Candidates: What will you do for children?

We have spent our lives working with children and young adults. One of us is a pediatrician from Iowa. One of us is from Virginia and spends her time helping young adults believe in themselves, their dreams, and their country.

We want all the presidential candidates to answer this question: What will you do for children?

As simple as this question may appear, it is deceptively complicated. There are no short-term solutions for this. The standard answer - access to quality primary care and a valuable education - does not cut it. It just says the candidate has not thought it through, will offer pat answers, and will remain clueless about the challenges young Americans confront.

In pediatrics, for example, several studies document how childhood stress damages the brain. Childhood stress cannot be confined to children living in violent homes or communities. Loss of a parent, lack of adequate food and shelter, parental financial anxiety, and parental substance abuse also attack a child's brain.

This is an epidemic. The 2012 National Survey of Children's Health found that 1 in 4 Americans (and 79.9% of low-income Iowa children) had been exposed to at least two of these factors and 1 in 5 lived through three. Two-thirds of the girls studied had endured sexual abuse, physical violence or watched their mothers attacked.

The American Academy of Pediatrics labels this stress 'toxic” to children. It undermines their ability to adapt and cope with challenges and is the 'root of unhealthy lifestyles.” For example, children who experienced four of these stresses are 1,525% more likely to commit suicide, 357% percent more likely to be clinically depressed, and 242% more likely to smoke.

This children's crisis extends beyond the pediatrician's office and into the community. It reaches into our elementary and high schools. It saps the courage students must have to dream and the stamina they need to risk themselves to learn. No matter how outstanding their teacher may be or how innovative her classroom may be, the teacher cannot combat this epidemic alone.

It requires a new framework for early childhood investments. We have seen up close and personal the impact of the Children's Health Insurance Program (CHIP). Iowa surveys show that its major impact is reducing stress - and thus helping children get ready to learn. The Family and Medical Leave Act (FMLA) has been a great asset for families who could afford to take up to three months off to care for grievously ill loved ones. You can have CHIP and FMLA but if you cannot afford to take off work to care for them, the stress catapults and the epidemic continues.

As First Lady, Hillary Clinton championed CHIP and played a key role in its adoption. She has been a tireless advocate for the FMLA and this week made paid sick leave a major issue in her presidential campaign. She understands that health insurance is not just about access to quality health care and reasonably priced prescription drugs. She recognizes that addressing toxic stress in families not only decreases stress but decreases health care costs. But perhaps most important, she knows that building resilient communities that celebrate families and empower children to live happy, productive, and civically engaged lives demands a public policy that addresses all the stress factors rather than just one.

More than a century ago, the great abolitionist Frederick Douglass argued, 'It is easier to build strong children than to repair broken men.” In 1996, Hillary Clinton wrote children 'do not deserve to inherit our debts, but neither should they be denied a fair chance at a standard of living that includes health care, good education, a protected environment, safe streets, and economic opportunity.”

We agree. We challenge all candidates to answer what policies they would champion to tackle this epidemic - because, as Hillary once said, 'Children, after all, are citizens too.”

' Julianne Thomas, MD is a retired pediatrician living in Cedar Rapids. Allida Black is Managing Director of the Allenswood Group and Senior Fellow at the Women's Research and Education Institute. Comments: thomaswltjht@mchsi.com; allida@theallenswoodgroup.com