America's Ailing Families: Diagnosing the Problem, Finding .-a Cure

By Dr. Louis Sullivan

am very pleased that The Heritage Foundation is conducting a lecture series on children and families. We all know that children have become one of the most popular issues of the nineties. We have had aWorld Summit on Children, a National Commission on Children, and a ground swell of state and local initiatives to aid children. Unfortunately, most of these e n deavors have fo- cused almost exclusively on allocating more funds to children's programs as the answer to the problems confronting American children. It seems that many "child advocates" have forgotten an essential truth: governments do not have children , parents do. If we are serious about improving the health and well-being of our children, then strengthening the American family must be the focus of our attention. Since becoming Secretary, I have toured several African countries in order to observe firs t hand the health status of children on the African continent. As I met with heads of state and with national health and social welfare ministers in Africa, it became clear that the problems confront- ing children in much of the world-malnutrition, dehydra t ion, and disease-are amenable to obvious, tangible solutions. American children, on the other hand, face intractable problems that are more social than medical. As Senator Daniel Moynihan points out, the problems of children in the United States are "over whelmingly associated with the strength and stability of their families. Our problems do not reside in nature, nor are they fundamentally economic. Our problems derive from behavior."

Fatherless Families: A Growing National Security Threat

I believe that one of the greatest threats to America's national security is the decay of our tradi- tional source of inner strength and security-the family. The majority of American children now spend at least part of their childhood in a single-parent h o me. We worry and strategize about holes in the ozone layer while our children's protective blanket of parental love and constancy is being shredded before our eyes. In one generation, fatherless families have become the norm rather than the exception. I u s e the term "fatherless families" because the vast majority of single-parents are mothers struggling to raise their children without the biological father in the home. Unfortunately, many absent fa- thers do not remain involved in their children's lives. O n ly a third of absent fathers report that they see their children at least once a week, and nearly one in five fathers has not seen his chil- dren for five years. Lack of financial support from absent fathers is one reason why children living in mother-onl y families are five times more likely to be poor than their two-parent counterparts. Presently, only half of women due to receive child support receive the full amount owed, a quarter receive par-

Dr. Louis Sullivan is the Secretary of Health and Human Services. He spoke at The Heritage Foundation on March 10, 1992. ISSN 0272-1155. 01992 by The Heritage Foundation.

tial payment, and a quarter receive nothing. Delinquent dads owed about $19 billion at the end of 1987. To ensure that non-custodial fathers k eep their financial commitment to their children, Presi- dent Bush has stepped up child support enforrement, and there has been a $3 billion increase in child support payments in the three years of the Bush Administration. Of course many argue that volunt a ry single parenthood is merely an alternative family struc- ture, no better and no worse than a mother-father family. Many in that crowd regard fathers as superfluous-someone whose absence is easily replaced with public assistance. I'm reminded of the lit tle boy who asked:

Mom, if the Lord gives us our Daily Bread, and Santa brings us our presents, and the stork brings babies, then what's the use of having a daddy around?

What is the use of having a daddy around? Research backs up common sense on this poi nt: Children need two parents not only to provide financial security, but to help them to blossom into healthy, emotionally secure adults. Compared with their counterparts growing up with both biological parents, children from sin- gle-parent families are more likely to be poor; to drop out of school; to be involved in criminal activity; to abuse drugs and alcohol; to become dependent on welfare and to suffer emotional and health problems. When one parent must do the job of two, children are more vulnerabl e to health problems and injury. In fact, a recent HHS study found that even after controlling for age, sex, race, and socio-economic status, children raised in single-parent homes were 20 to 40 per- cent more likely to suffer health problems than children living with both biological parents.

Welfare Reform

Because family life plays such an integral role in the health and well-being of children, the Bush Administration has pursued a plan of welfare reform that will strengthen the family and promote self-s ufficiency, not dependency, among the poor. As President Bush stated in his State of the Union address, welfare was never intended to be a way of life. Aid to Families with De- pendent Children (AFDC) was originally created to assist widows and their chil d ren, and to provide short-term economic aid to families in temporary need. Today, only 2 percent of AFDC cases are due to the death of a child's father-the majority of cases are due to a child being born to an unmarried mother. And, unfortunately, these c h ildren are likely to spend an entire child- hood dependent upon welfare. President Bush and I agree that the best way to help AFDC children is to help their families overcome barriers to self-sufficiency-barriers such as lack of education, lack of job ski l ls, lack of health insurance, or lack of child care. There are three principles which guide our efforts at welfare reform: First, programs should promote self-sufficiency and strengthen-families. The Family Sup- port Act is an important stop in this direc t ion. Through the JOBS program we offer incentives such as transitional child care and Medicaid benefits to families trying to work their way out of poverty. We also provide job training or educational opportunities to allow parents to increase their self- confidence and eaming potential.

Second, allow families with children to keep more of their income. Instead of taxing and spending their money for them, government should allow parents to keep more of their earnings and make their own decisions about h ow it should be spent. Families with children have been shouldering an unfair tax burden as the real value of the dependent income tax exemption has fallen dramatically over the past forty years. To remedy this, President Bush has proposed a $500 increase in the exemption for dependent children. And third, release states from burdensome federal regulations and encou 'rage them to de- velop practical, innovative solutions. President Bush and I believe that enduring solutions to problems such as dependency, t een pregnancy, and labor force non-participation will be devel- oped by those on the front lines in communities around the nation. We look forward to reviewing state waiver proposals that build on the Administration's goals. In addition to welfare reform, the Bush Administration has recently launched a number of child health initiatives. These efforts include campaigns to reduce infant mortality, to reduce the number of unvaccinated preschoolers, and to lower the incidence of lead poisoning. In addition, w e have expanded Medicaid coverage of poor and near-poor children,-as well as funded the larg- est expansion of Head Start in its 26-year history. HHS spent over $5 billion on child health and nutrition last year. However, even the combined energy and resou r ces of the U.S. government, private groups, and local community efforts, will never be sufficient to meet the needs of America's children if adults do not put the needs of children first. Not even Head Start, Healthy Start, and Even Start can completely a l leviate the impact of a bad family life-whether the child is raised in a two-par- ent or single-parent home. Surveys show that values are formed, and tradition is passed on, through family dinners and other times together. About two-thirds of children and teenagers say that they have a conversa- tion with their parents at least once a month about religion or values. It is through these conversations that children learn the most essential lessons about life. They learn where it is safe to play, and where it is not. They learn right from left, and right from wrong. These lessons are not easy to teach, and all too often they are not being taught. Children of the middle class, children of the poor, children of the rich are all being hit with an epidemic of par- ent-withdrawal. For reasons ranging from immaturity, to exhaustion, to pursuit of self-gratification, parents today spend 40 percent less time with their children than parents did in 1965. Our children average 17 hours a week with Mom and Dad, and over 25 hours a week with a TV nanny. Lack of parent-child interaction represents a troublesome trend for children and teens who need their parents to help navigate an increasingly permissive moral environment. Contrary to popular perceptions of teenagers thinkin g they have all the answers, kids say that they wish their parents would talk to them more about issues such as school work, drugs, dating and sex. One re- cent survey found that more than half of children aged ten through thirteen wish their parents would talk to them more about drugs, and about one in four teenagers aged fourteen through sev- enteen responded that they wished that their parents talked to them more about sex.

Culture Of Character

During my tenure at HHS, I have used my "bully pulpif' to c all for a reinvigoration of a cul- ture of character in America. By culture of chara ter I mean a national commitment to making children our first priority. Putting children first means that parents take the time to teach their children values-values such as respect for teachers and for authority; integrity; hard work; per-

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severance; and service to others. Putting children first means that neighbors watch out for one an- other, and for one another's children. ( I can remember growing up in the rural town of Blakely, Georgia. I was not only the child of my parents, I was a c h ild of the whole community. Those times when I dared to act up and Mom or Dad weren't around, Mrs. Lewis or Mr. Washington from down the street were sure to step in and administer appropriate corrective therapy immediately!) Putting children first also me a ns that when possible, divorce and separation, and raising chil- dren with only one parent, are avoided. America has one of the highest divorce rates in the world, nearly one in two marriages now end in divorce. America also has one of the highest pro- po rtions of out-of-wedlock births. More than one in four babies is born to an unmarried mother.

Conclusion

Taken in isolation, neither strategy-strengthening family values on the one hand, and expand- ing government programs on the other-will be able to pro vide a better future for every child. I believe that we need both effective, family-friendly government interventions and a cultural shift so that children come first, in order to help every American child realize his or her potential.

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