, mental, behavioral and developmental needs.

The authors warn that transforming the child health care system is not only an ethical and social imperative but an economic one.

“The outmoded operating system and obsolete logic employed by the U.S. child health system is analogous to a modern business ignoring the Internet, Windows and new Pentium processors and running their operations using MS-DOS on separate and unconnected 286 machines,” Halfon said. “It worked in the past, but it is not very effective and efficient for a competitive business, nor is it appropriate for a health system that needs to produce health outcomes that will help our children compete in the future.”

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