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THE STATE OF AMERICA'S CHILDREN YEARBOOK 1998 discretion to obtain higher rents to compensate for the loss offederal subsidies. Yet such action could deprive the neediest families of public housing or Section 8 assistance for years to come. For example, in a community where the median annual income is $35,000 (about the national average), a new applicant for public or assisted housing would need an income of more than $17,500, whereas the average income level ofcurrent tenants is only about $8,000 per year. What needs to be done. What action can be taken in the coming year to help ensure decent, affordable housing for low-income families with children? Advocates can work to persuade Congress and the Administration to continue targeting the great majority offederal low-income housing assistance to those who need it most-households with very low income, particularly those with children. It is also vital to provide adequate funds to operate and modernize public housing and to expand Section 8 rental assistance to more families, especially because so many are living in poverty or leaving the welfare rolls. Low-income Americans need affordable housing ifthey are to go to work, hold permanent jobs, and "make work pay." Another goal should be to prevent local housing agencies from giving preference exclusively to families with higher incomes. Although it is desirable to include more working families in these programs, denying assistance to the lowest-income families means abandoning some of our neediest parents and children, many ofwhom are homeless now. Advocates can also be effective at the local level by researching the need for affordable housing and the impact of welfare reform in their community. Advocates should put together coalitions to work on these issues and call on local, state, and federal officials. Thrning around the housing crisis will require not only a renewed commitment from the federal government to developing ample low-income housing, but also much more active involvement of state and local governments and the private sector. Failure to act jeopardizes the well-being and security of millions of poor children. A society that does not ensure adequate shelter for its most vulnerable members has failed to meet one of its most important challenges. 20 CHI L D R EN'S D E FEN S E FUN D
CHAPTER CHILD HEALTH dequate health care is essential for every child. Without it, children may suffer enormously, losing the chance for a healthy start in life and a productive future. Untreated medical conditions often worsen over time and can lead to permanent disabilities. In some cases, lack of medical care may cost children their very lives. Poor health can also jeopardize children's ability to succeed in school and in later jobs. Yet more than II million American children lack health insurance today, and the percentage of children without health coverage has risen in recent years to the highest levels ever recorded by the u.s. Census Bureau. The vast majority of uninsured children, more than 90 percent, have parents who work. However, as more and more employers have made dependent health coverage more costly for employees or dropped it altogether, fewer families can afford private insurance. In the past year, extraordinary strides were made in expanding children's health insurance coverage through landmark legislation that may help up to 5 million uninsured children. Intensive efforts are required in all 50 states for children to benefit fully from this new law. States now have an unprecedented opportunity to make high-quality, affordable health care more widely available to uninsured children and to dramatically improve the health of millions. Child Health: 1973 to 1998 Child health has improved in important ways over the past 25 years. For example, infant mortality and preventable childhood illnesses have declined substantially. Change has also swept the country's health care system, profoundly affecting access to health care for children. Notably, a nationwide shift to managed care delivery systems has altered the way many children receive health services. In addition, two dramatic and contradictory trends have emerged: a steep decline in employment-based coverage for children and significant increases in the number of children covered by Medicaid (health insurance coverage for lowincome children and families, for elderly individuals, and for people with disabilities). According to two different federal surveys, private coverage ofAmerican children (most ofwhich is employment-related) dropped more than 7 percent between 1977 and 1987 and another 7 percent from 1987 to 1996. Meanwhile, the number of children covered by Medicaid rose from between 9 CHI L D R EN'S D E FEN S E FUN D 21
Page 2 and 3: About CDF he Children's Defense Fun
Page 4 and 5: Copyright © 1998 by Children's Def
Page 6 and 7: Acknowledgments Susanne Martinez, d
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