updated 2/14/2007 8:02:17 PM ET 2007-02-15T01:02:17

The United States and Britain ranked at the bottom of a U.N. survey of child welfare in 21 wealthy countries that assessed everything from infant mortality to whether children ate dinner with their parents or were bullied at school.

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The Netherlands, followed by Sweden, Denmark and Finland, finished at the top of the rankings, while the U.S. was 20th and Britain 21st, according to the report released Wednesday by UNICEF in Germany.

One of the study’s researchers, Jonathan Bradshaw, said children fared worse in the U.S. and Britain — despite high overall levels of national wealth — because of greater economic inequality and poor levels of public support for families.

“What they have in common are very high levels of inequality, very high levels of child poverty, which is also associated with inequality, and in rather different ways poorly developed services to families with children,” said Bradshaw, a professor of social policy at the University of York in Britain.

“They don’t invest as much in children as continental European countries do,” he said, citing the lack of day care services in both countries and poorer health coverage and preventative care for children in the U.S.

U.S. officials questioned the comparisons made by the study, while Britain said it failed take into account recent social improvements.

Risky ways
The United States finished last in the health and safety category, based on infant mortality, vaccinations for childhood diseases, deaths from injuries and accidents before age 19, and whether children reported fighting in the past year or being bullied in the previous two months.

The U.S. was second to worst, behind only Hungary, for its infant mortality rate of 7 per 1,000 births. The rate, a standard indicator of children's health and prenatal care, is under 3 in Japan.

The study also gave the U.S. and Britain low marks for their higher incidences of single-parent families and risky behaviors among children, such as drinking alcohol and sexual activity.

Britain was last and the U.S. second from the bottom in the category focusing on relationships, based on the percentage of children who lived in single-parent homes or with stepparents, as well as the percentage that ate the main meal of the day with their families several times per week. That category also counted the proportion of children who said they had “kind” or “helpful” relationships with other children.

The report’s authors cautioned that the focus on single-parent families “may seem unfair and insensitive” and noted that many children do well with one parent.

“But at the statistical level there is evidence to associate growing up in single-parent families with greater risk to well-being — including a greater risk of dropping out of school, of leaving home early, poorer health, low skills and of low pay,” the report said.

On average, 80 percent of the children in the countries surveyed live with both parents. There were wide variations, however, from more than 90 percent in Greece and Italy to less than 70 percent in Britain and 60 percent in the U.S., where 16 percent of adolescents lived with stepfamilies.

Bob Reitemeier, chief executive of The Children’s Fund charity in Britain, said the UNICEF report also showed that less than half of British children reported good relations with their peers.

Bullying in Britain
“That really jumped off the page,” he said, citing concerns about the competitive, ratings-based school environment in Britain and higher reported incidences of bullying and fighting. “The environment for these young people is quite negative.”

The study ranked the countries in six categories, based on national statistics: material well-being, health and safety, education, peer and family relationships, behaviors and risks, and young people’s own subjective sense of well-being. Both the U.S. and Britain were in the bottom two-thirds of five of the six categories.

Britain finished at the bottom in behaviors and risks, which considered factors such as the percentage of children who had breakfast, ate fruit regularly, exercised, were overweight, used drugs or alcohol, were sexually active or became pregnant.

Both the U.S. and British governments criticized the report.

Wade Horn, an assistant secretary at the Department of Health and Human Services, said the study’s standard of measuring poverty differed from that of the United States.

Defining poverty
A family of four is defined by the U.S. as living in poverty if its combined income is less than $20,650 a year. The poverty threshold used by the report was an income of $35,000 a year for a family of four, he said.

“I think when you try to compare nations in a report like this, you tend to ignore so many other factors specific to those nations that the comparison becomes somewhat meaningless,” Horn said.

State Department spokesman Paul Denig was also critical of the report and said his department first learned of the study through the media and was not asked to provide input.

Britain said the report did not take account of recent improvements to education, health and general living standards in the country. Some of the statistics also went back as far as 2001, it said.

In general, northern European countries with strong social welfare systems dominated the upper half of the rankings. Southern European countries, such as Spain, Italy and Portugal, ranked higher in terms of family support and levels of trust with friends and peers.

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