unicef report card 11 final

7/28/2019 Unicef Report Card 11 Final

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UNICEFOfce o Research

Innocenti Report Card 11

Cd - rc corsA comparative overview


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Innocenti Report Card 11 was written by Peter Adamson.

The UNICEF Oce o Research Innocenti would like to acknowledge

the generous support orInnocenti Report Card 11 provided by the

Andorran and Swiss National Committees or UNICEF, and the

Government o Norway.

Any part o thisInnocenti Report Cardmay be reely reproduced using

the ollowing reerence:

UNICEF Oce o Research (2013). Child Well-being in Rich Countries:

A comparative overview,Innocenti Report Card 11, UNICEF Oce o

Research, Florence.

TheReport Cardseries is designed to monitor and compare the

perormance o economically advanced countries in securing the

rights o their children.

In 1988 the United Nations Childrens Fund (UNICEF) established a

research centre to support its advocacy or children worldwide and to

identiy and research current and uture areas o UNICEFs work. The

prime objectives o the Oce o Research are to improve international

understanding o issues relating to childrens rights, to help acilitate

ull implementation o the Convention on the Rights o the Child

supporting advocacy worldwide. The Oce aims to set out a

comprehensive ramework or research and knowledge within theorganization in support o its global programmes and policies. Through

strengthening research partnerships with leading academic institutions

and development networks in both the North and South, the Oce

seeks to leverage additional resources and infuence in support o

eorts towards policy reorm in avour o children.

Publications produced by the Oce are contributions to a global debate

on children and child rights issues and include a wide range o

opinions. For that reason, some publications may not necessarily refect

UNICEF policies or approaches on some topics. The views expressed

are those o the authors and/or editors and are published in order to

stimulate urther dialogue on child rights.

Cover photo luxorphoto/Shutterstock

United Nations Childrens Fund (UNICEF), April 2013

ISBN: 978-88-6522-016-0

ISSN: 1605-7317

UNICEF Oce o Research Innocenti

Piazza SS. Annunziata, 12

50122 Florence, Italy

Tel: +39 055 2033 0

Fax: +39 055 2033 [email protected]

www.unice-irc.org


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UNICEFOfce o Research

Innocenti Report Card 11

PART ONE prss a a a o cd - 29 o ords advacd cooms.

PART TWO ooks a a cdr say ao ro - (cd a a a ocdrs sasaco).

PART THREE xams cas cd - advacd cooms ovr rs dcad o 2000s, ook a ac corys prorss dcaoa acvm, a r ras,cdood osy vs, prvac o y,ad s o oacco, acoo ad drs.

Cd -

rc corsA comparative overview


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Ovra - Dmso 1 Dmso 2 Dmso 3 Dmso 4 Dmso 5

Average rank(all 5 dimensions)

Materialwell-being

Health andsaety

Education Behavioursand risks

Housing andenvironment

(rank) (rank) (rank) (rank) (rank)

1 Netherlands 2.4 1 5 1 1 4

2 Norway 4.6 3 7 6 4 3

3 Iceland 5 4 1 10 3 7

4 Finland 5.4 2 3 4 12 6

5 Sweden 6.2 5 2 11 5 8

6 Germany 9 11 12 3 6 13

7 Luxembourg 9.2 6 4 22 9 5

8 Switzerland 9.6 9 11 16 11 1

9 Belgium 11.2 13 13 2 14 14

10 Ireland 11.6 17 15 17 7 2

11 Denmark 11.8 12 23 7 2 15

12 Slovenia 12 8 6 5 21 20

13 France 12.8 10 10 15 13 16

14 Czech Republic 15.2 16 8 12 22 18

15 Portugal 15.6 21 14 18 8 17

16 United Kingdom 15.8 14 16 24 15 10

17 Canada 16.6 15 27 14 16 11

18 Austria 17 7 26 23 17 12

19 Spain 17.6 24 9 26 20 9

20 Hungary 18.4 18 20 8 24 22

21 Poland 18.8 22 18 9 19 26

22 Italy 19.2 23 17 25 10 21

23 Estonia 20.8 19 22 13 26 24

23 Slovakia 20.8 25 21 21 18 19

25 Greece 23.4 20 19 28 25 25

26 United States 24.8 26 25 27 23 23

27 Lithuania 25.2 27 24 19 29 27

28 Latvia 26.4 28 28 20 28 28

29 Romania 28.6 29 29 29 27 29

PART 1A leAgue tAble O ChilD well-being

t a o raks 29 dvopd cors accord o ovra - o r cdr. eac corys ovra rak s

asd o s avra rak or v dmsos o cd - cosdrd s rv.

A light blue background indicates a place in the top third o the table, mid blue denotes the middle third, and dark blue the bottom third.

Lack o data on a number o indicators means that the ollowing countries, although OECD and/or EU members, could not be included in the league table

o child well-being: Australia, Bulgaria, Chile, Cyprus, Israel, Japan, Malta, Mexico, New Zealand, the Republic o Korea, and Turkey.

2 I n n o c e n t I R e p o R t c a R d 1 1


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The league table opposite presents

the latest available overview o child

well-being in 29 o the worlds most

advanced economies.Five dimensions o childrens lives

have been considered: material

well-being, health and saety,

education, behaviours and risks, and

housing and environment. In total,

26 internationally comparable

indicators have been included in the

overview (see Box 1).

The table updates and renes the

rst UNICEF overview o child well-

being published in 2007 (Report

Card 7).i Changes in child well-being

over the rst decade o the 2000s

are examined in Part 3.

Ky ds

The Netherlands retains itsposition as the clear leader and

is the only country ranked among

the top ve countries in all

dimensions o child well-being.

The Netherlands is also the

clear leader when well-being isevaluated by children themselves

with 95% o its children rating

their own lives above the mid-

point o theLie Satisaction Scale

(see Part 2).

Four Nordic countries Finland,Iceland, Norway and Sweden sit

just below the Netherlands at the

top o the child well-being table.

Four southern European countries Greece, Italy, Portugal and Spain

are placed in the bottom hal o

the table.

The bottom our places in thetable are occupied by three o

the poorest countries in the

survey, Latvia, Lithuania andRomania, and by one o the

richest, the United States.

Overall, there does not appearto be a strong relationship

between per capita GDP and

overall child well-being. The

Czech Republic is ranked higher

than Austria, Slovenia higher

than Canada, and Portugal

higher than the United States.

There are signs that thecountries o Central and Eastern

Europe are beginning to close

the gap with the more

established industrial economies

(see Part 3).

Ca ovr a dcad

Although changes in methods and

structure make it dicult to make

comparisons between the rst twoissues o the UNICEF overview o

child well-being (see Part 3) it is

nonetheless clear that there have

been some signicant changes over

the rst decade o the 2000s.

Overall, the story o the rstdecade o the 2000s is one o

widespread improvement in

most, but not all, indicators o

childrens well-being. The low

amily afuence rate, the inant

mortality rate, and the percentage

o young people who smoke

cigarettes, or example, have

allen in every single country or

which data are available.

Data sources and background papers

The data sources used or this report are set out in the three backgroundpapers detailed below and available at p://.c-rc.or

Martorano, B., L. Natali, C. de Neubourg and J. Bradshaw (2013). Child Well-

being in Advanced Economies in the Late 2000s, Working Paper 2013-01.

UNICEF Oce o Research, Florence.

p://.c-rc.or/pcaos/pd/p_2013_1.pd

Martorano, B., L. Natali, C. de Neubourg and J. Bradshaw (2013). Child Well-

being in Economically Rich Countries: Changes in the rst decade o the 21st

century, Working Paper 2013-02. UNICEF Oce o Research, Florence.


Bradshaw, J., B. Martorano, L. Natali and C. de Neubourg (2013). Childrens

Subjective Well-being in Rich Countries, Working Paper 2013-03. UNICEF

Oce o Research, Florence.


Introduction

I n n o c e n t I R e p o R t c a R d 1 1 3


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Spain has slipped down therankings rom 5th out o 21

countries in the early years o

the decade to 19th out o 29

countries in 2009/2010.

The United Kingdom has risenup the rankings rom bottom

place (21st out o 21 countries)

in 2000/2001 to a mid-table

position today.

Part 3 o this report examines

changes over the rst decade o

the 2000s in more detail.

Masr prorss or cdr

The league table o child well-being

is designed to measure and

compare progress or children

across the developed world. Its

purpose is to record the standards

achieved by the most advanced

nations and to contribute to debate

in all countries about how such

standards might be achieved.

As a moral imperative, the need to

promote the well-being o children

is widely accepted. As a pragmatic

imperative, it is equally deserving

o priority; ailure to protect and

promote the well-being o children

is associated with increased risk

across a wide range o later-lie

outcomes. Those outcomes range

rom impaired cognitive

development to lower levels o

school achievement, rom reduced

skills and expectations to lower

productivity and earnings, rom

higher rates o unemployment to

increased dependence on welare,

rom the prevalence o antisocial

behaviour to involvement in crime,

rom the greater likelihood o drug

and alcohol abuse to higher levels o

teenage births, and rom increased

health care costs to a higher

incidence o mental illness.ii, iii

The case or national commitment

to child well-being is thereore

compelling both in principle and in

practice. And to ull that

commitment, measuring progress

in protecting and promoting the

well-being o children is essential to

policy-making, to advocacy, to the

cost-eective allocation o limited

resources, and to the processes o

transparency and accountability.

iraoa comparay

The measurement o child well-

being, however, is a relatively new

area o study and the overview

presented here remains a work in

progress. Chie among its

limitations is the act that

internationally comparable data on

childrens lives are not suciently

timely. Between the collection o

data in a wide variety o dierent

settings and their publication in

quality-controlled, internationally

comparable orm the time-lag is

typically two to three years. This

means that most o the statistics on

child well-being used in this report,

though based on the latest available

data, apply to the period 2009

2010. Such a delay would be

rustrating at the best o times. But

the last three years have been ar

rom the best o times. Beginning

in late 2008, economic downturn

in many developed nations has

seen rising unemployment and alls

in government expenditures which

cannot but aect the lives o many

millions o children. Data rom

2009 and 2010 capture only the

beginning o this turbulence.

Nonetheless, or the most part,

the data used in this overview track

long-term trends and refect the

results o long-term investments in

childrens lives. Average levels o

school achievement, or

immunization rates, or the

prevalence o risk behaviours,

or example, are not likely to be

signicantly changed in the short

term by the recessions o the last

three years.

For the time being, it must be

accepted that data-lag is part o

the entry price or international

comparisons o child well-being.And although national-level

monitoring o childrens lives is the

more important task, UNICEF

believes that international

comparison can also play a part.

It is international comparison that

can show what is achievable in the

real world, highlight strengths and

weaknesses in individual countries,

and demonstrate that child well-

being is policy-susceptible. And it

is international comparison thatcan say to politicians, press and

public everywhere This is how

your perormance in protecting

children compares with the record

o other nations at a similar level

o development.

Finally, any single overview o a

complex and multidimensional

issue carries a risk o hiding more

than it reveals. The ollowing pages

thereore set out to make this

overview o child well-being astransparent as possible by

examining each o its dimensions

in turn.



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Box 1 How child well-being is measured

The table below shows how the overview o child well-being has been constructed and sets out the ull list o

indicators used. The score or each dimension has been calculated by averaging the scores or each component.

Similarly, component scores are arrived at by averaging the scores or each indicator.

Dmsos Compos idcaors r o.

Dimension 1

Mara -

Figure 1.0

Monetary deprivationRelative child poverty rate 1.1a

Relative child poverty gap 1.1b

Material deprivationChild deprivation rate 1.2a

Low amily afuence rate 1.2b

Dimension 2

ha ad say

Figure 2.0

Health at birthInant mortality rate 2.1a

Low birthweight rate 2.1b

Preventive health services Overall immunization rate 2.2

Childhood mortality Child death rate, age 1 to 19 2.3

Dimension 3

edcao

Figure 3.0

Participation

Participation rate: early childhood

education 3.1a

Participation rate: urther education,

age 15193.1b

NEET rate (% age 1519 not in

education, employment or training)3.1c

AchievementAverage PISA scores in reading,

maths and science3.2

Dimension 4

bavors ad rsks

Figure 4.0

Health behaviours

Being overweight 4.1a

Eating breakast 4.1b

Eating ruit 4.1c

Taking exercise 4.1d

Risk behaviours

Teenage ertility rate 4.2aSmoking 4.2b

Alcohol 4.2c

Cannabis 4.2d

Exposure to violenceFighting 4.3a

Being bullied 4.3b

Dimension 5

hos ad vrom

Figure 5.0

HousingRooms per person 5.1a

Multiple housing problems 5.1b

Environmental saetyHomicide rate 5.2a

Air pollution 5.2b



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-3.5 -3.0 -2.5 -2.0 -1.5 -1.0 -0.5 0.0 0.5 1.0 1.5

Netherlands

Finland

Norway

Iceland

Sweden

Luxembourg

Austria

Slovenia

Switzerland

FranceGermany

Denmark

Belgium

United Kingdom

Canada

Czech Republic

Ireland

Hungary

Estonia

Greece

Portugal

Poland

Italy

Spain

Slovakia

United States

Lithuania

Latvia

Romania

Assss mara -

COMPOnentS inDiCAtORS

Moary

dprvao

Relative child poverty rate (% o children living

in households with equivalent incomes below

50% o national median)

Child poverty gap (distance between national

poverty line and median incomes o households

below poverty line)

Mara

dprvao

Index o child deprivation (% o children lacking

specic items)

Family afuence scale (% o children reporting

low amily afuence)

Figure 1.0 An overview o

childrens material well-being

t a a o cdrs mara

- sos ac corys

prormac rao o avra

or 29 dvopd cors dr

rv. t a s scad o so

ac corys dsac aov or

o a avra.

t o ac ar sos ac

corys dsac aov or o

avra or rop as a o. t

o masrm s sadard

dvao a masr o sprad

o scors rao o avra.

Dimension 1 Mara -



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The table opposite (Figure 1.0)

presents an overview o childrens

material well-being in developed

countries. Overall, it suggests that

material well-being is highest in

the Netherlands and in the our

Nordic countries and lowest in

Latvia, Lithuania, Romania and the

United States.

Two components o material well-

being have been considered inarriving at this overview relative

income poverty and material

deprivation. The strengths and

weaknesses o both measures were

discussed in detail in the previous

report in this series (Report Card 10)iv

which argued that both measures are

necessary to achieve a rounded view

o childrens material well-being.

Rav povry:

cd povry ras

Two separate indicators have

been used to measure monetary

deprivation. They are the relative

child poverty rate (Figure 1.1a) and

the child poverty gap (Figure 1.1b).

The relative child poverty rate shows

the proportion o each nations

0 5 10 15 20 25

Finland

Netherlands

Denmark

Iceland

Norway

Slovenia

Sweden

AustriaIreland

Switzerland

Germany

France

Czech Republic

United Kingdom

Hungary

Belgium

Luxembourg

Estonia

Slovakia

Poland

Canada

Portugal

Greece

Italy

Lithuania

Spain

Latvia

United States

Romania

Cyprus

Malta

Australia

New Zealand

Japan

Bulgaria

Childrens material well-being

Figure 1.1a Rav cd povry ras

% o children aged 017 living in households with equivalent incomesbelow 50% o national median

Countries with grey bars have not been

included in the ranking tables, or in the

overall league table o child well-being,

as they have data or ewer than 75% othe total number o indicators used.

Findings

Finland is the only country with a relative child poverty rate o lessthan 5% and heads the league table by a clear margin o more than

two percentage points.

The countries in the top hal o the league table all have relative childpoverty rates o less than 10%.

Four southern European countries Greece, Italy, Portugal and Spain have child poverty rates higher than 15% (along with Latvia, Lithuania,

Romania and the United States).

children living in households where

disposable income is less than 50%

o the national median (ater taking

taxes and benets into account

and adjusting or amily size and

composition). This is the denition

o child poverty used by the

majority o the worlds developed

economies. Broadly speaking, it

shows the proportion o children

who are to some signicant extent



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excluded rom the advantages and

opportunities which most children

in that particular society would

consider normal.

Rav povry:

povry ap

The relative child poverty rates in

Figure 1.1a show what percentage

o children live below each nations

relative poverty line. But they reveal

nothing about how ar below thatline those children are being

allowed to all. To gauge the depth

o relative child poverty, it is also

necessary to look at the child

poverty gap the distance between

the poverty line and the median

incomes o those below the line.

Figure 1.1b shows this child

poverty gap or each country.

Considering rate and gap together

shows six countries in the bottomthird o both tables. They are Italy,

Latvia, Lithuania, Romania, Spain

and the United States. By contrast,

there are also six countries that

eature in the top third o both

tables Austria, Finland,

Netherlands, Norway, Slovenia

and Sweden.

What this means or the children

o Spain or the United States, or

example, is that 20% or more all

below the relative poverty line and

that, on average, they all almost

40% below that line. In the

Netherlands or Austria, on the other

hand, 6% to 8% o children all

below the relative poverty line and,

on average, they all approximately

16% below.

Taken together, these two child

poverty indicators the rate and the

gap make up the relative income

component o childrens materialwell-being.

Luxembourg

Hungary

Netherlands

Austria

Finland

France

Norway

Sweden

Germany

Slovenia

Iceland

Switzerland

Canada

United Kingdom

Czech Republic

Belgium

Poland

Greece

Portugal

Latvia

Denmark

Estonia

Slovakia

Romania

Italy

Ireland

Lithuania

United States

Spain

Cyprus

Malta

Australia

New Zealand

JapanBulgaria

0 5 10 15 20 25 30 35 40

Figure 1.1b Cd povry aps

Gap between the poverty line and the median income o thosebelow the poverty line as % o the poverty line

Findings

Hungary and Luxembourg have the smallest child poverty gaps.

Denmark is an exception among Nordic countries in having a high childpoverty gap (almost 30%). Only a small proportion o Danish children

(6.3%) all below the countrys relative poverty line; but those who do,

all urther below than in most other countries.

Several countries have allowed the child poverty gap to widen to more

than 30%. They are Bulgaria, Ireland, Italy, Japan, Lithuania, Romania,Slovakia, Spain and the United States.



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Mara dprvao:

Child Deprivation Index

Relative income measures, however,

have little to say about the actual

living conditions o children in

dierent countries. The act that a

higher percentage o children live in

relative income poverty in Canada

than in the Czech Republic, or

0 10 20 30 40 50 60 70 80

Bulgaria

Malta

Cyprus

RomaniaHungary

Latvia

Portugal

Poland

Lithuania

Slovakia

Greece

Italy

Estonia

France

Belgium

Germany

Czech Republic

Austria

Slovenia

Spain

United Kingdom

Ireland

Luxembourg

Netherlands

Denmark

Finland

Norway

Sweden

Iceland

Figure 1.2a Cd dprvao ras% o children lacking two or more specic items see text

Findings

The ve Nordic countries and the Netherlands claim the top six places.

Luxembourg and Ireland are the only other countries with child deprivationrates below 5% (although the United Kingdom comes close at 5.5%).

France and Italy have child deprivation rates higher than 10%.

Four countries have child deprivation rates o more than 25% Hungary,Latvia, Portugal and Romania.

example, does not mean that

childrens actual living standards are

lower in Canada (only that a greater

proportion o Canadian children live

in households where disposable

income is 50% o the median). In

order to arrive at a more complete

picture o child poverty, a measure

o actual material deprivation has

thereore also been included.

Again, two indicators have been

used. The rst is the UNICEF Child

Deprivation Rate (introduced in

Report Card 10) v which shows what

percentage o children in each

nation lack two or more o the

ollowing 14 items:

1. Three meals a day

2. At least one meal a day

with meat, chicken or sh

(or vegetarian equivalent)3. Fresh ruit and vegetables

every day

4. Books suitable or the childs

age and knowledge level (not

including schoolbooks)

5. Outdoor leisure equipment

(bicycle, roller-skates, etc.)

6. Regular leisure activities

(swimming, playing an

instrument, participating in

youth organizations, etc.)7. Indoor games (at least one per

child, including educational baby

toys, building blocks, board

games, computer games, etc.)

8. Money to participate in school

trips and events

9. A quiet place with enough room

and light to do homework

10. An Internet connection

11. Some new clothes (i.e. not all

second-hand)12. Two pairs o properly tting

shoes

13. The opportunity, rom time

to time, to invite riends home

to play and eat

14. The opportunity to celebrate

special occasions such as

birthdays, name days, religious

events, etc.

Figure 1.2a presents the child

deprivation rate or 26 countries(no comparable data are available

or Canada, Switzerland or the

United States).



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Mara dprvao:

o amy afc

The second indicator used to

measure material deprivation is

based on written questionnaires

completed by representative

samples o children aged 11,

13, and 15 in each country.vi

The relevant part o the

questionnaire asks:

0 5 10 15 20 25 30 35 40

Romania

Slovakia

Hungary

Latvia

Lithuania

Poland

Czech Republic

Estonia

Greece

Italy

Portugal

United States

United Kingdom

Ireland

Austria

Spain

Germany

Canada

Belgium

France

Slovenia

Finland

Luxembourg

Sweden

Switzerland

Denmark

Netherlands

Norway

Iceland

Figure 1.2b Prca o cdr rpor o amy afc

Findings

The Netherlands and the Nordic countries, along with Luxembourgand Switzerland, have the smallest percentage o children reporting

low amily afuence.

Low amily afuence rates are highest in eight Central and EasternEuropean countries the Czech Republic, Estonia, Hungary, Latvia,

Lithuania, Poland, Romania and Slovakia.

Does your amily own a car, vanor truck?

During the past 12 months, howmany times did you travel away

on holiday with your amily?

How many computers does your

amily own?

Do you have your own bedroomor yoursel?

The results are computed into the

Family Auence Scale used in

Figure 1.2b to show the percentage

o children in each country living in

low afuence amilies.

As might be expected, the child

deprivation rate and the low amily

afuence rate produce broadly

similar league table rankings. They

are, however, dierent in that one

ocuses on the child and the otheron the amily. Taken together, they

provide a more secure overview o

childrens material deprivation.

Ra ad rav

The dierences between the two

components o childrens material

well-being relative poverty and

material deprivation are oten

misunderstood. It is not the case

that one is a relative measure and

the other absolute. Both are relativemeasures. Deprivation rates may

appear to measure absolute poverty

because they are based on a

specic list o possessions rather

than the median income o each

nation. But those possessions are

chosen to represent what most

people consider normal or a child

growing up in any wealthy country

in the early 21st century. They are

thereore relative to both time and

place. The true dierence betweenthe two approaches is that one

measures poverty in relation to an

income norm that varies rom

country to country (the national

median income) whereas the other

measures poverty by a common

standard or all o the countries

under review.

1 0 I n n o c e n t I R e p o R t c a R d 1 1


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-3.0 -2.5 -2.0 -1.5 -1.0 -0.5 0.0 0.5 1.0 1.5 2.0

Romania

Latvia

Canada

Austria

United States

Lithuania

Denmark

Estonia

Slovakia

Hungary

Greece

Poland

Italy

United Kingdom

Ireland

Portugal

Belgium

Germany

Switzerland

France

Spain

Czech Republic

Norway

Slovenia

Netherlands

Luxembourg

Finland

Sweden

Iceland

Assss a ad say


ha a r

Inant mortality rate (deaths under 12 months old

per 1,000 live births)

Low birthweight rate (% babies born below

2,500 grammes

Prvv a

srvcs

National immunization rate (average coverage

or measles, polio and DPT3 or children age

12 to 23 months)

Cd ad yomoray

Overall child and youth mortality rate

(deaths per 100,000 aged 1 to 19)

Figure 2.0 An overview o child

health and saety

t a a o cdrs a

ad say sos ac corys

prormac rao o avra

or 29 dvopd cors dr

rv. t a s scad o so


o a avra.

t o ac ar sos ac

corys dsac aov or o

avra or rop as a o.

t o masrm s

sadard dvao a masr o

sprad o scors rao o

avra.

Dimension 2 ha ad say

Findings

Nordic countries againhead the table, with Iceland,

Sweden and Finland claiming

the top three places.

Austria, Canada and Denmarkare to be ound towards the

oot o the league table along

with the United States. (In all

o these cases the low ranking

is partly attributable to low

immunization rates.)

I n n o c e n t I R e p o R t c a R d 1 1 1 1


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Health and saety

The health dimension o childrens

well-being is based on three

components or which

internationally comparable data are

available. The components are:

a) health at birth as measured

by the inant mortality rate and

the percentage o babies born

with low birthweight (below

2,500 grammes).

b) the availability o childrenspreventive health services

as measured by national

immunization levels or measles,

polio and DPT3.

c) child health and saety as

measured by the death rate o

children and young people

(aged 1 to 19) rom all causes.

The chart on the previous page

(Figure 2.0) combines these three

components into a league table o

child health or the 29 developed

countries under review.

ha a r:

a moray

In all developed countries, inant

mortality rates (IMRs) have been

reduced to ewer than 10 inant

deaths per thousand live births.

The relatively small dierences

between countries thereore refect

not variations in the undamentals

o public health such as sae water

and sanitation but variations in the

commitment and the capacity to

deliver whatever services are

necessary to protect every mother-

to-be, every birth, and every inant

in the earliest days and weeks o

lie. The IMRs set out in Figure 2.1a

may thereore be read as a measure

o commitment to maternal and

child health or all including the

mothers and children o the poorest

and most marginalized amilies.

0 2 4 6 8 10 12 14

Bulgaria

Malta

New Zealand

Australia

Cyprus

Japan

Romania

Latvia

Slovakia

United States

Hungary

Poland

Lithuania

Canada

United Kingdom

Switzerland

Greece

Spain

Belgium

Netherlands

France

Austria

Ireland

Germany

Czech Republic

DenmarkItaly

Estonia

Portugal

Norway

Finland

Luxembourg

Sweden

Slovenia

Iceland

Figure 2.1a ia moray ras

Deaths under 12 months old per 1,000 live births

Findings

Three Nordic countries Finland, Iceland and Sweden plusLuxembourg and Slovenia head the table with inant mortality rates

o ewer than 2.5 deaths per 1,000 births.

26 o the 35 countries have reduced inant mortality to 5 or ewerper 1,000 births.

The only countries with inant mortality rates higher than 6 per1,000 births are Latvia, Romania, Slovakia and the United States.

Three o the richest nations in the developed world Canada, theUnited Kingdom and the United States are placed in the bottom

third o the inant mortality league table.



15/60

It is possible that the low ranking

o the United States in the league

table o inant mortality is not

justied: there is an as yet

unresolved debate about whether

inant mortality rates in the United

States might include the deaths o

extremely premature and/or low

birthweight babies who are kept

alive or a time by advanced neo-

natal care but who, in other

countries, might not be classied

as live births.

ha a r:

o r

The second indicator used to

measure health at the beginning

o lie is the proportion o babies

who are born with low birthweights

(below 2,500 grammes).

According to the United States

Centers or Disease Control andPrevention, The birthweight o an

inant is the single most important

determinant o its chances o

survival and healthy growth.vii

It is also a guide to the general

health, and health behaviours, o

pregnant women and mothers, both

o which are important to every

other dimension o child well-being.

Low birthweight is also known to

be associated with increased risk

across a range o health problemsin childhood and on into adult lie.

Figure 2.1b shows the percentage

o babies born with low birthweight

in each o the 29 countries or

which data are available.

0 2 4 6 8 10 12

Japan

Australia

New Zealand

Greece

Hungary

Portugal

United States

Spain

Czech Republic

Slovakia

Austria

United Kingdom

Italy

Germany

Belgium

France

Switzerland

Luxembourg

Denmark

Canada

Poland

Slovenia

Netherlands

Norway

Ireland

Estonia

Finland

Sweden

Iceland

Figure 2.1b lo r

% babies born below 2,500 grammes

Findings

Five European countries Estonia, Finland, Iceland, Ireland and Sweden have succeeded in reducing the incidence o low birthweight below 5%.

Only in Greece, Hungary, Portugal and the United States does the lowbirthweight rate exceed 8%.



16/60

Prvv a srvcs:

mmzao

The second component chosen

to evaluate child health is the

availability and eectiveness o

each countrys preventive child

health services. This has been

measured by each countrys

immunization rate (average

vaccination coverage or measles,

polio and DPT3).

Routine immunization rates in the

developed nations are generally

maintained at high levels, averaging

close to 95%. As with inant

mortality rates, the relatively

small dierences between countries

can thereore be said to mirror

commitment to the ideal o

reaching out to every single child,

including the most marginalized,

with an essential preventive health

service to which all children havea right.

Figure 2.2 presents an immunization

league table or 29 countries.

It might be suspected that low

immunization rates in countries

such as Austria, Canada and

Denmark have been aected by

rumours, based on discredited

research, linking the triple MMR

vaccine (measles, mumps and

rubella) with autism. This wouldnot really be an excuse or low

coverage rates, as running a rst-

class immunization programme

means making sure that the public

is well inormed and that alse

inormation is not allowed to put

children at risk. But in act the MMR

scare would not appear to be the

major cause o low immunization

rates in Austria, Canada and

Denmark all o which have low

rates even when measlesvaccination is excluded rom the

calculations (in Canada, the measles

Findings

Greece and Hungary head the table with 99% immunization coverage.

Three o the richest countries in the OECD Austria, Canada andDenmark are the only countries in which the immunization rate alls

below 90%.

70 75 80 85 90 95 100

Malta

New Zealand

Australia

Cyprus

Bulgaria

Japan

Austria

Canada

Denmark

Latvia

Ireland

NorwayUnited States

Switzerland

Italy

Estonia

Germany

Iceland

Lithuania

United Kingdom

Slovenia

France

Romania

Spain

Netherlands

Portugal

Belgium

Sweden

Poland

Luxembourg

Czech Republic

Finland

Slovakia

Greece

Hungary

Figure 2.2 immzao ras

Average coverage or measles, polio and DPT3 or children aged 12 to 23 months



17/60

Findings

Iceland, Luxembourg, the Netherlands, Spain, Sweden and Switzerlandhead the table with child death rates below 15 per 100,000.

Central and Eastern European countries occupy the bottom third o thetable along with Belgium and Greece.

0 5 10 15 20 25 30 35 40

Bulgaria

Malta

Cyprus

Romania

Latvia

Lithuania

Estonia

Slovakia

Poland

Hungary

Greece

Belgium

Czech Republic

Austria

Ireland

Portugal

France

Denmark

Finland

United Kingdom

Italy

Slovenia

Norway

Germany

Spain

Sweden

Netherlands

Switzerland

Luxembourg

Iceland

Figure 2.3 Cd ad yo moray ras

Deaths per 100,000 aged 1 to 19

immunization rate is higher than

or DPT3 or polio).

Cd a:

1 o 19 da ra

The third component used to build

an overall picture o child health is

the death rate among children and

young people between the ages

o 1 and 19.

Deaths in this age group are rarein advanced economies and the

causes go beyond disease and

the ecacy o health services

to include deaths rom suicide,

murder, trac injuries, drownings,

alls and res. Dierences between

countries in the death rate or

children and young people in this

age group may thereore be said

to refect overall levels o health

and saety throughout childhood

and adolescence.

Figure 2.3 presents the 1- to

19-year-old death rate or each

country. In absolute numbers,

the dierences between countries

are clearly small. But it is worth

noting that i all European countries

had the same child death rate as

Iceland or Luxembourg then over

8,000 child deaths a year could

be prevented each one

representing unimaginable anguish

or the amily concerned.

Taken together, the three

components set out above provide

an approximate guide to the health

dimension o childrens well-being.

Ideally, such an overview would also

have included some indicator o

childrens mental and emotional

health, and o the prevalence o

child abuse and neglect. But such

issues are dicult to dene and

measure even within an individualcountry; internationally, no

comparable data are available.



18/60

-4.0 -3.0 -2.0 -1.0 0.0 1.0 2.0

Romania

Greece

United States

Spain

Italy

United Kingdom

Austria

Luxembourg

Slovakia

Latvia

Lithuania

Portugal

Ireland

Switzerland

France

Canada

Estonia

Czech Republic

Sweden

Iceland

Poland

Hungary

Denmark

Norway

Slovenia

Finland

Germany

Belgium

Netherlands

Assss dcaoa -


Parcpao

Preschool participation rate (% o those aged

between 4 years and the start o compulsory

education who are enrolled in preschool)

Further education participation rate (% o those

aged 15 to 19 enrolled in urther education)

NEET rate (% aged 15 to 19 not in education,

employment or training)

AcvmAverage score in PISA tests o reading, maths

and science literacy


children's educational well-

being

t a a o cdrs

dcaoa - sos ac

corys prormac rao o

avra or 29 dvopd

cors dr rv. t a

s scad o so ac corys

dsac aov or o a avra.

t o ac ar sos ac

corys dsac aov or o


o masrm s sadard

dvao a masr o sprad

o scors rao o avra.

Dimension 3 edcaoa -

Findings

Educational well-being isseen to be highest in Belgium,

Finland, Germany and the

Netherlands each o whichachieves an overall score

signicantly above average

or the 29 countries.

Greece, Romania, Spain andthe United States show the

lowest levels o educational

well-being.



19/60

Educational well-being

In gauging educational well-being,

two main components have been

considered participation rates and

achievement levels. Taken together

they provide an approximate

guide to both quantity and quality

o education. Figure 3.0 (opposite)

combines the two into a single

overview o childrens educational

well-being or 29 developed countries.

Parcpao:ary cdood dcao

The rst component participation

has been assessed by three

indicators:

a)participation in early childhood

education

b)participation in urther education

c)the proportion o young people,

aged 15 to 19, who are not

participating in education,training or employment.

In recent times it has been widely

acknowledged that the oundations

o educational success are laid down

beore ormal education begins.viii

In response to this and other

pressures, all governments in

developed countries have invested

to a greater or lesser degree in ree

or subsidized preschool education.

The quality and quantity o that early

years education is dicult to measure

on an internationally comparable

basis a diculty highlighted in

Report Card 7 (2007) which noted

that the lack o any indicator o

participation in early childhood

education is a glaring omission

rom the attempt to build an overall

picture o childrens well-being.ix

The present report begins to make

good that omission by including the

preschool participation rate or 32developed countries (Figure 3.1a).

Findings

Early childhood education is virtually universal in Belgium, France,the Netherlands and Spain.

Preschool enrolment rates exceed 90% in hal o the 32 countries listed.

In only eight countries do participation rates in early childhood educationall below 80% Bulgaria, Finland (but see Box 2), Greece, Lithuania,

Poland, Slovakia, Switzerland and the United States.

60 65 70 8075 85 90 95 100

Bulgaria

Cyprus

Malta

Japan

Finland

Greece

United States

Poland

Slovakia

Lithuania

Switzerland

RomaniaIreland

Latvia

Czech Republic

Portugal

Estonia

Slovenia

Austria

Hungary

Luxembourg

Sweden

Iceland

Germany

United Kingdom

Norway

Italy

Denmark

Belgium

Spain

Netherlands

France

Figure 3.1a Prscoo rom ras

% o children aged between 4 years and the start o compulsory education who areenrolled in preschool



20/60

The age at which compulsory

education begins varies between

4 and 7. The preschool participation

rate is here dened as the

percentage o children between

the age o 4 and the beginning o

compulsory education who are

enrolled in preschools.

Findings

Five countries enrol 90% or moreo their young people in urther

education Belgium, Ireland,

Lithuania, Poland and Slovenia.

Seven o the wealthiest OECDcountries all into the bottom

third o the urther education

league table Austria, Canada,

Italy, Luxembourg, Spain,

the United Kingdom and the

United States.

The urther education enrolmentrate exceeds 80% in all o the

more populous developed

countries except the United

Kingdom. The United Kingdom

is the only developed country

in which the urther education

participation rate alls below

75%; this may be the result

o an emphasis on academic

qualications combined with a

diverse system o vocational

qualications which have not

yet succeeded in achieving

either parity o esteem or

an established value in

employment markets.

60 65 70 75 80 85 90 95

Malta

Cyprus

Bulgaria

Australia

New Zealand

United Kingdom

Luxembourg

Romania

Austria

United States

Canada

SpainItaly

Greece

Denmark

France

Portugal

Estonia

Switzerland

Iceland

Slovakia

Norway

Finland

Sweden

GermanyLatvia

Czech Republic

Netherlands

Hungary

Slovenia

Lithuania

Ireland

Poland

Belgium

Figure 3.1b Parcpao rr dcao

% o children aged 15 to 19 in education

Note: It is possible that some countries with very small populations, or example Luxembourg and

Malta, may show low rates o participation in urther education because a proportion o the relevant

age group are continuing their studies outside their own countries.

rr dcao

At the other end o the educational

ladder is the urther education

participation rate (Figure 3.1b)

which shows the percentage oyoung people aged 15 to 19 who

are enrolled in schools and

colleges. Participation in urther

education refects educational well-

being in as much as it indicates

successul passage through the

years o compulsory schooling. It is

also, o course, associated with a

wider range o opportunities at the

beginning o adult lie.



21/60

neet ra

The third indicator o educational

well-being looks at participation

rom a dierent perspective the

percentage o young people (aged

15 to 19) who are not participating

in either education, employment or

training (the so-called NEET rate).

In all countries, NEET rates are

aected by economic conditions

Findings

At the top o the table, Denmark,Norway and Slovenia have NEET

rates below 3%.

At the oot o the table, Ireland,Italy and Spain have NEET rates

o more than 10%.

0 2 4 6 8 10 14 181612

Bulgaria

New Zealand

Malta

Australia

Cyprus

Spain

Italy

Ireland

Romania

United Kingdom

United States

Canada

Latvia

Estonia

Greece

Switzerland

Portugal

France

Austria

Belgium

Hungary

Sweden

Finland

Slovakia

Lithuania

Germany

Poland

Netherlands

Czech Republic

Luxembourg

Denmark

Slovenia

Norway

Figure 3.1c neet ra

% o children aged 15 to 19 not in education, employment or training

and employment opportunities as

well as by the eectiveness o

education systems in preparing

young people or the transition to

work. Equally obviously, a high

NEET rate represents a threat to the

present and uture well-being o

young adults, a disincentive to

those still in the education system,

and a waste o educational

investment and human resources.

Research in dierent countries

has also shown associations

between NEET status and mental

health problems, drug abuse,

involvement in crime, and long-term

unemployment and welare

dependence.x

Figure 3.1c records the NEET rate

or 33 advanced economies.

To make international comparisonsair, the data must reer to a similar

period o time. Unortunately, the

latest available common year or

NEET rates is 20092010. Figure

3.1c may thereore not refect the

current situation. It does however

refect the major impact o the

current economic downturn on

youth unemployment rates (which

reached a peak o 18.3% in

November 2009 and were slightly

below that level in 2012). In total,more than 23 million young people

in OECD countries now all into the

NEET category and more than hal

o this total are reported to have

given up looking or work.xi

Commenting on the impact o

economic crisis on the transition

rom school to work, the OECD

noted in 2011 that High general

unemployment rates make this

transition substantially more difcult,

as those with more work experience

are avoured over new entrants into

the labour orce.xii



22/60

(PISA) which measures pupils

abilities in three basic competences

reading, maths and science.

Repeated every three years, the

tests are administered to

representative samples o 15-year-

olds and are intended to measure

knowledge and skills in relation to

the demands o managing livesand careers in the modern world.

In total, 34 member countries o

the OECD, plus non-member

partner countries, participate in

this evaluation o educational

achievement.

Figure 3.2 presents an overview o

the results o the latest PISA survey

or the countries under review. In

each case, the scores shown are an

average o results in reading, maths

and science. All scores have been

re-presented on a common scale

based on an unweighted average

edcaoa acvm

The second component o

educational well-being is the quality

o the education received.

This key element o child well-being

is o course dicult to dene and

measure on an internationally

comparable basis. Ideally, the

concept o quality in education

would embrace a broad range o

Findings

Finland is a remarkable outlier registering a score almost 20

points clear o the second placed

country (see Box 2).

Canada and the Netherlands takesecond and third places.

Three o Europes wealthiestcountries, Austria, Luxembourg

and Sweden, nd themselves inthe bottom hal o the educational

achievement table, as do all our

countries o southern Europe.

Romania is also an outlier,registering a score more than

40 points below the next lowest

country in the table.

Australia, Japan and New Zealandwould all have been placed in the

top ve places had it been possible

to include them in the main league

table (see note page 7).

Bulgaria

Australia

New Zealand

Japan

Romania

Greece

Lithuania

Luxembourg

Spain

Italy

Latvia

Austria

Slovakia

Portugal

Czech Republic

Sweden

Hungary

United States

France

Ireland

Slovenia

Denmark

United Kingdom

Norway

Iceland

Poland

Belgium

Germany

Estonia

Switzerland

Netherlands

Canada

Finland

400 420 440 480460 500 520 540 560

Figure 3.2 edcaoa acvm y a 15

Average score in PISA tests o reading, maths and science literacy

actors such as the development

o social understanding and value

ormation (including education or

citizenship) as well as the

opportunity to develop the diverse

abilities and potentials o young

people. But this lies in the uture.

At present, the only practical

measure o quality in education is

provided by the OECDsProgramme

o International Student Assessment



23/60

1 Report Card 9 in this series ocused on this

issue, showing that dierent countries do muchmore than others or their lowest-achievingpupils (i.e. have a much smaller educationalachievement gap between the lowest-achieving10% and the national average).

The act that Finland has the lowest rate o preschool enrolment (Figure

3.1a) and the highest level o educational achievement (Figure 3.2)

might seem to contradict the idea that preschool education is important

to success at school. But it is perhaps better interpreted as a warning

o the care needed in making cross-national comparisons.

First, compulsory schooling in Finland does not begin until a child is

seven years old, which means that the age group on which thepreschool enrolment rate is based is the child population between the

ages o our and seven (in many other countries it is the child

population between the ages o our and ve). I the preschool

enrolment rate were to be re-dened as the percentage o children

enrolled in preschool education in the year beore compulsory schooling

beginsthen Finland would rank near the top o the table with an

enrolment rate approaching 100%.

Second, preschool enrolment rates say nothing about the qualityo the

education received. I it were possible to measure quality, then it is

likely that Finland would again be ound towards the top o the table.

This prediction is based on the act that Finland spends considerably

more than the OECD average on early years care and education, hasexceptionally high minimum qualication requirements or preschool

teaching sta, and the highest standards o sta-to-child ratios o any

advanced economy (1:4 or children under three years old, and 1:7 or

children between 4 and 6).

Most commentators on Finlands outstanding record o educational

achievement cite the quality o the countrys early years education.

Sources:

Miho Taguma, Ineke Litjens, Kelly Makowiecki, Quality Matters in Early ChildhoodEducation and Care: Finland, OECD, 2012.

Starting Strong II, Early Childhood Education and Care, OECD, 2006.

Box 2 The Finland paradox

score or all participating countries

(re-set to 500 to make interpretation

easier).

Dsadvaa

The indicators used here to

measure childrens overall

educational well-being broadly

refect each nations commitment

to ullling every childs right to be

adequately prepared or the

demands o the world in which heor she will live. Managing and

negotiating that world making

decisions about jobs and careers,

amilies and homes, nances and

pensions, citizenship and

community participation demands

a highly developed ability to acquire

and analyse new inormation and to

adapt to changing circumstances.

In such a society, the educationally

disadvantaged are likely to be very

much more disadvantaged than inthe past. They are also likely to nd

it ever more dicult to benet rom,

and contribute to, the complex

societies in which they live.1

As with the other dimensions o

child well-being considered in this

report, educational well-being is

thereore a critical measure both

or children today and or their

societies tomorrow.



24/60

Assss avors ad rsks


ea ad xrcs

% overweight

% eating breakast daily

% eating ruit daily

% exercising

Rsk avors

Teenage ertility rate

Smoking

Alcohol

Cannabis

exposr o vocFighting

Being bullied


behaviours and risks

t a a o cdrs

avors ad rsks sos ac

corys rcord rao o

avra or cors dr

rv. t a s scad o so


o a avra.

t o ac ar sos ac

corys dsac aov or o


o masrm s sadard

dvao a masr o sprad o

scors rao o avra.

Dimension 4 bavors ad rsks

-2.5 -2.0 -1.5 -1.0 -0.5 0.0 0.5 1.0 1.5 2.0

Lithuania

Latvia

Romania

Estonia

Greece

HungaryUnited States

Czech Republic

Slovenia

Spain

Poland

Slovakia

Austria

Canada

United Kingdom

Belgium

France

Finland

Switzerland

Italy

Luxembourg

Portugal

Ireland

Germany

Sweden

Norway

Iceland

Denmark

Netherlands



25/60

Behaviours and risks

The ourth dimension o child well-

being incorporated into the overall

league table o child well-being is

more dicult to pin down than

material well-being or health or

education. Yet the dimension here

labelled behaviours and risks

includes a range o habits and

behaviours critical to the present

and uture well-being o children.

Three separate components areincluded. The rst is the extent to

which children in each country are

orming healthy, well-inormed

habits o eating and exercise.

This has been measured by our

individual indicators:

a) the percentage who are

overweight (as measured by body

mass index computed rom sel-

reported height and weight)

b) the percentage o children ineach country who report eating

breakast every day

c) the percentage who report eating

ruit every day

d) the percentage who report

engaging in physical exercise

or at least an hour every day.

All o these indicators, though o

varying signicance, are associated

with long-term health and well-being. Regular exercise, or

example, is linked not only to

physical and mental health but to

the prevention and/or treatment o

such specic problems as asthma,

obesity, anxiety and depression.

Unhealthy eating patterns in the

early years have also been shown

to increase the risk o later-lie

health problems including diabetes,

heart disease and cancer.xiii

Figures 4.1a to 4.1d show country

rankings or each o the chosen

indicators. In all cases, data are

drawn rom questionnaires

completed by young people

themselves.

Rsk avors

The second component considered

under behaviours and risks is the

prevalence o a second set o

behaviours that represent

immediate dangers to children as

well as serious threats to longer-

term well-being. Within the

limitations o the available data,

our such risk indicators have

been chosen:

a) the teenage ertility rate (annual

number o births per 1,000 girls

aged 15 to 19)

b) the cigarette smoking rate

(percentage o children aged 11,

13 and 15 who smoke cigarettes

at least once a week)

c) the alcohol abuse rate

(percentage o children aged

11, 13 and 15 who report having

been drunk at least twice)

d) the cannabis use rate

(percentage o children aged

11, 13 and 15 who report

having used cannabis in the last

12 months).

Giving birth at too young an age

puts at risk the well-being o both

mother and child. The mother is at

greater risk o dropping out o

school, o unemployment, o

poverty, and welare dependence

so helping to perpetuate

disadvantage rom one generation

to the next. The child is also at

greater risk o poverty, o poor

health, and o underachievement

at school. The direction o causality

in these relationships is not

necessarily clear cut. Teenage

mothers tend to come rom poorer

backgrounds, to be doing less well

at school, and to have narrower

career prospects; having a baby

may make all these problems

worse, but not having a baby will

not make them go away.

Nonetheless, having a baby at too

young an age is an indicator o

much that may have gone wrong in

the lie o a teenager beore she

became pregnant. And it is or this

reason that teenage birth rates are

widely regarded as a particularly

revealing indicator o many aspects

o child well-being that are

otherwise dicult to capture.

The threats posed to physical and

mental health by tobacco, alcohol

and cannabis are well established.

Figures 4.2a to 4.2d record the

perormance o each country under

each indicator.

Voc

The nal component o the

behaviours and risks dimension o

child well-being is the degree to

which children and young people

experience violence in their lives.

Given the known dangers o

growing up in a violent environment

rom immediate suering and

injury to longer-term problems o

anxiety, depression, behavioural

problems, and propensity to use

violencexiv it is unortunate that

ew data are available to comparechildrens exposure to violence

either as victims or as witnesses.

However, theHealth Behaviour in

School-aged Children surveyxv

does provide data on childrens

experiences o both ghting

(Figure 4.3a) and being bullied

(Figure 4.3b).



26/60

Figure 4.1c ea r

% o children aged 11, 13 and 15 who eat ruit daily

Finland

LithuaniaEstonia

Latvia

Sweden

Poland

Netherlands

Greece

Iceland

Hungary

Slovakia

Germany

Ireland

Belgium

United Kingdom

SpainLuxembourg

France

Slovenia

Austria

Romania

Czech Republic

Italy

Norway

Switzerland

United States

Portugal

Canada

Denmark

0 10 20 30 40 50 60 0 5 10 15 20 25 30 35

Italy

DenmarkFrance

Switzerland

Sweden

Portugal

Estonia

Greece

Norway

Iceland

Lithuania

Belgium

Germany

Netherlands

Hungary

RomaniaLatvia

Slovenia

Poland

United Kingdom

Luxembourg

Slovakia

Canada

Finland

Czech Republic

Spain

Austria

United States

Ireland

Figure 4.1d exrcs

% o children aged 11, 13, 15 who report at least one hour o

moderate-to-vigorous physical activity daily

Figure 4.1b ea rakas

% o children aged 11, 13 and 15 who eat breakast every day

0 10 20 30 40 50 60 70 80 90

Slovenia

Romania

United States

Greece

Hungary

Czech Republic

Austria

Slovakia

Switzerland

Lithuania

Luxembourg

Poland

United Kingdom

Canada

Italy

Latvia

Estonia

Spain

Germany

France

Finland

Norway

Belgium

Ireland

Iceland

Sweden

Denmark

Portugal

Netherlands

Figure 4.1a Ovr

% o children aged 11, 13 and 15 who are overweight by BMI

0 5 10 15 20 25 30 35

United States

Greece

Canada

Portugal

Slovenia

Italy

Spain

Poland

Finland

Ireland

Hungary

Czech Republic

Romania

Estonia

Austria

Iceland

Luxembourg

Germany

Slovakia

United Kingdom

Norway

Sweden

Belgium

Lithuania

Latvia

France

Denmark

Switzerland

Netherlands



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Fig 4.2a ta ry ra

Births per 1,000 girls aged 15 to 19

0 5 10 15 20 25 30 35 40 45

BulgariaNew Zealand

MaltaAustralia

CyprusJapan

United StatesRomania

United KingdomEstoniaSlovakia

LithuaniaLatvia

HungaryPortugal

IrelandPolandIceland

BelgiumCanada

SpainAustriaGreece

Czech RepublicLuxembourg

FinlandNorway

Germany

FranceSweden

DenmarkItaly

SloveniaNetherlandsSwitzerland

Figure 4.2b Smok

% o children aged 11, 13 and 15 who smoke cigarettes atleast once a week

0 2 4 6 8 10 12 14 16

Latvia

Czech Republic

Lithuania

Hungary

Austria

Romania

Slovakia

Italy

Estonia

Finland

Luxembourg

France

Spain

Poland

Switzerland

Slovenia

Belgium

Netherlands

Sweden

Greece

Germany

Denmark

United Kingdom

Ireland

Portugal

United States

Canada

Norway

Iceland

Figure 4.2c Acoo

% o children aged 11, 13 and 15 who report having been

drunk at least twice

0 5 10 15 20 25 30

Lithuania

FinlandLatvia

Denmark

Czech Republic

Estonia

United Kingdom

Hungary

Slovenia

Romania

Slovakia

Canada

Poland

Austria

Spain

IrelandGermany

Belgium

Switzerland

Norway

Sweden

Greece

Portugal

France

Luxembourg

Italy

Netherlands

Iceland

United States

Figure 4.2d Caas

% o children aged 11, 13 and 15 who report having used

cannabis in the last 12 months

0 5 10 15 20 25 30

Canada

SwitzerlandSpain

France

United States

Czech Republic

Latvia

Slovenia

United Kingdom

Netherlands

Italy

Belgium

Luxembourg

Estonia

Poland

LithuaniaIreland

Slovakia

Denmark

Hungary

Portugal

Austria

Germany

Finland

Iceland

Greece

Romania

Sweden

Norway



28/60

Findings

Osy

Childhood obesity levels are running at morethan 10% in all countries except Denmark, the

Netherlands and Switzerland.

Only Canada, Greece and the United States havechildhood obesity levels higher than 20%.

ea r

The only countries in which ewer than 30% ochildren eat ruit every day are Finland and Sweden

plus the three Baltic countries, Estonia, Latvia

and Lithuania.

ea rakas

More than 50% o children eat breakast every day inall 29 countries except Romania and Slovenia. Only in

the Netherlands and Portugal does the percentage o

children who eat breakast every day exceed 80%.

exrcs

Ireland and the United States are the only countriesin which more than 25% o children report exercising

or at least an hour a day.2

Italy is the only country in which ewer than 10%o children report exercising or an hour a day.

ta rs

The Netherlands, Slovenia and Switzerland have thelowest rates o teenage births (below 5 per 1,000).

Romania, the United Kingdom and the United Stateshave the highest rates o teenage births (above 29

per 1,000).

Smok

Canada, Iceland, Norway, Portugal and the UnitedStates are the only countries in which the smoking

rate or young people is below 5%.

The highest smoking rates (more than 10% o youngpeople report smoking cigarettes at least once a

week) are ound in Austria, the Czech Republic,

Hungary, Latvia, Lithuania, Romania and Slovakia.

2 The one hour a day criterion used here ollows the recommendationso the World Health Organization.

Acoo

Alcohol abuse by young people is lowest in theUnited States.

Alcohol abuse by young people is 10% or less inonly eight countries France, Greece, Iceland, Italy,

Luxembourg, the Netherlands, Portugal and the

United States.

In the Czech Republic, Denmark, Estonia, Finland,

Latvia and Lithuania, more than 20% o young peoplereport having been drunk on at least two occasions.

Caas

Only in Norway does the rate o cannabis use byyoung people all below 5%.

Canadas children and young people have the highestrate o cannabis use (28%).

The young people o six countries record cannabisuse rates o 20% or more. They are Canada, the

Czech Republic, France, Spain, Switzerland and the

United States.

ad d

Germany is a clear leader in having the lowestpercentage o children who report being involved

in ghting.

Three Nordic countries Denmark, Iceland andSweden have low levels o both bullying and

ghting.

Only in Spain does the proportion o young peopleinvolved in ghting exceed 50% (with Greece close

behind at 49%).

Only in Lithuania does the proportion o youngpeople who report being bullied exceed 50%.



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Figure 4.3a shows what percentage

o 11-, 13 - and 15-year-olds report

being involved in a physical fght at

least once in the past 12 months.

Figure 4.3b shows the percentage

who report being bullied at school

at least once in the past couple

o months.

Being bullied can make a misery o

a childs lie or weeks, months or

even years. It can also contribute toemotional and behavioural problems,

including anxiety and depression,

impaired school perormance, and

increased absenteeism and truancy.xvi

But the monitoring o bullying in

childrens lives is made more dicult

by the act that bullying is dicult to

dene. In order to make measurement

and comparison as meaningul as

possible, the children who took part

in the survey were also given the

ollowing denition o bullying.

We say a student is being bullied

when another student, or a group

o students, say or do nasty and

unpleasant things to him or her. It is

also bullying when a student is teased

repeatedly in a way he or she does

not like or when he or she is

deliberately let out o things. But it

is not bullying when two students o

about the same strength or power

argue or fght. It is also not bullying

when a student is teased in a riendlyand playul way.

Figure 4.3a

% o children aged 11, 13 and 15 who report being involved in a physical ght atleast once in the past 12 months

0 10 20 30 40 50 60

Spain

Greece

Czech Republic

Hungary

Latvia

Romania

Slovenia

Belgium

Slovakia

Lithuania

Austria

United Kingdom

Italy

Canada

Poland

France

Ireland

United States

Netherlands

Luxembourg

Iceland

Sweden

Denmark

Estonia

Switzerland

Portugal

Finland

Germany



30/60

Figure 4.3b b d

% o children aged 11, 13 and 15 who report being bullied at school at least once inthe past couple o months

0 10 20 30 40 50 60

Lithuania

Latvia

Romania

Estonia

Austria

Portugal

Belgium

Switzerland

Canada

France

Finland

Germany

Luxembourg

Ireland

United Kingdom

Greece

Hungary

United States

Slovakia

Poland

Norway

Netherlands

Slovenia

Denmark

Iceland

Czech Republic

Spain

Sweden

Italy

good s

Reporting the behaviours and

risks dimension o child well-being

inevitably ocuses attention on the

negative behaviours o young

people. But in almost all cases such

behaviours involve only a small

minority. The same data may also

be used to report that, among

children and young people in the

countries under review:

99% o girls do not get pregnantwhile still a teenager

92% do not smoke cigarettes

85% are not overweight

86% do not use cannabis

85% do not get drunk

about two thirds are neitherbullied nor involved in ghting.



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Assss os ad vrom


hos

Rooms per person

% o households with children reporting more

than one housing problem

evroma say

Homicide rate (annual number o homicides

per 100,000)

Air pollution (annual PM10 [g/m3])


housing and environment

t a a o cdrs os

ad vrom sos ac

corys prormac rao o

avra or 29 dvopd

cors dr rv. t a s

scad o so ac corys

dsac aov or o a avra.

t o ac ar sos ac

corys dsac aov or o


o masrm s sadard

dvao a masr o sprad o

scors rao o avra.

Dimension 5 hos ad vrom



32/60

Housing and environment

An acknowledged weakness o the

rst UNICEF overview o child well-

being (Report Card 7) was the lack

o any measure o childrens

environmental well-being. This

has now begun to be remedied

by drawing on recent data rom

the European Unionxvii and the

World Health Organization. Two

components have been considered:

a) housing as measured byovercrowding and reported

housing problems

b) environmental saety as

measured by childrens exposure

to crime and pollution.

Ovrcrod

In many amilies, the modern era

has seen an emptying o childrens

lives and homes. Instead o having

our or ve siblings, todays child

more commonly has one or none.

At the same time, rising divorce

and separation rates, changes in

amily structure, and the rise o out-

o-home child care mean that many

children live in homes that are

signicantly less crowded than

in the past. Nonetheless, where

overcrowding remains it is a

signicant actor in childrens well-

being. Apart rom the loss o

opportunity or privacy, and orquiet time and study, overcrowding

has also been linked to adverse

eects on parenting behaviours and

on childrens cognitive and

emotional development, including

increased risk o stress and

behavioural diculties.xviii

Given the available data,xix the most

signicant variable appears to be

rooms-per-person and this is the

measure used in Figure 5.1a.

Findings

In 17 o 26 countries, the average home has more rooms than people.

O the nine countries with ewer rooms than people, eight are inCentral and Eastern Europe.

Figure 5.1a Rooms pr prso

0 0.2 0.4 0.6 0.8 1 1.2 1.4 1.6

Bulgaria

Cyprus

Malta

Hungary

Latvia

Romania

Poland

Lithuania

Slovakia

Slovenia

Estonia

Greece

Czech Republic

Italy

Portugal

Iceland

Austria

France

Germany

Denmark

Sweden

Luxembourg

United Kingdom

Norway

Finland

Spain

Netherlands

Ireland

Belgium



33/60

Mp os proms

Figure 5.1b complements the

overcrowding indicator by

attempting an assessment o the

physical quality o childrens homes.

Specically, it shows what

percentage o households with

children report more than two o

the ollowing problems:

1. leaking roo, damp foors/walls/

oundations/rot in windows

2. dwelling too dark

3. no bath or shower

4. no indoor fushing toilet or the

sole use o the household.

As with overcrowding, the table

again shows the expected divide

between the poorer countries

o Eastern Europe and the

wealthier North.

Crm ad poo


childrens environmental well-being

is the saety o the environment as

measured by two quite dierent

indicators: the level o crime and

the level o pollution.

Crm

Suering violence, witnessing

violence, or earing violence should

not be part o growing up. And

although it seems that early

exposure to violence aects some

children more severely than others,

the risk or all children is that an

environment o violence may

disrupt normal development and

aect well-being in both short and

long term. Consequences may

include behavioural disorders such

as aggression and an inability to

relate to others, emotional disorders

such as depression and anxiety, and

Findings

Denmark, Iceland and Norway head the table with ewer than 1%o households reporting multiple housing problems.

The rate o multiple housing problems rises to more than 20% inLatvia and to almost 40% in Romania.

Belgium and Luxembourg are the only two countries in westernEurope in which more than 5% o households with children report

multiple housing problems.

Figure 5.1b Mp os proms

% o households with children reporting more than one housing problem



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health-related disorders such as

sleep disruption and nightmares.xx

Exposure to violence, says theSae

Startinitiative in the United States,

can interere with a childs ability to

think and learn and can disrupt the

course o healthy physical,

emotional, and intellectual

development.xxi

Measuring and comparing violence

in the childs environment isobviously problematical. Crime and

victimization rates would be a

possible measure, but variations in

methods o dening and recording

crimes in dierent legal systems

make it impossible to make reliable

cross-national comparisons. The

one available indicator that

eliminates most o the potential or

bias is the homicide rate or each

country. Rather than omit altogether

the important issue o violence inthe environment o the child, it was

decided to accept the homicide rate

as an approximate guide to the

overall level o violence in the

society (Figure 5.2a).

Poo


childrens environmental well-being

the extent o environmental

pollution is also dicult to

compare internationally. One

common standard or which data

are available is the level o outdoor

air pollution and this has been

used to construct the league table

presented in Figure 5.2b.

Figure 5.2a homcd ras

Annual number o homicides per 100,000

Findings

Estonia, Latvia, Lithuania and the United States are the only countriesin which the homicide rate rises above 4 per 100,000. Almost all other

countries all into the range o 0 to 2.5 per 100,000.

Homicide rates are more than teen times higher in the worst perormingcountry, Lithuania, than in the best perormer, Iceland.



35/60

Findings

The lowest levels o air pollution are ound in Estonia, Finland, Ireland,Luxembourg and the United States (all below 20 parts per million).

The good result or the United States is infuenced by legislation on air

pollution (1997, revised in 2006) which enorced stricter limits than in

most European countries.

The highest levels are ound in Greece, Italy, Latvia, Poland and Romania(all higher than 30 parts per million).

Figure 5.2b Ar poo

Average annual concentration o ne particulate matter in the atmosphere(annual PM10 [g/m3])



36/60

The ve dimensions o child well-

being considered here material

well-being, health, education,

behaviours and risks, and housing

and environment contribute

equally to the league table o overall

child well-being on page 2. But as

will be obvious rom the comments

on each o the indicators used, the

measurement and comparison o

child well-being levels acrossdierent countries is an imperect

exercise with signicant gaps and

limitations. Ideally, it would also

require better and more child-

oriented data on such critical

important indicators as:

the quality o parenting

the quality as opposed toquantity o early childhood

education

childrens mental and emotionalhealth

childrens exposure to violencein the home (both as victims

and as witnesses)

the prevalence o child abuseand neglect

the quality and saety ochildrens specic environments

including the opportunity or sae,

unsupervised play

the well-being o childrenbeing brought up in the care

o the state

the commercialization andsexualization o childhood

the exposure to, and eecto, media o all kinds in

childrens lives.

t ars yars

In addition to these gaps, there is

one other weakness in almost all

current attempts to monitor the

well-being o children, whether

internationally or within individual

countries. That weakness is the lacko data about childrens

developmental well-being in the

earliest months and years o lie.

It is perhaps no longer necessary

to argue the case or the

importance o the early years.

Advances in both neuro-science

and social science have repeatedly

conrmed that it is at this time that

genetic potential interacts in

innitely complex ways with early

experience to construct the neuralpathways and connections that

quickly become both the

oundations and the scaolding or

all later development. It is thereore

at this time that the childs well-

being, health and development are

most in need o societys concern

and protection.

Yet in practice most o the available

data on childrens lives relate to

older children and young teenagers.

The two major international surveys

on which this report draws, or

example, are theHealth Behaviour

in School-aged Children survey

(ocusing on children aged 11 to 15)

and theProgramme o International

Student Assessment(examining

the educational progress o pupils

at age 15).

The almost total absence o

nationwide data on the

developmental progress o very

young children may refect the act

that the importance o early

childhood development has only

relatively recently been brought to

public and political prominence.In part, also, it may refect the

traditional view that the collection

o data on the lives o the very

young is impractical, potentially

intrusive, and o limited relevance

to public policy. But in part, also,

the problem has been the lack o

any widely applicable means o

measuring and monitoring childrens

developmental progress in the

earliest years o lie. Without such

a measure, policy is blind,expenditure dicult to justiy, goals

impossible to set, and progress

incapable o being monitored.

This may now be beginning to

change as two countries Canada

and Australia become the rst in

the world to begin the regular

monitoring o early years

development or all children.

Box 3 tells the story o the

measures now being used.

In essence, the method deployed

in both countries is a teacher-

completed checklist or every child

at about the age o ve years (a ew

months ater entry into ormal

schooling). The checklist includes

Cocso



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approximately 100 items covering

ve domains o early child

development physical health

and well-being, social competence,

emotional maturity, language and

cognitive skills, and communication

skills. We now have community-

level inormation about early

childhood development or all o

Australia,says the oreword to the

rst issue o the Australian EarlyDevelopment Index (AEDI). In the

same way that the GDP is a

measure o our economic status,

the AEDI is a national measure o

how well we are supporting our

childrens development.

There is a long way to go be

unicef report card 11 final

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