Save the Children, the world’s leading independent organization for children, has released the second annual End of Childhood Index in honor of International Children’s Day, a day to celebrate and raise awareness on children’s rights and wellbeing around the world. Save the Children’s annual End of Childhood Index ranks 175 countries based on eight childhood “ender” events that jeopardize children’s chance of a happy, healthy and safe childhood. While the report shows that the majority of countries have made progress for children since last year (95 out of 175 countries), conditions in about 40 countries appear significantly worse and are not improving fast enough.

No country is on track to meet the 2030 SDGs (Sustainable Development Goals) for children.  Over 1 billion children around the world live in countries plagued by poverty and it is not just a developing world problem. In the 2018 report, the United States didn’t rank in the top 10 or top 25. Instead, the U.S. shockingly ranked 36th place smack between Belarus and Russia. The growing urban and rural child poverty rate within the United States continues to widen.  The results of the report may surprise you.

This year’s report has two components: “The Many Faces of Exclusion” and “Growing Up in Rural America”, a new U.S. complement that offers first-of-its kind analysis of rural child poverty rates across America as well as state by state ranking of where childhood is most and least threatened. In advance of the report’s release, I listened in on a telebriefing by Carolyn Miles, President and CEO of Save the Children to get some of the key highlights of the report and a call to action by governments around the world.

Here are some of the key findings worldwide and in America.

“The Many Faces of Exclusion” –  World Report 

1 in 4 children around the world have had their childhood ended. “The Many Faces of Exclusion” examines 8 childhood “enders” that have destroyed children’s childhoods and impacts them for life:

  1. Child Mortality under age 5: Every day over 15,000 children die before reaching their fifth birthday.
  2. Malnutrition : Globally, 155 million children under age 5 suffer from chronic malnutrition, which leads to lifelong physical, developmental and mental stunting.
  3. Children out of school:  1 in 6 school-age children worldwide are out of school, denying these children a way out of poverty through education.
  4. Child Labor: An estimated 152 million children are trapped in child labor with over half doing dangerous work.
  5. Early Marriage: Globally one girl under 15 gets married every 7 seconds, denying them their rights to health, education, income and safety.
  6. Adolescent Births: Every two seconds a girl gives birth.
  7. Children forcibly being displaced due to conflict: Conflict has forced nearly 1 child in 80 from their homes and even some onto the front lines.
  8. Child victims of violence and homicide: Every day more than 200 boys and girls around the world are murdered.


Photos, statistics and captions are from Save the Children. To read each photos caption and story, click on the photo to enlarge.

The report looks at the underlying factors to why this is happening and why 1.2 billion children are at risk of losing their childhoods.  There are three key indicators:

  1. Poverty: 1 billion children live in countries plagued by poverty.
  2. Conflict: 240 million children live in countries affected by conflict and fragility.
  3. Discrimination against girls: 575 million girls live in countries characterized by discrimination against girls.

Key Trends from the Report:

  • By 2030, 150 million girls will marry before their 18th birthday. Despite the SDG (Sustainable Development Goal) #5 to achieve gender equality and empower all women and girls, 1 in 4 women between the ages of 20 and 24 were married before the age of 18 denying them the opportunity of an education and causing early child-rearing. The poorest girls in the world are four times more likely to marry early.
  • The world is witnessing the highest level of displacement in all time with 20 people newly displaced every minute each day.
  • 263 million children are excluded from going to school.
  • By 2025, 130 million children will be stunted due to malnutrition (over one half live in Sub-Saharan Africa).

The report ranks the best and worst 175 countries to have a happy, healthy childhood. While Scandinavian countries are towards the top so is Singapore. Africa and other conflict regions are the worst. Shockingly, the United States is ranked 36th between Belarus and Russia.

Although these figures are somewhat numbing there is hope, and progress has been made. 95 out of the 175 countries measured have made progress which indicates smart investment and policy-making does work.

So what needs to be done?

Save the Children recommends three critical call to action items for each country to address these issues.

  1. Make investing in health, education and nutrition for children a priority.
  2. Look at the poorest and wealthiest children inside of each country and try to understand the reasons behind the gap.
  3. When you look within a country by measuring statistics, make sure that all children are being measured. For example, both boys and girls, rural and urban, poor and wealthy.

 To read the report “Faces of Exclusion” in full, click here. 

“Growing Up in Rural America”

It is shocking that the United States, one of the wealthiest countries in the world, was ranked 36th in the world in Save the Children’s report. Oftentimes, there are many misconceptions about poverty in the US and a lot is not covered in the press. Save the Children wanted to dig deeper into the reasons why and uncover the urban and rural poverty gap for each state. The report identifies 5 childhood enders in the US:

  1. Infant Mortality Rates: 23,161 babies died before their first birthday in 2016.
  2. Malnutrition and Food Security: 12.9 million children – approximately 1 out of every 7 – lived in food insecure households in 2015.
  3. High School Drop Out Rates: Around 707,000 teens aged 16-19 were not in school and not high school graduates in 2016.
  4. Teen Pregnancy: 209,809 babies were born to girls aged 15 to 19 in the U.S. in 2016.
  5. Child Homicide/Suicide: Roughly 5,300 children were killed or committed suicide in 2016.

Graph: Save the Children

The research shows that the highest rates of childhood poverty exist in the Southeastern states and in some places, the child poverty goes back three generations of children growing up poor. Nationwide, 1 in 5 children live in poverty however in rural areas 1 in 4 children live in poverty in rural areas. Most alarming is the fact that rural children under age 6 who are the most vulnerable, are living with a poverty rate of 27th in some rural places.

All photos above from Save the Children. To read captions or view as slide show, click on the photos to enlarge. 

Save the Children is urging three main call of action items to policymakers in the US:

  1. Must treat rural childhood poverty in the U.S. as an emergency. Right now it is getting no attention and the devastating impact of childhood poverty will be lifelong if nothing is changed. Many people have no idea that the life expectancy in Appalachia is less than in Bangladesh.
  2. More funding needs to go toward community-based solutions as locally-based initiatives is what works best.
  3. More investment must be placed in the early years for children (under age 6) when they are most vulnerable. Unfortunately many rural communities lack proper health care, educational services, employment opportunities and mental health support.

To read “Growing Up Rural in America” click here. 

Closing thoughts:

Not all news is grim. There is hope that proper policies and investments can and do work to create change. However, we need to act now while we can impact change. The increasing inequality within children is very alarming. The gap between rich and poor is widening in both the US and around the world and the poorest, most vulnerable children  are getting further and further behind creating a lifelong vicious cycle of poverty.

To learn more about Save the Children, please visit





  1. These figures are shocking — especially the ones about the U.S. Once again I’m realizing how privileged I am, and how insulated. As painful as it was to consider the children behind these statistics, thank you for the wake-up call.

    1. Yes they are aren’t they. It is hard to read but also hopeful that we can do something to change it. Thanks for reading!

  2. Nicole when I wen to the article I see Canada is 24th. Really so shocking to see that our countries are not near the top of the list. Having visited Slovenia, which anectodally we declared the cleanest country in the world, it doesn’t surprise me to see it at #2.

    1. I looked up Canada too as I always am saying how much I’d rather be there then here for so many reasons. I was very surprised at the ranking . I thought Canada would have fared better. I didn’t have enough time yet to look into the underlying five “Enders” and obviously I know about the problems more in the US than in Canada. But I was surprised.

  3. I am not surprised by our standing in the world, given how the wealth is distributed in this country and the amount of greed, but still deeply saddened and ashamed of those who have the power to make significant changes in our children’s’ lives. I too was surprised that Canada wasn’t higher on the list. I really appreciate all the research you do Nicole to provide us with this information. Thank you!

    1. Yes isn’t it crazy that our numbers are so bad? We have such high maternal death and infant mortality rates too. Wish we would do

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