Article Text

Download PDFPDF
Disproportionate disadvantage of the young: Britain, the Unicef report on child well-being, and political choices
  1. Ingrid Wolfe
  1. Health Services Research and Policy, London School of Hygiene and Tropical Medicine, and Evelina London Children's Hospital, London, UK
  1. Correspondence to Dr Ingrid Wolfe, Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK; ingrid.wolfe{at}

Statistics from

Unicef Innocenti's latest comparative overview of child well-being in rich countries looks like good news for the UK. We have risen up the ranks, now reaching 16th place among 29 countries.1 This mediocre position is worthy of celebration because Unicef's previous report in 2007 was shocking: our overall position was lowest among 21 rich countries.2 We shared this lamentable place with the USA. Indeed many newspaper headlines reflected the recent progress, albeit with one or two examples of scepticism about the notion of measuring child well-being. Children's health policy and systems research has not yet proven its worth to all in the health community, which is trained to believe that the randomised controlled trial is the gold standard of evidence. So it is good to see arguments around this new and important research field, still defining new methods and standards, reaching beyond medical journals to the mainstream press.3

Although ranking countries by health system performance, or any other outcome, can be controversial and often stimulates heated arguments, it effectively focuses attention onto important issues. Indeed the 2007 report provoked debate about important problems for children and families, and crucially prompted investment and research. Unicef UK, for example, enquired further into why children in this country experience such strikingly low well-being, while some children from countries with less economic security have a greater sense of well-being.4 One explanation to this finding lies in the damaging effects of inequality.5 Governments can act to reduce poverty and inequalities directly through redistributive fiscal policy, benefitting those who are most at-risk. However, there is even more that could be done to help children. The harsh effects of poverty can be softened through social protection. For example, Sweden has lower child deprivation rates than other countries of similar wealth (as measured …

View Full Text


  • Competing interests None.

  • Provenance and peer review Commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.