The US and Britain have ranked at the bottom of a UN survey of child welfare in 21 rich countries that assessed everything from infant mortality to whether children ate dinner with their parents or were bullied at school.
The Netherlands, followed by Sweden, Denmark and Finland, finished at the top while the US was 20th and Britain 21st in the rankings released on Wednesday by UNICEF in Berlin.
One of the study's researchers, Jonathan Bradshaw, said children fared worse in the US and Britain -- despite high overall levels of national wealth -- because of greater economic inequality and poor levels of public support for families.
"What they have in common are very high levels of inequality, very high levels of child poverty, which is also associated with inequality, and in rather different ways poorly developed services to families with children," said Bradshaw, a professor of social policy at the University of York in northeast England.
"They don't invest as much in children as continental European countries do," he said.
Bradshaw cited thin day care services in both countries, and poorer health coverage and preventative care for children in the US.
The study gave the US and Britain low marks for the high number of single-parent families and the incidence of risky behaviors among children, such as drinking alcohol and sexual activity.
The US was 20th and Britain 21st in the category focusing on relationships, based on the percentage of children who lived in single-parent homes or with stepparents, as well as the number who ate the main meal of the day at least once a week with their families.
That category also counted the proportion of children who said they had "kind" or "helpful" relationships with other children.
In Washington, US State Department spokesman Paul Denig was highly critical of the report, noting that the authors acknowledged in effect that their data "does not support their conclusions and rankings."
The report's authors cautioned that the focus on single-parent families ``may seem unfair and insensitive'' and noted that many children do well with one parent.
``But at the statistical level, there is evidence to associate growing up in single-parent families with greater risk to well-being -- including a greater risk of dropping out of school, of leaving home early, poorer health, low skills and of low pay,'' they said.
Eighty percent of the children in the countries surveyed live with both parents, but with wide variations, from over 90 percent in Greece and Italy to less than 70 percent in Britain and 60 percent in the US, where 16 percent of adolescent children lived with stepfamilies.
The study ranked the countries in six categories, based on national statistics: material well-being, health and safety, education, peer and family relationships, behaviors and risks, and young people's own subjective sense of well-being.
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