It is possible to reduce rates of school dropout, teenage pregnancy, arrests for violent crime, and long term dependence on welfare. Programs that have improved outcomes among children in disadvantaged families provide access to an array of services cross professional and bureaucratic boundaries, emphasize relationships of trust and respect, are deeply, rooted in the community, are family focused, and recognize the distinctive needs of those most at risk. If health, mental health, social service and education programs with these attributes are to reach the large numbers who need them, the systems within which these programs operate must be restructured.
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