Dominic Richardson

Health of the world's adolescents: a synthesis of internationally comparable data

Adolescence and young adulthood offer opportunities for health gains both through prevention and early clinical intervention. Yet development of health information systems to support this work has been weak and so far lagged behind those for early childhood and adulthood. With falls in the number of deaths in earlier childhood in many countries and a shifting emphasis to non-communicable disease risks, injuries, and mental health, there are good reasons to assess the present sources of health information for young people. We derive indicators from the conceptual framework for the Series on adolescent health and assess the available data to describe them. We selected indicators for their public health importance and their coverage of major health outcomes in young people, health risk behaviours and states, risk and protective factors, social role transitions relevant to health, and health service inputs. We then specify definitions that maximise international comparability. Even with this optimisation of data usage, only seven of the 25 indicators, covered at least 50% of the worlds adolescents. The worst adolescent health profiles are in sub-Saharan Africa, with persisting high mortality from maternal and infectious causes. Risks for non-communicable diseases are spreading rapidly, with the highest rates of tobacco use and overweight, and lowest rates of physical activity, predominantly in adolescents living in low-income and middle-income countries. Even for present global health agendas, such as HIV infection and maternal mortality, data sources are incomplete for adolescents. We propose a series of steps that include better coordination and use of data collected across countries, greater harmonisation of school-based surveys, further development of strategies for socially marginalised youth, targeted research into the validity and use of these health indicators, advocating for adolescent-health information within new global health initiatives, and a recommendation that every country produce a regular report on the health of its adolescents.

Does Child Income Poverty Measure Child Well-Being Internationally?

To date the main indicator used to compare the well-being of children in industrialised countries has been the proportion of children in income poverty. This article exploits data from recent work developing indices of child well-being in EU, OECD and CEE/CIS countries to explore whether child income poverty is a good representation of a wider understanding of child well-being. Using the poverty estimates in each index, as well as more recent estimates for the European Union, we find that for OECD countries income poverty still has some explanatory power but this is not the case for EU and CEE/CIS countries.

Child poverty and child well‐being in Europe

European Union (EU) indicators on poverty and social exclusion employ only two child breakdowns: the proportion of children living in households with incomes below 60% of the national median using the modified OECD equivalence scale and the proportion of children living in workless households. The UK also uses these indicators in the Opportunities for All series. This article first develops a new indicator of child poverty based on income, subjective and deprivation indicators which may be more reliable than income alone. It then explores the extent to which income poverty and worklessness represent international variation in child well‐being using an index that we have developed. The conclusions are that: (1) relative income poverty and worklessness are poor indicators of child well‐being, especially for some of the new EU countries; (2) deprivation has a stronger association with overall well‐being than relative income poverty or worklessness; (3) there are a number of other single indicators of child well‐being that could be used as proxies for overall child well‐being; and (4) The EU (and the UK) could easily develop its own index of child well‐being.

Regional Case Studies—Child Well Being in Europe

Recent years have seen a growth in the literature comparing child well-being outcomes in advanced economies. UNICEF (2007), OECD (2009), the European Commission (2008), as well as efforts by academics (Bradshaw, Hoelscher, & Richardson, 2007; Bradshaw & Richardson, 2009) have contributed to the field. These comparisons are either entirely made up of European countries, or the majority of the countries compared are European. Because of these studies more is known about the regional relative standing of EU countries in terms of their child well-being, than children in any other region of the world.