Over the past century, child morbidity and mortality has decreased for most children in Western societies due to improved living conditions and advances in health services. Nevertheless, growing numbers of poor and disadvantaged children in the United States still do not enjoy even the most basic services like prenatal care and regular immunizations. While many of the infectious diseases that threatened all children earlier in the century have been eliminated among middle and upper class Americans, such diseases continue to affect the poor and underserved. Moreover, scholars and public health officials are now recognizing "new morbidities" such as developmental delays, school problems, emotional and behavioral problems, child abuse and neglect, intrauterine drug or alcohol exposure, and the effects of family disruption and violence. Unlike the "old morbidities," which have single biological origins amenable to relatively simple interventions such as antibiotics, immunizations, and improved nutrition, the new morbidities result from multiple social and behavioral factors that demand complex responses. Problems such as alcohol and drug abuse, school failure, and teenage pregnancy seldom have a single identifiable and treatable cause. Consequently, these problems require a combination of social, familial, behavioral, and educational interventions provided through infant development programs or family preservation programs designed to change the ecology of the child and family.

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