UK 'worst country for children' - and the most violent

The UK has the lowest level of child well-being among the world’s richest countries, and it is also the most violent country in the European Union according to two new international surveys, both of which highlight the role of alcohol in the problems they identify.

The first survey, carried out for UNICEF and designed primarily to measure child poverty, assessed 21 of the world’s richest countries on the basis of six dimensions of child well-being including material factors of wealth and poverty, health, family relationships and risky behaviour. It found that overall the UK ranked lowest as the worst country for children among those studied. The Netherlands was assessed as having the highest levels of child-wellbeing, with Nordic countries claiming four of the top ten places.

The report concludes that there is no obvious relationship between levels of childwellbeing and affluence.The Czech Republic, for example, achieved a higher ranking for child well-being than several much richer countries such as the UK and the USA.

The report identifies the UK’s particularly high levels of family break-up and the growth in single parent families and stepfamilies as a main factor reducing child well-being. The report says that children growing up in such families have been shown to be at greater risk of dropping out of school, of leaving home early, of poorer health, of low skills and of low pay.

On alcohol and other substance abuse problems, the report says that these provide a clear indication of the problems and pressures facing young people and of their ability or inability to cope with them. It is on this dimension that the UK scored particularly badly in the survey, having far higher levels of ‘risk behaviour’ than all the other countries.

Violent Britain
The second report, an analysis of the European Crime and Safety Survey, found that among 18 EU member states up to 2004, the UK had the second highest victimisation rate for 10 common crimes, and ranked first in relation to victimisation rates for assaults and threats.

A main finding of the survey, and one contrary to what many believe,was that there was no apparent association between indicators of wealth or economic inequality and levels of crime. It is often suggested that poverty is a major cause of crime, but in this study, both high crime countries and low crime countries included mixtures of both the more affluent and the less affluent. This also applied to specifically violent crime.

However, levels of violent crime did appear to be moderately strongly related to alcohol consumption. Beer consumption per head was taken to be indicative of alcohol consumption among young people, and beer consumption was related to the prevalence of assaults and threats. Generally, the countries with the highest levels of beer consumption were also the countries with higher levels of violent crime.The report says that although consumption of alcohol cannot be seen as a cause of violent crime by itself, its excessive use is known to lessen controls and to contribute to violent behaviour among young males in specific cultural settings.

Rising Teenage Hospital Admissions for Alcohol
The publication of official reports into low child wellbeing and high violence rates in the UK coincided with reports of still higher levels of alcohol related harm even in young children. Medical experts warned of problems extending into the future and of a whole generation being scarred by alcohol.

Figures released by the Department of Health showed that among 16-19 year olds there has been a steep increase in alcohol-related admissions to hospital following a visit to an accident and emergency department. Between 1998/9 and 2005/6, such admissions rose by 72%. Public health minister Caroline Flint explained that this increase was almost entirely due to binge drinking.

Alcohol-related admissions for patients
aged 16-19, England, 1998-9 to 2005-6
2005-6 7596
2004-5 6004
2003-4 4727
2002-3 3916
2001-2 4079
2000-1 4232
1999-2000 4675
1998-9 4417

Other reports confirmed that the problems are evident some years before the age of 16, with children as young as 12 or 13 also being admitted.

Commenting on the figures, Professor Mark Bellis of the Centre for Public Health at Liverpool John Moores University, said: “Hospital statistics grossly under-estimate the number of young people drinking alcohol in ways that will damage their health. It is only the tip of the iceberg. Many more children are admitted for problems not recorded as alcohol. The admissions include everything from being involved in violence to teenage pregnancies.

For every one youth admitted due to alcohol consumption there are many more whose health suffers through excessive alcohol consumption.”

Prof Bellis, added:“We are in danger of creating a generation permanently scarred by alcohol.”

Professor Ian Gilmore of the Royal College of Physicians and a liver specialist at the Royal Liverpool Hospital said he too was dismayed by the scale of the problem. He said 24-hour licensing was a key factor, in particular the round-the-clock availability of alcohol in supermarkets and corner shops.

“Alcohol seems to be all around us,” he added. “I'm particularly concerned about the cut-price offers in supermarkets which are fuelling drinking among young people.”

Storing up problems for the future
Professor Gilmore said that binge drinking by teenagers was likely to cause a major increase in liver disease in the future. He said: “Cirrhosis of the liver has increased tenfold since the 1970s. There is a big concern about the rise in deaths from cirrhosis among young people. I think we are going to see big increases in people in their 20s and 30s being diagnosed with liver cirrhosis.”

David Mayer, chair of the UK Transplant Liver Advisory Group, also warned that young drinkers are storing up a problem for the future and are likely to require his services in years to come. “People have more money and more opportunity to drink from an earlier age and therefore their livers are exposed to chronically high alcohol levels.We are concerned that it's becoming an epidemic. It does take many years to develop cirrhosis, but if you start drinking at an early age you are going to see problems sooner rather than later.”

Alcohol Related Brain Damage ‘will become commonplace’
In Scotland specialists warned of an increase in alcohol related brain damage being caused by teenage binge drinking. Dr Jonathan Chick, a consultant psychiatrist in Edinburgh said: “For the first time, we are seeing people in their thirties and early forties with conditions such as Korsakoff's syndrome. This is at least ten years younger than the patients with alcohol-related brain damage we used to deal with. This definitely reflects the growing trend for heavy alcohol consumption at an ever earlier age.”

Dr Chick said that the point about Korsakoff's syndrome was that it was very disabling and very expensive to deal with because sufferers were no longer able to live on their own and needed safe and often secure accommodation.

He said the availability of cheap, clear cider - or what he termed “oblivion in a bottle” - was at the root of the problem in Scotland.

Shona Neil, the chief executive of Scottish Association for Mental Health, agreed. She said: “The numbers of young people we are recording with alcohol-related brain damage is just the tip of a substantial and growing iceberg. The difficulty at the moment is that there will be young people in the community with these syndromes, but because of the current lack of information they do not know what is wrong with them.”

Tom Wood, chairman of the Scottish Association of Alcohol and Drug Action Teams, said: “Instead of alcohol related brain damage being exceptional, it will soon become commonplace. That is why these early drinking patterns… have such sinister implications for the future. My very real fear is that we will start to pay the price for this behaviour years down the line. It all adds to the growing body of evidence that young Scots need to change their relationship with alcohol.”