Dr. Hanshaw is a pediatrician to college students and reflects pessimistically on the current state of the country in which they are coming of age. HIV infection is the leading cause of death in young adults. Conquering AIDS requires us to address also problems of poverty, drugs, and the hopelessness felt by many of those coming of age in urban America. An effort to fight poverty in the Kennedy and Johnson administrations was undercut by the unwinnable war in Vietnam. Major cities are in decline, plagued by enormous social problems One of every four infants born in the United States is born to teen age mothers. In some city hospitals as many as 18% of infants born are exposed to alcohol or hard drugs. Homicide is the leading cause of death among young black men.
Dr. Hanshaw's view is that a fundamental cause of this social unraveling is the breakdown of the American family and particularly the absence of a father. Traditional values have been discarded and not replaced by any better.
The place to begin to turn around decades of neglect must be with the young. Comprehensive programs for underprivileged children such as the Head Start program have been very successful in promoting education, preventive health care, and parental involvement and have been shown to increase school graduation rates and decrease criminal activity. However, because of funding cuts, Head Start now serves only one in five eligible children and although reauthorized by Congress with the aim of serving all those eligible by 1994, the 1992 budget makes it impossible to achieve that goal. Pregnancy in unmarried teenagers is an immense problem which assures poverty in at least two generations. Compounding this problem is the lack of affordable day care.
It would be a mistake, Dr. Hanshaw believes, to assume that our success as a democracy is assured. We must invest in the future and for that we need inspired leaders who understand that children are our most important natural resource and realize that compared with other developed countries we are lagging in child welfare. Dr. Hanshaw quotes Henry Steele Commager that "there are three things we simply must do if we care about posterity: we must preserve the natural resources and take care of the health of our children and end poverty -- all of these things." Dr. Hanshaw believes these things are possible with a sufficiently strong national will.