Child Advocacy

...And meanwhile, year after year children die...

...When Marion Wright Edelman started the Children's Defense Fund, it was in part to find a new route to improved civil rights...

...Calling themselves the Coalition for America's Children, the original steering group of a dozen or so included children's hospitals, educators, the Association SPRING • 1993 • 215 Child Advocacy of Junior Leagues, and the Association of Child Advocates...

...for too many children the array of categorical programs presented almost as many barriers as opportunities...

...We make excuses for community leaders who claim to know how to run a business or a government, but not to understand why prenatal care is important or how child welfare services work...

...Or, as Elizabeth Wickenden has noted, by the fact that the children we want government to help come attached to parents we don't much like...

...An administration presided over by the Clintons and the Gores (all four avowed advocates for children and families) and a new Congress with record numbers of women and people of color hold out additional reason for hope...

...Until fairly recently, child advocates were more typically liberals, comfortable with the notion of activist government, and drawn from a fairly narrow band of associations— including mainline churches, helping professions, and the solid (but usually unmoneyed) middle class...

...It is as though the circuits capable of taking in bad news have been overloaded: being aware of the problems translates into being overwhelmed by them...

...Now it falls to advocates to deal directly with some of the reasons for inaction and join quickly around a few specific proposals for which a consensus is already partly formed...

...Almost by default, the 1980s forced children's advocates to forge a new kind of coalition politics...

...Before long many children in desperate need were falling through the cracks...

...It is not a cliché to say that these are matters of life or death: in America every year, thousands of children die unnecessarily because of choices made by adults who know better...

...Each will be less devastating for the teen and her baby if prenatal care is assured...

...The new element was that this time they organized politically...

...22 live in families with at least one full-time, year-round worker...

...and every state...

...Since Hawaii became the one state in the nation with universal health coverage and a clear emphasis on prevention, it has racked up some of the nation's best health statistics—even for groups that are usually thought to be at high risk...

...The principal barrier is cost, though there would be large future savings in medical care, remedial education, and social welfare expenditures, along with future social and economic benefits...

...They pledge to "pounce" on public SPRING • 1993 • 217 Child Advocacy officials and others who resort to unfair, unfounded stereotypes about welfare families, racial minorities, and others...

...11 live in families headed by persons younger than 25...

...62 live in families with at least one worker...

...In that context, issue-specific movements made less sense...

...q 220 • DISSENT...

...In November 1991, over 60 percent of adults in a national poll said the top priority for the use of tax dollars should be to "guarantee all children health care, quality education, safe neighborhoods, and economic security...

...The notion of a broad societal responsibility for all of a community's children appears to be catching on...

...By the end of the decade some were even among the voices for a more aggressive government role in children's services—including wealthy Orange County, California, conservatives, who fought for welfare expansion after learning that "volunteering" wouldn't pay the six-figure health-care costs of the babies born to their agency's high-risk teens, and Utah's conservative Senator Orrin Hatch, who became persuaded of the need for federal child-care legislation...

...Focusing on efforts that cost money is not entirely unrealistic...

...If legislators went into the homes of poor children and physically abused them, there would be a public outcry...

...Children may not vote, but their parents (teachers, doctors, grandparents) do, and they can be mobilized...

...Or we could adopt the proposal developed by maternal and child health experts for "Universal Free Maternity Care...

...for too many children, time is running out...

...Stories related to dependent care, child care, or education reforms used to be confined to the "Women's Page," or written as neighborhood news...

...And always there is the nagging question: Given all that is known—about lead-paint poisoning, low birthweight, hunger, homelessness, poverty, violence—why is there still so little action...

...money will be raised and spent by countless local charities and corporations...

...The idea had such strong support that Senator Abraham Ribicoff attached it to the child-care bill then moving through the Congress...

...The same groups that have learned to issue "report cards" on legislators and agencies must build the capacity to "flunk" them when they don't respond...

...Americans feel a deeply ingrained reluctance to have government involved in what are seen as family affairs...

...Lisbeth Schorr made the case brilliantly in her 1988 book Within Our Reach...

...But if all this sounds too polite, too nice—it is...

...Today, media decision makers see children's issues as "hot...

...In schools where the teachers and principals know the children, they are better able to prevent dropping out, retard absenteeism, and increase the possibilities for learning...

...Over time the consequences of that neglect became increasingly evident, until one day, the plight of the children could no longer be ignored...

...Finally, it seemed, attention would be paid...

...Progress toward securing basic health, education, and income support will not come easily, but it would make a dramatic difference in children's lives...

...That's why what appears to be a debate about the use of government funds to sustain life, subsidize child care, or provide for temporary foster care, may—depending on one's perspective—conjure up the image of government as helpmate or as a threat to parental rights...

...she argued convincingly that alleviating any one of the problems facing children reduces the harmful effects of all the others...

...They are discouraged and tired...

...Those who credit the bill's success to "changing demographics" forget that low-income women have always been in the paid work force, and two-earner families of every income group have always faced child-care problems...

...A broad-based campaign might capture some of that money for children first, and for competing interests (deficit reduction, infrastructure improvements, more tax breaks) later...

...But by now there is also strong evidence that intolerance of any kind, including that based on class or welfare receipt, cannot go unchallenged...

...It took decades to develop a consensus around the proper role of government in the lives of senior citizens...

...But it was so poor in spirit that it surrounded its children with violence and left them hungry, homeless, ignored...

...And despite tight budgets, there has been renewed interest in universal solutions as one way to minimize class and racial tensions...

...32 live in suburban areas...

...It was a hollow notion (wealthy volunteers did not make up for lost operating funds), but it had an interesting side effect...

...SPRING • 1993 • 219 Child AdIocf room size should be reduced...

...Since the children at greatest risk came disproportionately from communities of color, focusing on them afforded a less threatening route to improved race relations...

...Several have been proposed in recent years (such as the Children's Defense Fund's "Leave No Child Behind" campaign...

...This collaboration sharply increased the likelihood of children's issues being part of political campaigns waged at every level...

...all include elements of health, education, and income support...

...The job of changing the old mindset is already underway...

...The fight for federal child-care legislation, which helps defray the costs of child care for poor families, was a case in point...

...Then, for older children, school and classA Profile of Poor Children in America Out of 100 poor children in America: 40 are white, non-Latino...

...Third, there is the issue of education...

...Five of these changes deserve special mention, because they frame the context in which any next steps will be taken...

...Practical Steps First, there is the matter of poverty...

...Victories have tended to be piecemeal, grudging, never enough to change the conditions that put so many children at risk in the first place...

...It has that effect in European countries...

...Dominating all policy debates this year are twin concerns: how big the deficits (state and federal) and how small the will for new revenues...

...In that climate, several governors established offices for children and youth, as did many independent groups...

...the lack of basic prenatal care still contributes to infant mortality rates that are among the highest in the industrialized world...

...Parents have variously been regarded as the virtual owners of their children (and government an unwelcome intruder), and at other times as the guardians of a sacred trust...

...Reprinted from The State of America's Children 1992 01992 Children's Defense Fund...

...That is still true, and it is in that spirit that some children's advocates are working to change attitudes toward welfare families by shifting the debate away from "those women" and onto the need to move their children up and out of poverty...

...This question haunts advocates for vulnerable children...

...Victory" became a misnomer if protecting Medicaid services for low-income children meant less money for free school meals or low-cost housing—particularly when the same children were likely to need all three...

...If there is a note of bad news in the changes of recent years, or any leitmotiv to the start of the Clinton administration and the 103rd Congress, it is money...

...f these observations help explain our national inaction, then all is not lost...

...Thus, if there are to be any changes in the tax code, changes to shore up poor families with children should come first...

...A similar consensus about the role of government in the lives of young children with parents is still evolving...

...Until they are dealt with, other policy initiatives would be put on hold...

...that is largely accomplished...

...Even in the face of shrinking budgets, choices will be made...

...Plans to bring low-income families with children above the poverty line (or higher if desired) through the use of refundable tax credits are readily available and should be aggressively pursued...

...1. National opinion surveys record a striking change in the attitudes of the general public...

...But other industrial countries invest more in prevention than we do, and evidence of its value can be put to good use—as the cross-national studies of Columbia University professors Sheila Kammerman and Alfred Kahn show...

...The only issue is initial cost...

...4. There has been a change in the agendas of the nation's policymakers...

...Few (just one in five) think we can't afford to spend more for children because of the deficit, and most (over 80 percent in an Arizona poll) think we'll pay more later if we fail to invest now in programs for children...

...As Wendy Lazarus, a vice-president of California's CHILDREN NOW points out, the timing is bad...

...Federal, state, and local lawmakers now spend more of their time on issues important to children— everything from condoms and clinics in the schools or family leave in the workplace to how children fare in the budget...

...By now child advocates come from all political persuasions, all professions, all classes, all regions of the country...

...The nation's economy will not be quickly repaired, but it is clear that new priorities will guide the allocation of whatever dollars there are...

...We Americans have a tendency to wait until there is a crisis rather than invest up-front in heading off the problem...

...If there is reason for hope as the United States lurches toward the twenty-first century, it is in part because of shifts that occurred in the eighties...

...Now the question: What will it take to speed up the process...

...Task #2 requires building the societal consensus for a shared responsibility for children...

...However, in the 1992 campaigns the leaders were sometimes ahead of the troops...

...It is not that no one ever tried for a stronger commitment to our children...

...Children in trouble are seen as "other people's" (that is, children of color, of immigrants, of poor parents) whereas "our" children (read: white, middle class) are doing just fine—suggesting that an underlying racism or elitism is the real enemy...

...The 1980s only made things worse...

...Such associations help assure that all advocacy groups, including the newest and smallest, can profit from the experience of others...

...5 are Asian, Pacific Islander, Native American, or Alaskan Native...

...It is obscene that in a nation as rich as ours we continue to worry over the language we use or the possibility that someone might be offended by plans that sound idealistic, while year after year the quality of life for our children declines...

...Advocates need to help clarify what constitutes a private family matter and what a matter for public concern...

...For a host of reasons related to confidentiality and privacy it is difficult to politicize the harm being done to children...

...Done right, the effort would strengthen our sense of community and mutual responsibility for the vulnerable among us, remove some of the reasons for voters' distrust of their government, and give hope to troubled communities...

...But in the United States their warnings rarely resulted in anything more than a token response...

...Most would build on the Earned Income Credit and other devices already in the tax code, and some are related to proposals for more aggressive enforcement of child support...

...For example, if it is only possible to assure that poor pregnant teens get early prenatal care, then it's worth doing—even if the teen remains poor, poorly housed, or faced with other problems...

...The demonstrably successful WIC program is in place all over the country...

...it should be fully funded...

...We elect and re-elect political leaders whose priorities are askew...

...Or the reforms are left unimplemented, without the money needed to carry them out...

...Over the years it has gotten broader, deeper, and more sophisticated...

...Neglecting children leads to death more often than does physical abuse, but it is much harder to detect...

...Their task will not be made easier by the growing sentiment that government—not normally regarded as a good parent—should move more quickly to substitute itself for parents who abuse or neglect their children...

...and • Americans like winners, and children are beginning to be seen as losers...

...Second, there is our disturbingly high infant mortality rate—another topic on which both problems and solutions are well known...

...Radio and television now devote far more attention to such issues as child abuse, child care, child health, and education reforms...

...they have...

...But countless small cateSPRING • 1993 • 213 Child Advocacy gorical fiefdoms do not a rational, user-friendly system make...

...Signs of Hope Fortunately the changes of the 1980s went beyond a handful of powerful individuals and some new strategic thinking...

...now they are likely to be covered on the business pages or in front-section news and editorial columns...

...now we agree that when people can no longer work, there is an obligation to provide a minimal level of support and care...

...Not only did she offer evidence that we know what works in several key areas of concern (especially preventing teen pregnancy, dropping out of school, and getting in trouble with the law...

...Using the national networks, for example, successful San Francisco advocates for a tax set-aside for children's services learned from the experience of tax-raising initiatives that failed elsewhere...

...One turning point came in the 1960s when a report by the Joint Commission on the Mental Health of Children called for a consistent voice for children: child advocacy offices in Washington, D.C...

...So the story that began by asking a question ends by providing a sobering answer...

...That's true in the political arena as well...

...Americans feel deep ambivalence toward families in need: torn between wanting to help the children and wanting to punish the parents...

...Throughout the twentieth century that has been the case...

...45 live in central cities...

...That helps explain why significant changes proposed in the past did not win passage, or were so watered-down as to be scarcely worth having...

...From the time when advocates first got together to develop a draft bill in 1986, through enactment in 1990, the campaign to win a federal child-care bill was a model of national sophistication and broadbased, grass-roots passion...

...Groups sprang up around such diverse issues as children born with spina bifida, Head Start programs, families who'd lost a child to crib death, teachers of autistic children, and adults concerned with how the courts treat children...

...There is an almost manic sense of urgency...

...and every year abused and neglected children die while already in state care...

...Ironically, that process was spurred a bit by the Reagan-era belief that when the taxes of the wealthy individuals and corporations were reduced, they would help to fill the gaps, for example, by volunteering for the service agencies whose budgets were being slashed...

...We can't fill the rotundas with abused and wounded kids," says Washington state lobbyist Margaret Casey...

...We have underspent on children for so long that some new spending is necessary...

...Long before the 1992 election results were in, a growing majority of Americans were telling pollsters they would be more inclined to vote for candidates with children's issues on their agendas (67 percent), and would even be willing to pay higher taxes if they felt confident the money would be used to help children (59 percent...

...The 101st Congress (1989-1990) enacted nearly a dozen major child-related laws, thanks in part to the presence of two women in the Senate and twenty-nine women in the House...

...In the early decades advocates were strong enough to win creation of a federal Children's Bureau and child-labor laws, and in 1935 to win provisions in the Social Security Act for maternal and child health programs, child welfare services, and income supports for needy children (the precursor to AFDC...

...So long as funds (public and private) continued to flow along categorical lines and public budgets were expanding, a categorical, highly intensive form of organizing and advocacy often was best for winning immediate, tangible results...

...4 live in male-headed families...

...Making complex problems understandable is what good advocacy is all about...

...44 live in families with incomes of less than half the poverty level ($6,962 for a family of four...

...They used common polling and focus-group information to develop a single bipartisan message ("Who's For Kids and Who's Just Kidding"), along with common logos, videos, and information kits...

...Fred Brancato, who deals with New York City children needing out-of-home care, observes, "We used to get children needing `rehabilitation,' but many of the children needing care now have never been 'habilitated.' " That is a whole new ballgame for advocates and service providers...

...Those who accepted the invitations then became informed about the needs of their adopted agencies and the inadequacy of volunteer efforts for the task...

...Advocates are as conscious of the problem as anyone...

...And while she is quick to point out that more money isn't the only answer, it is the right answer when demonstrably effective, lifechanging benefits still reach only a fraction of the children eligible...

...5. The last change worth noting is to some degree responsible for all the others: the advocacy community has changed...

...Their interests are as much commercial as humanitarian, but the results are the same: meeting children's needs is becoming part of the business community's agenda...

...17 live in families with two or more workers...

...But when public officials neglect abused or troubled children through inadequate budgets, untrained and overloaded child welfare workers, or subpoverty welfare grants, there is little outcry—though the consequences may be more devastating and long lasting...

...And yet .. . . Child advocates may have a growing mastery of the policy process, but they've also faced years of escalating numbers and worsening needs...

...A deep recession affected private as well as public giving, public budgets were slashed, and the prevailing philosophy in the White House was a commitment to ending the social welfare role of government...

...22 are Latino...

...Rather, it is that a country that takes the plight of its children seriously would give these items the first attention, the first dollars...

...It isn't that no one would speak for the children...

...For the future, then, task #1 is a continuation of work underway: to broaden and politicize the base...

...Similar accounts could be given for all the other issues that produced legislative victories on behalf of children in a time of rising voter cynicism and shrinking budgets: the fight to expand Medicaid to cover more high-risk pregnant women and children, to expand the Earned Income Tax Credit for low-earning families with children, to win a Younger Americans Act and a Youth Services Act, to win funding for cities hard hit by AIDS and to reform children's mental health services, as well as court battles to win disability coverage for emotionally disturbed children or representation rights for abused and neglected children, and more...

...And always there have been different rules and expectations depending upon whether the parents and children were rich or poor, and whether their reasons for needing help are deemed worthy...

...similar evidence exists with respect to early child development, teen-pregnancy prevention, and a variety of education and social services...

...Moreover, all are in some form already on the advocates' agendas, and all will be helped by the changes that have taken place in public attitudes, the media, the business community, the policymakers, and the advocacy community itself...

...That is, helped by computer bulletin boards, newsletters, and training, some advocacy groups were able to issue reports and attract media attention before they'd actually built a membership base 216 • DISSENT Child Advocacy capable of acting politically...

...Why do we take such cautious steps in support of actions known to be effective, while tolerating policies known to continue or increase the harm...

...each is to some degree amenable to action...

...It is a small step, but significant, that the theme used by the Coalition for America's Children during the 1992 campaigns—"It takes a village to raise a child" —has been cropping up ever since...

...One measure of child advocates' growing sophistication could be seen during the 1992 campaigns, in the form of an unprecedented joint national effort...

...One way to acknowledge that resources are limited while still being an advocate for children is by focusing some attention on a practical, minimalist plan that puts children first and enjoys a broad consensus...

...Head Start, with its record of proven success, could be fully funded and expanded to provide more full-day care for very young children from working families...

...Impediments to Action As discussions with child advocates around the country reveal, there is no single answer, but these veterans identify five elements that begin to explain our national inaction on behalf of children: • Children don't fare better in the political arena because they don't vote, and because we don't yet agree on the proper role of government in the lives of children...

...Along the way, so many new statewide, regional, and municipal child advocacy groups have sprung up that a National Association of Child Advocates has formed...

...And "politicizing" is doubly hard when the harm isn't easily quantified or seen—as in the case of emotional abuse, or neglect...

...The prejudice against poor, single parents runs very deep...

...Task #5 involves taking on the "it's-alltoobig-to-handle" backlash...

...The virtual doubling of women in the Congress and the election of many more women officials at state and local levels nationwide are among the reasons the 1992 election results bode well for children's issues...

...The challenge for earlier times was to document the needs and bring them to the attention of public and policy makers alike...

...Making good on those victories is another matter: in the 1990s migrant children still labor in fields without clean water or sanitation...

...As data compiled by Rutgers University's Center for the American Woman and Politics has shown, women elected officials focus more on social issues such as women's roles as caregivers in family and society, and—conservative or liberal— are likely to compile more progressive voting records on those issues than their male counterparts...

...Task #3 involves taking on any implicit racism or classism underlying inaction...

...Through much of the 1960s and 1970s advocates learned that no matter whether they targeted public or private resources, they got some of their best results by organizing around specific issues with discrete and directly affected constituencies...

...It is time to put children at the top of the list for a change...

...Particular comprehensive education reforms do not yet enjoy a consensus, but two elements of the many recent proposals do...

...40 are younger than six...

...24 live in rural areas...

...Why are we so slow to change the systems that are failing our children (education, health, child protection), given how well and how often the needs and solutions have been set out...

...Task #4 lies in focusing on prevention...

...37 live in married-couple families...

...Viewing children's services as a basic responsibility of government, for example, to be financed from general tax revenues and available to all children, would diffuse many of the race and class tensions distorting current policy debates...

...When Richard Nixon vetoed the child-care bill in 1972, the Ribicoff amendment went down with it, but an infrastructure for child advocacy was in place...

...Now the organizing efforts have to catch up with the technology...

...It is always difficult to get policymakers to put tax dollars into efforts that may not pay off for years, reflecting a political system that feeds on publicity and quick results, rather than long-term investments and proven cases...

...214 • DISSENT Child Advocacy 3. The media's response has changed...

...Children's organizations were among the social agencies that began inviting wealthy conservatives onto their boards...

...The long-term effects of programs like Head Start and WIC (Women, Infants, and Children Supplemental Food Program) are well known...

...If we fail to invest in our children, they argue, before long we will no longer be productive at home or competitive abroad...

...59 live in female-headed families...

...34 are black...

...Child advocates are also working on better ways to humanize the issues for the policy makers, without exploiting children who may be troubled or in pain...

...To paraphrase the president, in the depth of winter, we must force the spring...

...That said, money will be raised and spent by Congress and the new administration...

...Here, too, there are proposals largely in hand...

...Since the late 1980s, when the Committee for Economic Development (consisting of the CEOs of over a hundred major corporations) helped push national childcare legislation through the 101st Congress, business-community leaders have gradually become more aware of the needs and more active in support of quality services for children...

...The argument is not that children 218 • DISSENT Child Advocacy deserve a claim on all available money...

...Happily, these items involve no significant problems of technical design, offer the promise of future savings, and already enjoy broad support...

...Once again, money, not design, is the principal issue...

...2. The attitudes of the business community have changed...

...Using data showing that poor pregnancy outcome is a leading cause of uncompensated care provided in hospitals, analysts can show that the additional services would soon pay for themselves...

...The measures needed to reduce infant mortality would also have the effect of reducing low birthweight in infants, which in turn is related to higher rates of ill health, disability, learning disorders, sensory-nervous system disorders, and a generally higher risk of lifetime health and education difficulties...

...It is in part about national leadership, and because we are a democracy, it is about each of us as well...

...And, when the consequences of not acting have been documented for so long and the case is so compelling, what more will it take to quicken the pace...

...Just as children's groups are building real constituencies, public budgets at all levels are collapsing...

...That helps explain why, for example, there have been successful advocacy campaigns in Florida to create special taxing districts for children's services at the county level, and why San Francisco voters agreed in 1991 to set aside a portion of tax revenues to fund children's services...

...Moreover, billions of dollars will be available from savings in military spending (thanks to Ron Dellums's new role as chair of the House Armed Services Committee, the very amounts under consideration will be higher...

...Members of a Utah-based group called POUNCE (People Opposed to UNfair Characterizations Everywhere) represent one approach...

...a number of today's best-known child advocacy organizations can be traced to that time...

...Where it is standard for the parents of all young children to stay home without losing their jobs there is less need for governments to be concerned with the problems of particular parents, the special problems surrounding infant care and sick child care, or any of the "behavior modification" experiments now masquerading as welfare reforms...

...We tolerate tax and budget choices we know will harm children...

...For home-grown comparisons, we can point to Alabama, whose infant mortality rates and other health indices improved after it began spending more on prenatal care and shifted to a focus on prevention...