Places and Spaces Environments and children's well-being - Innocenti Report Card 17 - Unicef
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The Innocenti Report Card series is designed to monitor and compare the performance of economically advanced countries in securing the rights of their children. Innocenti Report Card 17 was written by Eszter Timar, Anna Gromada, Gwyther Rees and Alessandro Carraro with contributions from Dominic Richardson, Gunilla Olsson, Celine Little, Dagna Rams, Gro Dehli Villanger, Nicole Quattrini, Tim Huijts, Mirza Balaj and Terje Eikemo. The United Nations Children’s Fund Office of Research – Innocenti (UNICEF Innocenti) would like to acknowledge the generous support for Innocenti Report Card 17 provided by the Government of Italy. Any part of this Innocenti Report Card may be freely reproduced using the following reference: UNICEF Office of Research (2022). Places and Spaces: Environments and children’s well-being, Innocenti Report Card 17, UNICEF Office of Research – Innocenti, Florence. About the UNICEF Office of Research – Innocenti In 1988, the United Nations Children’s Fund (UNICEF) established a research centre to support its advocacy for children worldwide and to identify and research current and future areas of UNICEF work. The prime objectives of the UNICEF Office of Research – Innocenti are to improve international understanding of issues relating to children’s rights, to help facilitate full implementation of the Convention on the Rights of the Child, and to support advocacy worldwide. The Office aims to set out a comprehensive framework for research and knowledge within the organization, in support of its global policies and programmes. Through strengthening research partnerships with leading academic institutions and development networks in both the North and the South, UNICEF Innocenti seeks to leverage additional resources and influence in support of efforts towards policy reform, in favour of children. The Office of Research – Innocenti receives financial support from the Government of Italy, while funding for specific projects is also provided by other governments, international institutions and private sources, including UNICEF National Committees. Publications produced by the Office are contributions to a global debate on children and may not necessarily reflect UNICEF policies or approaches. The views expressed are those of the authors. The designations employed in this publication and the presentation of the material do not imply on the part of UNICEF the expression of any opinion whatsoever concerning the legal status of any country or territory, or of its authorities or the delimitations of its frontiers. Cover photo © Yukiko Noritake - garance illustration llc ©United Nations Children’s Fund (UNICEF), 2022 ISBN: 9788865220641 UNICEF Office of Research – Innocenti Via degli Alfani 58 - 50121 Florence, Italy Tel: +39 055 2033 0 Fax: +39 055 2033 220 researchpublications@unicef.org www.unicef-irc.org @UNICEFInnocenti on Twitter, LinkedIn, Facebook, Instagram and YouTube Graphic design: Art&Design Srl, Rome Editorial production: Sarah Marchant, UNICEF Innocenti
FOREWORD Home. In a good childhood, home children and our planet. The level making children’s journeys to is a safe and stable place, with of consumption in most rich school safer – and can reduce healthy food to eat, clean water to countries would require at least carbon dioxide (CO2) emissions. Or drink and a loving family. three planet earths if replicated in transitioning towards sustainable all countries. E-waste – the fastest- agriculture can improve children’s Yet, many children – even in the growing type of domestic waste diets and reduce the environmental world’s richer countries – lack – contains hazardous substances damage of current food these necessities of life. They are that damage bodies and brains, production. These synergies are surrounded by toxic air, lead and it takes its highest toll on well recognized in the Sustainable pollution, loud noise or mouldy children. Development Goals, where walls. Others live in homes that are meeting one goal is essential to too dark, too cold or too crowded. Through global efforts to achieve meeting another. sustainable development and Unhealthy living conditions a more equitable world, the Conversely, if we, as a global irretrievably harm children’s mental international community has community, do not improve the and physical well-being, their for decades been calling on environments in which children live cognitive development, and their governments, the private sector, and develop, what hope is there for prospects for a happy and healthy civil society and individuals to a better future? We can do better, life. For a child living with high protect our planet. Children and and we must. How? By listening levels of road traffic or without young people have also sounded to children and young people; by enough green space in which to the alarm, with millions globally making discerning choices about play, the options to escape or participating in climate strikes how we consume and how we offset these dangers are few. and demanding transformative dispose of what we discard; by Environmental risks are also action to save their own future on designing our neighbourhoods and unequally distributed. Children the planet. The United Nations homes with children in mind; by from poorer families and Secretary-General’s report Our supporting children’s involvement marginalized groups face greater Common Agenda presents “a in environmental debates and exposure to severe housing stark and urgent choice: a decisions; by ensuring that the deprivation, which deepens breakdown or a breakthrough”. distinct needs of children are built disadvantage and perpetuates The first option is characterized into environmental policies; and cycles of poverty. by “a perpetual crisis”, while the by pursuing policies and practices second offers the “prospect of a that safeguard the natural Beyond the doorstep of children’s greener, safer, better future”.1 environment, on which children homes, schools and communities, and young people depend. our collective home – the planet The good news is that, by tackling – is also in jeopardy. Rising one challenge, we improve the temperatures, loss of biodiversity chances of solving another. Put and extreme weather events differently, what provides a child threaten both livelihoods and with a safe and healthy home Gunilla Olsson lives themselves. The pressure also protects the environment. Director that our natural resources are Reducing motorized traffic, UNICEF Office of Research – coming under and the mounting for example, can have a positive Innocenti waste are harmful to both our impact on road safety – I N N O C E N T I R E P O R T C A R D 1 7 3
SECTION 1 INTRODUCTION © Séverine Assous - garance illustration llc I N N O C E N T I R E P O R T C A R D 1 7 5
SECTION 1 INTRODUCTION Environmental changes taking hygiene or chemicals.2 Children Rich countries, and rich people, place around the world find their are especially vulnerable – partly can often try to buy their way out way into the bodies and minds of because their bodies and immune of a crisis; but an environmental children. Through polluted air, water systems are still developing, but crisis is different. Buying an air and food, we each inadvertently also because of their behaviour purifier does not obviate the need consume a quarter of a kilogram (for example, they are more likely to breathe public air. Even of plastic per year – equivalent to to put their fingers in their mouths if countries reduce their own eating a credit card every week. than adults). The consequences carbon footprint, they still face In nine of the world’s richest of climate change will persist the problems created by those countries, more than 1 child in 20 throughout the lives of today’s that do not. have elevated levels of lead in their children, requiring them to In October 2021, the United blood. The environmental ‘problem’ adapt to, and mitigate, the risks Nations Human Rights Council is not an abstract concept about associated with a warming planet. recognized the right to a a distant future: it is affecting Yet, the environment influences not clean, healthy and sustainable children – right here, right now. only whether today’s children grow environment,5 while the United The results of climate change up to be healthy and happy adults, Nations Committee on the are already clear and present. but also their current mental Rights of the Child decided that a Rising temperatures, higher sea well-being. A survey covering six country can be held responsible levels, air and soil pollution and high-income countries3 reported for the impact of its emissions on extraordinary-turned-ordinary that nearly half of all young children both within and beyond weather events affect not only people feel distressed about the its territory.6 Yet, more effort is the world we leave for future environment to an extent that is needed to avert the most dire generations, but also the brains, affecting their daily functioning.4 consequences of environmental lungs and hearts of us all today. Some 6 in 10 believe that their neglect. The importance of having governments have failed them, as all countries work towards the Globally, one death in four among regards the environment. Two in goals set out in the 2030 Agenda children aged under 5 years five have doubts about becoming for Sustainable Development is could be averted by improving a parent in the future, due to the becoming ever more apparent. environmental factors, such as climate crisis. air pollution, water, sanitation, 6 I N N O C E N T I R E P O R T C A R D 1 7
S E C T I O N 1 I N T R O D U C T I O N Definitions and scope and outside UNICEF; and focus to the planet as a whole. Some In English, the word ‘environment’ group discussions with young participants also mentioned that can be linked to many concepts – people aged 10–17 years from culture and religion shape what e.g., the ‘economic environment’ Canada, Chile, Mexico, Spain and the environment is and how we or the ‘digital environment’. For Sweden. When asked to define see it. the purposes of this report, we the environment, young people This report covers the 43 adopt a narrower focus on ‘the tended to list both natural and countries that are members of environment’ and use the term man-made elements; and to the Organisation for Economic to cover the physical aspects of agree that nature, the landscape Co-operation and Development natural and built environments that and all living things are part (OECD) and/or the European Union children experience and that affect of the environment. Children (EU), because their harmonized their well-being. highlighted the connections data infrastructures allow for a between all living things – flora, This definition, and the conceptual comparative analysis of children’s fauna and humans – and the need framework that is presented environmental well-being. There for a balance between humans below, were developed on the are some data limitations relating and nature. Other definitions basis of a literature review; to countries that have recently of the environment included consultations with research and joined the OECD, particularly “everything that surrounds us”, policy professionals both within Colombia and Costa Rica. from the home that we live in AIMS The report focuses on the following questions: 1. How do environmental factors affect children’s well-being? 2. How are many of the world’s richest countries faring in terms of providing a healthy environment in which children can live, develop and thrive? 3. What actions can these countries take to improve the environments in which children live? I N N O C E N T I R E P O R T C A R D 1 7 7
S E C T I O N 1 I N T R O D U C T I O N Figure 1: Broad conceptual framework Our framework Over the past two decades, UNICEF Innocenti Report Cards have led the way in comparing world at large children’s well-being across rich The countries. Innocenti Report Card 16 introduced a multi-level framework that put the child at the centre. Child outcomes – physical health, around th mental well-being and skills – are world ec e hi affected by the world of the child, h l the world around the child and the T d world at large. Innocenti Report Card 17 takes this approach a rld of the wo c step further (see Figure 1). As the e current state of the environment hi Th ld is shaped by past actions, and is already shaping what lies ahead, The child we add a time perspective to the model: the world we inherit and the world we leave behind. And because the environmental actions The world of one country can affect children The world we will leave in others, we also consider the we inherit behind impact that countries have beyond their own borders. Three crosscutting themes run through our framework: interlinkages, inequalities and children’s influence. Interlinkages mean that many factors that cause climate change in the long run are also harming children now. For example, cars emit CO2, but also cause noise and air pollution, take up space, create risks and limit children’s activities, such as playing outside. 8 I N N O C E N T I R E P O R T C A R D 1 7
S E C T I O N 1 I N T R O D U C T I O N Inequalities mean that Children, often the worst affected Yet, young people are aware and environmental factors affect by environmental problems, will are calling for action. In 2019, people in different ways, not only inherit them in the future, at the World Economic Forum depending on their resources – but are also the least able to in Davos, Greta Thunberg told as we have seen during the influence the course of events. delegates: “I want you to act as COVID-19 pandemic. Some Choices that affect their lives are you would in a crisis. I want you countries and individuals are better taken by parents, governments to act as if our house is on fire. able to protect themselves than and businesses. Many of the Because it is.”8 are others. Environmental risks are national climate plans submitted also spread both geographically ahead of the 26th United Nations – from rich countries to poor Climate Change Conference of countries – and temporally, the Parties (COP26) were neither with today’s choices causing child sensitive nor created with tomorrow’s disasters. children’s participation.7 THE CONCEPTUAL FRAMEWORK IS APPLIED IN THIS REPORT AS FOLLOWS: 1. Child outcomes are grouped into three broad categories – physical health, mental well-being and skills – as in Innocenti Report Card 16. 2. The world of the child focuses on children’s direct experiences of the environment, in terms of their consumption of air, water and food, and their exposure to light, noise, heat, cold and hazardous substances. 3. The world around the child covers the physical aspects of the environments that the child encounters directly, such as housing, green space, schools, traffic and environmental hazards. 4. The world at large refers to the broader context within which these physical environments are created and maintained. This can include the impact of government policy and expenditure. Here, we include the impact of a country’s actions not only within its borders, but also externally. 5. The world we inherit refers to a country’s historical environmental record and actions, the cumulative results of which are still being felt today. 6. The world we leave behind refers to a country’s current actions and progress, which will influence the environment in the future. I N N O C E N T I R E P O R T C A R D 1 7 9
S E C T I O N 1 I N T R O D U C T I O N Figure 2 depicts key topics that are The design of the framework lends Finally, underpinning this analysis, covered in this report within each itself to exploring interlinkages it is important to consider the of these parts of the framework. within and between levels, as will potential role of the United Nations be shown through an example Convention on the Rights of the later in the report. Two other Child and of the 2030 Agenda cross-cutting themes – children’s for Sustainable Development in influence and inequalities – are providing opportunities for strong relevant in each of the nested advocacy on environmental issues circles. (see also Spotlight 1). Figure 2: Topics covered in this Report Card Management of natural environment Housing and Climate change transport policy and natural disasters Waste/ Renewable recycling Basic home services energy Emissions School Housing quality Space Food Participation Inequalities playgrounds at home policy Public Play transport Heat/cold facilities Toxicants Water quality Walkability Green Pesticides Air pollution spaces Traffic Light Noise pollution pollution Physical health Mental well-being Skills Footprint Historical Loss of pollution biodiversity 1 0 I N N O C E N T I R E P O R T C A R D 1 7
SECTION 2 A LEAGUE TABLE OF ENVIRONMENTAL CONDITIONS I N N O C E N T I R E P O R T C A R D 1 7 1 1
S E C T I O N 2 A L E A G U E T A B L E O F E N V I R O N M E N T A L C O N D I T I O N S SECTION 2 A LEAGUE TABLE OF ENVIRONMENTAL CONDITIONS Figure 3 presents a league table Spain is at the top of the league The picture in Romania and Costa based on the best available table – despite not being at the Rica is remarkably different from indicators to represent the aspects top position in any of the individual that in the United States. In the of environmental conditions set dimensions (it is ranked 8th for first two, children’s immediate out in Figures 1 and 2. It contains the ‘world of the child’, and 13th environments are lacking (visible three indicators in each of three for both the ‘world around the from their low scores in the ‘world groupings – the world of the child, child’ and the ‘world at large’). of the child’ and ‘world around the the world around the child and the This is illustrative of the pattern child’), but the countries are among world at large. Box 1 describes that no country does consistently the least responsible for harming the criteria we used in selecting well or consistently badly across the environment at large. The the indicators for the league all dimensions. Spain is followed United States, in contrast, performs table. Table 1 provides details of by Ireland, a country with good poorly in the ‘world at large’, while the definition and source of each performance in the indicators there is also room for improvement indicator, and also refers to the closest to the child but an average in the ‘world of the child’ and the figure in the report that shows record at the macro-level. Romania ‘world around the child’. country statistics for the indicator. lies at the bottom of the table, where it is preceded by Costa Rica and the United States of America. BOX 1: HOW INDICATORS WERE SELECTED FOR THE LEAGUE TABLE League table indicators were chosen to reflect different aspects of the framework presented in Figure 1. The following criteria were used to select indicators. Quality: Data had to meet high standards of quality, drawn either from national and internationally recognized data sources, or from peer-reviewed publications. Coverage: Data should be available for all, or the great majority, of the Innocenti Report Card 17 countries. Recency: Data should be available for 2018 or later. Relevance: Data should be relevant to cross-national comparisons. Variability: There should be enough cross-national variability to be informative. Comparability: The indicators should have comparable meanings across cultures. 1 2 I N N O C E N T I R E P O R T C A R D 1 7
S E C T I O N 2 A L E A G U E T A B L E O F E N V I R O N M E N T A L C O N D I T I O N S Figure 3: A league table of environmental conditions that affect children’s well-being Overall ranking Country World of the child World around the child World at large 1 Spain 8 13 13 2 Ireland 6 4 20 3 Portugal 25 9 9 4 Cyprus 15 17 10 5 Finland 1 2 30 6 Italy 7 16 14 7 Iceland 3 1 32 8 Slovenia 19 14 16 9 Germany 13 6 22 10 Sweden 4 10 26 11 United Kingdom 11 12 23 12 Netherlands 12 8 27 13 Japan 2 21 25 14 Norway 5 5 35 15 New Zealand 24 15 17 16 France 14 27 18 17 Switzerland 21 3 33 18 Hungary 34 22 6 19 Austria 9 19 29 20 Czechia 26 23 21 21 Estonia 27 11 28 22 Lithuania 32 24 15 23 Croatia 29 33 5 24 Denmark 18 26 34 25 Slovakia 31 29 11 26 Greece 22 35 8 27 Poland 30 31 7 28 Canada 17 7 38 29 Malta 33 18 24 30 Australia 10 20 37 31 Latvia 36 30 12 32 Republic of Korea 16 32 31 33 Chile 35 37 3 34 Israel 23 36 19 35 Bulgaria 37 34 4 36 Belgium 28 25 36 37 United States 20 28 39 38 Costa Rica 38 38 1 39 Romania 39 39 2 Note: The ranking is calculated as follows: (1) a z-score for each indicator was calculated (reversed where necessary so that a higher score represents a more positive condition); (2) the mean of the z-scores within each dimension was calculated; (3) the z-score for each mean was calculated and served as a basis for ranking a given dimension; (4) the mean of the three ranks was calculated and served as a basis for the final ranking. If two countries had the same average of three ranks, the average of z-scores was used to determine their position. Countries are ranked on a dimension if they have data for at least two of the three indicators. Four OECD/EU countries are not included in the ranking: Colombia is excluded due to missing data on the ‘world around the child’ dimension, while Turkey, Mexico and Luxembourg are excluded as they are extreme outliers on at least one indicator (z-scores below -4.0). I N N O C E N T I R E P O R T C A R D 1 7 1 3
S E C T I O N 2 A L E A G U E T A B L E O F E N V I R O N M E N T A L C O N D I T I O N S Many countries perform quite prosperity is no guarantee The league table therefore differently across the three that children will grow up in a presents a complex and multi- dimensions, and not one nation healthy environment. In Canada faceted picture, which will be shows consistently high or and Australia, present-day explored more fully in the following low scores across them. The environments appear relatively sections. Overall, no country does presence of wealthy countries child friendly, but the countries’ well across the board. There is in some of the bottom positions unsustainable consumption substantial room for improvement, (such as the United States and patterns threaten the future. even among those at the top of Belgium) indicates that national the table. Table 1: Details of indicators included in the league table Dimension Figure Indicator Indicator definition Source Global Burden of Disease Collaborative Disability-adjusted life years (DALYs) Network (2021). The Global Burden of 6 Air pollution lost to unsafe air per 1,000 children Disease Study 2019. Seattle, Institute (
S E C T I O N 2 A L E A G U E T A B L E O F E N V I R O N M E N T A L C O N D I T I O N S Spotlight 1 Children’s environments, children’s rights and sustainable development The United Nations Convention A very important development in terms of the on the Rights of the Child environment and children’s rights is the decision by the United Nations Committee on the Rights There is a strong connection between the question of the Child to draft a general comment (No. of how the natural and the built environments 26) on children’s rights and the environment, affect children and the promotion of children’s with a special focus on climate change. The rights under the United Nations Convention on the general comment has the objective of providing Rights of the Child (CRC). “authoritative guidance on how children’s rights 1. First, there are clear direct links with article 6 of are impacted by the environmental crisis and what the CRC (right to life, survival and development) governments must do to uphold these rights”. This and article 24 (health), which references “a is a “major step to hold governments accountable clean environment”. for ensuring children live in a clean, green, healthy and sustainable world”.9 At the time of writing 2. In a broader sense, article 3 of the Convention (January 2022), the consultation on this general requires all actions “concerning children” to comment is under way. consider the best interests of the child. Many Report Card countries have implemented this broadly, in requiring child rights impact The 2030 Agenda for Sustainable assessments for legislation, while others Development have incorporated the CRC into law. These are important measures that can be used to ensure A second global instrument that is highly relevant that the impact of environment on children is to the content of this report is the 2030 Agenda fully considered in decision making and policy. for Sustainable Development. A majority of the 17 Sustainable Development Goals (SDGs) have 3. Another link with the CRC is the non- an environmental focus. While many aspects on discrimination principle embedded in article 2. the agenda that focus on environment relate to all This report has highlighted how environmental age groups, sustainable development will naturally risks are distributed unequally and weigh most benefit children, and it provides a framework by heavily on children living in poverty and other which progress on reducing the adverse effects of already disadvantaged groups. environmental risks on children can be monitored. 4. This report has also highlighted the need and A relevant example from the list of SDG indicators potential to involve children in environmental is the level of air pollution. As discussed in Section debates and decisions. Article 12 requires 3, children are more vulnerable than adults to the that a child “who is capable of forming his or negative impacts of air pollution. her own views” has the right to express them, and for these views to be given due weight “in all matters affecting the child”. Children have amply demonstrated their ability to form and express their views on environmental issues, and these are certainly matters that affect them. I N N O C E N T I R E P O R T C A R D 1 7 1 5
S E C T I O N 2 A L E A G U E T A B L E O F E N V I R O N M E N T A L C O N D I T I O N S Spotlight 1 Children’s environments, children’s rights and sustainable development Figure 4 shows how much improvement there has Rica, Japan, the Republic of Korea and Turkey. been in air quality over the past three decades While Australia, New Zealand and Iceland have in Report Card countries. Countries are ordered comparatively low levels of air pollution, they have according to their most recent level of air pollution. made only small improvements in recent decades. While many countries have made substantial The chart illustrates how much has still to be done progress, the chart shows that there is still much to ensure healthy air for all children (and adults) to to do. Compared to 1990, air quality has remained breathe. broadly the same or worsened in Chile, Costa Figure 4: Over the last decades, air quality has improved in 38 out of 43 OECD/EU countries Mean population exposure to fine particulate matter PM2.5 (1990–2019) 35 30 PM2.5 micrograms per cubic metre 25 20 15 10 5 0 Finland Sweden Estonia New Zealand Iceland Australia Norway Canada United States Ireland Portugal Denmark Spain Switzerland United Kingdom Luxembourg Lithuania France Germany Netherlands Austria Belgium Latvia Malta Japan Greece Romania Italy Cyprus Hungary Czechia Slovenia Costa Rica Slovakia Israel Bulgaria Mexico Colombia Croatia Poland Chile Turkey Republic of Korea 2019 1990 Source: OECD, , accessed 16 February 2022. 1 6 I N N O C E N T I R E P O R T C A R D 1 7
SECTION 3 THE WORLD OF THE CHILD © Lainey Molnar I N N O C E N T I R E P O R T C A R D 1 7 1 7
S E C T I O N 3 T H E W O R L D O F T H E C H I L D SECTION 3 THE WORLD OF THE CHILD Children’s well-being and considering children’s development are directly and consumption of air, water and tangibly affected by their interface food, and their exposure to heat/ with the environments around cold, light, noise and hazardous them. This section presents substances. evidence on those pathways – world at large The lduant d waorro lartge Tohreld he w ch he il T d around orld of the c w ld the hil he wor c e T d hi Th ld rld of the wo c e hi The child Th ld The child The world The world we will leave we inherit behind 1 8 I N N O C E N T I R E P O R T C A R D 1 7
S E C T I O N 3 T H E W O R L D O F T H E C H I L D Air Figure 5: Many children in OECD/EU countries live with high levels of air pollution Air pollution from chemicals and gases released through energy Mean population exposure to PM2.5 (2019) use and production directly affects our health. In Europe, polluted air Finland 5.6 contributes to more deaths than Sweden 5.7 Estonia 5.9 tobacco.10 New Zealand 6.1 Children are more vulnerable to air Iceland 6.4 pollution than are adults, because Australia 6.7 they have a smaller lung capacity Norway 6.7 and a less-developed immune Canada 7.1 system. Being shorter than adults, United States 7.7 they are also closer to ground Ireland 7.8 level, where pollution typically Portugal 8.2 Denmark 9.8 accumulates. Air pollution starts Spain 10.0 to harm children even before they Switzerland 10.0 are born – toxic air inhaled by a United Kingdom 10.0 pregnant woman can lead to faster Luxembourg 10.1 cell ageing of the foetus.11 Lithuania 10.5 Fine particulate matter in outdoor France 11.4 air is a common indicator of air Germany 11.9 quality: the small diameter of such Netherlands 12.0 Austria 12.2 matter allows it to penetrate deep Belgium 12.7 into the respiratory tract. Latvia 12.7 Malta 13.1 Japan 13.6 Greece 14.3 Romania 15.1 Cyprus 15.8 Italy 15.8 Hungary 16.6 Czechia 17.0 Slovenia 17.1 Costa Rica 17.4 Slovakia 18.5 Israel 19.4 Bulgaria 19.9 Mexico 20.1 Colombia 22.5 Croatia 22.5 Poland 22.8 Chile 23.7 Turkey 26.9 Republic of Korea 27.4 0 5 10 15 20 25 30 Micrograms per cubic metre Source: OECD, , accessed 16 February 2022. I N N O C E N T I R E P O R T C A R D 1 7 1 9
S E C T I O N 3 T H E W O R L D O F T H E C H I L D Outdoor air quality is not the Figure 6: In the average country, a child is 10 times more likely to suffer from only issue. The quality of indoor outdoor than indoor air pollution air is affected by factors such Air-related morbidity of children under the age of 15 (2019) as cooking and smoking. This Finland presents fundamental risks to Japan children’s health and survival. Estonia Child morbidity attributable to Norway air pollution shows substantial Iceland variation across Report Card Spain countries (see Figure 6). We use Portugal disability adjusted life years Sweden (DALYs) to account for the number Ireland of years of ‘healthy’ life lost due Luxembourg to pollution. Ambient particulate Slovenia matter and household air pollution Lithuania from solid fuels (used for heating Australia Italy or cooking) are jointly responsible New Zealand for a substantial loss of years of Belgium healthy life among children under Austria the age of 15. Overall, Colombia France (3.7) and Mexico (3.7) had the Germany highest number of years of ‘healthy Czechia life’ lost due to air pollution, while Republic of Korea Japan (0.2) and Finland (0.2) Cyprus have the lowest values. Switzerland Netherlands Latvia Water Denmark Water is one of the essential United Kingdom building blocks of human life, Greece but universal access to safe and Canada clean water is not yet a reality in Hungary all Report Card countries. This is Israel Croatia reflected in years of healthy life United States lost per per 1,000 children (aged Poland 0-14) attributable to an unsafe Slovakia water source, unsafe sanitation, Malta or no handwashing facilities in Chile the home (see Figure 7). Safe Costa Rica water, sanitation and handwashing Bulgaria facilities are far from being fully Romania implemented in 13 countries. Most Turkey years of healthy life lost are in Mexico Mexico (3.8 years lost per 1,000 Colombia children), Colombia (3.7) and Turkey 0,0 0,5 1,0 1,5 2,0 2,5 3,0 3,5 4,0 (2.7). The quality of essential services in these countries remains Outdoor air pollution Indoor air pollution an important threat to children’s DALYs per 1,000 children health and survival. Source: OECD Environment Database, ‘Mortality, morbidity and welfare cost from exposure to environment-related risks’ accessed on 20 March 2022 2 0 I N N O C E N T I R E P O R T C A R D 1 7
S E C T I O N 3 T H E W O R L D O F T H E C H I L D Figure 7: Children lose more years of life from unsafe water than from inadequate sanitation and handwashing facilities put together Water-related morbidity of children under the age of 15 (2019) Republic of Korea Japan Norway Netherlands Switzerland United Kingdom Finland Germany Sweden Iceland Spain Denmark Luxembourg Ireland Malta Greece Belgium France Italy United States Israel Cyprus Austria Canada Australia Portugal New Zealand Slovenia Czechia Chile Slovakia Poland Croatia Hungary Estonia Bulgaria Latvia Lithuania Costa Rica Romania Turkey Colombia Mexico 0.0 0.5 1.0 1.5 2.0 2.5 3.0 3.5 4.0 Unsafe water source Unsafe sanitation No access to handwashing facility DALYs per 1,000 children Source: OECD Environment Database, ‘Mortality, morbidity and welfare cost from exposure to environment-related risks’ accessed on 20 March 2022 I N N O C E N T I R E P O R T C A R D 1 7 2 1
S E C T I O N 3 T H E W O R L D O F T H E C H I L D Heat and cold Figure 8: In six countries, at least 1 family in 10 with children finds it difficult to heat their home The ability to control the indoor temperature is important in Percentage of households with children that have difficulty heating their homes (2019) maintaining safe temperatures in locations with cold winters and/ Switzerland or hot summers. There are also Iceland safety issues: burning solid fuels like wood may generate adequate Norway warmth but can also pollute the air Estonia indoors. Slovenia Many households in high-income Finland countries struggle to keep the Austria house warm in winter, and this Sweden issue is strongly linked to socio- economic inequalities. Among Germany 31 European countries, poor Luxembourg households with children were Czechia more than twice as likely to have Netherlands difficulties keeping their home warm as non-poor households with Poland children (see Figure 8). Denmark Belgium Croatia Hungary Ireland France United Kingdom Malta Slovakia Latvia Spain Romania Italy Portugal Greece Lithuania Cyprus Bulgaria 0 10 20 30 40 50 60 All households (%) Poor households (%) Percentage of households with children Note: Chart refers to 2019, except Iceland and United Kingdom (2018). Poor households defined as below 60 per cent of median equivalized income. Source: European Union Statistics on Income and Living Conditions (EU-SILC) (indicator ilc_mdes01). 2 2 I N N O C E N T I R E P O R T C A R D 1 7
S E C T I O N 3 T H E W O R L D O F T H E C H I L D Light Figure 9: In nine countries, over a tenth of poor children live without sufficient light A bright home, with plenty of daylight, can support the mood Percentage of children living in homes that are too dark, by poverty status (2019) of children.12 Outdoor spaces at home, such as gardens or Italy balconies, make it easier for children to enjoy direct sunlight, Norway which improves their immune Iceland systems (via the production Netherlands of vitamin D) and reduces the Slovakia likelihood of chronic conditions, such as multiple sclerosis, in Denmark adulthood.13 Czechia However, nocturnal light pollution Estonia (exposure to artificial light at night) Finland has adverse effects on children’s Cyprus sleep.14 Sleep quality and duration are key predictors of the three Slovenia child outcomes at the heart of Germany our model: well-being, health and Croatia skills. Therefore, sleep disruption should not be taken lightly. The Poland combination of nocturnal light Greece pollution and underexposure Austria to daylight is associated with higher risks of cancer and other Romania diseases.15 Switzerland In European countries, many Sweden homes do not have adequate Spain lighting (see Figure 9). The Luxembourg proportion of children living in such conditions ranges from less than Lithuania 3 per cent in Italy, Norway, Iceland, Bulgaria the Netherlands and Slovakia, France to almost 20 per cent in Turkey. Belgium In almost all countries, children living in relative household income Ireland poverty are noticeably more likely Portugal to be living in homes that are too Latvia dark. Hungary Malta Turkey 0 5 10 15 20 25 30 Children in all households Children in poor households Percentage of children Note: Chart refers to 2019 (2018 for Iceland and Turkey). The United Kingdom is excluded as data was marked as ‘unreliable’. Poor defined as below 60 per cent of median equivalized income. Source: EU-SILC (indicator ilc_mdho04c). I N N O C E N T I R E P O R T C A R D 1 7 2 3
S E C T I O N 3 T H E W O R L D O F T H E C H I L D Noise Figure 10: In many European countries, over a tenth of families with children are affected by noise Noise – both indoor and outdoor – is an environmental hazard that Percentage of households with children affected by noise, by poverty status (2019) can have serious consequences for children. Noise pollution is linked to various adverse health effects, Croatia including poor birth outcomes, Estonia stress, cognitive functioning and Ireland school performance. Traffic and Bulgaria aircraft noise increases stress responses in children.16 There is Iceland also a relationship between noise Hungary and cardiovascular disease in Finland both children and adults.17 Figure Slovakia 10 shows the percentage of households in European countries Norway that are affected by noise. In most Poland countries, the rate is higher among Italy poorer households. Slovenia Latvia Lithuania Spain Czechia Cyprus Belgium Sweden Denmark Switzerland Austria Romania France Greece Luxembourg United Kingdom Germany Portugal Netherlands Malta 0 5 10 15 20 25 30 35 40 All households (%) Poor households (%) Percentage of households with children Note: Chart refers to 2019, except Iceland and United Kingdom (2018). Poor defined as below 60 pr cent of median equivalized income. Source: EU-SILC (indicator ilc_mddw01). 2 4 I N N O C E N T I R E P O R T C A R D 1 7
S E C T I O N 3 T H E W O R L D O F T H E C H I L D Hazardous substances Children can encounter lead at Hazardous substances can affect home from various sources – children before they are even born cosmetics, paints and pigments, (see Spotlight 2). toys, clothing, jewellery, dishes and cookware, and even water While there are many hazardous pipes and fixtures may all contain and toxic substances, suitable, lead.25 Lead can even enter our comparative data on health food supplies through the soil impacts for Report Card countries or water.26 Historical pollution are only available for lead and from leaded petrol can still be pesticide pollution. found in soils around the world.27 Lead pollution In the past, lead was present in children’s products, such as Lead poisoning affects hundreds painted toys. Today, it can still of millions of children globally.18 feature in lead-glazed ceramics Lead is a neurological and (e.g., in Mexico), lead pellets used cardiovascular toxicant, which in hunting (a major source of lead is globally responsible for more among children who eat wild game deaths than malaria, war and in Norway), new paint, and in terrorism, or natural disasters.19 spices that are mixed with lead to Not only does it affect children’s increase the weight or add colour bodily functions, but it also has (often produced in South Asia, but adverse effects on attention imported around the world).28 span, memory (both long and short term) and the ability to plan There are no safe levels of lead and solve problems.20 It can also – the detrimental effects of lead increase aggression and antisocial exposure appear even at very low behaviour.21 Boys are especially levels of lead concentration in the vulnerable to brain damage and bloodstream.29 In all Report Card cognitive impairment due to lead countries, at least 1 child in a 100 poisoning,22 probably because had elevated levels of lead in the higher levels of oestrogen blood (see Figure 12). In most and oestradiol in girls act as countries, the proportion is more neuroprotectants.23 The exposure than 1 in 50; and in Costa Rica of girls to lead early on in life, or and Mexico, 13 per cent and 31 even in the womb, may disrupt per cent of children, respectively, their hormonal patterns and has have elevated levels of lead in been associated with delayed their blood. Explanations for the puberty.24 high figure in Mexico could include the use of lead-glazed ceramic tableware and the less-stringent regulation of lead content in paints used in the home.30 I N N O C E N T I R E P O R T C A R D 1 7 2 5
S E C T I O N 3 T H E W O R L D O F T H E C H I L D Figure 11: In nine OECD/EU countries, more than 1 child in 20 is being Pesticide pollution poisoned by lead Agricultural activities interact Percentage of children with levels of lead in the blood of over 5 μg/decilitre with the environment in a myriad (2019) of ways. First, and perhaps most obviously, agricultural activities Finland 1.0% require land: according to recent Iceland 1.1% Sweden 1.2% estimates, 37 per cent of the Luxembourg 1.3% global land surface is used for United Kingdom 1.4% agriculture.31 The clearing of Japan 1.5% land for crops and grazing, and Italy 1.5% poor agricultural practices, are United States 1.5% major drivers of environment Austria 1.5% degradation.32 Moreover, Netherlands 1.6% agriculture, forestry and other Canada 1.6% land use are responsible for 24 Norway 1.8% per cent of global greenhouse gas Australia 1.8% emissions.33 Cyprus 1.9% Slovenia 2.0% Agricultural activities can also Ireland 2.0% release toxic materials that Germany 2.1% have a direct impact on physical France 2.2% health. Children are at higher risk Denmark 2.2% than adults of suffering serious Turkey 2.4% Republic of Korea 2.5% health effects from exposure Israel 2.8% to pesticides. Such pollution Spain 2.8% has been linked to damage to Chile 2.9% children’s nervous, cardiovascular, Switzerland 3.2% genitourinary, digestive, Czechia 3.2% reproductive, endocrine, blood and Greece 3.4% immune systems. It has also been Slovakia 3.6% associated with cancer, including Poland 3.6% childhood leukaemia. And it can Croatia 3.6% cause harm to skin and eyes, as Colombia 3.8% well as developmental delays.34 Estonia 3.8% 3.8% Early exposure to pesticides may New Zealand Lithuania 3.9% likewise be linked to attention Bulgaria 5.0% deficit disorder and autism Portugal 5.3% spectrum disorder, although more Hungary 5.4% research is needed on this topic.35 Latvia 5.6% Malta 7.6% Belgium 7.8% Romania 10.1% Costa Rica 13.4% Mexico 31.1% 0 5 10 15 20 25 30 35 Percentage of children with elevated lead blood levels Source: Own calculations based on number of children with elevated levels of lead in the blood from Rees and Fuller (2021) and United Nations Department of Economic and Social Affairs (2021) population projections. 2 6 I N N O C E N T I R E P O R T C A R D 1 7
S E C T I O N 3 T H E W O R L D O F T H E C H I L D Figure 12: In most OECD/EU countries, more than 1 child in 20 lives in an area of high pesticide risk Percentage of children under 18 living in areas with high pesticide pollution risk (2019) Denmark 0% Estonia 0% Finland 0% Iceland 0% Latvia 0% Malta 0% Slovakia 0% Slovenia 0% Sweden 0% Austria 0.1% Croatia 0.1% Germany 0.1% Lithuania 0.1% Luxembourg 0.1% Romania 0.2% Bulgaria 0.3% Australia 1.0% New Zealand 1.7% Ireland 1.8% United States 2.7% Norway 2.9% Mexico 4.2% Hungary 4.7% Chile 5.4% Greece 5.4% Japan 5.4% France 5.8% United Kingdom 6.2% Canada 6.3% Cyprus 6.7% Spain 6.7% Portugal 7.6% Republic of Korea 7.7% Italy 7.8% Turkey 7.8% Colombia 8.1% Costa Rica 8.3% Switzerland 8.4% Netherlands 8.6% Belgium 8.9% Israel 8.9% Poland 9.1% Czechia 9.7% 0 2 4 6 8 10 12 Percentage of children living in areas with high pesticide pollution risk Source: UNICEF (2021). I N N O C E N T I R E P O R T C A R D 1 7 2 7
S E C T I O N 3 T H E W O R L D O F T H E C H I L D Spotlight 2 Child brain development in the womb is particularly sensitive to environmental chemicals – results from the NeuroTox study Chemical pollution is a continuously increasing pregnant women’s blood and urine, and the later problem and among the largest threats to child risks to their children of ADHD, ASD and cognitive health and development worldwide. Since the impairment. 1950s, over 140,000 chemicals and pesticides The findings show a number of connections: have been produced, 36 most of which have never been tested for child safety or for any toxic effect 1. Elevated maternal levels of some phthalates 40 on the developing brain. Meanwhile, since the and per- and polyfluoroalkyl substances 1980s, attention deficit hyperactivity disorder (PFASs) 41 were associated with a reduction in (ADHD) and autistic spectrum disorder (ASD) have cognitive functions (such as working memory) come to be diagnosed increasingly frequently in the child (see Figure 13). in developed countries, leading to concerns 2. Elevated maternal levels of several toxic that hazardous substances in the environment metals (cadmium, lead and arsenic) 42 and of may be among the causes of these disorders.37 PFASs (e.g. perfluorooctanoic acid (PFOA) and Environmental toxicants in our food and drinking perfluorooctane sulfonic acid (PFOS)) 43 were water, in appliances, cosmetics and the air may associated with increased risk of ADHD and/or adversely affect child brain development, even as ASD in the child. the foetus grows in the womb. 3. Some plastic toxicants (organophosphate esters Expectant mothers are exposed to chemicals (OPEs) and phthalates) were associated with daily, and some of them are stored in the body increased risk of ADHD.44 for long periods of time. During pregnancy and breastfeeding, toxicants can pass from mother These toxic chemicals are found in food, drinking to child. Infants are also exposed to toxicants water as well as in everyday items that we cook through the food, water and consumer products with and store our food in, put on our bodies and they come into contact with. Young children’s consume: packaging, utensils, pots and pans, bodies are less able than those of adults to cosmetics, fabrics and even medical products. protect themselves from toxic chemicals, and The burden of mental health conditions their brains are particularly sensitive to the attributable to pollution, and in particular impact of these. Levels that would be considered hazardous chemicals in the environment, is hugely tolerable for adults may be harmful for children, 38 underestimated.45 The results from the NeuroTox and may cause irreversible effects that emerge study indicate the need for stronger global action in later childhood and adolescence, including to increase knowledge of the harmful impact mental health and behavioural problems, learning of chemical exposure, and to prevent early life disabilities and cognitive impairments.39 exposure to toxicants. The NeuroTox study investigated pregnant women’s exposure to toxins and the subsequent development of their children, using 3,500 mother–child pairs from the Norwegian Mother, Father and Child Cohort study. On the basis of these data, the study explored the potential link between the levels of environmental toxicants in 2 8 I N N O C E N T I R E P O R T C A R D 1 7
S E C T I O N 3 T H E W O R L D O F T H E C H I L D Figure 13: Impact of hazardous chemicals in the environment on child brain development Metals Organophosphate Phthalates Per- and polyfluoroalkyl esters substances Cognitive function ASD ADHD Cadmium Lead BDCIPP DEHP MBzP PFOS PFOA Arsenic DPHP DiNP DBPs PFAS Carboxylate mixture PFAS Toxicants Note: Toxicants are colour-coded by group: metals in green; OPEs in orange; phthalates in navy blue; and PFASs in turquoise. Darker filled boxes denote an adverse effect, while a lighter shade indicates no finding or not yet investigated. Grey boxes indicate that the relationship was not tested. DPHD = diphenyl phosphate; BDCIPP = bis(1,3-dichloro-2-propyl) phosphate; DiNP = diisononyl phthalate; DEHP = di(2-ethylhexyl) phthalate; DBP = Dibutyl phthalate (including mono-n-butyl phthalate and mono-iso-butyl phthalate); MBzP = mono-benzyl phthalate. I N N O C E N T I R E P O R T C A R D 1 7 2 9
S E C T I O N 3 T H E W O R L D O F T H E C H I L D 3 0 I N N O C E N T I R E P O R T C A R D 1 7
SECTION 4 THE WORLD AROUND THE CHILD © Kari Moden I N N O C E N T I R E P O R T C A R D 1 7 3 1
SECTION 4 THE WORLD AROUND THE CHILD This section looks at the aspects of the natural and built world at large The environment with which children interact directly. The quality, enjoyability and safety of homes and surrounding public spaces influence children’s daily lives. They have implications for the lduant d waorro lartge Tohreld he children’s physical and mental w ch health, as well as for their he il cognitive, emotional and social T d development. Interactions between housing quality and around orld of the c the quality of local surroundings w ld the hil he wor c further shape children’s well- e T d being. Issues to do with transport hi Th ld systems and mobility likewise rld of the have many implications for wo c children’s well-being and e hi The child Th development. Our focus is on the ld links between these factors and children’s outcomes: mental The child well-being, physical health and skills. The world The world we will leave we inherit behind 3 2 I N N O C E N T I R E P O R T C A R D 1 7
S E C T I O N 4 T H E W O R L D A R O U N D T H E C H I L D The home Figure 14: In 22 countries, over a tenth of children live in a damp house Children, especially in the early Percentage of children living in a dwelling with damp or mould (2019) years, spend much of their time indoors at home.46 They are Finland 4.2% particularly susceptible to the Slovakia 5.6% effects of the home environment – not only because of the amount Malta 7.1% of time they spend in it, but Norway 8.0% also because of their unique Sweden 8.3% physiological, biological and social Czechia 8.4% characteristics. Their immune systems are still developing, they Croatia 9.5% tend to breathe more rapidly and Austria 10.1% have more hand-to-mouth activity Poland 11% than adults, rendering them more Romania 11% exposed to pollutants.47 Therefore, better conditions inside the home Greece 11.5% can go a long way in promoting France 12.8% children’s health and development. Italy 12.8% Section 3 discussed the way in Bulgaria 12.9% which the presence and quality of Estonia 13.5% facilities in the home can affect children’s well-being. For example, Ireland 13.8% a lack of safe cooking or heating Switzerland 13.8% facilities forces families to burn Germany 14.6% solid fuels, which pollute indoor air. Lithuania 15.2% Similarly, even if the infrastructure of water is adequate, basic Spain 15.5% facilities need to be present in the Netherlands 15.9% home for children to benefit fully Denmark 17.6% from them. Luxembourg 18.4% Damp Belgium 18.8% Damp and mould are major Slovenia 19.3% environmental risk factors within the home. Upper respiratory Latvia 20.5% infections, asthma and bronchitis United Kingdom 21.7% are substantially and significantly Iceland 23.9% associated with mould and damp in the dwelling.48 For instance, Portugal 24.7% estimates of the proportion of Cyprus 25.7% asthma cases attributable to these Hungary 28.3% factors ranges from 6 per cent in Turkey 39.8% one study in the Netherlands to 20 per cent in another study in 0 10 20 30 40 50 the United States.49 According to Percentage of children living in a dwelling with damp or mould European data, even in Finland – the highest-ranked country – Notes: Indicator refers to the child population living in a dwelling with a leaking roof, damp walls, floors or more than 1 child in 25 lives in foundation, or rot in window frames or doors. Data refer to 2019 (2018 for Iceland and Turkey). Source: EU-SILC (indicator ilc_mdho01c). I N N O C E N T I R E P O R T C A R D 1 7 3 3
S E C T I O N 4 T H E W O R L D A R O U N D T H E C H I L D a home with wet walls, mould or Figure 15: In the average country, one household in nine is overcrowded rotting doors or window frames. Percentage of households living in an overcrowded dwelling (2019) In Turkey, Hungary, Cyprus, Portugal, Iceland, the United Canada 0.7% Kingdom and Latvia, more than New Zealand 0.8% one child in five is exposed to Malta 1.6% damp and mould. Japan 1.6% Space in the home can affect Cyprus 1.7% various aspects of children’s lives, Ireland 1.8% including their health, social Spain 3.0% relationships, privacy and United States 4.2% academic performance. Overcrowding in the home creates Netherlands 4.3% social tension (including between Portugal 5.0% adult members and children) and Switzerland 5.1% has a negative effect on the quality Republic of Korea 5.2% of parent–child relationships and Belgium 5.9% household members’ physical United Kingdom 5.9% and mental health. Surveys have Germany 6.1% found overcrowding to be related France 6.5% to socio-economic status, meaning Luxembourg 7.2% that lower-income households are Norway 7.3% more likely to have inadequate living space.50 Insufficient space Slovenia 8.7% at home can contribute to the Finland 8.9% intergenerational transmission of Denmark 9.1% social inequalities. Iceland 9.2% Chile 9.3% The home environment also plays an important role in children’s Estonia 9.9% education – particularly since Hungary 11.3% the COVID-19 pandemic forced Czechia 11.6% schools to close and students to Austria 12.4% study at home. Overcrowding has Sweden 14.4% strong adverse effects on learning Lithuania 14.7% outcomes.51,52 In Latvia and Greece 18.1% Mexico, more than one household Italy 18.9% in three, and in Slovakia, Bulgaria, Slovakia 25.7% Croatia, Romania and Poland, Bulgaria 27.0% more than one in four, suffers Croatia 28.1% from overcrowding (see Figure 15). Households in Canada and Romania 29.2% New Zealand have the most space Poland 29.4% available at home, with less than Latvia 33.1% 1 per cent of them experiencing Mexico 33.2% overcrowding. 0 5 10 15 20 25 30 35 Percentage of households living in an overcrowded dwelling Source: OECD Affordable Housing Database, , accessed 16 February 2022. 3 4 I N N O C E N T I R E P O R T C A R D 1 7
S E C T I O N 4 T H E W O R L D A R O U N D T H E C H I L D Having a quiet space of one’s own Figure 16: In an average country, one in seven 15-year-olds lacks facilities provides both privacy and a good for studying environment in which to study. Percentage of schoolchildren aged 15 with their own desk and a quiet place On average, almost 9 adolescents to study (2018) in 10 (86 per cent, unweighted average) in Report Card countries Lithuania 94% said they had their own desk and Switzerland 93% a quiet place to study in 2018 (see Romania 93% Figure 16). However, more than Austria 92% 30 per cent of 15-year-olds in Norway 92% Chile, Mexico and Colombia did Poland 92% not have these facilities. In all the Slovenia 92% countries included in the OECD Germany 92% Programme for International Portugal 92% France 92% Student Assessment (PISA), Hungary 92% children who had a quiet place Latvia 91% to study at home registered Netherlands 91% higher science test scores than Iceland 91% children who did not. However, Luxembourg 91% this difference in test scores is Israel 91% probably not caused solely by Estonia 91% having a quiet place to study. Belgium 91% The socio-economic position of Spain 91% the family, for instance, could Finland 90% affect both student performance Czechia 89% and the space available in the Italy 89% home. In other words, some of Denmark 88% the relationship between test Sweden 87% scores and private space could Greece 86% be explained away by household Slovakia 84% socio-economic status. Malta 84% Croatia 83% This issue of educational Ireland 83% inequalities related to the home Japan 83% learning environment has come Republic of Korea 83% to the fore during the lockdowns Canada 82% triggered by the COVID-19 United Kingdom 82% pandemic. Children have been Australia 82% educated at a distance for lengthy Turkey 81% periods of time, and many New Zealand 79% households, particularly poorer Bulgaria 77% ones, have lacked the space and United States 73% equipment for this to happen Costa Rica 73% effectively. Chile 69% Mexico 66% Colombia 57% 0 20 40 60 80 100 Percentage of adolescents with a desk and a quiet place to study Source: PISA 2018. I N N O C E N T I R E P O R T C A R D 1 7 3 5
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