Paediatricians and the UNICEF report on child well-being in rich countries

The recently published United Nations Children’s Fund (UNICEF) review of child well-being1 concluded that children in the United Kingdom had the worst level of well-being of the 21 countries in the Organisation for Economic Co-operation and Development (OECD). The review ranked countries on six dimensions of well-being. These were material well-being, health and safety, educational well-being, family and peer relationships, behaviours and risks, and subjective well-being. Each dimension was informed by three components, which are themselves made up of a variable number of indicators. For example, the three components of the material well-being dimension were relative income poverty, households without jobs and reported deprivation. Relative income poverty was represented by the percentage of children living in homes with equivalent incomes less than 50% of the national median, households without jobs by percentage of children in households without an employed adult and reported deprivation by the percentage of children reporting low family affluence, the percentage reporting few educational resources and the percentage reporting fewer than 10 books in the home. z scores were calculated for each indicator based on data from each country and then averaged to give an average z score for each component. These in turn were averaged to give an average z score for each of the six dimensions.

The measures used in the UNICEF review were developed by Bradshaw et al2 following a thorough review of child well-being measures. The authors set out to include “topics that matter to children from their point of view but also those that point to adults’ responsibility for the well-being of children”. The authors acknowledge the difficulty of accurately reflecting complex concepts such as child well-being and are clear that better measures will need to be developed in the future. International comparisons are always problematic as a result of …