Americans must accept the notion that each and every American is responsible for each and every child and the United States must develop a national children's policy encompassing concerns that influence children's health. There are at least four fundamental steps that the United States can take to improve children's health in the 1990s. They are: (1) embrace a broad view of children's health to encompass environmental and educational needs; (2) provide universal access to high quality health care, regardless of income levels; (3) reduce poverty; and (4) develop and maintain surveillance systems to keep children from falling through the cracks of the existing health care system. In addition, there are numerous specific programs that improve children's health currently being used in Canada and Europe that could be adopted for the United States. Programs focus on health visits, health insurance, preschool care, community health stations providing access to care, and pre- and postnatal care clinics. The foregoing conclusions were reached at the Conference on Cross-National Comparisons of Child Health, a conference held in March 1990 in Washington, D.C. (RH)