Public health policy: maternal substance use and child health

Maternal substance use and abuse is a public health issue. Much of what researchers have discovered in this field has been achieved through support of funds appropriated by Congress to the Public Health Service agencies and institutes whose mandates include stimulating and supporting this research in the scientific community. In this same vein the research institutes have a responsibility for disseminating new knowledge and encouraging its application in real-life settings. Individual freedom, social justice and public health relationships need to be carefully weighed by the architects of public policy. We elect those architects through our system of citizen participation in government. However, how to effectively incorporate the relevance of what has been learned about harmful effects of substance abuse into policy that will enable society to deal with emerging maternal and child health issues remains unresolved. Health-policy-relevant issues, as they impact the lives and well-being of our children, including the increasing number who are children of drug-abusing parents, are too important for politicians to ignore and too complex for health professionals to resolve alone. Participation by the research community in policy development is critical. It is clear that a policy of preventive intervention will need widespread public support. It will need to be feasible, effective and affordable in relation to other public demands. Society will ultimately need to make choices among those options that can be implemented and sustained in a political climate characterized by conflicting values.