The Reva Rubin Inaugural Lectureship. Looking toward the year 2000: implications for maternal and child health...

The document Promoting Health/Preventing Disease: Year 2000 Objectives for the Nation has as one of its five broad national goals, to "Reduce infant mortality to no more than 7 deaths per 1,000 live births." Many factors influence whether this nation will be able to achieve this and the other objectives contained in this document that pertain to mothers and children. The most critical variable to achieving these outcomes is the public will to commit the resources necessary to adequately address the problems that impede achievement of these desired ends. Factors in this country's macro socioeconomic environment will both contribute to expanding the need for resources and influence the willingness of our country to devote resources to the endeavor of promoting health and preventing disease by the year 2000. Many of these same macro socioeconomic factors contribute to the current reshaping of the health care delivery system. As a result of all these factors the health care delivery system is experiencing a great deal of turbulence. As with individuals, when a system is experiencing turbulence the opportunities to influence that system are increased. In addition to describing the interrelationships of these factors, this paper addresses opportunities that exist for maternal-child nurses to influence the changing system. The desired outcome would be to increase the probability that mothers and children get their fair share of national public and private resources.