Poorer children fare less well than richer ones in each society. But a recent UNICEF report detailing 40 indicators of child wellbeing, said children in the UK and the USA fared worse than in any of the other rich countries. The new research examines whether the damage is done by being poor, or by being poorer than others.
To answer this question, the authors examined whether measures of child wellbeing were most closely related to average income (material living standards) or to the scale of income differences (inequality) in each society.
The authors studied these relationships in two different settings: among 23 rich countries, and then, independently, among the 50 states of the USA (and District of Columbia).
Among the 23 rich countries, the UNICEF index of child wellbeing (covering material wellbeing, health and safety, educational wellbeing, family and peer relationships, unhealthy and risky behaviours, and subjective wellbeing) was unrelated to average income, but was strongly related to the size of the income differences between rich and poor within each country.
Findings were similar among the 50 states of the USA. Data were analysed for teenage births, juvenile homicides, infant mortality, low birth weight, educational performance, high school drop-out rate, the proportion of children overweight, and mental health problems. All were more strongly related to the scale of income inequality in each state than to its average income.
The authors used data from various sources, including the United Nations, Organisation for Economic Co-Operation and Development (OECD), UNICEF, World Bank, US Census Bureau, and US National Centre for Health Statistics.
Among the 50 states of the USA and among affluent countries, the results suggest that children's wellbeing is not higher, either among the richest of the 50 US states, or among the richest of the affluent countries. It is instead, significantly better in those countries and states in which income differences are smaller.
Commenting in an accompanying BMJ editorial, other researchers state that "We know enough to say that inequalities affect child wellbeing and that relative poverty kills as effectively as any disease," They believe that we need to get better at identifying the programmes that work and much better at getting governments to invest in the wellbeing of children.