In the newspaper today there is an Associated Press report on UNICEF's "An overview of child well-being in rich countries." RJ had sent to me the link to the complete report yesterday. I have had a chance to read the 52 page report as the well-being of children has been a life long focus of myself. The AP article was the summary of the first page of the UNICEF report which ranked and gave a report card on 21 nations, those who were in the European Union plus USA, Canada, Iceland, Japan and New Zealand. Several of the former "Eastern Block" countries were given a different heading and ranked in that heading.
Almost any activity which raises myown and the public at large awareness of how to improve the health and well-being of children is a good thing in my book. What I liked the most about this report were the individual questions which were solicited and how an individual country was ranked for each of these questions. Taking the categories in aggregate as reported by AP on the summary first page obscured some of the most important, and addressable (such a word?) issues. The first word that popped into my head as I was reading this report was "Standard Error"; the statistical reflection of how widely divergent the country's reponses to individual questions were in ranking within the same category.
For instance in the Dimension of Children's (0 to 19 years of age) Health Behavior, accounting for eating habits in childhood and adolescence as indicators of both present and future health, the overview has the Netherlands second from the top (good) and the USA being at the very bottom (bad). Several of the individual questions in this category: Mean number of days on which young people reported being physically active (good), the top three were: Ireland, Canada, and USA; and the lowest ranking on the question about being overweight (bad) were: Spain, Canada, and USA. Are these questions, although in the same category, linked? Or do they each reflect some information not easily generalizable?
The large standard error of this category made me query the more indepth reasons for these differences. What I know fairly well, and I am sure most of you have read something about this issue, that obesity in the USA is not homogeneous within our population. Rather, obesity in children is primarily an issue first: Hispanic young women, second: African-American young women, and third: rural Caucasian young women. Physical activity, although the lack of it has been associated with obesity, is primarily a domain of very young children, then there is gender and age separation with boys remaining active as they grow older and young women not.
Therefore the value of this UNICEF report to me is, is to prompt further inquiry, decipher the target population within our country that needs intervention, develop unique strategies for each of the targeted populations at risk, then lobby for and direct the limited resources towards the targeted populations. We know a lot about the "why" in these ethnic categories. In general, the individual questions serve as a template for further inquiry. These categories in and of themselves are but stepping stones across a rather large river of children's issues.
The other overaching impression I got from this report: there are profound differences in the degree of diversity of the populations in the listed countries. The USA has the largest, in terms of percentages, and diverse population. The United Kingdom has a large diverse population, think London and Manchester (at least for this study since the data was for England and not Wales, Scotland). The Northen European countries are highly homogeneous (language, culture, ethnenticty, government) compared to the UK & USA. To me this means, that identifying and targeting populations for intervention will be more efficacious than a one shoe fits all approach. Of course, this mean to some extent racial, gender, geographic profiling; not a politically correct concept. This also means that immigrant populations who come legally or illegally, many from Mexico and Central America, require visibility as well as aculturation to become included into the solution.
I close by saying: "the success in achieving a goal, is to measure its outcomes." (somebody other than myself must have said this although I can't for the life of me remember who)
What do you think?
3 comments:
The maxim you quoted is in the report!
What do I think? Despite all you critiques, I would say that the assessment of Sweden is dead on: material well-being (family stipends), health (socialized health care) and safety are the best out there, but family and social relationships are a weakess. Also, my experiences as a teacher also suggest that the US isn't doing very well taking care of its children. This strong relationship between what I observe in both societies and what is in the report tells me that the report is accurate, despite your critiques.
I would also like to point out that in actual fact, the UK has approximately the same number of non-whites (8%) as the Netherlands (9%), according to the CIA World Fact Book.
As a quick follow up, I did a quick regression analysis on the correlation between the score by the UNICEF report and the percentage of minorities living in the country as reported by the CIA World Fact book and also other sources where available and found no statistically significant correlation. Of course, this was an extremely sloppy experiment and I suspect that a careful analysis would reveal that there is in fact some correlation, but I doubt that it would be a very large one.
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