STRUGGLING TO SAVE OUR KIDS Many more than ever face the crises of childhood: violence, drugs, bad schools, poverty, divorce, or two parents at work. And no one seems to care.
(FORTUNE Magazine) – IF THE WELL-BEING of its children is the proper measure of the health of a civilization, the United States is in grave danger. Of the 65 million Americans under 18, fully 20% live in poverty, 22% live in single-parent homes, and almost 3% live with no parent at all. Violence among the young is so rampant that the American Academy of Pediatrics calls it a public health emergency. The loss of childhood innocence is a recent phenomenon, affecting all income levels and all ethnic groups. Playground fights that used to end in bloody noses now end in death. Schools that once considered talking in class a capital offense are routinely frisking kids for weapons, questioning them about drugs. AIDS has turned youthful experimentation with sex into Russian roulette. A good public education, safe streets, and family dinners -- with both mother and father present -- seem like quaint memories of a far distant past. The bipartisan National Commission on Children wrote in ''Beyond Rhetoric,'' its 1991 report, that addressing the unmet needs of American youngsters ''is a national imperative as compelling as an armed attack or a natural disaster.'' FORTUNE is unwilling, as some policymakers implicitly are, to write off an entire generation of kids. FORTUNE is unwilling to wait for today's children to grow up -- or to die young -- before speaking out in support of their welfare and their future, which, after all, is our welfare and our future. That's why FORTUNE has devoted this issue to Children in Crisis. The stories in it do not simply recount the problems of growing up in America in the Nineties; they offer solutions to those problems. Solutions cannot come fast enough. Consider: -- Every day, more than 25% of women giving birth, 2,900 in all, will have received no prenatal care in the first trimester of their pregnancies. And 25% of that group will have had late care or none at all. Their babies are far more likely to be under normal weight, to have learning disabilities, and to die in their first year of life than children who have had prenatal care. -- Children under 16 make up the largest group of Americans without medical insurance. And 56% of kids without health insurance live in households with incomes above the poverty line. The U.S. infant mortality rate, 9.8 per 1,000 live births, is higher than that of 19 other industrialized nations, including Spain and Singapore. The proportion of U.S. nonwhite 1-year-olds immunized against polio, measles, and other preventable illnesses lags behind that of 55 other nations, including Iraq and Libya. -- The parents of nearly 2,750 children separate or divorce each day. More than half of all white kids and three-quarters of African American children under 18 will spend some part of their childhood in a single-parent household. -- Every day more than three children die of injuries inflicted by abusive parents. Nearly 90 kids a day are taken from their parents' custody and added to the overburdened foster care system. -- Mothers of children under 6, the fastest-growing segment of new entrants to the labor force in the 1980s, struggle to find child care solutions for their 11 million children. Some 1.3 million latchkey kids ages 5 to 14 are left to fend for themselves for much of the day. -- The typical 14-year-old watches three hours of television daily but does just one hour of homework. During the average school day, more than 2,200 kids drop out. These kids are 3 1/2 times more likely to be arrested and six times more likely to become unmarried parents than those who graduate. -- Every day over 500 children ages 10 to 14 begin using illegal drugs, and over 1,000 start drinking alcohol. Nearly half of all middle-schoolers abuse drugs or alcohol, or engage in unprotected sex, or live in poverty. -- Over 1,400 teenage girls a day -- two-thirds of them unmarried -- become mothers. Only 60% of these teen moms will earn a high school diploma or its equivalent. -- Among 15- to 19-year-olds, homicide by firearms is the third-leading cause & of death (after motor vehicle crashes and suicide) for whites, and the leading cause of death for blacks. EVEN IN THIS election year, when domestic issues dominate the presidential campaign, politicians find it easier to embrace children than their issues. Kids cannot vote. They don't fill the coffers of political action committees. And they lack the lobbying clout of the elderly, on whom the federal government lavishes $354.5 billion each year -- five times more than it spends on children -- though the population of Americans over age 65 is less than half that of children under 18. People of all political persuasions should be able to find areas of agreement. Despite their emphasis on ''family values,'' most conservatives recognize that today's families are vastly different from the ones they grew up in. And few big-government liberals can disagree with Ronald Reagan's former Education Secretary, William Bennett, who says, ''Trying to legislate solutions to help distressed children is the equivalent of trying to save a patient by implanting an artificial heart. Only healthy families headed by responsible parents in caring communities can succeed in raising healthy kids.''
Corporate America's stake in children couldn't be clearer: The well-being of kids is a competitiveness issue. Business knows well how important education is. If current trends continue, more than 20% of today's sixth-graders will quit before graduating from high school. The Committee for Economic Development (CED), a business-backed research group, estimates that each year's dropouts will earn, in aggregate, $237 billion less (measured in 1990 dollars) over the course of their working lives than those who receive a diploma. That reduced spending power will slow economic growth, lower living standards, and further widen the gap between the haves and the have-nots. As the tax base shrinks, government will be forced to lift spending for welfare, prisons, and the other adversities of a growing young adult population ill- equipped to lead productive lives. By our continued neglect, a 1991 CED report warns, ''we are jeopardizing America's survival as a free and prosperous society.'' Fixing schools alone won't solve the problem. Chester E. Finn Jr., an education specialist currently at the Edison Project, which is trying to start a chain of private elementary schools, points out that of all the hours children are alive from birth to age 18, only 9% of them are spent in school. Says William S. Woodside, chairman of Sky Chefs Inc., who headed the National Commission on Children's corporate advisory board: ''Nothing business hopes to achieve in the areas of school reform and building a better-skilled work force will happen unless it starts paying attention to early childhood development.'' Employers are rapidly stepping up their commitments to helping young children by easing the burdens of working parents. From 1986 to 1989, the number of companies offering child care assistance programs to employees more than doubled, to 5,400. Of course, those efforts can't reduce all the stress on dual-career families. Ron James, CEO of the Minnesota operations of US West Communications and co-chairman of the state's Action for Children Commission, grew up in a poor black family headed by a single mother in Port Arthur, Texas. But he recalls fondly the values imparted through leisurely conversations around the dinner table. Now families are too busy for that. ''The new mode of communication between parents and children,'' he says, ''is through notes held to refrigerators by magnets.'' More dangerous, and increasingly more common, modes of family communication: beatings, brutal language, and intimidation. In some families parents don't communicate with their children at all. Because of alcoholism, overwork, or indifference, there are no stories, no family folklore, no joking around, no values, no discipline. Simply ratcheting up the efforts of the present welfare system by adding programs and channeling more money will not help poor children, those most at risk. As many states and localities are discovering, the problem isn't too few programs but too many. In a report last February, Minnesota's Action for Children Commission found that the state spends $4.5 billion on schools and other children's programs annually, but that river of money trickles through some 250 youth and family agencies in 32 different departments, each with its own eligibility and accountability standards. What's needed is cooperation among public and private youth services, coordination on a community-wide basis, and concentration on preventing problems early instead of dealing with crises when they get out of hand. How can corporations help? James Renier, CEO of Honeywell, thinks business can bring to organizations that work with children the same emphasis on quality, customer orientation, and benchmarking that has been the hallmark of corporate restructuring. But more business people must be involved. Says Renier: ''We won't start moving the rock pile until the day we begin shoveling.'' THE MOST SUCCESSFUL and cost-effective interventions on behalf of children and families are those undertaken early in the child's life -- even before the child is born. Each dollar spent on early prenatal care, for example, saves $3.38 on intensive care in a hospital neonatal nursery. Douglas W. Nelson is head of the Annie E. Casey Foundation, a child-oriented philanthropy established by James E. Casey, founder of United Parcel Service, in honor of his mother. He says, ''Allowing problems to become full-blown is the expensive way to solve them. If we get just a little better at prevention early in a child's life, we can afford to do a lot more of it.'' That impressive rate of return doesn't include the biggest dividend -- a reduction in the misery of babies like Nicole (as we have chosen to call her), born at Metro Health St. Luke's Medical Center in Cleveland just before dawn on June 5. Nicole's mother, 33, an unwed cocaine addict, had already given birth to two other children -- a boy, now 17, and a girl, 3. Both had been removed from their mother's custody. As with her earlier pregnancies, Nicole's mother first saw an obstetrician after her labor pains had begun. Still, of the 15 or so drug-exposed babies born at St. Luke's each month, Nicole was one of the luckier ones. Since she was delivered at full-term, her near-normal birth weight and fully developed organs made it easier for her to withstand the two weeks of drug withdrawal tremors that wracked her body beginning when she was three days old. Her relative sturdiness also sustained her during ten days of intravenous antibiotic treatments to eradicate any of the treatable sexually transmitted diseases to which she may have been exposed in the womb. When this medical ordeal ended, she was ready to be leave the hospital nursery. But she had nowhere to go. St. Luke's overloaded social worker scrambled to line up one of the few foster parents specially trained to care for babies like Nicole. By early fall, however, she will have to be placed into a second foster home to free up space for another crack-exposed newborn. For preschoolers, a most effective childhood intervention effort is the Head Start program. A long-term study of Head Start participants at the Perry Preschool Project of Ypsilanti, Michigan, found that $1 spent on good preschools lowers expenditures for special education, welfare, teen pregnancy, and incarceration of criminals by $6. The Bush Administration and Congress committed to extend Head Start to all low-income preschoolers by 1994. They still have a long way to go. Last year's appropriation of nearly $2 billion raised outlays 26%, but that was just half the $800 million increase needed. Only 6% of existing Head Start centers are open full days year-round, though 32% of all participating parents -- the vast majority of them single mothers -- work full time. What about children who don't get a Head Start? Gregory (not his real name) is one of the 87% of the 10,000 Head Start-eligible children in Minneapolis whom the program does not reach. In 1990 he entered a kindergarten in a mostly minority neighborhood. Though he showed no signs of learning handicaps, Gregory, 5, was unable to identify shapes and colors or speak in complete sentences as most of his classmates could. Because he had never been around other children in a structured setting, sharing and taking turns were alien concepts to him. During mealtimes, Gregory would grab his food and wander off as the other children sat at tables and ate with forks and spoons. At the end of the term, his class was given a test requiring them, among other things, to distinguish the letters of the alphabet. Nearly all the children passed, but to Gregory the alphabet remained a mystery. Gregory is already at risk of dropping out one day. Recently business and community leaders in several cities, including Minneapolis-St. Paul and Savannah, have begun coordinated efforts to help children like Gregory. In Minneapolis-St. Paul, Honeywell and other major employers, among them General Mills, the Dayton Hudson retail chain, and American Express's IDS investment advisory subsidiary, joined forces with the United Way, city and state government, and organizations serving children and parents to pioneer an innovative early childhood development program called Success By 6. Its aim: to assure that every child enters school healthy and ready to learn. If that sounds familiar, it's because President Bush's first goal in the Administration's ''America 2000: An Education Strategy'' is strikingly similar: ''All children will start school ready to learn.'' Success By 6, started in 1988, came first by three years. It aims to knock down barriers that make it difficult for parents and young children to receive nutritional, medical, and counseling services. All the groups involved cooperate to meet the targets of ensuring early prenatal care to every pregnant woman, immunizing all preschool children, and helping young parents develop child-rearing skills that foster early learning and reduce abuse. Corporations in and around the Twin Cities are financing an aggressive communications campaign to convey the importance of children's well-being to the entire community. Success By 6 is now being replicated in 25 other cities. Taking a broader approach, Savannah launched its Youth Futures program in 1988. Financed initially by a grant from the Annie E. Casey Foundation, the program hopes to reach all the city's at-risk pregnant women and children from birth through high school. How? With one-stop neighborhood family centers that will coordinate the services of 20 state, city, and private agencies. Youth Futures plans to track by computer all the families it helps, periodically evaluating children's health status and educational achievement and offering continued follow-up support. The Casey Foundation has funded similar Youth Futures startups in four other cities. Of all the risks children face, poverty and the irresponsible parental role models bred by a welfare system that fosters dependency are arguably the most pernicious. Children today are America's poorest citizens. Some 13 million youngsters -- two million more than in 1980 -- live in households whose annual incomes fall below the poverty line. Kids reared by young and single parents are the worst off. A study by the Children's Defense Fund found that 40% of kids whose parents are under the age of 30 are poor -- double the proportion since 1973. Three-quarters of the children of single parents will live in poverty during at least part of the crucial first ten years of their lives. POVERTY, along with the violence and hopelessness it breeds, has been the major factor in the staggering rise in the number of children removed from parental custody. In 1990 a record 407,000 minors were placed in foster homes -- up 66% just since 1983. While some of the forced separations result from the physical or sexual abuse that grabs tabloid headlines, most stem from parental neglect -- or inability -- to provide basic food, clothing, or shelter. A combination of abuse and neglect required Detroit's Department of Social Services and the police to remove a 9-year-old girl we will call Janice and ^ her four siblings from their 32-year-old mother in the middle of the night in 1988. The scene that greeted the cops and the social worker when they arrived at Janice's home -- the tenth the family had lived in during her life -- was one of five dirty, ill-clad children crowded into a barely furnished apartment. Confused and terrified, the children were separated into two groups, piled into police squad cars, whisked away. Though the child welfare agency found a caring, seasoned foster parent to take Janice in, she soon rebelled. Like many deprived children who don't know when they might receive their next meal, she hoarded food. She would scream for hours at a time and bridled at the discipline her foster mother imposed in the first structured environment Janice had ever known. After she falsely accused her foster guardian of abusing her, the authorities were forced to move Janice again -- this time to a more closely supervised treatment home. During weekly visits with a caseworker trained as a therapist, it came out that Janice and another of her sisters had been sexually abused by her mother's boyfriends. Two years into her counseling, Janice is now attending school regularly and getting above-average grades. By summer's end, her caseworker hopes that Janice will be able to be reunited with her mother and other siblings, all of whom have received counseling. The burdens on the nation's foster care system are now so heavy that frustrated care givers are dropping out. Since the mid-1980s the number of foster parents has declined from 137,000 to 100,000 as demand for placements has swelled. Straining to keep up, states have begun shifting course: They now try holding troubled families together instead of pulling them apart. In Michigan a new family-preservation effort called Families First relies on intensive intervention by case managers, who work with parents and their children in their homes and are available 24 hours a day over a four- to six-week period. The concept behind the program, says Susan Kelly, its director, is that ''the state can never be a good family for children.'' The family-preservation approach represents an about-face in how child welfare agencies view their clients. Says Kelly: ''We were so busy documenting the family's deficits that we ignored its fundamental strengths.'' To build on those underlying bonds, caseworkers -- who typically help just two or three families at a time over a brief period, vs. the 50 or more drawn-out cases that most social workers must cope with -- can use their budgets flexibly for anything from defraying transportation costs for a mother looking for a job to registering a child in a substance-abuse program. Early evaluations of the program show promise. Over 80% of the 2,400 families who have participated in Families First are still together. In the 18 Michigan counties that have the program, new foster care placements have fallen 10%, compared with a 28% increase in those where the approach has yet to be tried. Families First is also far less expensive than foster care: an average of $4,500 per family, vs. $14,000 for each child placed with a foster parent for a year. If a child ends up in a juvenile detention facility, the state could pay up to $86,000 annually. The goal of reforming the perverse welfare system should be to preserve and strengthen families. Yet the principal form of public assistance, Aid to Families With Dependent Children (AFDC), is aggressively antifamily. AFDC reaches fewer than 60% of children living below the official poverty level ($10,857 a year for a family of three). It undermines a single parent's incentive to work by withdrawing a dollar of support for each dollar of earnings and discourages welfare mothers from marrying a man who works but doesn't earn very much. In doing so, AFDC deprives children of both sustenance and a socially productive role model. A bipartisan bill sponsored by Representatives Thomas Downey, a New York Democrat, and Henry Hyde, an Illinois Republican, now in congressional hearings, offers a promising way out of the child poverty trap. The Downey/ Hyde bill would change federal tax law to replace the current dependent income tax exemption of $2,050 with a refundable $1,000 tax credit for all children. This would be much more valuable than the tax exemption for the children of the poor. Trouble is, it would be costly -- an estimated $44 billion -- and a way to finance it would have to be found. One unquestionably good part of the bill would step up efforts to identify fathers of illegitimate children and collect child support payments from absent parents. Only 25% of divorced and separated parents who are left with the kids now receive the full amount of court-ordered child support from the absent parent. From all those contributing any support, payments average a meager $52 a week. Children born out of wedlock usually receive nothing from their fathers. ( Under Downey/Hyde, the Internal Revenue Service would collect part of the father's income from each paycheck, like the payroll withholding tax for Social Security, and remit it to his children's mother. This would eliminate repeated skirmishes in family court between balking fathers and mothers demanding that they pay up. Columbia University sociologist Irwin Garfinkel calculates that obligatory parental support could yield single parents with children over $24 billion a year -- about four times as much as they currently receive. More important, Garfinkel thinks, the new system would remove some of the welfare stigma by demonstrating to kids that their parents, not the state, are looking after them. Beyond poverty, the other gaping hole in children's social safety net is inadequate health care. While federal Medicaid coverage will expand to reach every poor child under age 6 by 1994, low-income youngsters from 6 to 18 will not get coverage until the end of the decade. Thus, many children of the working poor and long-term unemployed go unprotected. BLUE CROSS of Western Pennsylvania created its Caring Program for Children to provide low-cost health care to 40,000 poor youngsters in its 29-county region who do not qualify for Medicaid and lack private insurance. Included: Clyde Waltenbaugh, 8, who suffers from lupus and another chronic ailment. Launched in 1985 as steel mills shut down, the program enlisted the support of local businesses, churches, civic groups, hospitals, and 12,000 physicians to cover uninsured dependent children from birth to age 19. Operating as a charitable foundation, the Caring Program solicits individual and corporate contributions of $156 per child. Blue Cross of Western Pennsylvania and Pennsylvania Blue Shield match each contribution and absorb all of the $1.5 million administrative costs. For that, every child gets a year of routine doctor visits, diagnostic tests, immunizations, emergency care, and outpatient surgery. Since its start, the program has reached 19,000 children, and it has expanded to 19 other Blue Cross regions around the country. Eugene J. Barone, Blue Cross of Western Pennsylvania chairman, sees the community's mobilization as one of the Caring Program's biggest successes. Says he: ''When people hear about the 12 million uninsured American children, they throw up their hands in despair. But when businesses and citizens set to work tackling the problem in their localities, they can have an enormous impact.'' ^ Teenagers, failed by parents, schools, and communities, are perhaps in the most danger. Today some 600,000 feral youth roam the streets of America's cities and towns -- long since having given up on school and putting themselves at risk of crime, drug addiction, and, increasingly, AIDS. Ronnie Lemieux, 16, was one of them. He was born in a blue-collar neighborhood of Boston, the youngest of three children whose father left when he was 2. For the next ten years the family lived with Ronnie's maternal grandmother, who provided the structure and love that their frequently absent mother could not. But when the grandmother died four years ago, Ronnie and his fragile family had to fend for themselves. As the Lemieux family wandered from apartment to apartment around Boston, Ronnie would enroll in a new school -- eight over the next four years -- but never went to class. He would hang out with friends on the streets where their mischief soon turned to drugs and crime. By 14, his daily drill involved buying a 40-ounce bottle of beer for breakfast, scoring some ''herb'' (marijuana), and downing more beer for lunch. For money, he and his friends broke into homes and mugged an occasional passer-by, but they soon found dealing drugs far more profitable. Ronnie says he would earn several hundred dollars a week selling ''angel dust'' and cocaine. He bought a 9-mm handgun for protection. After a fistfight with his mother's boyfriend, he left home for good. By the time Ronnie turned 15, he had seen a close friend killed and had been wounded himself. When, finally, the Massachusetts Department of Social Services caught up with him last winter, even Ronnie knew that his life had become too dangerous to continue unchanged. He was referred to a private local group called Bridge Over Troubled Waters that works with homeless youngsters and was offered a place in its South End ''independent living'' residence. During the three months since moving into the Bridge facility, Ronnie has begun putting his life in order. The tightly structured but supportive program requires all its youngsters to attend school and hold a job. Otherwise: eviction. Despite his spotty education, Ronnie has already passed his high school equivalency exam. He works full time at a Cambridge restaurant and is saving money for college. ''I'm determined to change,'' he says. ''Nothing they ask me to do is hard because it is what I want.'' And if he hadn't found a last chance with Bridge? ''I'd have no choice but | to go back to selling drugs,'' he says. ''By 18, I'd be dead.'' For the health of its own civilization, America just cannot afford to let Ronnie fail again.
CHART: NOT AVAILABLE CREDIT: FORTUNE CHART/SOURCE: CONGRESSIONAL BUDGET OFFICE CAPTION: THE OLD VS. THE YOUNG
CHART: NOT AVAILABLE CREDIT: RENEE KLEIN FOR FORTUNE/SOURCE: U.S. BUREAU OF THE CENSUS CAPTION: YOUNG AND UNINSURED
CHART: NOT AVAILABLE CREDIT: RENEE KLEIN FOR FORTUNE/SOURCE: U.S. NATIONAL INSTITUTE ON DRUG ABUSE CAPTION: DANGEROUS VICES