Alive and well - our children's health - Cover Story

Nothing is more heartbreaking than a sick child. And in this country many of our children are in ill health from the time they are born through their teenage years. Far too many of them don't ever live to see their eighteenth birthday.

In the last several years, AIDS has added to the devastation by killing thousands of children and leaving scores of others motherless. More than half of all pediatric AIDS cases are Black children, and two thirds of the women who are stricken with AIDS are African-American.

Other facts about our children's health are equally astounding:

* Black babies are more than twice as likely as White babies to die in the first year of life. This infant-mortality rate is higher than those in many Third World countries.

* Nearly one in seven Black babies is born at a low birth weight. Babies like these who are born too small are 40 times more likely to die than normal-weight babies.

* Many of our children die in accidents, many in the home, which are 15 times more common for Black youngsters than for White.

In a health-care system that excludes more people than that of any developed nation outside of South Africa, it is Black children who suffer the most. Many are never immunized against childhood diseases, have mouthfuls of rotting teeth, are not properly nourished or sit in classes unable to see the blackboard. And no one notices. More facts:

* One in seven children - 1.5 million American youngsters - is without any health insurance.

* Fewer than 40 percent of Black children are insured by their parents' health-insurance plans.

* More than 40 percent of Black children are covered by Medicaid. If Medicaid did not exist, more than half of all Black children would be completely uninsured.

* Black infants are more than twice as likely as White babies to lack routine health care.

* At a time when other nations have improved their immunization rates dramatically, fewer than half of American infants and toddlers in urban areas have been vaccinated. The problem is most pronounced among poor children.

Sexual activity, including the horror of sexual abuse of children, is adding to the health problems of our children and adolescents:

* Black teens between the ages of 15 and 19 are more than twice as likely as White teens to give birth. In 1989, more than half the births to girls under 15 were to Black teens.

* Almost half of all sexually experienced African-American girls report that they did not use any kind of contraception the first time they had intercourse, compared with fewer than one in three White girls.

* Rates of syphilis and gonorrhea are many times higher among Black teens and young adults than among their White peers.

What can we do about the state of our children's health? Some communities have found an answer.

A MARVEL IN MARVELL

Marvell, Arkansas, is a poor town in a poor state, and it's the kids who suffer the most. Located in Phillips County, the second-poorest county in the state, Marvell has a poverty rate of 85 percent - twice the countywide average. The small mostly Black community's infant-mortality rate is 34 percent higher than the national average, which means that 13 of every 10,000 babies in the county die before reaching their first birthday. One in four births is to a teen mother - 25 percent more than in the rest of Arkansas.

But something remarkable is happening there. The first thing you notice as you drive into Marvell is a shoe-box-shaped building made of rose-colored cinder blocks. It used to be an abandoned sock factory with a roof so deteriorated that you could look up to the ceiling and see the sky. Today it's the Boys, Girls, Adults Community Development Center, and it is bringing new hope to Black children.

Inside you can see the hope in a tiny health unit where an infant, happily drowsy with milk, is startled awake by the sting of a needle. Her teenage mother knows the hurt is nothing like the pain of having no vaccinations at all. That's what mothers here endured for years. The nearest health facility was 16 miles away, but many mothers lacked a car or the $10 to pay for a ride. There were measles and mumps, rubella and chicken pox. Virtually every child had decaying teeth, the result of long-term bottle-feeding that bathed young mouths in lactose (milk sugar). "We had more failure-to-thrive infants in Marvell than in the entire county combined," recalls Shirley Hicks, administrator of the Phillips County Health Unit for the Arkansas Department of Health.

Today things are different. Marvell's immunization rate for 2-year-olds stands at 60 percent - the statewide average. Mothers learn basic prenatal and infant care from nurses who make home visits. And failure-to-thrive children are a thing of the past.

The difference is the center, a communitywide effort catering to all the child's needs from conception to young adulthood. In the room next to the health unit, which also offers prenatal care and nutrition counseling, an immaculate day-care center teems with happy 3-year-olds. Next to that, middle schoolers listen to a talk about drugs. Down the hall, a restaurant dishes up plates of barbecued chicken, cabbage and corn bread.

To Beatrice Clark Shelby, executive director for 11 of the center's 15 years, one service led logically to another. "We discovered that children couldn't start school because they hadn't been vaccinated on time," recalls the quick-speaking mother of four. "So health became an issue. "The center recently constructed a 39-unit low-income housing project, which was one reason Shelby and the center received a $100,000 Community Health Leadership Award from the Robert Wood Johnson Foundation earlier this year.

The center's accomplishments would be remarkable anywhere. But in a remote rural town with little money, they are astonishing. The center began in the late 1970's, when a group of energetic African-Americans took a hard look at how the town's children were growing up and didn't like what they saw. "The kids had nowhere to go," recalls Gale Thrower, a high-school teacher who helped organize the center. "We wanted to build a place for good kids."

The first order of business was to set up shop. A local community-action agency agreed to let the group use one room in the former factory if they would fix it up. With donated materials and volunteer labor from the local high school, the staff began renovating after school and on Saturdays. When the $150 monthly rent came due, the 15 board members chipped in $10 each. Eventually public and private grants supplemented the center's money-raising fish fries and raffles. Today, with a staff of 25, the center is the town's third-largest employer.

Beatrice Clark Shelby's strategy is simple: Believe that every member of the community has something to offer. And work, work, work. "I was a daydreamer," recalls Shelby, who read voraciously as a girl. "I didn't see things as other people did. I thought about how I wanted the world to be, not how it was."

Raised in the nearby town of Trenton by a single parent, Shelby graduated from Marvell High School in 1966 and obtained a secretary's certificate from Southern Business College in North Little Rock. Since then, she has managed to squeeze in 50 credits toward a business degree at Phillips County Community College in nearby Helena. Because Shelby believes in indigenous leadership, local folks from the community - like her - comprise the board, the staff and 54 volunteers. "When I'm dead, I want this work to continue," she says.

And that may mean that the newly vaccinated infant lying in her mother's arms for a well-deserved nap will be one of Beatrice Shelby's successors.

HELPING KIDS

STAY HEALTHY

HERE'S WHAT YOU CAN DO TO IMPROVE THE HEALTH OF ALL CHILDREN.

* Lobby for universal health care. Write or call local politicians and let them know that every-one - rick, poor and in-between - deserves medical care.

* Encourage medical societies, students and faculties of medical and public-health schools to join campaigns to ensure that infants and children receive proper health care.

* Encourage people in your community to make sure that children are getting proper medical attention. Even if money's tight, you and your neighbors can utilize Medicaid or local clinics.

* Lobby for free immunization for all children. And get your child immunized. For more information and sources of free and low-cost immunization programs, contact your local health department.

* Pool friends, neighbors and family members to help one another get proper care for children. Organize transportation to the clinic or doctor's office or share child care to make going to appointments easier.

* Feed children properly. Like adults, kids should have a diet low in fat, salt, sugar and "junk" and high in whole grains, vegetables and fruit.

* Make sure that your children are exercising. Black kids watch far too much TV, and a disproportionate number are overweight. Find out about sports activities at school or in your community.

* Set a good example by eating right, exercising, stressing the importance of health and not smoking or abusing drugs and alcohol.

* Have discussions with your children about their bodies, sex, sexuality, birth control, pregnancy and sexually transmitted diseases. Initiate these talks when your young children begin showing curiosity, and discuss the facts in more detail when they become preteens.

COPYRIGHT 1993 Essence Communications, Inc.
COPYRIGHT 2004 Gale Group