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Violence and Health Care Top the Agenda

1994 FORECAST: Trends and Ideas for the New Year. One in a series.

January 05, 1994|ELIZABETH MEHREN and LYNN SMITH

Families can expect to find themselves at the vanguard of a number of other important trends in 1994. Among them:

* A surge in local violence-prevention programs such as California's Wellness Foundation, which has funded the San Francisco-based Pacific Center for Violence Prevention. "Parents will see the discussion about violence becoming more sophisticated," said Darwin Farrar, the center's director. He said practical solutions will "either go to harsher penalties--longer sentences and incarcerating more young people--or toward alternatives to incarceration, particularly for the majority of kids who do not commit violent crime."

* An increase of self-help efforts to curb violence, such as ex-gang members mentoring youths. In many communities, parents will also hear their children talking about conflict-resolution programs in schools. To provide safety zones, some schools may stay open until well into the evening, or even seven days a week.

* For divorcing parents, a national movement toward "parenting plans"--mandated agreements on long-term child-raising strategies intended to replace the adversarial concepts of custody and visitation.

* Steadily increasing legal and judicial action on behalf of children. State legislatures, predicted Howard Davidson, director of the National Center on Children and the Law, will take pains to provide for adequate representation for children in court proceedings. Lawyers and judges, Davidson added, will ignore "at their peril" the fact that "proceedings that are about children will have to treat the children with the dignity and respect that would normally be accorded to parties in any lawsuit."

* On the health care front, aggressive lobbying to ensure that universal coverage for children is included in all health care reform packages. "Most of the nation's 9 million uninsured children are in families who work full time," said Eve Brooks, president of the National Assn. of Child Advocates in Washington, D.C. "Anything short of universal coverage will leave a lot of those kids out."

* In anticipation of the reforms, some family physicians are moving toward team-oriented, family focused treatment, rather than one-on-one doctor/patient relationships. A model program at the University of Rochester is one illustration of the effort to train family-focused physicians.

* New recognition by health care professionals of the importance of including families in treatment strategies and decision-making. "Research has shown that including spouses and family in the treatment of medical illnesses increases the likelihood of people having better outcomes," said John Hutchins of the American Assn. for Marriage and Family Therapy in Washington, D.C.

* Full-scale health care clinics for women, sponsored by the Planned Parenthood Federation of America, and located in schools and workplaces. Pamela Maraldo, the group's president, said these clinics would offer obstetrical care and diagnostic services.

* To accommodate crowded personal and professional schedules, a growing demand for flexibility in the workplace. Benefits that include flexibility in terms of hours, home office work or computer commuting will take on the importance of salary increases in attracting people to jobs, said Fran Rodgers, president of Work/Family Directions in Boston. Brad Googins, head of the Center for Work and Family at Boston University, agrees that in 1994, "Work/family will become less of a benefit and more of a strategy."

* With continued corporate downsizing, Rodgers also foresees employers offering support seminars for families, looking at the effect on families when primary wage-earners lose their jobs.

* A surge in volunteer activities by whole families, representing concrete efforts by families to address critical needs in their own communities. Virginia Austin, director of the Family Matters volunteer program at the Points of Light Foundation in Washington, D.C., said 1,000 families signed up for volunteer projects in Houston in 1992, the program's first year. Nationally, Austin said, "our goal is to increase participation by 30% in three years."

* A rise in the number of people older than 65 who have adult children dependent on them. Eileen Crimmins, a professor of gerontology and sociology at USC, said 14% of people older than 65 live with an adult child--half of them because the child needs help or a place to live. Whereas a coveted American fantasy has elderly widows moving in with their children to be cared for and respected, "typically nowadays, it's you moving in with your mom," Crimmins said. By terms of this intergenerational restructuring, Crimmins explained, an aging mother provides "free lodging and meal service."

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