Saving Children From Generational Harm

Think about the last ninetv days. Consider the adjustments to life that have been forced on us. Now, could you consider your ability to think through the fusillade of activity aimed at you, note issues, and tie those to your experience? Even on your worst day, there was a focus of control, an outlet, a reasoning capability inside your head. A voice that whispered,” You will survive.” And in your mind, that was the default; you would survive, though society might be different. Because you always survived. Perhaps you started to plan, to prepare for eventualities. Maybe you consulted trusted advisors about finances, your will, or moving to Europe.

Now, I’m going to ask you to consider the world through the eyes of a child and think specifically about the implications of policy changes made and proposed.

Children develop infectious diseases with some regularity. Some of these diseases are life-threatening, and in the recent past, we have developed systems to track these diseases so that the harm caused by outbreaks can be diminished. Our experience has been that tracking allows risk reduction and saves lives. Yet the Agency that tracks these diseases has been dramatically reduced in scale.

If we were raised in the 1920s or after, there was more risk of mortality from disease, which has been diminished in the late 20th and 21st centuries because a safe and effective program of vaccination was established through scientific research funded by the federal government and monitored for the presence of risk or the lack of efficacy. Our experience has been that childhood diseases that were lethal in the first half of the 20th century were adequately controlled. Parents could take solace in the reality of at least one safety focus for children they could depend on.

However, executive fiat has eviscerated the Agency responsible for developing new vaccines, and the Agency monitoring vaccines has been similarly degraded.

Children in America have, in the past, been able to depend on education that was reasonably comparable to the best in European and Asian countries. Unless you resided in some poor states, primarily in the South, that didn’t feel everybody needed to get the best education. When that became clear, the federal government reinforced the idea that all men, women, and children are created equal and should all get a good education. Thus, the federal Department of Education was born.

But equality under law has fallen out of favor in some quarters, and the Department of Education is under attack.

Medical care is expensive in the United States, more so than in any other country in the world. Children in most countries are guaranteed health care as a right of citizenship. In the US, healthcare for children and families is an afterthought, and many families whose parents work for minimum wage must decide if they will eat or if they will pay exorbitant rates for health insurance. For these families, the Federal government, recognizing long ago the income disparities that are the reality of life in the US, developed Medicaid. This highly efficient managed care program provides basic healthcare to children, families, and people with disabilities. Problem solved, except successive Republican administrations have wanted to gut the program, and the current administration is making a supreme effort to ensure that healthcare is not a reality for impoverished citizens, child or not.

Children have diseases that are unique and sometimes deadly. Acute lymphoblastic leukemia is an example of a disease that most children did not survive in the early 20th century. Most now survive and thrive despite this diagnosis because of research funded by the National Institutes of Health. Cystic Fibrosis, a prevalent disease of early childhood, was an assassin of kids until the 1990s and beyond. At this point, because of groundbreaking research from the NIH, there is a survivable chronic illness.

Children depend on parents, and parents on jobs in a functioning economy to survive, to eat, to pay rent, to purchase clothing, and school books. What could be worse than having an economy that was the envy of the world and eliminating hundreds of thousands of jobs in the public sector for no reason, increasing the unemployment rate dramatically? Parents take most of that psychological hit, but children certainly get that their lives are now different.

From the perspective of a child advocate, many of the recent executive orders and further proposed legislation seem to be aimed at children. Others would argue the point, but the Federal responsibilities that are being hit all seem to be in areas critical to the health and safety of children. This has been a recurrent theme over the last fifty years for those of us who try to see the world through the eyes of a four-year-old. Four-year-olds don’t talk to adults that much. They do not have the world’s most powerful lobbyists. The American Academy of Pediatrics, the national organization to which I owe the most allegiance, is great, but 75000 pediatricians can’t match the volume of 100 million members of AARP.

The problem is in the title of this piece: “Generational Harm.” That is, disturbances in the fabric of society, not just now, but for years to come. An impact on a four-year-old's safety, health, education, and nutrition now reverberates through our society for 100 years. Years, and may not stop there. In 1918, hundreds of thousands died from influenza in the United States, but ten years after this epidemic, children and adults were developing serious psychological issues, such as major depression, thought to be secondary to CNS injury produced by influenza.

Influenza did not come about because of the federal government's malfeasance, yet it produced harms that were still being dealt with after the Second World War. In 2025, harms to children are being directed by the Federal Government through the Executive Branch and with the acquiescence of the Republican-led Congress. These injuries to children will reverberate through our nation for years to come, affecting multiple generations and severely limiting the potential of our children and our country.