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Elderly Gain More in Social Welfare Spending Than
Children
Sept. 14, 2004 - Public spending for the social
welfare of the elderly was four times greater than for children in 2000
– up from a three-fold difference in 1980. The authors of the study say
the growth in per capita spending on the elderly is primarily due to
higher medical expenses, a phenomenon called the “graying ” of the
federal budget.
This new study found the public spending gap
between children and elders increased by twenty percent despite the fact
the U.S. poverty rates among children have consistently exceeded those
for the elderly, and that in absolute numbers, three times as many
children live in poverty, compared to elders. Researchers from The
Children’s Hospital of Philadelphia examined trends in social welfare
spending for children and elders from 1980 to 2000 and the relationship
of national economic trends to public spending patterns. The results are
published in the September/October issue of Health Affairs.
“The balance of spending on elders and spending on
children, is an important issue in evaluating the allocation of public
resources,” said Susmita Pati, M.D., a general pediatrician at The
Children’s Hospital of Philadelphia and principal investigator of the
study. “Though children represent an increasing proportion of the
population living in poverty, the topic has received little attention.”
Social welfare spending for each group as a
percentage of the gross national product (GNP) remained relatively
unchanged over the 20-year period – hovering between 4 and 5 percent of
the GNP for children, and beginning and ending the period at 6.5 percent
for elders. However, the gap in per capita spending between the two
groups during this time period grew nearly 20 percent – from about an
$11,000 difference in 1980 to a more than $13,000 difference in 2000.
The major component of social welfare spending for
children has been in education, while for elders it has been in Social
Security. The researchers obtained public spending data for social
welfare programs, including social insurance, public aid, government
health insurance, education and nutrition programs, for children and
elders from U.S. federal agencies.
According to the authors, two other factors
contributed to the increasing gap. During periods of recession, spending
for children’s programs suffered compared to spending on the elderly. In
addition, federal budget policies have maintained guarantees of support
for the elderly, while social welfare programs for children have
devolved to state governments, where funding is less stable.
“Despite the economic expansion of the 1990s and
persistent socioeconomic health disparities, the gap in per capita
public spending between children and the elderly has continued to
increase. A public discussion on the consequences of the current
disparity in public spending structures for children and elders is
necessary,” said Dr. Pati.
The authors conclude that children represent an
increasing proportion of the population living in poverty, and poverty
has been shown to be associated with poor health outcomes. “Given that a
large proportion of costly adult morbidities, such as cardiovascular
disease and cancer, are associated with preventable childhood
precursors, such as obesity and smoking, increasing and stabilizing
investments in child health merit serious consideration,” said Dr. Pati.
Co-authors of the study were Ron Keren, M.D.,
Evaline A. Alessandrini, M.D., and Donald F. Schwarz, M.D., M.P.H., all
from The Children’s Hospital of Philadelphia.
Founded in 1855 as the nation's first pediatric
hospital, The Children’s Hospital of Philadelphia is ranked in 2004 as
the best pediatric hospital in the nation in 2004 by U.S.News & World
Report and in 2003 by Child magazine. Through its long-standing
commitment to providing exceptional patient care, training new
generations of pediatric healthcare professionals and pioneering major
research initiatives, Children's Hospital has fostered many discoveries
that have benefited children worldwide. Its pediatric research program
is among the largest in the country, ranking second in National
Institutes of Health funding among children's hospitals. In addition,
its unique family-centered care and public service programs have brought
the 430-bed hospital recognition as a leading advocate for children and
adolescents from before birth through age 19. Children's Hospital
operates the largest pediatric healthcare system in the U.S. with more
than 40 locations in Pennsylvania, New Jersey and Delaware.
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