Starting Right: How America Neglects Its Youngest Children and What We Can Do About It

America has long been heralded as the land of opportunity, but for our very youngest citizens, it is too often a land of despair. Every year, a shocking 32,000 American babies die before they reach their first birthday. More than one-quarter of the children under age three live in families with incomes below the poverty line, and only 67% of children under two get the necessary series of immunizations needed to protect them from life-threatening illnesses. Despite America's world leadership in research in child healthcare and development, in all the statistical indicators of children's well-being--physical, developmental, educational and behavioral--we lag well behind most advanced industrialized societies. While recent years have seen some piecemeal attention paid to policy issues affecting preschoolers aged three to five, our infants and toddlers are still perilously ignored, largely invisible in American social policy.

In Starting Right, internationally recognized child and family policy experts Sheila B. Kamerman and Alfred J. Kahn present the pressing practical, political, and moral reasons why we must invest more time and money in America's youngest children, and their families. Singling out the best of current childcare policies and practices in the U.S. and western Europe, they call for a three-pronged approach to helping parents raise young children well: ensuring adequate income through strategies such as a child tax credit; providing essential services such as children's healthcare, child care, and family support programs; and offering working parents more generous leaves to spend time with their children. Kamerman and Kahn carefully assess the costs of implementing each of their proposals, demonstrating that the price is neither unreasonable nor beyond our means. Drawing on their own studies and all the latest research, the authors show that this investment in our children's early years is ultimately cheaper in both financial and human terms than the alternatives we live with now. For example in 1950, when Finland was just establishing its healthcare system, the infant mortality rate was 43.5 per 1,000 live births. The Finnish system emphasizes free and universal access to healthcare for all citizens, including family planning services, prenatal care, and home visits by nurses to families with newborns. Contagious childhood diseases have now been virtually eliminated, and by 1990 the infant mortality rate had plunged to 5.5 per 1,000, making Finland the world leader in the conquest of infant mortality.

A clarion call to action and a reasoned and attainable prescription for change, Starting Right lays the groundwork for providing all of America's youngest children with the fighting chance they deserve to lead happy, healthy, and productive lives. At stake are our children's futures, and America's future as well.