Child well-being in rich countries - A comparative overview - UNICEF Office of Research Innocenti Report Card 11 - UNICEF Innocenti

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Child well-being in rich countries - A comparative overview - UNICEF Office of Research Innocenti Report Card 11 - UNICEF Innocenti
UNICEF
Office of Research

Innocenti Report Card 11

Child well-being
in rich countries
A comparative overview
Innocenti Report Card 11 was written by Peter Adamson.
The UNICEF Office of Research – Innocenti would like to acknowledge
the generous support for Innocenti Report Card 11 provided by the
Andorran and Swiss National Committees for UNICEF, and the
Government of Norway.
Any part of this Innocenti Report Card may be freely reproduced using
the following reference:
UNICEF Office of Research (2013). ‘Child Well-being in Rich Countries:
A comparative overview’, Innocenti Report Card 11, UNICEF Office of
Research, Florence.

The Report Card series is designed to monitor and compare the
performance of economically advanced countries in securing the
rights of their children.

In 1988 the United Nations Children’s Fund (UNICEF) established a
research centre to support its advocacy for children worldwide and to
identify and research current and future areas of UNICEF’s work. The
prime objectives of the Office of Research are to improve international
understanding of issues relating to children’s rights, to help facilitate
full implementation of the Convention on the Rights of the Child
supporting advocacy worldwide. The Office aims to set out a
comprehensive framework for research and knowledge within the
organization in support of its global programmes and policies. Through
strengthening research partnerships with leading academic institutions
and development networks in both the North and South, the Office
seeks to leverage additional resources and influence in support of
efforts towards policy reform in favour of children.
Publications produced by the Office are contributions to a global debate
on children and child rights issues and include a wide range of
opinions. For that reason, some publications may not necessarily reflect
UNICEF policies or approaches on some topics. The views expressed
are those of the authors and/or editors and are published in order to
stimulate further dialogue on child rights.

Cover photo © luxorphoto/Shutterstock
©United Nations Children’s Fund (UNICEF), April 2013
ISBN: 978-88-6522-016-0
ISSN: 1605-7317

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Piazza SS. Annunziata, 12
50122 Florence, Italy
Tel: +39 055 2033 0
Fax: +39 055 2033 220
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www.unicef-irc.org
UNICEF
Office of Research

Innocenti Report Card 11

Child well-being
in rich countries
A comparative overview

PART ONE presents a league table of child well-being
in 29 of the world’s advanced economies.

PART TWO looks at what children say about their
own well-being (including a league table of
children’s life satisfaction).

PART THREE examines changes in child well-being
in advanced economies over the first decade of the
2000s, looking at each country’s progress in
educational achievement, teenage birth rates,
childhood obesity levels, the prevalence of bullying,
and the use of tobacco, alcohol and drugs.
2                                                                                                    I n n o c e n t i      R e p o r t    C a r d      1 1

PART 1
A league table of child well-being

The table below ranks 29 developed countries according to the overall well-being of their children. Each country’s overall rank is
based on its average ranking for the five dimensions of child well-being considered in this review.
A light blue background indicates a place in the top third of the table, mid blue denotes the middle third, and dark blue the bottom third.

                                   Overall well-being    Dimension 1         Dimension 2        Dimension 3        Dimension 4        Dimension 5
                                   Average rank          Material            Health and         Education          Behaviours         Housing and
                                   (all 5 dimensions)    well-being          safety                                and risks          environment

                                                         (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
Lack of data on a number of indicators means that the following countries, although OECD and/or EU members, could not be included in the league table
of child well-being: Australia, Bulgaria, Chile, Cyprus, Israel, Japan, Malta, Mexico, New Zealand, the Republic of Korea, and Turkey.
I n n o c e n t i   R e p o r t   C a r d   1 1                                                                                    3

Introduction

The league table opposite presents            »   The bottom four places in the             Change over a decade
the latest available overview of child            table are occupied by three of            Although changes in methods and
well-being in 29 of the world’s most              the poorest countries in the              structure make it difficult to make
advanced economies.                               survey, Latvia, Lithuania and             comparisons between the first two
                                                  Romania, and by one of the                issues of the UNICEF overview of
Five dimensions of children’s lives
                                                  richest, the United States.               child well-being (see Part 3) it is
have been considered: material
well-being, health and safety,                »   Overall, there does not appear            nonetheless clear that there have
education, behaviours and risks, and              to be a strong relationship               been some significant changes over
housing and environment. In total,                between per capita GDP and                the first decade of the 2000s.
26 internationally comparable                     overall child well-being. The             »   Overall, the story of the first
indicators have been included in the              Czech Republic is ranked higher               decade of the 2000s is one of
overview (see Box 1).                             than Austria, Slovenia higher                 widespread improvement in
                                                  than Canada, and Portugal                     most, but not all, indicators of
The table updates and refines the
                                                  higher than the United States.                children’s well-being. The ‘low
first UNICEF overview of child well-
being published in 2007 (Report               »   There are signs that the                      family affluence’ rate, the infant
Card 7) .i Changes in child well-being            countries of Central and Eastern              mortality rate, and the percentage
over the first decade of the 2000s                Europe are beginning to close                 of young people who smoke
are examined in Part 3.                           the gap with the more                         cigarettes, for example, have
                                                  established industrial economies              fallen in every single country for
Key findings                                      (see Part 3).                                 which data are available.
»   The Netherlands retains its
    position as the clear leader and
    is the only country ranked among               Data sources and background papers
    the top five countries in all
    dimensions of child well-being.
»   The Netherlands is also the
    clear leader when well-being is
                                                   The data sources used for this report are set out in the three background
    evaluated by children themselves               papers detailed below and available at http://www.unicef-irc.org
    – with 95% of its children rating
    their own lives above the mid-                 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.
    point of the Life Satisfaction Scale
                                                   UNICEF Office of Research, Florence.
    (see Part 2).                                  http://www.unicef-irc.org/publications/pdf/iwp_2013_1.pdf
»   Four Nordic countries – Finland,               Martorano, B., L. Natali, C. de Neubourg and J. Bradshaw (2013). ‘Child Well-
    Iceland, Norway and Sweden – sit               being in Economically Rich Countries: Changes in the first decade of the 21st
    just below the Netherlands at the              century’, Working Paper 2013-02. UNICEF Office of Research, Florence.
    top of the child well-being table.             http://www.unicef-irc.org/publications/pdf/iwp_2013_2.pdf

»   Four southern European countries               Bradshaw, J., B. Martorano, L. Natali and C. de Neubourg (2013). ‘Children’s
    – Greece, Italy, Portugal and Spain            Subjective Well-being in Rich Countries’, Working Paper 2013-03. UNICEF
                                                   Office of Research, Florence.
    – are placed in the bottom half of
                                                   http://www.unicef-irc.org/publications/pdf/iwp_2013_3.pdf
    the table.
4                                                                            I n n o c e n t i   R e p o r t   C a r d   1 1

»   Spain has slipped down the          The case for national commitment          school achievement, or
    rankings – from 5th out of 21       to child well-being is therefore          immunization rates, or the
    countries in the early years of     compelling both in principle and in       prevalence of risk behaviours,
    the decade to 19th out of 29        practice. And to fulfil that              for example, are not likely to be
    countries in 2009/2010.             commitment, measuring progress            significantly changed in the short
                                        in protecting and promoting the           term by the recessions of the last
»   The United Kingdom has risen        well-being of children is essential to    three years.
    up the rankings from bottom         policy-making, to advocacy, to the
    place (21st out of 21 countries)                                              For the time being, it must be
                                        cost-effective allocation of limited
    in 2000/2001 to a mid-table                                                   accepted that data-lag is part of
                                        resources, and to the processes of
    position today.                                                               the entry price for international
                                        transparency and accountability.          comparisons of child well-being.
Part 3 of this report examines                                                    And although national-level
                                        International comparability
changes over the first decade of                                                  monitoring of children’s lives is the
the 2000s in more detail.               The measurement of child well-
                                                                                  more important task, UNICEF
                                        being, however, is a relatively new
Measuring progress for children                                                   believes that international
                                        area of study and the overview
                                                                                  comparison can also play a part.
The league table of child well-being    presented here remains a work in
                                                                                  It is international comparison that
is designed to measure and              progress. Chief among its
                                                                                  can show what is achievable in the
compare progress for children           limitations is the fact that
                                                                                  real world, highlight strengths and
across the developed world. Its         internationally comparable data on        weaknesses in individual countries,
purpose is to record the standards      children’s lives are not sufficiently     and demonstrate that child well-
achieved by the most advanced           timely. Between the collection of         being is policy-susceptible. And it
nations and to contribute to debate     data in a wide variety of different       is international comparison that
in all countries about how such         settings and their publication in         can say to politicians, press and
standards might be achieved.            quality-controlled, internationally       public everywhere – ‘This is how
As a moral imperative, the need to      comparable form the time-lag is           your performance in protecting
promote the well-being of children      typically two to three years. This        children compares with the record
is widely accepted. As a pragmatic      means that most of the statistics on      of other nations at a similar level
imperative, it is equally deserving     child well-being used in this report,     of development.’
of priority; failure to protect and     though based on the latest available
                                        data, apply to the period 2009–           Finally, any single overview of a
promote the well-being of children
                                        2010. Such a delay would be               complex and multidimensional
is associated with increased risk
                                        frustrating at the best of times. But     issue carries a risk of hiding more
across a wide range of later-life
                                        the last three years have been far        than it reveals. The following pages
outcomes. Those outcomes range
                                        from the best of times. Beginning         therefore set out to make this
from impaired cognitive
                                        in late 2008, economic downturn           overview of child well-being as
development to lower levels of
                                        in many developed nations has             transparent as possible by
school achievement, from reduced
                                        seen rising unemployment and falls        examining each of its dimensions
skills and expectations to lower
                                        in government expenditures which          in turn.
productivity and earnings, from
higher rates of unemployment to         cannot but affect the lives of many
increased dependence on welfare,        millions of children. Data from
from the prevalence of antisocial       2009 and 2010 capture only the
behaviour to involvement in crime,      beginning of this turbulence.
from the greater likelihood of drug     Nonetheless, for the most part,
and alcohol abuse to higher levels of   the data used in this overview track
teenage births, and from increased      long-term trends and reflect the
health care costs to a higher           results of long-term investments in
incidence of mental illness.ii, iii     children’s lives. Average levels of
I n n o c e n t i   R e p o r t   C a r d   1 1                                                                         5

      Box 1 How child well-being is measured

   The table below shows how the overview of child well-being has been constructed and sets out the full list of
   indicators used. The score for each dimension has been calculated by averaging the scores for each component.
   Similarly, component scores are arrived at by averaging the scores for each indicator.

     Dimensions                      Components                   Indicators                               Figure no.
                                                                  Relative child poverty rate              1.1a
     Dimension 1                     Monetary deprivation
                                                                  Relative child poverty gap               1.1b
     Material well-being
                                                                  Child deprivation rate                   1.2a
     Figure 1.0                      Material deprivation
                                                                  Low family affluence rate                1.2b

                                                                  Infant mortality rate                    2.1a
     Dimension 2                     Health at birth
                                                                  Low birthweight rate                     2.1b
     Health and safety
                                     Preventive health services   Overall immunization rate                2.2
     Figure 2.0
                                     Childhood mortality          Child death rate, age 1 to 19            2.3

                                                                  Participation rate: early childhood
                                                                                                           3.1a
                                                                  education
                                                                  Participation rate: further education,
     Dimension 3                     Participation                                                         3.1b
                                                                  age 15–19
     Education
                                                                  NEET rate (% age 15–19 not in
     Figure 3.0                                                                                            3.1c
                                                                  education, employment or training)
                                                                  Average PISA scores in reading,
                                     Achievement                                                           3.2
                                                                  maths and science

                                                                  Being overweight                         4.1a
                                                                  Eating breakfast                         4.1b
                                     Health behaviours
                                                                  Eating fruit                             4.1c
                                                                  Taking exercise                          4.1d
     Dimension 4
                                                                  Teenage fertility rate                   4.2a
     Behaviours and risks
                                                                  Smoking                                  4.2b
     Figure 4.0                      Risk behaviours
                                                                  Alcohol                                  4.2c
                                                                  Cannabis                                 4.2d
                                                                  Fighting                                 4.3a
                                     Exposure to violence
                                                                  Being bullied                            4.3b

                                                                  Rooms per person                         5.1a
     Dimension 5                     Housing
                                                                  Multiple housing problems                5.1b
     Housing and environment
                                                                  Homicide rate                            5.2a
     Figure 5.0                      Environmental safety
                                                                  Air pollution                            5.2b
6                                                                                         I n n o c e n t i   R e p o r t   C a r d   1 1

Dimension 1 Material well-being

                                                                                                  Figure 1.0 An overview of
       Netherlands                                                                                children’s material well-being
            Finland                                                                               The league table of children’s material
            Norway                                                                                well-being shows each country’s
            Iceland                                                                               performance in relation to the average
           Sweden                                                                                 for the 29 developed countries under
                                                                                                  review. The table is scaled to show
       Luxembourg
                                                                                                  each country’s distance above or
            Austria
                                                                                                  below that average.
           Slovenia
        Switzerland                                                                               The length of each bar shows each
            France                                                                                country’s distance above or below the
                                                                                                  average for the group as a whole. The
          Germany
                                                                                                  unit of measurement is the ‘standard
          Denmark
                                                                                                  deviation’ – a measure of the spread
           Belgium
                                                                                                  of scores in relation to the average.
    United Kingdom
            Canada
     Czech Republic
            Ireland
           Hungary
            Estonia
            Greece
           Portugal
            Poland
               Italy
             Spain
           Slovakia
      United States
          Lithuania
             Latvia
           Romania

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

    Assessing material well-being
    COMPONENTS                        IND I C ATOR S

                                      Relative child poverty rate (% of children living
                                      in households with equivalent incomes below
    Monetary                          50% of national median)
    deprivation                       Child poverty gap (distance between national
                                      poverty line and median incomes of households
                                      below poverty line)

                                      Index of child deprivation (% of children lacking
    Material                          specific items)
    deprivation                       Family affluence scale (% of children reporting
                                      low family affluence)
I n n o c e n t i   R e p o r t   C a r d   1 1                                                                                   7

Children’s material well-being

The table opposite (Figure 1.0)                   Figure 1.1a Relative child poverty rates
presents an overview of children’s                % of children aged 0–17 living in households with equivalent incomes
material well-being in developed                  below 50% of national median
countries. Overall, it suggests that
                                                           Finland
material well-being is highest in
                                                      Netherlands
the Netherlands and in the four
                                                         Denmark
Nordic countries and lowest in
                                                           Iceland
Latvia, Lithuania, Romania and the                         Norway
United States.                                            Slovenia
Two components of material well-                          Sweden
                                                           Austria
being have been considered in
                                                            Ireland
arriving at this overview – relative
                                                      Switzerland
income poverty and material
                                                         Germany
deprivation. The strengths and                              France
weaknesses of both measures were                   Czech Republic
discussed in detail in the previous               United Kingdom
report in this series (Report Card 10)iv                  Hungary
which argued that both measures are                       Belgium
necessary to achieve a rounded view                  Luxembourg
of children’s material well-being.                         Estonia
                                                          Slovakia
Relative poverty:                                           Poland
child poverty rates                                        Canada
Two separate indicators have                              Portugal
been used to measure monetary                              Greece
deprivation. They are the relative                             Italy
child poverty rate (Figure 1.1a) and                     Lithuania
                                                              Spain
the ‘child poverty gap’ (Figure 1.1b).
                                                              Latvia
The relative child poverty rate shows               United States
the proportion of each nation’s                          Romania

                                                           Cyprus
Countries with grey bars have not been                      Malta
included in the ranking tables, or in the                Australia
overall league table of child well-being,
                                                      New Zealand
as they have data for fewer than 75% of
                                                            Japan
the total number of indicators used.
                                                          Bulgaria
                                                                       0        5           10           15              20       25
children living in households where
disposable income is less than 50%                Findings
of the national median (after taking              »   Finland is the only country with a relative child poverty rate of less
taxes and benefits into account                       than 5% and heads the league table by a clear margin of more than
and adjusting for family size and                     two percentage points.
composition). This is the definition
of child poverty used by the
                                                  »   The countries in the top half of the league table all have relative child
                                                      poverty rates of less than 10%.
majority of the world’s developed
economies. Broadly speaking, it                   »   Four southern European countries – Greece, Italy, Portugal and Spain –
shows the proportion of children                      have child poverty rates higher than 15% (along with Latvia, Lithuania,
who are to some significant extent                    Romania and the United States).
8                                                                               I n n o c e n t i   R e p o r t   C a r d   1 1

Figure 1.1b Child poverty gaps                                                       excluded from the advantages and
Gap between the poverty line and the median income of those                          opportunities which most children
below the poverty line – as % of the poverty line                                    in that particular society would
                                                                                     consider normal.
   Luxembourg
        Hungary                                                                      Relative poverty:
    Netherlands                                                                      the poverty gap
         Austria
                                                                                     The relative child poverty rates in
         Finland
                                                                                     Figure 1.1a show what percentage
          France
         Norway
                                                                                     of children live below each nation’s
        Sweden                                                                       relative poverty line. But they reveal
       Germany                                                                       nothing about how far below that
        Slovenia                                                                     line those children are being
         Iceland                                                                     allowed to fall. To gauge the depth
    Switzerland                                                                      of relative child poverty, it is also
         Canada                                                                      necessary to look at the ‘child
United Kingdom                                                                       poverty gap’ – the distance between
 Czech Republic
                                                                                     the poverty line and the median
        Belgium
                                                                                     incomes of those below the line.
          Poland
         Greece                                                                      Figure 1.1b shows this ‘child
        Portugal                                                                     poverty gap’ for each country.
            Latvia
       Denmark                                                                       Considering ‘rate’ and ‘gap’ together
         Estonia                                                                     shows six countries in the bottom
        Slovakia                                                                     third of both tables. They are Italy,
       Romania                                                                       Latvia, Lithuania, Romania, Spain
             Italy                                                                   and the United States. By contrast,
          Ireland
                                                                                     there are also six countries that
       Lithuania
                                                                                     feature in the top third of both
  United States
                                                                                     tables – Austria, Finland,
            Spain
                                                                                     Netherlands, Norway, Slovenia
         Cyprus                                                                      and Sweden.
          Malta
                                                                                     What this means for the children
       Australia
                                                                                     of Spain or the United States, for
    New Zealand
          Japan
                                                                                     example, is that 20% or more fall
        Bulgaria                                                                     below the relative poverty line and
                                                                                     that, on average, they fall almost
                     0   5    10     15      20      25       30   35      40
                                                                                     40% below that line. In the
Findings                                                                             Netherlands or Austria, on the other
                                                                                     hand, 6% to 8% of children fall
»   Hungary and Luxembourg have the smallest child poverty gaps.
                                                                                     below the relative poverty line and,
»   Denmark is an exception among Nordic countries in having a high child            on average, they fall approximately
    poverty gap (almost 30%). Only a small proportion of Danish children             16% below.
    (6.3%) fall below the country’s relative poverty line; but those who do,
                                                                                     Taken together, these two child
    fall further below than in most other countries.
                                                                                     poverty indicators – the rate and the
»   Several countries have allowed the child poverty gap to widen to more            gap – make up the relative income
    than 30%. They are Bulgaria, Ireland, Italy, Japan, Lithuania, Romania,          component of children’s material
    Slovakia, Spain and the United States.                                           well-being.
I n n o c e n t i        R e p o r t   C a r d    1 1                                                                                9

Material deprivation:                                 example, does not mean that              Again, two indicators have been
the Child Deprivation Index                           children’s actual living standards are   used. The first is the UNICEF Child
Relative income measures, however,                    lower in Canada (only that a greater     Deprivation Rate (introduced in
have little to say about the actual                   proportion of Canadian children live     Report Card 10) v which shows what
living conditions of children in                      in households where disposable           percentage of children in each
different countries. The fact that a                  income is 50% of the median). In         nation lack two or more of the
higher percentage of children live in                 order to arrive at a more complete       following 14 items:
relative income poverty in Canada                     picture of child poverty, a measure      1. Three meals a day
than in the Czech Republic, for                       of actual material deprivation has
                                                                                               2. At least one meal a day
                                                      therefore also been included.
                                                                                                  with meat, chicken or fish
Figure 1.2a Child deprivation rates                                                               (or vegetarian equivalent)
% of children lacking two or more specific items – see text
                                                                                               3. Fresh fruit and vegetables
         Iceland                                                                                  every day
        Sweden                                                                                 4. Books suitable for the child’s
         Norway                                                                                   age and knowledge level (not
         Finland                                                                                  including schoolbooks)
       Denmark
    Netherlands                                                                                5. Outdoor leisure equipment
   Luxembourg                                                                                     (bicycle, roller-skates, etc.)
          Ireland                                                                              6. Regular leisure activities
United Kingdom                                                                                    (swimming, playing an
            Spain
                                                                                                  instrument, participating in
        Slovenia
                                                                                                  youth organizations, etc.)
         Austria
 Czech Republic                                                                                7. Indoor games (at least one per
       Germany                                                                                    child, including educational baby
        Belgium                                                                                   toys, building blocks, board
          France                                                                                  games, computer games, etc.)
         Estonia
                                                                                               8. Money to participate in school
             Italy
                                                                                                  trips and events
         Greece
        Slovakia                                                                               9. A quiet place with enough room
       Lithuania                                                                                  and light to do homework
          Poland
                                                                                               10. An Internet connection
        Portugal
            Latvia                                                                             11. Some new clothes (i.e. not all
        Hungary                                                                                    second-hand)
       Romania                                                                                 12. Two pairs of properly fitting
                                                                                                   shoes
         Cyprus
          Malta                                                                                13. The opportunity, from time
        Bulgaria                                                                                   to time, to invite friends home
                                                                                                   to play and eat
                     0        10       20        30       40      50     60      70      80
                                                                                               14. The opportunity to celebrate
Findings                                                                                           special occasions such as
»   The five Nordic countries and the Netherlands claim the top six places.                        birthdays, name days, religious
                                                                                                   events, etc.
»   Luxembourg and Ireland are the only other countries with child deprivation
    rates below 5% (although the United Kingdom comes close at 5.5%).                          Figure 1.2a presents the child
                                                                                               deprivation rate for 26 countries
»   France and Italy have child deprivation rates higher than 10%.
                                                                                               (no comparable data are available
»   Four countries have child deprivation rates of more than 25% – Hungary,                    for Canada, Switzerland or the
    Latvia, Portugal and Romania.                                                              United States).
1 0                                                                             I n n o c e n t i   R e p o r t   C a r d   1 1

Figure 1.2b Percentage of children reporting low family affluence                    The results are computed into the
                                                                                     Family Affluence Scale used in
         Iceland                                                                     Figure 1.2b to show the percentage
         Norway                                                                      of children in each country living in
    Netherlands                                                                      ‘low affluence’ families.
       Denmark
    Switzerland                                                                      As might be expected, the child
        Sweden                                                                       deprivation rate and the low family
   Luxembourg                                                                        affluence rate produce broadly
         Finland                                                                     similar league table rankings. They
        Slovenia                                                                     are, however, different in that one
          France
                                                                                     focuses on the child and the other
        Belgium
                                                                                     on the family. Taken together, they
         Canada
                                                                                     provide a more secure overview of
       Germany
            Spain
                                                                                     children’s material deprivation.
         Austria
          Ireland
                                                                                     Real and relative
United Kingdom                                                                       The differences between the two
  United States                                                                      components of children’s material
        Portugal                                                                     well-being – relative poverty and
             Italy                                                                   material deprivation – are often
         Greece                                                                      misunderstood. It is not the case
         Estonia
                                                                                     that one is a relative measure and
 Czech Republic
                                                                                     the other absolute. Both are relative
          Poland
                                                                                     measures. Deprivation rates may
       Lithuania
            Latvia                                                                   appear to measure absolute poverty
        Hungary                                                                      because they are based on a
        Slovakia                                                                     specific list of possessions rather
       Romania                                                                       than the median income of each
                     0   5      10      15      20      25     30     35        40
                                                                                     nation. But those possessions are
                                                                                     chosen to represent what most
Findings                                                                             people consider normal for a child
»   The Netherlands and the Nordic countries, along with Luxembourg                  growing up in any wealthy country
    and Switzerland, have the smallest percentage of children reporting              in the early 21st century. They are
    low family affluence.                                                            therefore relative to both time and
                                                                                     place. The true difference between
»   Low family affluence rates are highest in eight Central and Eastern
                                                                                     the two approaches is that one
    European countries – the Czech Republic, Estonia, Hungary, Latvia,
                                                                                     measures poverty in relation to an
    Lithuania, Poland, Romania and Slovakia.
                                                                                     income norm that varies from
                                                                                     country to country (the national
                                                                                     median income) whereas the other
Material deprivation:                     »   Does your family own a car, van        measures poverty by a common
low family affluence                          or truck?                              standard for all of the countries
The second indicator used to              »   During the past 12 months, how         under review.
measure material deprivation is               many times did you travel away
based on written questionnaires
                                              on holiday with your family?
completed by representative
samples of children aged 11,              »   How many computers does your
13, and 15 in each country.vi                 family own?
The relevant part of the                  »   Do you have your own bedroom
questionnaire asks:                           for yourself?
I n n o c e n t i      R e p o r t     C a r d     1 1                                                                             1 1

Dimension 2 Health and safety

                                                                                                Figure 2.0 An overview of child
          Iceland                                                                               health and safety
         Sweden
                                                                                                The league table of children’s health
          Finland
                                                                                                and safety shows each country’s
    Luxembourg
                                                                                                performance in relation to the average
     Netherlands                                                                                for the 29 developed countries under
         Slovenia                                                                               review. The table is scaled to show
         Norway                                                                                 each country’s distance above or
  Czech Republic                                                                                below that average.
           Spain
                                                                                                The length of each bar shows each
          France                                                                                country’s distance above or below
      Switzerland                                                                               the average for the group as a whole.
        Germany                                                                                 The unit of measurement is the
         Belgium                                                                                ‘standard deviation’ – a measure of
         Portugal                                                                               the spread of scores in relation to
          Ireland                                                                               the average.

 United Kingdom
             Italy
          Poland
          Greece
                                                                                                Findings
         Hungary                                                                                »   Nordic countries again
         Slovakia                                                                                   head the table, with Iceland,
          Estonia                                                                                   Sweden and Finland claiming
        Denmark                                                                                     the top three places.
        Lithuania                                                                               »   Austria, Canada and Denmark
    United States                                                                                   are to be found towards the
          Austria                                                                                   foot of the league table along
          Canada                                                                                    with the United States. (In all
           Latvia                                                                                   of these cases the low ranking
        Romania                                                                                     is partly attributable to low
                     -3.0   -2.5     -2.0   -1.5    -1.0   -0.5   0.0   0.5   1.0   1.5   2.0       immunization rates.)

 Assessing health and safety
 COMPONENT S                           IND I C ATOR S

                                       Infant mortality rate (deaths under 12 months old
                                       per 1,000 live births)
 Health at birth
                                       Low birthweight rate (% babies born below
                                       2,500 grammes

                                       National immunization rate (average coverage
 Preventive health
                                       for measles, polio and DPT3 for children age
 services                              12 to 23 months)

 Child and youth                       Overall child and youth mortality rate
 mortality                             (deaths per 100,000 aged 1 to 19)
1 2                                                                            I n n o c e n t i   R e p o r t   C a r d   1 1

Health and safety

The health dimension of children’s      Figure 2.1a Infant mortality rates
well-being is based on three            Deaths under 12 months old per 1,000 live births
components for which
internationally comparable data are              Iceland
                                               Slovenia
available. The components are:
                                                Sweden
a) health at birth – as measured           Luxembourg
   by the infant mortality rate and              Finland
   the percentage of babies born                 Norway
   with low birthweight (below                  Portugal
   2,500 grammes).                               Estonia
                                                      Italy
b) the availability of children’s
                                               Denmark
   preventive health services –
                                        Czech Republic
   as measured by national
                                               Germany
   immunization levels for measles,               Ireland
   polio and DPT3.                               Austria
c) child health and safety – as                   France
   measured by the death rate of            Netherlands
   children and young people                    Belgium
   (aged 1 to 19) from all causes.                  Spain
                                                 Greece
The chart on the previous page               Switzerland
(Figure 2.0) combines these three       United Kingdom
components into a league table of                Canada
child health for the 29 developed              Lithuania
countries under review.                           Poland
                                                Hungary
Health at birth:                          United States
infant mortality                                Slovakia
                                                    Latvia
In all developed countries, infant
                                               Romania
mortality rates (IMRs) have been
reduced to fewer than 10 infant                   Japan
deaths per thousand live births.                 Cyprus
The relatively small differences               Australia
between countries therefore reflect         New Zealand
not variations in the fundamentals                Malta
of public health such as safe water            Bulgaria
and sanitation but variations in the                          0   2        4         6        8        10        12        14
commitment and the capacity to
deliver whatever services are           Findings
necessary to protect every mother-      »   Three Nordic countries – Finland, Iceland and Sweden – plus
to-be, every birth, and every infant        Luxembourg and Slovenia – head the table with infant mortality rates
in the earliest days and weeks of           of fewer than 2.5 deaths per 1,000 births.
life. The IMRs set out in Figure 2.1a
                                        »   26 of the 35 countries have reduced infant mortality to 5 or fewer
may therefore be read as a measure
                                            per 1,000 births.
of commitment to maternal and
child health for all – including the    »   The only countries with infant mortality rates higher than 6 per
mothers and children of the poorest         1,000 births are Latvia, Romania, Slovakia and the United States.
and most marginalized families.         »   Three of the richest nations in the developed world – Canada, the
                                            United Kingdom and the United States – are placed in the bottom
                                            third of the infant mortality league table.
I n n o c e n t i   R e p o r t   C a r d   1 1                                                                           1 3

It is possible that the low ranking           Figure 2.1b Low birthweight
of the United States in the league            % babies born below 2,500 grammes
table of infant mortality is not
justified: there is an as yet                            Iceland
unresolved debate about whether                         Sweden
infant mortality rates in the United                     Finland
States might include the deaths of                       Estonia
extremely premature and/or low                           Ireland
birthweight babies who are kept
                                                         Norway
alive for a time by advanced neo-
                                                    Netherlands
natal care but who, in other
                                                        Slovenia
countries, might not be classified
                                                         Poland
as ‘live births’.
                                                         Canada
Health at birth:                                       Denmark
low birthweight                                     Luxembourg
The second indicator used to                         Switzerland
measure health at the beginning                          France
of life is the proportion of babies                     Belgium
who are born with low birthweights                     Germany
(below 2,500 grammes).
                                                            Italy
According to the United States                United Kingdom
Centers for Disease Control and                          Austria
Prevention, “The birthweight of an                      Slovakia
infant is the single most important               Czech Republic
determinant of its chances of
                                                           Spain
survival and healthy growth.” vii
                                                   United States
It is also a guide to the general
                                                        Portugal
health, and health behaviours, of
pregnant women and mothers, both                        Hungary

of which are important to every                          Greece
other dimension of child well-being.
Low birthweight is also known to                    New Zealand
be associated with increased risk                       Australia
across a range of health problems                         Japan
in childhood and on into adult life.
                                                                    0   2         4         6         8        10         12
Figure 2.1b shows the percentage
of babies born with low birthweight           Findings
in each of the 29 countries for               »    Five European countries – Estonia, Finland, Iceland, Ireland and Sweden –
which data are available.                          have succeeded in reducing the incidence of low birthweight below 5%.
                                              »    Only in Greece, Hungary, Portugal and the United States does the low
                                                   birthweight rate exceed 8%.
1 4                                                                                    I n n o c e n t i   R e p o r t   C a r d   1 1

Figure 2.2 Immunization rates                                                               Preventive health services:
Average coverage for measles, polio and DPT3 for children aged 12 to 23 months              immunization
        Hungary                                                                             The second component chosen
         Greece                                                                             to evaluate child health is the
        Slovakia                                                                            availability and effectiveness of
         Finland                                                                            each country’s preventive child
Czech Republic                                                                              health services. This has been
   Luxembourg                                                                               measured by each country’s
          Poland                                                                            immunization rate (average
        Sweden
                                                                                            vaccination coverage for measles,
        Belgium
                                                                                            polio and DPT3).
        Portugal
    Netherlands                                                                             Routine immunization rates in the
            Spain                                                                           developed nations are generally
       Romania                                                                              maintained at high levels, averaging
          France
                                                                                            close to 95%. As with infant
       Slovenia
                                                                                            mortality rates, the relatively
United Kingdom
       Lithuania
                                                                                            small differences between countries
         Iceland                                                                            can therefore be said to mirror
       Germany                                                                              commitment to the ideal of
         Estonia                                                                            reaching out to every single child,
              Italy                                                                         including the most marginalized,
     Switzerland                                                                            with an essential preventive health
  United States                                                                             service to which all children have
         Norway                                                                             a right.
          Ireland
            Latvia                                                                          Figure 2.2 presents an immunization
       Denmark                                                                              league table for 29 countries.
         Canada
         Austria
                                                                                            It might be suspected that low
                                                                                            immunization rates in countries
            Japan                                                                           such as Austria, Canada and
         Bulgaria                                                                           Denmark have been affected by
           Cyprus                                                                           rumours, based on discredited
         Australia                                                                          research, linking the triple MMR
      New Zealand                                                                           vaccine (measles, mumps and
            Malta
                                                                                            rubella) with autism. This would
                      70   75       80         85        90         95           100        not really be an ‘excuse’ for low
                                                                                            coverage rates, as running a first-
Findings                                                                                    class immunization programme
»   Greece and Hungary head the table with 99% immunization coverage.                       means making sure that the public
                                                                                            is well informed and that false
»   Three of the richest countries in the OECD – Austria, Canada and
                                                                                            information is not allowed to put
    Denmark – are the only countries in which the immunization rate falls
                                                                                            children at risk. But in fact the MMR
    below 90%.
                                                                                            scare would not appear to be the
                                                                                            major cause of low immunization
                                                                                            rates in Austria, Canada and
                                                                                            Denmark – all of which have low
                                                                                            rates even when measles
                                                                                            vaccination is excluded from the
                                                                                            calculations (in Canada, the measles
I n n o c e n t i   R e p o r t   C a r d   1 1                                                                            1 5

immunization rate is higher than              Figure 2.3 Child and youth mortality rates
for DPT3 or polio).                           Deaths per 100,000 aged 1 to 19

Child health:                                            Iceland
the 1 to 19 death rate                              Luxembourg
The third component used to build                    Switzerland
an overall picture of child health is               Netherlands
the death rate among children and                       Sweden
young people between the ages                              Spain
of 1 and 19.                                           Germany

Deaths in this age group are rare                        Norway

in advanced economies and the                           Slovenia
causes go beyond disease and                                Italy
the efficacy of health services               United Kingdom
to include deaths from suicide,                          Finland
murder, traffic injuries, drownings,                   Denmark
falls and fires. Differences between                     France
countries in the death rate for                         Portugal
children and young people in this                        Ireland
age group may therefore be said                          Austria
to reflect overall levels of health               Czech Republic
and safety throughout childhood                         Belgium
and adolescence.                                         Greece
Figure 2.3 presents the 1- to                           Hungary
19-year-old death rate for each                          Poland
country. In absolute numbers,                           Slovakia
the differences between countries                        Estonia
are clearly small. But it is worth                     Lithuania
noting that if all European countries                     Latvia
had the same child death rate as                        Romania
Iceland or Luxembourg then over
8,000 child deaths a year could                          Cyprus
be prevented – each one                                    Malta
representing unimaginable anguish
                                                        Bulgaria
for the family concerned.
                                                                    0   5   10     15      20     25     30     35     40
Taken together, the three
components set out above provide              Findings
an approximate guide to the health            »    Iceland, Luxembourg, the Netherlands, Spain, Sweden and Switzerland
dimension of children’s well-being.                head the table with child death rates below 15 per 100,000.
Ideally, such an overview would also
have included some indicator of               »    Central and Eastern European countries occupy the bottom third of the
children’s mental and emotional                    table – along with Belgium and Greece.
health, and of the prevalence of
child abuse and neglect. But such
issues are difficult to define and
measure even within an individual
country; internationally, no
comparable data are available.
1 6                                                                                   I n n o c e n t i   R e p o r t   C a r d   1 1

Dimension 3 Educational well-being

                                                                                              Figure 3.0 An overview of
       Netherlands                                                                            children's educational well-
           Belgium                                                                            being
          Germany
                                                                                              The league table of children’s
            Finland
                                                                                              educational well-being shows each
           Slovenia                                                                           country’s performance in relation to
           Norway                                                                             the average for the 29 developed
          Denmark                                                                             countries under review. The table
           Hungary                                                                            is scaled to show each country’s
            Poland                                                                            distance above or below that average.
            Iceland                                                                           The length of each bar shows each
           Sweden                                                                             country’s distance above or below the
  Czech Republic                                                                              average for the group as a whole. The
            Estonia                                                                           unit of measurement is the ‘standard
            Canada                                                                            deviation’ – a measure of the spread
                                                                                              of scores in relation to the average.
            France
       Switzerland
            Ireland
           Portugal
          Lithuania
                                                                                              Findings
             Latvia                                                                           »   Educational well-being is
           Slovakia                                                                               seen to be highest in Belgium,
      Luxembourg                                                                                  Finland, Germany and the
            Austria                                                                               Netherlands – each of which
 United Kingdom                                                                                   achieves an overall score
               Italy                                                                              significantly above average
             Spain                                                                                for the 29 countries.
      United States                                                                           »   Greece, Romania, Spain and
            Greece                                                                                the United States show the
          Romania                                                                                 lowest levels of educational
                       -4.0   -3.0         -2.0       -1.0     0.0       1.0         2.0          well-being.

 Assessing educational well-being
 COMPONENTS                          IND I C ATOR S

                                     Preschool participation rate (% of those aged
                                     between 4 years and the start of compulsory
                                     education who are enrolled in preschool)

 Participation                       Further education participation rate (% of those
                                     aged 15 to 19 enrolled in further education)

                                     NEET rate (% aged 15 to 19 not in education,
                                     employment or training)

                                     Average score in PISA tests of reading, maths
 Achievement                         and science literacy
I n n o c e n t i   R e p o r t   C a r d   1 1                                                                                 1 7

Educational well-being

In gauging educational well-being,                Figure 3.1a Preschool enrolment rates
two main components have been                     % of children aged between 4 years and the start of compulsory education who are
considered – participation rates and              enrolled in preschool
achievement levels. Taken together
                                                           France
they provide an approximate
                                                      Netherlands
guide to both quantity and quality
                                                            Spain
of education. Figure 3.0 (opposite)
                                                          Belgium
combines the two into a single
                                                         Denmark
overview of children’s educational
                                                              Italy
well-being for 29 developed countries.
                                                          Norway

Participation:                                United Kingdom

early childhood education                                Germany
                                                           Iceland
The first component – participation –
                                                          Sweden
has been assessed by three
                                                      Luxembourg
indicators:
                                                         Hungary
a) participation in early childhood                        Austria
   education                                             Slovenia
                                                           Estonia
b) participation in further education
                                                          Portugal
c) the proportion of young people,            Czech Republic
   aged 15 to 19, who are not                               Latvia
   participating in education,                             Ireland
   training or employment.                               Romania
                                                       Switzerland
In recent times it has been widely
                                                         Lithuania
acknowledged that the foundations
                                                          Slovakia
of educational success are laid down
                                                           Poland
before formal education begins.viii
                                                   United States
In response to this and other
                                                          Greece
pressures, all governments in
                                                           Finland
developed countries have invested
to a greater or lesser degree in free
                                                            Japan
or subsidized preschool education.
                                                            Malta
The quality and quantity of that early                     Cyprus
years education is difficult to measure                   Bulgaria
on an internationally comparable                                      60   65   70     75      80      85      90      95      100
basis – a difficulty highlighted in
Report Card 7 (2007) which noted                  Findings
that the lack of any indicator of                 »   Early childhood education is virtually universal in Belgium, France,
participation in early childhood                      the Netherlands and Spain.
education is a “glaring omission”
from the attempt to build an overall              »   Preschool enrolment rates exceed 90% in half of the 32 countries listed.
picture of children’s well-being.ix               »   In only eight countries do participation rates in early childhood education
The present report begins to make                     fall below 80% – Bulgaria, Finland (but see Box 2), Greece, Lithuania,
good that omission by including the                   Poland, Slovakia, Switzerland and the United States.
preschool participation rate for 32
developed countries (Figure 3.1a).
1 8                                                                                                    I n n o c e n t i   R e p o r t   C a r d   1 1

Figure 3.1b Participation in further education                                                              Findings
% of children aged 15 to 19 in education
                                                                                                            »   Five countries enrol 90% or more
                                                                                                                of their young people in further
          Belgium
                                                                                                                education – Belgium, Ireland,
           Poland
           Ireland
                                                                                                                Lithuania, Poland and Slovenia.
         Lithuania                                                                                          »   Seven of the wealthiest OECD
         Slovenia                                                                                               countries fall into the bottom
         Hungary                                                                                                third of the further education
      Netherlands
                                                                                                                league table – Austria, Canada,
Czech Republic
                                                                                                                Italy, Luxembourg, Spain,
            Latvia
                                                                                                                the United Kingdom and the
         Germany
                                                                                                                United States.
          Sweden
           Finland                                                                                          »   The further education enrolment
          Norway                                                                                                rate exceeds 80% in all of the
          Slovakia                                                                                              more populous developed
           Iceland
                                                                                                                countries except the United
       Switzerland
                                                                                                                Kingdom. The United Kingdom
           Estonia
                                                                                                                is the only developed country
          Portugal
                                                                                                                in which the further education
           France
         Denmark
                                                                                                                participation rate falls below
          Greece                                                                                                75%; this may be the result
              Italy                                                                                             of an emphasis on academic
            Spain                                                                                               qualifications combined with a
          Canada                                                                                                diverse system of vocational
   United States                                                                                                qualifications which have not
           Austria                                                                                              yet succeeded in achieving
         Romania                                                                                                either ‘parity of esteem’ or
      Luxembourg                                                                                                an established value in
United Kingdom                                                                                                  employment markets.

      New Zealand
         Australia
          Bulgaria
           Cyprus
            Malta

                  60         65          70         75          80         85         90          95
Note: It is possible that some countries with very small populations, for example Luxembourg and
Malta, may show low rates of participation in further education because a proportion of the relevant
age group are continuing their studies outside their own countries.

The age at which compulsory                           Further education                                     colleges. Participation in further
education begins varies between                                                                             education reflects ‘educational well-
                                                      At the other end of the educational
4 and 7. The preschool participation                                                                        being’ in as much as it indicates
                                                      ladder is the further education
rate is here defined as the                                                                                 successful passage through the
percentage of children between                        participation rate (Figure 3.1b)                      years of compulsory schooling. It is
the age of 4 and the beginning of                     which shows the percentage of                         also, of course, associated with a
compulsory education who are                          young people aged 15 to 19 who                        wider range of opportunities at the
enrolled in preschools.                               are enrolled in schools and                           beginning of adult life.
I n n o c e n t i      R e p o r t       C a r d   1 1                                                                           1 9

Figure 3.1c NEET rate                                                                       Findings
% of children aged 15 to 19 not in education, employment or training
                                                                                            »   At the top of the table, Denmark,
                                                                                                Norway and Slovenia have NEET
        Norway
                                                                                                rates below 3%.
       Slovenia
      Denmark                                                                               »   At the foot of the table, Ireland,
   Luxembourg                                                                                   Italy and Spain have NEET rates
Czech Republic                                                                                  of more than 10%.
   Netherlands
        Poland
      Germany
      Lithuania
       Slovakia
        Finland
                                                                                            Research in different countries
       Sweden
                                                                                            has also shown associations
       Hungary
                                                                                            between NEET status and mental
       Belgium
                                                                                            health problems, drug abuse,
        Austria
                                                                                            involvement in crime, and long-term
        France
                                                                                            unemployment and welfare
       Portugal
                                                                                            dependence.x
    Switzerland
        Greece                                                                              Figure 3.1c records the NEET rate
        Estonia                                                                             for 33 advanced economies.
         Latvia
        Canada
                                                                                            To make international comparisons
  United States                                                                             fair, the data must refer to a similar
United Kingdom                                                                              period of time. Unfortunately, the
       Romania                                                                              latest available common year for
        Ireland                                                                             NEET rates is 2009–2010. Figure
           Italy                                                                            3.1c may therefore not reflect the
          Spain                                                                             current situation. It does however
                                                                                            reflect the major impact of the
        Cyprus                                                                              current economic downturn on
       Australia                                                                            youth unemployment rates (which
          Malta                                                                             reached a peak of 18.3% in
   New Zealand                                                                              November 2009 and were slightly
       Bulgaria                                                                             below that level in 2012). In total,
                   0       2         4        6          8   10   12    14     16     18    more than 23 million young people
                                                                                            in OECD countries now fall into the
                                                                                            NEET category and more than half
                                                                                            of this total are reported to have
NEET rate                                            and employment opportunities as
                                                                                            given up looking for work.xi
The third indicator of educational                   well as by the effectiveness of
well-being looks at participation                    education systems in preparing         Commenting on the impact of
                                                     young people for the transition to     economic crisis on the transition
from a different perspective – the
                                                     work. Equally obviously, a high        from school to work, the OECD
percentage of young people (aged
                                                     NEET rate represents a threat to the   noted in 2011 that “High general
15 to 19) who are not participating
                                                     present and future well-being of       unemployment rates make this
in either education, employment or
                                                     young adults, a disincentive to        transition substantially more difficult,
training (the so-called ‘NEET’ rate).
                                                     those still in the education system,   as those with more work experience
In all countries, NEET rates are                     and a waste of educational             are favoured over new entrants into
affected by economic conditions                      investment and human resources.        the labour force.” xii
2 0                                                                                    I n n o c e n t i   R e p o r t   C a r d   1 1

Figure 3.2 Educational achievement by age 15                                                Findings
Average score in PISA tests of reading, maths and science literacy
                                                                                            »   Finland is a remarkable outlier –
                                                                                                registering a score almost 20
            Finland
                                                                                                points clear of the second placed
           Canada
                                                                                                country (see Box 2).
       Netherlands
       Switzerland                                                                          »   Canada and the Netherlands take
           Estonia                                                                              second and third places.
          Germany
          Belgium
                                                                                            »   Three of Europe’s wealthiest
            Poland
                                                                                                countries, Austria, Luxembourg
           Iceland                                                                              and Sweden, find themselves in
           Norway                                                                               the bottom half of the educational
United Kingdom                                                                                  achievement table, as do all four
          Denmark                                                                               countries of southern Europe.
          Slovenia
                                                                                            »   Romania is also an outlier,
            Ireland
                                                                                                registering a score more than
            France
                                                                                                40 points below the next lowest
      United States
                                                                                                country in the table.
          Hungary
           Sweden                                                                           »   Australia, Japan and New Zealand
Czech Republic                                                                                  would all have been placed in the
          Portugal                                                                              top five places had it been possible
           Slovakia                                                                             to include them in the main league
            Austria                                                                             table (see note page 7).
             Latvia
               Italy
             Spain
      Luxembourg                                                                            (PISA) which measures pupils’
          Lithuania                                                                         abilities in three basic competences
           Greece                                                                           – reading, maths and science.
          Romania                                                                           Repeated every three years, the
                                                                                            tests are administered to
             Japan                                                                          representative samples of 15-year-
      New Zealand                                                                           olds and are intended to measure
          Australia                                                                         knowledge and skills in relation to
           Bulgaria                                                                         the demands of managing lives
                  400   420      440      460      480      500      520   540   560        and careers in the modern world.
                                                                                            In total, 34 member countries of
                                                                                            the OECD, plus non-member
Educational achievement                         factors such as the development             partner countries, participate in
                                                of social understanding and value           this evaluation of educational
The second component of
                                                formation (including education for          achievement.
educational well-being is the quality
                                                citizenship) as well as the                 Figure 3.2 presents an overview of
of the education received.
                                                opportunity to develop the diverse          the results of the latest PISA survey
This key element of child well-being            abilities and potentials of young           for the countries under review. In
is of course difficult to define and            people. But this lies in the future.        each case, the scores shown are an
measure on an internationally                   At present, the only practical              average of results in reading, maths
comparable basis. Ideally, the                  measure of quality in education is          and science. All scores have been
concept of ‘quality’ in education               provided by the OECD’s Programme            re-presented on a common scale
would embrace a broad range of                  of International Student Assessment         based on an unweighted average
I n n o c e n t i     R e p o r t     C a r d     1 1                                                                                      2 1

score for all participating countries
(re-set to 500 to make interpretation
easier).                                                  Box 2 The Finland paradox
Disadvantage
The indicators used here to
measure children’s overall
educational well-being broadly
reflect each nation’s commitment
to fulfilling every child’s right to be
adequately prepared for the
demands of the world in which he
or she will live. Managing and
negotiating that world – making
decisions about jobs and careers,
families and homes, finances and
pensions, citizenship and
community participation – demands                       The fact that Finland has the lowest rate of preschool enrolment (Figure
                                                        3.1a) and the highest level of educational achievement (Figure 3.2)
a highly developed ability to acquire
                                                        might seem to contradict the idea that preschool education is important
and analyse new information and to
                                                        to success at school. But it is perhaps better interpreted as a warning
adapt to changing circumstances.
                                                        of the care needed in making cross-national comparisons.
In such a society, the educationally
disadvantaged are likely to be very                     First, compulsory schooling in Finland does not begin until a child is
much more disadvantaged than in                         seven years old, which means that the age group on which the
the past. They are also likely to find                  preschool enrolment rate is based is the child population between the
it ever more difficult to benefit from,                 ages of four and seven (in many other countries it is the child
and contribute to, the complex                          population between the ages of four and five). If the preschool
societies in which they live.1                          enrolment rate were to be re-defined as ‘the percentage of children
As with the other dimensions of                         enrolled in preschool education in the year before compulsory schooling
child well-being considered in this                     begins’ then Finland would rank near the top of the table with an
report, educational well-being is                       enrolment rate approaching 100%.
therefore a critical measure both                       Second, preschool enrolment rates say nothing about the quality of the
for children today and for their                        education received. If it were possible to measure quality, then it is
societies tomorrow.                                     likely that Finland would again be found towards the top of the table.
                                                        This prediction is based on the fact that Finland spends considerably
                                                        more than the OECD average on early years care and education, has
                                                        exceptionally high minimum qualification requirements for preschool
                                                        teaching staff, and the highest standards of staff-to-child ratios of any
                                                        advanced economy (1:4 for children under three years old, and 1:7 for
                                                        children between 4 and 6).

                                                        Most commentators on Finland’s outstanding record of educational
                                                        achievement cite the quality of the country’s early years education.

                                                        Sources:
                                                        Miho Taguma, Ineke Litjens, Kelly Makowiecki, Quality Matters in Early Childhood
                                                        Education and Care: Finland, OECD, 2012.
1 Report Card 9 in this series focused on this          Starting Strong II, Early Childhood Education and Care, OECD, 2006.
issue, showing that different countries do much
more than others for their lowest-achieving
pupils (i.e. have a much smaller ‘educational
achievement gap’ between the lowest-achieving
10% and the national average).
2 2                                                                                  I n n o c e n t i   R e p o r t   C a r d     1 1

Dimension 4 Behaviours and risks

                                                                                             Figure 4.0 An overview of
       Netherlands
                                                                                             behaviours and risks
          Denmark
            Iceland                                                                          The league table of children’s
                                                                                             behaviours and risks shows each
           Norway
                                                                                             country’s record in relation to the
           Sweden
                                                                                             average for the countries under
          Germany
                                                                                             review. The table is scaled to show
            Ireland                                                                          each country’s distance above or
           Portugal                                                                          below that average.
      Luxembourg
                                                                                             The length of each bar shows each
               Italy
                                                                                             country’s distance above or below the
       Switzerland                                                                           average for the group as a whole. The
            Finland                                                                          unit of measurement is the ‘standard
            France                                                                           deviation’ – a measure of the spread of
           Belgium                                                                           scores in relation to the average.
  United Kingdom
            Canada
            Austria
           Slovakia
            Poland
             Spain
           Slovenia
  Czech Republic
      United States
           Hungary
            Greece
            Estonia
          Romania
             Latvia
          Lithuania

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

 Assessing behaviours and risks
 COMPONENTS                          IND I C ATOR S

                                     % overweight

                                     % eating breakfast daily
 Eating and exercise
                                     % eating fruit daily

                                     % exercising

                                     Teenage fertility rate

                                     Smoking
 Risk behaviours
                                     Alcohol

                                     Cannabis

                                     Fighting
 Exposure to violence
                                     Being bullied
I n n o c e n t i   R e p o r t   C a r d   1 1                                                                        2 3

Behaviours and risks

The fourth dimension of child well-           drawn from questionnaires               career prospects; having a baby
being incorporated into the overall           completed by young people               may make all these problems
league table of child well-being is           themselves.                             worse, but not having a baby will
more difficult to pin down than                                                       not make them go away.
                                              Risk behaviours
material well-being or health or                                                      Nonetheless, having a baby at too
                                              The second component considered         young an age is an indicator of
education. Yet the dimension here
                                              under ‘behaviours and risks’ is the     much that may have gone wrong in
labelled ‘behaviours and risks’
                                              prevalence of a second set of           the life of a teenager before she
includes a range of habits and
                                              behaviours that represent               became pregnant. And it is for this
behaviours critical to the present
                                              immediate dangers to children as        reason that teenage birth rates are
and future well-being of children.
                                              well as serious threats to longer-      widely regarded as a particularly
Three separate components are                 term well-being. Within the             revealing indicator of many aspects
included. The first is the extent to          limitations of the available data,      of child well-being that are
which children in each country are            four such risk indicators have          otherwise difficult to capture.
forming healthy, well-informed                been chosen:
habits of eating and exercise.                                                        The threats posed to physical and
                                              a) the teenage fertility rate (annual   mental health by tobacco, alcohol
This has been measured by four
                                                 number of births per 1,000 girls     and cannabis are well established.
individual indicators:
                                                 aged 15 to 19)                       Figures 4.2a to 4.2d record the
a) the percentage who are                                                             performance of each country under
                                              b) the cigarette smoking rate
   overweight (as measured by body                                                    each indicator.
                                                 (percentage of children aged 11,
   mass index computed from self-
                                                 13 and 15 who smoke cigarettes       Violence
   reported height and weight)
                                                 at least once a week)
                                                                                      The final component of the
b) the percentage of children in
                                              c) the alcohol abuse rate               ‘behaviours and risks’ dimension of
   each country who report eating
                                                 (percentage of children aged         child well-being is the degree to
   breakfast every day
                                                 11, 13 and 15 who report having      which children and young people
c) the percentage who report eating              been drunk at least twice)           experience violence in their lives.
   fruit every day                                                                    Given the known dangers of
                                              d) the cannabis use rate
d) the percentage who report                     (percentage of children aged         growing up in a violent environment
   engaging in physical exercise                 11, 13 and 15 who report             – from immediate suffering and
   for at least an hour every day.               having used cannabis in the last     injury to longer-term problems of
                                                 12 months).                          anxiety, depression, behavioural
All of these indicators, though of                                                    problems, and propensity to use
                                              Giving birth at too young an age
varying significance, are associated                                                  violencexiv – it is unfortunate that
                                              puts at risk the well-being of both
with long-term health and well-                                                       few data are available to compare
                                              mother and child. The mother is at
being. Regular exercise, for                                                          children’s exposure to violence
                                              greater risk of dropping out of
example, is linked not only to                                                        either as victims or as witnesses.
                                              school, of unemployment, of
physical and mental health but to                                                     However, the Health Behaviour in
                                              poverty, and welfare dependence –
the prevention and/or treatment of                                                    School-aged Children surveyxv
                                              so helping to perpetuate
such specific problems as asthma,                                                     does provide data on children’s
                                              disadvantage from one generation
obesity, anxiety and depression.                                                      experiences of both fighting
                                              to the next. The child is also at
Unhealthy eating patterns in the                                                      (Figure 4.3a) and being bullied
                                              greater risk – of poverty, of poor
early years have also been shown                                                      (Figure 4.3b).
                                              health, and of underachievement
to increase the risk of later-life
                                              at school. The direction of causality
health problems including diabetes,
                                              in these relationships is not
heart disease and cancer.xiii
                                              necessarily clear cut. Teenage
Figures 4.1a to 4.1d show country             mothers tend to come from poorer
rankings for each of the chosen               backgrounds, to be doing less well
indicators. In all cases, data are            at school, and to have narrower
2 4                                                                                           I n n o c e n t i        R e p o r t    C a r d        1 1

Figure 4.1a Overweight                                                  Figure 4.1b Eating breakfast
% of children aged 11, 13 and 15 who are overweight by BMI              % of children aged 11, 13 and 15 who eat breakfast every day

    Netherlands                                                             Netherlands
     Switzerland                                                                Portugal
       Denmark                                                                 Denmark
          France                                                                Sweden
            Latvia                                                               Iceland
       Lithuania                                                                  Ireland
        Belgium                                                                 Belgium
        Sweden                                                                   Norway
         Norway                                                                  Finland
United Kingdom                                                                    France
        Slovakia                                                               Germany
       Germany                                                                      Spain
   Luxembourg                                                                    Estonia
         Iceland                                                                    Latvia
         Austria                                                                      Italy
         Estonia                                                                 Canada
       Romania                                                          United Kingdom
Czech Republic                                                                    Poland
        Hungary                                                            Luxembourg
          Ireland                                                              Lithuania
         Finland                                                             Switzerland
          Poland                                                                Slovakia
            Spain                                                                Austria
              Italy                                                     Czech Republic
       Slovenia                                                                 Hungary
        Portugal                                                                 Greece
         Canada                                                           United States
         Greece                                                                Romania
  United States                                                                Slovenia
                      0   5    10        15        20    25   30   35                         0   10    20        30    40   50      60    70    80        90

                                                                        Figure 4.1d Exercise
Figure 4.1c Eating fruit                                                % of children aged 11, 13, 15 who report at least one hour of
% of children aged 11, 13 and 15 who eat fruit daily                    moderate-to-vigorous physical activity daily

       Denmark                                                                    Ireland
         Canada                                                           United States
        Portugal                                                                 Austria
  United States                                                                     Spain
     Switzerland                                                        Czech Republic
         Norway                                                                  Finland
              Italy                                                              Canada
Czech Republic                                                                  Slovakia
       Romania                                                             Luxembourg
         Austria                                                        United Kingdom
       Slovenia                                                                   Poland
          France                                                               Slovenia
   Luxembourg                                                                       Latvia
            Spain                                                              Romania
United Kingdom                                                                  Hungary
        Belgium                                                             Netherlands
          Ireland                                                              Germany
       Germany                                                                  Belgium
        Slovakia                                                               Lithuania
        Hungary                                                                  Iceland
         Iceland                                                                 Norway
         Greece                                                                  Greece
    Netherlands                                                                  Estonia
          Poland                                                                Portugal
        Sweden                                                                  Sweden
            Latvia                                                           Switzerland
         Estonia                                                                  France
       Lithuania                                                               Denmark
         Finland                                                                      Italy
                      0   10        20        30        40    50   60                         0     5        10        15    20       25        30         35
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