IN THIS issue of the Archives, Willis et al call attention to the potential for undernutrition occurring when so-called welfare reform results in reduced budgets for a variety of support services for children. When the mandatory return to work provision for mothers on welfare kicks in and there are not enough jobs, many children face severe reduction in calories and other nutrients. If nothing intervenes, we are likely to return to what inner-city hospitals saw on a regular basis 25 or 30 years ago.
See also page 871
These diagnoses include marasmus, stunting of growth, even a rare kwashiorkor, and severe iron deficiency anemia. These diseases have become uncommon and almost nonexistent in large cities since the advent of the Special Supplemental Nutrition Program for Women, Infants and Children and perhaps other programs directed toward children, all of which will see a reduction in funding.
Two roles for pediatricians present