The European Child Guarantee outlines recommendations for Member States to support effective and free access to quality healthcare for children at risk of poverty or social exclusion. The analysis presented here covers infant mortality, mental health, reported levels of very good health and unmet healthcare needs among children.
The infant mortality rate is expressed as the ratio of the number of deaths of children under one year of age during the year to the number of live births in that year. The value is expressed per 1,000 live births. The latest Eurostat data for 2021 show an infant mortality rate in the EU27 of 3.2 deaths per 1,000 live births.
Between 2015 and 2021, the EU27 average infant mortality rate went from 3.6 to 3.2 deaths per live births. Regarding disparities between countries, the standard deviation decreased over time. This trend can be described as upward convergence, given the improvement of the situation in the EU27 over time (that is, lower infant mortality) together with a decrease in disparities between countries.
The mental health of children is measured by looking at the percentage of children in three age groups (11, 13 and 15 year-olds) who reported feeling low more than once a week. The indicator used comes from the Health Behaviour in School-aged Children study (HBSC). This is a cross-national research study into the health and well-being of adolescents across Europe and North America, carried out by several research institutions together with the World Health Organization Regional Office for Europe. The study has been repeated every four years since the 1980s, with the latest data available corresponding to 2022.
Children were asked how often they had experienced feeling low in the last six months. When it comes to 11-year-olds, Italy was the country with the highest percentage of children (40.1%) reporting feeling low more than once a week. Austria recorded the lowest level (10%). Even though no EU27 average is available, the unweighted average (that is, giving the same weight to all countries regardless of population size) for the 27 Member States for which data are available was 18.6%.
For children aged 13, a similar picture emerges. Italy and Austria rank as the highest and lowest performers again, respectively, with the unweighted EU27 average amounting to 26.6%. Lastly, for children aged 15, the unweighted EU27 average was 32.7%. For this age group, Denmark recorded the lowest percentage, with Italy having once again the highest percentage.
Data are available for all EU Member States in 2022, albeit no EU27 average is provided. The data for 2018 and 2014 do not include Cyprus.
A higher percentage of children aged 11 reported feeling low more than once a week in 2022 than in 2014. Disparities between countries have increased, as shown in the higher standard deviation. These changes over time can be described as downward divergence, since there is a worsening of the situation (more children reported feeling low in 2022 than in 2014) coupled with increasing disparities between the Member States.
In the case of 13-year-olds, the EU unweighted average has increased steadily between 2014 and 2022. The standard deviation has also increased over time, which can also be described as downward divergence.
For 15-year-olds, between 2014 and 2022, the EU unweighted average increased. The standard deviation decreased during the period. The change over time can thus be considered as downward convergence due to the worsening of the situation over time) and the decrease in disparities between countries.
The EU-SILC ad hoc module on health and children’s health is one of the three modules that are repeated every three years due to their policy relevance. To date, data are available for 2021 and 2017. Information is available about children aged less than 16 years, with additional age breakdowns available within that age group. Information is also available about the number of adults in the household. Interviewees are asked how they would describe the health in general of children in that age group living in the household. The choices provided to interviewees range from ‘Very good’ to ‘Very bad’.
In 2021, 68.7% of children in the EU27 had ‘very good’ health. Greece (96.1%), Cyprus (88.7%) and Croatia (86.5%) recorded the highest percentages. Portugal (52.5%), Lithuania (52.1%) and Latvia (30.4%) reported the lowest percentages.
For children at risk of poverty or social exclusion (AROPE), the EU27 average for children with ‘very good’ health in 2021 was 62.7%. Greece (96.1%), Cyprus (84.8%) and Croatia (82.8%) recorded the highest percentages, while Portugal (37.4%), the Netherlands (36.5%) and Latvia (22.9%) showed the lowest percentages.
For children who are not at risk of poverty and social exclusion (non-AROPE), the EU27 average in 2021 was 70.9%. The countries with the highest percentages were the same as those in the case of children at risk of poverty (Greece 96.1%, Cyprus 89.7% and Croatia 87.3%). The Netherlands (56.4%), Lithuania (55.6%) and Latvia (32.3%) recorded the lowest percentages.
Looking at the changes between 2017 and 2021, the two years where data are available, the EU27 average corresponding to all children under 16 with very good health increased from 66.1% in 2017 (estimated data) to 68.7% in 2021. In terms of disparities between countries, the standard deviation decreased during the period. This reflects upward convergence regarding the general health status of all children under 16, as there is an improvement of the situation over time (that is, more children had very good health in 2021 than in 2017) together with a decrease in disparities in the performance of Member States.
Data on unmet healthcare needs also come from the EU-SILC ad hoc module on health and children’s health and concerns the children under age 16 in the household. More specifically, interviewees are asked whether, during the last 12 months, there was at least one occasion where at least one of the children did not have a medical examination or treatment.
In 2021, 3.6% of children in households with dependent children had unmet healthcare needs. Poland (7.3%), Latvia (6.4%) and Hungary (4.7%) reported the highest percentages. Meanwhile, Croatia (0.9%), Luxembourg (0.4%) and Austria (0.3%) recorded the lowest percentages.
For AROPE children, the EU27 average for children with unmet medical needs in 2021 was 5.7%. Austria (0.2%), Luxembourg (1%) and Cyprus (1.8%) recorded the lowest percentages for the group. Conversely, Sweden (9.9%), Latvia (10.5%) and Poland (11.4%) reported unmet medical needs more often. Data for Germany, Ireland and Slovenia are not available due to low reliability.
For non-AROPE children, the EU27 average for children with unmet medical needs in 2021 was 3%. Luxembourg, Bulgaria and Greece (all 0.2%) reported the lowest percentages, compared to Slovenia (4.6%), Latvia (5.4%) and Poland (6.5%) with the highest percentages. Data for Germany and Ireland are not available due to low reliability.
Comparing the two years for which data are available, the EU27 average for all children under 16 with unmet healthcare needs increased from 1.6% in 2017 (estimated) to 3.6% in 2021.
In terms of disparities between countries, the standard deviation decreased over the period. This reflects downward divergence regarding the unmet healthcare needs of all children under 16, as there is a worsening of the situation over time (that is, more children had unmet healthcare needs in 2021 than in 2017) together with an increase in disparities in the performance of Member States.
Children at risk of poverty or social exclusion and other children in need of support
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Effective and free access to high quality early childhood education and care (ECEC)
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Effective and free access to high quality primary and secondary education and school-based activities
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Effective and free access to quality healthcare for children at risk of poverty or exclusion
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Effective access to adequate housing for children at risk of poverty or exclusion
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