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All child deaths occurring from 1976 to 1980 in Maine were studied. All children who were participating in social welfare programs (Medicaid, Food Stamps, or Aid to Families with Dependent Children [AFDC]) at the time of death were categorized as children from "low-income" families. This group of children had an overall death rate 3.1 times greater than children who were not on a social welfare program at the time of death. Children from low-income families were at higher risk for disease-related deaths (3.5:1), accidental deaths (2.6:1), and homicide deaths (5.0:1), but not for suicides. These data suggest that excess mortality is occurring among infants and children from low-income families in spite of Medicaid and other poverty programs and that this excess mortality has important public health and social policy implications. Pediatricians and others interested in the well-being of children should support improvement of current health care delivery and social welfare programs, because the current system is failing to provide an optimal health outlook for every child.