SUMMARY:In the lifetime of the National Children's Bureau childhood death and serious infection have become increasingly rare. Chronic disease and disability may have become more common, partly as a result of the increased number of survivors of once fatal conditions. Income and social class are strongly associated with health, children in unskilled manual households being twice as likely to die before the age of 15 years as children in the professional social class. The proportion of children living in poverty doubled in the last decade. The rational allocation of resources to improve the health of children and teenagers is discussed.