By Donella Meadows
–October 10, 1991–
U.S. Secretary of Health and Human Services, Louis W. Sullivan, wrote a newspaper column last week to celebrate Child Health Day. In it he told us what’s really wrong with our kids’ health. The reason their mortality is higher than that of other industrialized nations, he said, the reason they die in accidents, go unvaccinated, suffer from drugs, depression, fear, and violence, is bad parenting.
The Bush administration has launched numerous child-health initiatives, said our health secretary, glossing over the steady Republican record of budget cuts in child support services. But you parents aren’t doing your part. You don’t buckle the kids’ seat belts, make them wear helmets when bicycling, install smoke detectors, or erect child-proof fences around your swimming pools. You let your offspring watch violence-ridden television. Secretary Sullivan guesses that you are so neglectful because of your “immaturity, exhaustion, and pursuit of self-gratification.”
Every parent I know will admit to the exhaustion, though Secretary Sullivan might look more closely into the reasons for it. Because of a long-term slide in real incomes, many families now have two parents working to earn what one parent earned ten years ago.
Immaturity of parents is indeed a problem. Each year in this country about 200,000 children are born to children under the age of 17. Though there is certainly parental responsibility in this matter, there is also responsibility on the part of advertisers who cynically sell through sexual titillation, and on the part of recent administrations, which have withdrawn virtually all government support for family planning.
As for self-gratification and failure to put up fencing around swimming pools, how can the Secretary of Health and Human Services fail to understand that the children whose health is most gravely endangered don’t live anywhere near swimming pools? Their parents can’t begin to afford smoke detectors, or bicycle helmets, or bicycles.
The eagerness of conservatives to divert all responsibility to the sufferers of a problem (as long as the sufferers are poor people, not rich corporations) always makes me mad. But I also have trouble with the eagerness of liberals to give government all responsibility. I’d like to find some middle ground, from which we might be able to stop playing right-left right-wrong games and start actually solving the problem.
From middle ground it would be apparent that some families are simply failing. They haven’t the income, energy, education, opportunity, life experience, or confidence to care for their children properly. Intervention in many forms — free clinics, school lunches, childcare training, not to mention cash — could really help these families.
It would also be apparent from middle ground that conservatives are pointing to at least one real problem. Outright handouts to people who don’t know how to make their lives work can be counterproductive. They can destroy what self-confidence was there. They can provide an excuse to stop trying. They can create a cadre of professional care-givers who have an investment in the continuation of the problem. Liberals might recognize this problem under the term “co-dependency.” Systems analysts call it “shifting the burden to the intervener.”
If a family, corporation, economy, or whatever is failing to cope with a problem, an unaware intervener may come in and solve the immediate problem, but inadvertently undermine the coping mechanisms the system did have — thereby setting up further failure. Food aid is a classic example. If it is delivered in such a way as to cut food prices in the recipient country, local farmers may go bankrupt. Then the country will be even less able to produce enough food.
Another example of shifting the burden is a pesticide that wipes out the natural enemies of the pest. Another is the hand-calculator that allows you to forget your arithmetic and increases your dependence on hand-calculators. And another is government intervention in the health care system, which has quickly addicted the health care system to government intervention.
The way to avoid “shifting the burden” is NOT to refuse to intervene. There IS a problem. The system isn’t coping. The level of health of our children is shameful for a supposed superpower. The secret is to intervene TO STRENGTHEN THE SYSTEM’S ABILITY TO SOLVE ITS OWN PROBLEM. In the case of food aid, that can mean market supports and an extension service to enhance the capability of local farmers. In the case of pesticides it can mean learning to foster natural predators to control pests.
For the children whose health is at risk it means looking seriously, carefully, without ideology, at the problems of their parents. It may mean adult education. Job training. Non-condescending family support programs that are not handouts. It means giving young people the information and technologies they need not to have babies until they’re ready. If you want to see a living example of how it can work, look at the Scandinavian countries, which have the best child health statistics in the world.
Intervention that rebuilds an ailing system, instead of taking over its burden, requires understanding and care. It takes time. It does not include a swashbuckling, high-spending fix-up from which politicians can get easy credit. It does need intervenors who are willing to enter into ongoing human relationships with the people who have the problem — not to lecture them from afar about their failings.
Copyright Sustainability Institute 1991