Nations are only as strong or as weak as their infrastructure. Infrastructure remains a most confusing area.

Some clarifications and categorizations:

    -Spiritual Infrastructure - belief in the American ideal, trust in the nation and its leadership

    -Political Infrastructure - how the nation distributes

    -Civil Infrastructure - how the nation supports itself structurally

    -Human Infrastructure - the important people component of the nation, the front lines of people interactions, the best representation of America to Americans, the component that determine efficiency and effectiveness, as do all of the other components above .

Nations are as efficient and effective as they believe they are,

as they distribute with reasonable equity to encourage all to fully participate, as they think and plan ahead to build and rebuild a few years in advance, and as they support the lower and middle income children who become the serving human infrastructure of the nation - teachers, nurses, primary care, public health, and public servants.

The serving professionals are the eyes and ears of the nation, the component that connects the leadership to the nation. Upper status children will become leaders in all areas, but they cannot lead with awareness when isolated from lower and middle income America and they cannot be advised to lead well without serving professionals.

The serving human infrastructure has had no real income gains for the past 30 years. They have been ignored. They are caught between serving and those who manage them. Primary care has joined this in the last decade. Budgets for school districts, health care institutions, and government are about people costs. When these budgets are slashed, when local property values are low, when the costs of delivering care, when energy costs increase, and when health care costs increase, the people infrastructure suffers most. Typically this means cuts in personnel with fewer to do more work and more complex work as more and more children are left behind in America. American has produced more than enough teachers, nurses, public servants, and primary care practitioners to meet need, but has to produce 2 - 3 times as much to get the current supply because the support is so low, often not salary support but support in terms of enough to get the work done.

America is out of balance primarily because the communications have broken down between lower and middle income America and those who shape the nation. Only improved awareness, improved priority on children age 0 - 8, and improved emphasis on the human infrastructure of the nation will change the American situation. Then the 65% of America children who are left behind will invest themselves in a better life, then the nation will understand that it most constantly build and rebuild and then Americans can believe in America, then the political and spiritual infrastructure will move toward unified purpose rather than constant and increasing divisions.

Robert C. Bowman, M.D.


-Political, Civil, and Spiritual Infrastructure has many advocates. The nation needs more advocates for the children who become human infrastructure and the critically important work that they do.

-For more about Priority Infrastructure contact


-For more about rebuilding health care www.ruralmedicaleducation.org


Infrastructure America