Children and youth face special nonfinancial barriers to care. This article suggests that, while public health and medical care interventions have produced dramatic changes in the health of U.S. children, newly recognized forms of morbidity, such as behavioral and learning disorders and child abuse and neglect, have taken their place. Case studies of immunization delivery, children with chronic illness, and mobile populations of children reveal the mismatch between the health care system and children's basic health needs. Integrated models are essential mechanisms for coordinating the delivery of medical, developmental, educational, and social services needed by high-risk populations of children and families. Producing the tools to achieve these objectives is less challenging than developing and implementing policies to assure universal, coordinated public health and medical services of adequate scope and quality for children through market and health care reform.
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