In an era when politicians talk of the need for smaller government and cutting unnecessary spending — all of which is most definitely needed — it is good to see there are still effective programs that have expanded in recent years with good success.

Recently released figures show in North Carolina child death rates are at a historic low, a trend mirrored here in Surry County.

In 1991 North Carolina implemented the Child Fatality Prevention System, which has evolved over the years. Today in Surry County efforts in the program include identifying high-risk pregnancies, then working with the mother to ensure she has adequate education, support, and access to needed health care during the pregnancy, and that both are extended to her and her baby in the days and weeks after the birth.

Oftentimes that means teaching about nutrition, healthful living habits, and simply how to raise a baby.

In 1990 children — defined by those younger than age 18 — died at the rate of 105.4 per 100,000. In 2011, that rate had dropped to 57.4.

In 1990 many of those who died very young were from low-income homes where access to adequate health care was nearly non-existent. That’s right, in a nation that had some of the best health care capabilities in the world, children were dying because they did not have access to that health care.

We don’t mean to overstate the case. Some of those deaths were results of automobile wrecks, accidents, overdoses, birth defects and sicknesses that might still happen today. But the continued and sustained improvements in the childhood mortality rate throughout the implementation of this program is clear.

Beyond the numbers, we suspect this program has had even more far-reaching effects.

“Each child death is just the tip of the iceberg, representing hundreds if not thousands of injuries or other undesirable results,” said Karen McLeod, co-chair of the North Carolina Child Fatality Task Force. “The same strategies that reduce child death help prevent poor birth outcomes, broken homes and violence against and by children.”

That means children growing up in homes that have benefited from the Child Fatality Prevention System not only are more likely to survive, but they are likely to be healthier, less likely to be exposed to violence in the home, and are set up for a better chance at success in school. That can have life-long, even multi-generational effects for the family and the larger community.

Despite the fact that some people in Surry County, and elsewhere, still do not want to admit the truly needy exist, they clearly do. And despite the fact those same people with their heads in the sand often decry the existence of government health and intervention programs, they are clearly effective.