SylviaAnnHewlett. Child neglect in rich nations. UNICEF. 1993. 03. Policies and problems.

Policies and problems

In Anglo-American societies, the stress and strain on family life triggered by shrinking wages, the employment of both parents and marital breakdown have not been counterbalanced by new and more generous benefits and services. On the contrary, support for families has lost ground to other priorities recently. In the 1980s, the proportion of public money spent on families and children was reduced, and even more responsibility was returned to the family — despite the manifest erosion in the family’s ability to shoulder these responsibilities. There is probably no way policy makers can protect children from the earthquake that has shuddered through the family over the last 20 years, but rather than responding with generous support, governments in the Anglo-American world, in tightening the purse-strings, have increased the penalties attached to childraising, albeit unintentionally.

In the United States, 60 per cent of American working women still have no benefits or job protection when they give birth to a child. In the United Kingdom, only 2 per cent of child care available for children under age three is publicly funded. In Canada, 5 billion Canadian dollars (one Canadian dollar = US$0.76, 1 September 1993) have been removed from social programmes that benefited poor children. In all three countries, the claims of families with children have been subordinated to other needs.

A dramatic feature of United States public policy is the way in which the Government has intervened on behalf of the elderly but not on behalf of children. According to figures compiled by Timothy Smeeding (see overleaf), from 1984 to 1987 the same tax policy and income transfers in the United States (including health and housing subsidies) that reduced the rate of poverty among the elderly from 46 per cent to 11 per cent, have reduced child poverty by only 2 per cent, taking the rate from 22 to 20 per cent. (35) Indeed, the United States Government now allocates an average sum of US$9,500 in federal subsidies to each elderly person, but only US$870 to each child. It is small wonder that the poverty rate among American children is now twice as high as among the elderly. (36)

Canadian public policy has followed a similar path. Government transfer payments now account for 52 per cent of the income of seniors, up from 44 per cent in the 1970s. As a result, the proportion of seniors in poverty is now one half of what it was in 1980. There has been no corresponding reduction in child poverty rates, however. On the contrary, in 1990, child poverty was two percentage points higher than in 1980. A large part of the problem is the low level of public support for families with children. Real income from government programmes for children has been declining; income support per child averaged 751 Canadian dollars in 1989, down from 913 in 1978. (37)

The situation in Europe is quite different from that in the United States and Canada. In France, for example, in recent years, tax policy and income transfers have reduced poverty among the elderly by a decisive 75 per cent, taking the rate from 76 to 0.7 per cent; but poverty among children has also been reduced significantly, falling from 21 to 5 per cent. Similarly, in the Netherlands, public policies have reduced poverty among the elderly by an impressive 56 per cent, taking the rate from 56 per cent to zero, while these same policies have lowered the child poverty rate from 14 to 4 per cent. (38)

	Australia	Canada	France	Germany	Netherlands	Sweden	UK	US	Average
	1985	1987	1984	1984	1987	1987	1986	1986
All People
Pre *	19.1	17.1	26.4	21.5	21.5	25.9	27.7	19.9	22.4
Post **	6.7	7.0	4.5	2.8	3.4	4.3	5.2	13.3	5.9
Change	-12.4	-10.1	-21.9	18.8	-18. 1	-21.6	-22.5	-6.6	-16.5
Age 65 or older
Pre	54.5	50.2	76.2	81.0	56.1	83.2	62.1	46.5	63.6
Post	4.0	2.2	0.7	3.8	0.0	0.7	1.0	10.9	2.9
Change	50.5	48.0	-75.5	-76.3	-56.1	-82.5	-61.1	-35.6	-60.7
Adults (18-64)
Pre	12.9	11.5	17.6	9.8	17.4	13.5	18.1	12.8	14.2
Post	6.1	7.0	5.2	2.6	3.9	6.6	5.3	10.5	5.9
Change	-6.8	-4.5	-12.4	-7.2	-13.5	-6.8	-12.8	-2.3	-8.3
Children (17 or younger)
Pre	16.4	15.7	21.1	8.4	14.1	7.9	27.9	22.3	16.7
Post	9.0	9.3	4.6	2.8	3.8	-1.6	7.4	20.4	7.4
Change	-7.4	-6.4	-16.5	-5.6	-10.3	-6.3	-20.5	-1.9	-9.4
Children with one parent
Pre	70.2	56.6	43.1	46.0	70.3	23.2	71.2	58.1	54.8
Post	34.6	37.1	13.1	15.9	3.8	2.0	8.5	54.2	21.2
Change	-35.6	-19.5	-30.0	-30.1	-66.5	-21.2	-62.7	-3.9	-33.7
Other children
Pre	11.3	11.7	19.4	6.9	9.2	5.2	22.2	15.7	12.7
Post	6.6	6.6	4.0	2.3	3.8	1.5	7.3	14.1	5.7
Change	-4.7	-5.1	-15.4	-4.6	-5.4	-3.7	-14.9	-1.6	-6.9

Poverty rates of children in eight industrialized countries Tax and transfer policy in the eight industrialized countries shown below leaves children (17 years or under) no better off than adults and worse off than those aged 65 or above — often by a big margin These mid-1980s data show that income security measures reduce child poverty by an average of 9.4% but cut senior citizen poverty by 60.7% (or over six times more). The US has the worst disparity in this regard. It reduces child poverty by 1.9% but decreases poverty among the elderly by 35.6% (or nearly 19 times more). Even children in single-parent families in these eight countries are left worse off than senior citizens by such measures: Their poverty is reduced by an average of 33.7% compared to 60.7% for those aged 65 or above. Direct comparison of income and poverty across a wide range of countries was made possible by the Luxembourg Income Study (LIS) database.

Poverty rates measured as percentages of children living below 40% of the adjusted median family income in each country.

* Pre tax and transfer income compares family income based on earnings, property income and private transfers (e.g., private

pensions, alimony and child support) to 40% of the adjusted median family income in each country.

** Post tax and transfer income includes the effect of direct taxes, including negative taxes such as the US Earned Income Tax

Credit, and public transfers on poverty.

Source: Timothy M. Smeeding, The War on Poverty: What Worked?' Testimony to the Joint Economic Committee, the United States Congress, 25 September 1991.

Shortfalls in funding

Housing and health care are two policy areas where the allocation of generous amounts of public money is capable of making a great deal of difference to the well-being of families with children. Unlike most European countries, the United Kingdom and the United States do not fund these services at levels that guarantee universal access.

In the United States, federal support for low-income housing dropped from US$32 billion in 1978 to US$9 billion in 1988, a decline of more than 80 per cent after adjusting for inflation. (39) The cut-back is the main cause of an acute housing shortage that now stretches across the nation. Estimates vary, but in the early 1990s, somewhere between 600,000 and 3 million people are homeless. Approximately 30 per cent of them are families, most often a parent with two or three children. The average child is 6 years old; the average parent, 27. The loss of a home often leads to the dissolution of a family: two older children in foster care, the wife and baby in apublic shelter, the husband sleeping on apark bench or under abridge.

Homelessness can be a devastating experience for a child, because a home is much more than four walls and a roof. A home provides warmth, security and continuity. Homeless children quickly lose their emotional anchor—and their chance at an education. In the United Kingdom and the United States, local authorities estimate that more than half of all homeless children fail to attend school on a regular basis.

The growing ranks of the homeless are merely the most visible indicator of the contemporary housing shortage. In 1989, 10 million Americans were living near the edge of homelessness, doubled up with friends or family. The arrival of a new baby, a landlord’s displeasure or simply rising tensions due to overcrowding could cost these people a place to live. According to Barry Zigas, Director of the National Low Income Coalition in Washington, B.C., conditions are “the worst since the Great Depression.” (40) Local officials report that there is no public housing available for hundreds of thousands of poor families who, under existing government regulations, qualify for help. There are today about 44,000 persons on the waiting list in Chicago, 60,000 in Miami and 200,000 in New York City.

While approximately 330,000 children are homeless in the United States, 12 million are uninsured and have little or no access to health care. During the 1980s, growing numbers of families with children fell through the medical safety net. The reasons are simple: Since 1980, far fewer families have been able to rely on company-sponsored insurance to take care of their health needs, and government programmes, especially Medicaid, have been cut back.

During the 1980s, the number of uninsured Americans rose by one fifth, from 30 million in 1980 to 37 million in 1987. (41) More parents are working at low-wage servicesector jobs that offer no benefits. Medicaid is intended to help uninsured low-income families to cover their health costs, but today such families are unlikely to get help unless their income is at or below the eligibility level of Aid for Families with Dependent Children (AFDC) — often considerably below the poverty line — and their children are under six years old. In 1990, the Medicaid system financed health care for only 40 per cent of those below the poverty line, compared with 65 per cent in the mid-1970s. Families with children who do not qualify for Medicaid must rely on a patchwork of public health programmes that fail to serve the eligible population because of a shortfall in public funds. For example, the nation’s 550 community health centres serve only 5 million patients each year, leaving 20 million eligible people, two thirds of them mothers and children, without such services. Funding for Title V (the maternal and child health programme targeted at the uninsured) is now so low that fewer than half of all states are able to offer prenatal programmes on a statewide basis, and only a handful of states can pay for hospital delivery services for lowincome uninsured women.

Current American policies do not emphasize the importance of prenatal and maternity care. The resulting statistics speak for themselves, In 1991, 40,000 babies died before their first birthday, and half of the deaths could have been avoided because they were the direct result of mothers receiving little or no prenatal care. It has been shown that women who do not receive adequate prenatal care are 40 times more likely to lose their baby in the first month of life than those who initiate prenatal care in the critical first three months of pregnancy. (42) They are also three times as likely to have premature, low-birth-weight babies. Infants who weigh less than 5.5 pounds at birth often need expensive medical attention and are much more likely than full-term babies to suffer lifelong disabilities such as cerebral palsy, seizure disorders, blindness and mental retardation.

None of this pain and suffering comes cheaply. In 1989, the United States Congress estimated the cost of caring for dangerously premature babies at US$2.4 billion annually. Initial hospital costs averaged US$54,000 per child, and the price tag of a lifetime of care and treatment for these children averaged US$389,800. (43)

Yet, despite the enormous savings inherent in effective prenatal care, it is more difficult to obtain today than it was in 1975. Seventeen per cent of American women of child-bearing age do not have medical coverage, up from 12 per cent 10 years ago.

The United States is unique in its lack of provision for childbirth. In all other rich nations, pregnant women and newborn children are treated with much more generosity and humanity — which is a large part of the reason why infant mortality rates are so much lower in France, Japan, the Netherlands and Sweden than they are in the United States. (44)

On the housing front, however, the United States is not alone. In recent years, Australia and the United Kingdom have tended to take the same direction as the United States. In the United Kingdom, housing has suffered the sharpest cuts of all social expenditure, falling from £7 billion in 1978 to 52.7 billion in 1989 (in real terms). This produced a considerable decline in the stock of low-income housing and pushed rents up. The result has been a significant increase in homelessness, particularly among young families. Homelessness doubled during the 1980s, and 79 per cent of homeless households now include children. The number of young runaways aged 16 to 19 who are homeless and living on the streets of large cities has also markedly increased. The problems of these young people can be traced to the shortage of housing, but they are greatly exacerbated by recent changes in the social security rules that have removed entitlements from 16- and 17-year-olds. Many youngsters who cannot rely on support from their families and who cannot find jobs are now destitute.

A shortage of time

In Australia, the United Kingdom and the United States laissez-faire policies towards families with children have failed miserably in the task of enhancing the amount of time working parents are able to spend with their children. Maternity or parenting leave is a case in point.

In the United States, the only federal provision for pregnancy or maternity is contained in the 1978 Pregnancy Disability Amendment, which decrees that an employer cannot fire a worker solely because she is pregnant and that a pregnant woman is eligible for the same fringe benefits as workers with “other disabilities.” (45)

Although this Amendment was hailed as a major victory for women’s rights, it affords pregnant women and their newborn children very few protections or benefits. Specifically, it does not guarantee any leave from employment for a mother (or father) to spend time with a newborn child, nor does it direct employers to reinstate women in their jobs after they have recovered from childbirth. The only thing it does provide is six to eight weeks of partial wage replacement at the time of birth if a working woman is covered by temporary disability insurance. However, since only five states require this kind of insurance, experts estimate that 60 per cent American working women have no benefits for pregnancy or childbirth.

Recent attempts to improve on the Pregnancy Disability Amendment have run into trouble. In 1990, the House and the Senate finally passed a Family and Medical Leave Bill that would have provided 12 weeks of unpaid, job-protected leave for both male and female employees at the time of birth, but it was vetoed. (46) Despite the fact that 50 per cent of mothers with babies under 12 months old are now in the workforce, the American system has had an extraordinarily difficult time defining childbirth as an appropriate target for legislation, and American Presidents have been loath to regulate employers or interfere with the intimate workings of family life. More recently, one of the first acts of the Clinton Administ ration was to pass the Family and Medical Leave Act in February 1993, that went into effect on 5 August 1993. However, this has only partially solved the problem since companies with fewer than 50 employees remain exempt, and many American working women are employed by small firms.

The United Kingdom also displays laissez-faire tendencies on the maternity leave front. Along with the rest of the European Community, the United Kingdom mandates a series of rights and benefits around birth, but it then restricts these rights more severely than anywhere else in Europe. In the United Kingdom, women qualify for maternity leave only if they have been in full-time employment with the same employer for two years, or part time for five years. As a result, in 1990, 45 per cent of British working women failed to qualify for benefits. (47) The country has resisted adopting European Community standards in this area, preferring to rely on voluntary private-sector initiatives.

Similarly, Australian provisions for maternity leave are far from comprehensive. A survey conducted by the Australian Institute of Family Studies in the late 1980s found that in the private sector one third of all working women were ineligible for maternity leave or benefits. (48)

In sharp contrast to the restricted maternity benefits typical of the Anglo-American world, a large number of Western European governments provide a generous package of rights and benefits to all working parents when a child is born. For example, Sweden provides a parenting leave of 15 months at the birth of a child, to be taken by either parent, and replaces 90 per cent of earnings up to a specified maximum. In Italy, a pregnant women is entitled to five months of paid leave at 80 per cent of her wage, followed by a further six months at 30 per cent of her wage. Her job is guaranteed for both periods. Perhaps the most remarkable fact about the Italian system is that a woman is entitled to two years of credit towards seniority each time she gives birth to a child. Not only does an Italian woman not get fired for having a child — she is actually rewarded.

An obvious consequence of the absence of comprehensive maternity or parenting leave policies in Anglo-American countries is that children are deprived of parental time and attention during those critical first weeks of life. Most child-rearing experts see six months as the minimally adequate period of time for a parent to bond with a new child. (49) Approximately 30 per cent of American babies and 20 per cent of British babies are deprived of that precious time.

Forging a public morality

Harvard legal scholar Mary Ann Glendon tells us to be wary. We need to be very careful about the “stories we tell,” the “symbols we deploy” and the “visions we project” in our public policies, because these ciphers forge the aspirations and identity of the nation, and in so doing, help construct a public morality. (50) This is bad news for those who care about the welfare of children in the Anglo-American world. Take, for example, the story told by American policies at the beginning of life.

Some revealing symbolism is embedded in the language of American labour laws. It is striking that in the United States the only legal provision for childbirth — the most miraculous event in human life — is written in weak, even demeaning, language that defines pregnancy as just another disability in the eyes of the law. Employers are supposed to provide a pregnant woman with the same fringe benefits they provide workers with other disabilities. In 60 per cent of all cases, these benefits amount to nothing.

And there is further poignant symbolism in what policies do not address. Apart from the recently passed Family and Medical Leave Act, American laws, for example, “are silent about any period a mother, or indeed a father, may wish to be at home to care for an infant child,” (51) and this is despite the fact that the majority of new mothers in the United States are now in paid employment. In most other countries, rich and poor, childbirth receives prominent treatment in the law and is the subject of elaborate legislative support.

Finally, American policies promote an almost punitive vision of personal accountability. In the United States, a baby is seen as an item of private consumption, a little like a winter vacation or a second car, and large portions of the costs of child-raising have been privatized. There are a multitude of direct expenses: Prenatal and maternity care, day care and preschools all need to be purchased in the private market-place. And there are significant indirect costs. Because a large number of American women are not entitled to job protection when they give birth to a child, they are often redefined as ‘new hires’ when they return to work, routinely losing seniority, benefits and pay. This is a large part of the reason why working mothers in the United States lose from 13 to 20 per cent of their earning power after giving birth to a first child. (52)

In extensive interviews in the 1980s, Vance Packard found that, in the United States, “the decision to have a child is met with perhaps less enthusiasm than at any time in our history, except possibly the depression years... Having a child has changed from being part of the natural flow of life, to an apprehensive act — or even an act of courage.” (53)

In other rich democracies, parents are not required to pay such a high price for their children. In continental Europe, for example, the vision of family life and the incentive structure faced by parents are quite different. Charles de Gaulle, the late President of France, once said that motherhood should be regarded as “a social function similar to military service for men, that has to be financially supported by the whole community.” (54) This statement dramatizes the French view of children as precious national resources deserving the aid and attention of the community at large. Nations as diverse as Italy, Japan and Sweden have a profound appreciation of the child as the worker and the citizen of the future. Thus, the health, wealth and security of the nation depend on ensuring that each baby gets a good start in life and that societal conditions permit children to flourish. This sense of collective responsibility for children is the source of the elaborate social supports — family allowances, home visits, preschools — that are so common in continental Europe.

Clearly, government possesses the levers for change. It can alter the rules of the game to make it harder to abandon or otherwise neglect a child, and it can transform tax and transfer policy to reward and strengthen, rather than penalize, families with children.