Money doesn't buy everything

When you compare children's health and well-being in the US to that of children around the world, we come off very well. But when you compare how well we do by our children with the way they fare in the rest of the industrialized, well-to-do world-a reasonable comparison, most would agree-the US doesn't come out so well. Nor does the United Kingdom. In fact, in an overall ranking arrived at by the United Nations Children's Fund (UNICEF), we and our British friends are at the bottom of the list of 21 wealthy countries in the Organisation for Economic Cooperation and Development (OECD), outranked by the Netherlands, Sweden, Germany, Greece, the Czech Republic, and Hungary, among others. (Data for Australia, Japan, and South Korea were insufficient for inclusion in the overview.)

The UNICEF ranking is based on six dimensions of child well-being: material well-being, health and safety, educational well-being, family and peer relationships, behaviors and risks, and children's reports of their own sense of well-being. Each dimension is assessed by a series of indicators. Indicators of material well-being, for example, are: the percentage of children in homes with incomes below 50% of the national median income; the percentage in families without an employed adult; and the percentage reporting deprivation in terms of family income, educational resources, and fewer than 10 books in the home. Child health and safety indicators are infant mortality, low-birth-weight births, immunization levels, and deaths from accidents and injuries.

Countries vary widely in how they rank on the various dimensions, the study found. No country scored the highest ranking on all six dimensions, although Sweden and the Netherlands came close. All countries have weaknesses that need to be addressed, and no single dimension is a reliable proxy for child well-being as a whole. Finally, riches don't guarantee high levels of child well-being. The Czech Republic, for example, achieves a higher overall rank than several much wealthier countries, including France, Austria, the US, and the UK. The report has its weaknesses: indicators of child mental health and child abuse and neglect are not included, because internationally comparable data are not available. But it is a significant first step in measuring how well the countries in the OECD, the rich countries of the world, take care of their children. The full report can be downloaded from the UNICEF Web site, http://www.unicef.org/.