Research identifies many low cost, practical approaches for policy makers to make big improvements in child health, even if poverty remains persistent.
Removing flakes of leaded paint from older homes improves children’s school test scores as much as cutting class sizes by a third, but at a fraction of the cost, according to our research.
This is one of a series of findings showing how relatively small, practical and inexpensive changes can have a considerable impact on children’s health and lifelong prospects. Amid the gloom that often surrounds the stubborn prevalence of childhood poverty, policy makers should understand how much they can achieve for children’s health using methods that are both financially and politically feasible.
“A similar level of educational improvement was secured by a program that reduced class sizes from 25 to 15. But the costs were about five times higher per child, compared with tackling the flaking leaded paint.”
We studied levels of lead in children’s blood following a low-cost program in Rhode Island in the United States that required landlords to stabilize leaded paintwork in older rented homes. Removing all the paint in these properties would have been prohibitively expensive. Getting rid of flaking paint was more realistic. Children living in these repaired homes were found to have reduced levels of lead in their blood and, as a result, achieved higher test scores at school. A striking feature of these findings was how the costs and benefits stacked up against other programs. For example, a Tennessee program produced a similar level of educational improvement by reducing class sizes from 25 to 15, but it cost about five times more per child. Removing flaking paint also has an element of racial justice – African-American children particularly benefited, because they disproportionately live in poorly maintained, rented housing.
Many other inexpensive changes could have sizeable impacts on children’s health. For example, influenza can be harmful both early in a pregnancy, when it is linked to cognitive effects in children, and also later in the pregnancy, when it is linked to premature birth. We recently found that influenza leads to a spike in prematurity among U.S. babies born in the winter. Increasing flu vaccination rates for pregnant women, as the U.S. Centers for Disease Control recommends, could make a significant difference.
We’ve also shown how living near an industrial plant that emits toxic chemicals can affect children’s health. Among families living within a mile of a plant, infants’ health improved when plants closed down and declined after plants opened. We detected no effect in infants living two miles away.
These findings show that it’s possible to mitigate the effects of pollution by zoning, because many pollutants don’t travel far from their sources. The same is true for pollution from busy roads. In the long run, we could engineer cleaner vehicles and encourage more people to take public transport. But, in the meantime, a quicker and less expensive win for policy makers could be to use zoning to keep housing, schools and playgrounds a healthy distance from freeways. Our research bolsters the case for such policies. We studied the health of children born to mothers who live near toll plazas. We found that when the freeways switched to electronic toll collection, which greatly reduced traffic congestion and vehicle emissions near the plazas, mothers living nearby had fewer premature and low-birth-weight babies.
Our work shows that policy makers need to know and act on some of the easy options for tackling the consequences of childhood poverty. We’ve already achieved a lot through this approach: trends for the health of young children raised in poverty are positive, with reduced mortality rates, in contrast with stalled mortality rates for some middle-aged groups. Targeted nutrition support is helping children’s health: supplemental feeding for infants and children has greatly expanded in the US and has had a positive impact. Both school nutrition programs and the food stamp program have also improved children’s health.
Changes in the environment have also had an impact. Air pollution has been reduced. Removing lead from gasoline has reduced blood lead levels. More care is being taken with hazardous waste, which can harm children both in the womb and as infants. Children’s toys are better regulated. A huge decline in smoking has reduced children’s exposure to second-hand smoke. Accidents, which are a major killer of children over age 1, have been declining in all countries, thanks to a host of factors that include better education and awareness as well as tougher regulations. For example, we now have safer cars, fall bars on windows in apartment buildings, and temperature limits on hot water heaters.
These considerable achievements – on top of fresh insights from research – don’t remove the urgency of finding global solutions to reduce persistent child poverty. But they challenge what can be a gloomy narrative. We can make a lot of improvements using inexpensive, effective ways to transform the prospects for children’s lives.
Header photo: USAG- Humphreys. Creative Commons.
Aizer A & Currie J (2014), The intergenerational transmission of inequality: Maternal disadvantage and health at birth, Science 344.6186
Currie J (2013), Pollution and infant health, Child Development Perspectives 7.4