U.S. children are not well

A new report released by UNICEF ranks the U.S. 20th out of 21 industrialized countries in what they term “children’s well-being.” Only the U.K. lagged behind.

“The true measure of a nation’s standing is how well it attends to its children – their health and safety, their material security, their education and socialization, and their sense of being loved, valued, and included in the families and societies into which they are born.”

So begins the 52-page publication, titled “Child poverty in perspective: An overview of child well-being in rich countries – A comprehensive assessment of the lives and well-being of children and adolescents in the economically advanced nations.” What does it mean to be well? And why is the U.S., one of the wealthiest countries in the world, almost dead last?

According to the Associated Press, Professor Jonathan Bradshaw of the U.K., one author of the study, said, “Children fared worse in the U.S. and Britain – despite high overall levels of national wealth – because of greater economic inequality and poor levels of public support for families.” Bradshaw goes on to say: “What they have in common are very high levels of inequality, very high levels of child poverty, which is also associated with inequality, and in rather different ways poorly developed services to families with children… They don’t invest as much in children as continental European countries do.” He goes on to cite poorer health coverage and preventative care for children in the U.S. The U.S. finished last in the health and safety category, in part based on rates of infant mortality and deaths from injuries and accidents before age 19.

We pride ourselves on having one of the best health care systems in the world. And this is true for certain things – high tech, acute care. That is important, but have we developed a system that sacrifices long-term goals – optimal health and functioning – for short-term, media-friendly achievements? A recent publication in Pediatrics points out that over half of all children aged 0 to 18 years in the U.S. had no well-child visits during a one-year period, and almost 40% had no well-child visits over a 2-year period. Something is rotten in America. And for those wondering, Denmark performed quite well in the survey.

Initial U.S. and British official reaction was typically defensive. As per the A.P., Wade Horn, an assistant secretary at the Department of Health and Human Services, said the study’s standard of measuring poverty differed from that of the United States. “I think when you try to compare nations in a report like this, you tend to ignore so many other factors specific to those nations that the comparison becomes somewhat meaningless,” Horn said. Generally, officials were either unavailable for comment or attacked the merits of the study. How typically American. At least some of the Brits are taking their last-place finish quite seriously. The British press is all over Tony Blair and friends. The BBC News, for example, laments that the “UK is accused of failing children.” Here are some of the reactions from across the pond (courtesy BBC News):

The Children’s Society chief executive Bob Reitemeier: “We simply cannot ignore these shocking findings. Unicef’s report is a wake-up call to the fact that, despite being a rich country, the UK is failing children and young people in a number of crucial ways.”

The Children’s Commissioner for England, Professor Sir Al Aynsley-Green: “We are turning out a generation of young people who are unhappy, unhealthy, engaging in risky behaviour, who have poor relationships with their family and their peers, who have low expectations and don’t feel safe.”

All of this should be cause for concern, and the UNICEF report should help frame the dialogue about how we better address the needs of children in the world.

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Here are the rankings. Countries are listed by their average overall ranking, with the lowest figure indicating the best result. The numbers in brackets are their rankings for the individual categories: material well-being, health and safety, education, peer and family relationships, behaviors and risks, and young people’s own subjective sense of well-being.

1. Netherlands 4.2 (10 2 6 3 3 1)

2. Sweden 5.0 (1 1 5 15 1 7)

3. Denmark 7.2 (4 4 8 9 6 12)

4. Finland 7.5 (3 3 4 17 7 11)

5. Spain 8.0 (12 6 15 8 5 2)

6. Switzerland 8.3 (5 9 14 4 12 6)

7. Norway 8.7 (2 8 11 10 13 8)

8. Italy 10.0 (14 5 20 1 10 10)

9. Ireland 10.2 (19 19 7 7 4 5)

10. Belgium 10.7 (7 16 1 5 19 16)

11. Germany 11.2 (13 11 10 13 11 9

12. Canada 11.8 (6 13 2 18 17 15)

13. Greece 11.8 (15 18 16 11 8 3)

14. Poland 12.3 (21 15 3 14 2 19)

15. Czech Republic 12.5 (11 10 9 19 9 17)

16. France 13.0 (9 7 18 12 14 18)

17. Portugal 13.7 (16 14 21 2 15 14)

18. Austria 13.8 (8 20 19 16 16 4)

19. Hungary 14.5 (20 17 13 6 18 13)

20. United States 18.0 (17 21 12 20 20 )

21. United Kingdom 18.2 (18 12 17 21 21 20)

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