From the Dean: Our Debt to Our Children

From the Dean: Our Debt to Our Children

One of the sacred duties of every generation is to ensure that their children, and their children’s children, will inherit a world better than the one they were bequeathed by their parents. On this, in many ways we have failed.

“The Greatest Generation”—my parents’ generation—did their job. They helped save us from Hitler’s grotesque ambitions and paved the way toward an unprecedented path of global economic growth. Yet they left us with a legacy that is itself far from perfect. We struggle today with the immense challenge of global warming, a byproduct of that phenomenal run of economic growth that, unfortunately, all too few of us anticipated, and that all too few today seem willing to confront. One of the Greatest Generation’s greatest contributions, Medicare and Medicaid, along with the major contribution of their parents’ generation, Social Security, imperils the solvency of the nation. But it is my generation that has failed to deal with the challenges created by these cornerstones of our society.

Older Americans vote in far larger numbers than do young Americans; and the youngest Americans—those under age 18—have no vote. Our self-protection mode translates into congressional dread about addressing the financial stability of Social Security and Medicare. In a world of me-first politics, the situation will only worsen as the baby-boom generation reaches retirement age. Today, 13 percent of the United States population is 65 or older. By 2030 one in five Americans will be a senior citizen. Our failure to bequeath our kids a reasonable level of national debt and a plan for ensuring the future of Social Security, Medicare, and Medicaid places them in an untenable, and possibly unsalvageable, situation. How will they pay the public’s bills—our bills—and manage to cover their own at the same time? Our recent struggle to come together to finally realize health care reform in this country—while a great victory—vividly illustrates our inability to work productively across party lines to address our most difficult challenges.

Will we leave our children with a series of eventually intractable problems? The epidemic of childhood obesity, spawned by an admixture of basic genetics, the physical inactivity of modern life, and the rapacious needs of the fast-food industry, threatens to make our children the first generation to live fewer years than their parents. Inadequate education, a lack of permanent housing, abusive or absent parents, a myriad of preventable emotional and behavioral disorders—all these constitute serious challenges to the health and well-being of all too many of our kids.

And what of children outside the developed nations? Ten million kids still die annually, the vast majority from utterly preventable conditions. Diarrhea claims the lives of two million children each year. Measles—a vaccine-preventable condition—still kills nearly 200,000 children annually. In sub-Saharan Africa alone, 11.6 million children have been orphaned by HIV/AIDS, and many of them will succumb to complications of the disease. In a world increasingly plagued with over-nutrition, under-nutrition continues to exact a price for millions of kids living in the world’s poorest nations. This was brought very close to home earlier this year in the heartbreaking pictures of the often emaciated orphans of Haiti.

If you have read this far, I fear that I have left you depressed and/or angry. The picture is definitely gloomy, but it is not hopeless. The horror stories in the preceding paragraph must be contrasted with the good news: Worldwide, despite an increasing population, the child death toll today is literally half that of just a few years ago. Deaths from vaccine-preventable diseases have plummeted. Led by both the U.S. government and major private organizations, like the Gates Foundation, resources are flowing into global health at an unprecedented rate. With a few notable exceptions, low- and middle-income countries are experiencing substantial decreases in infant mortality and, associated with that, fertility rates, as well as rapid increases in adult life expectancy.

In the U.S., the nation’s premier foundation devoted exclusively to health, the Robert Wood Johnson Foundation, has made childhood obesity one of its principal programmatic targets. Health and education are focal points of the current administration in Washington, as witnessed by First Lady Michelle Obama’s campaign to improve children’s eating and exercise habits. And scientists are producing new knowledge that will undoubtedly improve the health and well-being of children in America and around the world. The present issue of Findings reports on many such exciting efforts here in your University of Michigan School of Public Health. Dr. Warner prescribes a thorough reading of the issue to cure the depression with which he may have afflicted you.

Now, when will Congress ever get the backbone to deal with Social Security, Medicare, and Medicaid? <

-Kenneth E. Warner

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