No one makes a conscious decision to be a bad parent. Often, people simply lack the necessary resources or skills, face other obstacles, or make poor decisions along the way that result in the inability to effectively raise a child, most often perpetuating their disadvantage for another generation. Disadvantage allows weak social determinants to prevail. To break the cycle that is driving today's health care costs, we must find ways to fund programs that will immunize disadvantaged children against bad social determinants. While we cannot mandate a certain degree of financial stability, skill and commitment to fully engage in the art/science of child rearing before issuing a license to conceive, we can rely on the thinking behind models such as the Perry Preschool and Abecedarian projects, as well as the concepts of Healthy Start and the Regional Intervention Program (RIP) and their successes. in an attempt to break the cycle of disadvantage and its role in the health of our nation. Public health should focus on a continuum of services that begins during prenatal care with a needs assessment. Based on assessment scores related to socioeconomic status, the potential for transgenerational determinants, and other factors, at-risk families would be automatically enrolled in these types of programs. Healthy Start would be mandatory for all families at risk, with progression to other services as required by ongoing screening, using health IT in conjunction with public health, social care and education data to stratify families into specific social determinant risk categories for prevention and intervention services. . When Little Johnny is taken to the doctor for his third ear infection in two months, the...... middle of paper ......1/how-effective-preschool-programs-are-the-proposals- government-funded-Educare: create comprehensive early childhood care and education centers. (2014) COALITION policy solutions that work for low-income people. Accessed 02/22/14 from http://www.clasp.org/babiesinchildcare/state/educare-creating-comprehensive-early-care-and-education-centers Heckman, J. J. (2012). Promote social mobility. (cover story). Boston Review, 14-34. Maher, E., Zulliger, K., Marcynszy, L., Wilson, D., Carroll, CL, & Calpin, C. (2013). Advocate for early childhood intervention in child protection. (2013). Casey Family Programs. Accessed 02/21/14 from http://www.casey.org/Resources/Publications/pdf/EarlyChildhoodIntervention.pdf Pay now, escape poverty later. (2007). Prevention action. Retrieved 02/21/14 from http://www.preventionaction.org/what-works/pay-now-break-out-poverty-later