Child well being in rich countries – Canada's ranking

Abstract

To the Editor; The United Nations has published a report card for the top 21 countries in the ‘industrialized world’. This is the seventh report in a series from the United Nations Children’s Fund (UNICEF) Innocenti Research Centre . Canadian paediatricians and family physicians have a lot to consider after reading this report. First, some satisfaction will be found knowing that, overall, Canada ranks in the middle third with a numeric score of 11.8. This is considerably better than the scores for the United States and the United Kingdom, which have two of the worst scores; however, Canada’s score is still far lower than the top scoring countries – the Netherlands, Sweden, Norway, Finland, Spain and Switzerland. However, the aggregate scoring is not the most useful reflection of Canada’s performance. There are six dimensions recorded; on “Material Well Being”, Canada ranked six of 21 and on “Educational Well Being”, Canada ranked two of 21. A total of 40 measures made up the aggregate scores. However, “Family and Peer Relationships” ranked Canada at 18 of 21 nations. This dimension covers several measures that try to impact on the ‘quality of children’s relationships’. It uses measures of family structure (percentage of children from single parent families and percentage of children from step-families), family relationship (percentage of children who report eating a main meal with parents more than once a week and percentage of children who report that parents spend time ‘just talking to them’) and peer relationship (percentage of 11-, 13- and 15-year-old children who report finding their peers ‘kind and helpful’). These measures are assessed by questionnaires. Less than 50% of Canadian children (children older than 15 years of age), according to this report, have parents who spend time ‘just talking to them’ several times a week. Only 63% of young people, younger than 15 years of age, find their peers ‘kind and helpful’. For “Behaviours & Risk Taking”, Canada was ranked 17 of 21. On behaviours, such as smoking, being drunk more than twice, using cannabis by 15 years of age and having unprotected sex by 15 years of age, Canada performs poorly. Combined with these scores is the “Converse Health Behaviours” – such as the percentage of children who eat breakfast, fruit and are physically active – in which Canada is only ranked at 12 of 21. Four of seven days, Canadian children report physical activity for 1 h or more a week. Of the 13- and 15-year-old age group, 19% reported overweight violence; Canada reported 36% of 11-, 13- and 15-year-old children involved in bullying over the previous 12 months. Finally, in the dimension of “Subjective Well Being”, five measures place Canada at 16 of 21 countries. The percentage of young people rating their health as ‘fair or poor’ was 14%. Only 21% of children in Canada (11, 13 and 15 years of age) rated themselves as ‘liking school a lot’. However, it is true that Canadian children rated themselves above the ‘middle of the life’ satisfaction scale. The notions of preventive health in Canada must be re-examined for children in the light of this report. Complacency from overall material well-being (ignoring large worrying gaps) obscures some cold facts.