The good news about Canadian children, according to UNICEF

Posted on April 11, 2013 in Child & Family Debates – FullComment
13/04/11. Jonathan Kay

Child Well-being In Rich Countries: A Comparative Overview, UNICEF’s just-released report, makes for interesting reading — but not for the reasons reported by most Canadian media.

“Canadian kids’ well-being trails other rich nations” is how one Toronto-area newspaper reported the news on its Wednesday front page. In fact, we came in 17th out of 29 — middle of the pack. Moreover, as the UNICEF report makes clear, conditions for children are improving across the board in almost all developed nations, including Canada — so the inter-country comparisons mostly are just a scoreboard that tracks who’s improving fastest. (A chart that appears on page 44 of the report shows that, in relative terms, we’re more or less exactly where we were a decade ago: just behind Switzerland, and just ahead of the United States, Italy and Austria.)

Moreover, there are a lot of specifically Canadian good-news stories in this report:

– Teenage fertility rates have plummeted in this country, from 20 live births per 1,000 teenaged girls a decade ago, to about 13 in 2009.

– Our rate of teen smoking is among the lowest in the world: Just 4% of teens report having smoked in the past week, half the rate of a decade ago. (No other developed country except Norway has a lower rate.) This is a huge public-health development for Canada, because youth smoking is a strong predictor of adult smoking — which means Canada is producing a cohort of youth that will have massively less susceptibility to cancer and other smoking-associated diseases later in life. (Ironically, we also have the highest reported usage of teen cannabis use, at 28% — seven times the rate of tobacco usage — although that number is down from 40% a decade ago.)

– The percentage of Canadians aged 15-19 who remain in the education system increased markedly in the surveyed period, from 74% to 81%. That’s the fourth biggest jump in the entire OECD. And Canadian students’ average score on standardized tests is second only to Finland.

– Finally, for what it’s worth, a greater share of our children eat fruit daily than in any other nation — except Denmark (not that seems to be helping our obesity numbers much). Last-place Finland, apparently, needs some kind of national fruit strategy.

Even the bad news comes with big asterisks that make us wonder if Canada doesn’t deserve to have a much higher UNICEF ranking than it actually does. One area in which we do poorly, for instance, is infant mortality. But as a 2009 Conference Board of Canada report concluded, international comparisons of infant-mortality stats are tricky because of differences “in the registration of babies with an extremely low birth weight or countries’ classifications of births as live births or stillbirths … This discrepancy can lead to under-reporting of infant deaths by some countries, particularly when compared with countries that use a broader definition for live birth.” Moreover, “Canada’s ability to reduce infant mortality is constrained by the successful delivery of more preterm babies and babies with very low birth weight. These babies face higher risk of death.”

In other words, the way the UNICEF rankings are constructed has the perverse effect of penalizing advanced Canadian pediatric clinics for keeping long-shot fetuses alive till such time as they can be counted as living children.

Another perverse effect is contained in UNICEF’s rankings of nations according to “relative child poverty” — which has nothing to do with absolute levels of child welfare. Instead, it is based on the percentage of children living in households with income 50% below the national median.

Indeed, a close reading of the UNICEF report shows that there is really only one area where Canada is unequivocally letting down our children in a statistically scandalous manner: immunization for measles, polio, diphtheria, pertussis and tetanus. Of the 29 developed countries on the list, we come in 28th — with only Austria lagging (badly) behind us.

These UN rankings of developed countries come in various flavours, and they inevitably set off spasms of wounded-pride soul-searching among Canadians, as if it really makes much of a difference whether our kids are eating more cantaloupe than those in Estonia. But in the case of vaccines, there truly is a valuable takeaway in regard to Canadian healthcare policy — even if it’s buried in Figure 2.2: If Hungary, Greece, Slovakia, Finland and a dozen other countries can score above 90% vaccine coverage, how is it that our vaunted medicare system is generating an immunization rate of just 84%?

Our doctors, and parents, can do better. A nation that can get its teenagers off cigarettes surely can get its babies and toddlers to the pediatrician.

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