ABSTRACT
This chapter aims to call attention to the themes covered by the participants in the sixth Cornell University Medical College conference on health policy and to identify the points of some of the discussions that led to the participants' recommendations for policy interventions. A disturbing account was provided about recent developments at New York City's Harlem Hospital, which is located in the midst of a low-income, severely disadvantaged black community in which the crack epidemic is raging. Early testing could lead to early interventions that might result in improved cognitive, social, and behavioral outcomes; but widespread early assessments were recognized to have a downside risk. Important ethical issues are involved in large-scale testing and classification of young children, and the danger of the self-fulfilling prophecy exists. Early interventions improved the cognitive and social development of children at risk. In the case of the nurse visitation program, the cost/benefit analysis suggested the program could pay for itself within a four-year period.
