Just as the Christmas season celebrates a very special child's birth, it's hard to disagree that children—even from our poorest families—are a national treasure and our shared future.
But states and cities find it easier to expend billions of dollars on after-the-fact cures and fixes - foster homes, juvenile courts, prisons - than to fund family support and after-school programs to stem the problems before they ever occur.
Does it have to be so? Are there better strategies to improve the health and welfare of millions of children born to poor urban families?
Perplexed by those questions and alarmed by the Los Angeles riots of the early 1990s, the Robert Wood Johnson Foundation decided to launch a unique multiyear Urban Health Initiative. (Disclosure: I served on the initiative's advisory board.) The goal: to see what strategic changes and prevention strategies could be launched in the real world of big-city politics across the nation. And whether new change-agent organizations, formed in target cities to advance the interests of children, could help make it happen.
Ruby P. Hearn, the Robert Wood Johnson vice president who conceived the idea, climbed on a plane to visit Seattle and convince Charles Royer, that city's former mayor, to lead the effort. Hearn could hardly have made a better choice; as mayor (1978-89), Royer had created a widely-emulated "KidsPlace" program to reinvent the city as a place for children. And mayors respected him as a former president of the National League of Cities.
Child advocates in major cities were invited to set up campaigns with allies both inside and outside the government; eventually five were chosen for the foundation's 1995-2005 effort to see if it was possible to move the needle," not just in small pilot projects, but in citywide indicators of children's welfare.
Now, following 10 years and over $75 million of the foundation's spending for operations in the five selected cities - Philadelphia, Baltimore, Oakland, Detroit and Richmond - what's been achieved, what's been learned?
A short answer, from reviews at a wind-up meeting in Miami earlier this month: a few needles indicating better kids' outcomes have moved upward in individual cities. But it's tough, grueling work. The newly founded catalyst organizations made their share of false starts; it took time to form truly effective collaborations with city departments and other funders.
Still, there are successes to celebrate. Case in point: Baltimore, for years one of America's worst cities in outcomes for children. The Baltimore Safe & Sound campaign, funded by the foundation, mounted such efforts as "Success by Six," serving 15,000 families, and "Operation Safe Kids," to reduce shootings and homicides among teenagers.
And it is working, claims Hathaway Ferebee, Safe & Sound's director: citywide incidents of reported child abuse and neglect are down 32 percent since 1997. Births to Baltimore teenagers are down 25 percent, the school dropout rate down 23 percent, while the high-school graduation rate is up 28 percent.
How does it work? "We try to have rigorous data, comparisons, surveys, so elected officials can't say 'no'" to promising new or expanded initiatives, says Ferebee. "After 10 years of vision, partnership and action," with the statistical proof of success, "our message to government is simple: 'Cut the check!'"
Example: Foster care for children whose parents become drug addicts costs $50,000 for an average four-year period, often leaving children with serious attachment disorders. But a program of intensive treatment of the addicted parent, mounted collaboratively by the courts, probation officers, the Department of Social Services and others, typically makes the parent clean and sober far sooner. Results: kids emerge more quickly from foster care, rejoined with their parent. Average saving to the state: $30,000. So Maryland is agreeing to return a major share of its savings to help the program thrive and grow.
In Philadelphia, the campaign releases yearly report cards—citywide and soon by neighborhood - to trace progress against child poverty, abuse and neglect, teen pregnancy and violence. Oakland's "Safe Passages" campaign claims the violence prevention/social skills curriculum it has pushed has cut suspensions for violence at targeted middle schools by 72 percent. The Oakland program also provides training for police, including a guidance card on how to deal with very vulnerable 1-to-5-year-olds at crime scenes.
Detroit's program - called "Mayor's Time" with Mayor Kwame Kilpatrick's warm endorsement—claims its intense focus on after-school programs has been the key in raising participation from 18 percent to 49 percent citywide.
And Richmond's "Youth Matters," interestingly based in the Greater Richmond Chamber of Commerce, appears to have sold businesses both in the city and suburbs on the importance of children's services, as well as helping prompt gubernatorial-level early childhood care and education initiatives.
All five cities' programs have now attracted sufficiently strong new support, including major grants from local foundations, to continue even with the ending of the Urban Health Initiative. The effort has not been perfect - but in serving such easily forgotten children, a splendid gift to us all.
(c) 2005, The Washington Post Writers Group