Kids At Risk Action Cofounder David Strand made public policy in Northern Europe for ten years before becoming a CASA (Court Appointed Special Advocate) volunteer Guardian ad Litem in Hennepin County Minnesota in 1994. CASAs speak for abused and neglected children lucky enough to be seen and heard in CPS (Child Protective Services).
About 7.8 million American children are reported to CPS annually, and at least that many go unseen and unreported (child abuse is invisible and children have no voice in their homes, courts, media, or the State House).
David was so outraged by the terrible things happening to the children in his CASA caseload and the many problems he was having in CPS saving and healing them, that he joined up with fellow CASA Guardian ad Litem Mike Tikkanen to found KARA, Kids At Risk Action. He then entered a PHD program at Hamline University to study child abuse and neglect, how it compares to other nations, and the issues impeding the saving and healing of the children suffering from it.
Today, KARA focuses on child abuse and neglect in America, comparisons to other nations are instructive and necessary if better decisions are to be made for improving the policies and programs of Child Protective Services.
Follow this link to
David’s PHD manuscript:
nation out of step
Nation Out of Step is 23 years old, but it is as true today as it was then. In some ways, (crime, education, suicide, and mental health) the statistics are worse today and trending badly.
Continue in the READ MORE to learn about how David’s work could benefit policy makers today, other suggested reading, and how ignoring these issues has harmed and continues to harm at risk children and families and American communities.
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How misinformed international comparisons are being used to compare program viability.
What happens when child protection is weaponized politically.
When politicians are misinformed
An ACEs (Adverse Childhood Experiences) snapshot of the size of the problem
Across multiple independent datasets, the United States ranks near the bottom of wealthy countries on core measures of child well‑being, including poverty, mortality, and learning. Below are some of the clearest, most “damning” comparative statistics, with source URLs you can use directly.
Overall child well‑being rankings
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A UNICEF Innocenti league table of 41 high‑income countries ranked the U.S. 36th out of 38 for child well‑being across mental health, physical health, and skills, putting it near the very bottom of rich nations.
Source: UNICEF Innocenti Report Card (summary via Equity for Children) – https://equityforchildren.org/2020/10/at-the-bottom-again-child-wellbeing-in-the-u-s/ -
A National Academies overview notes that the U.S. “lags well behind other wealthy OECD countries” on infant mortality, low‑birthweight, childhood poverty, and several education indicators, again referencing that UNICEF ranking of 36/38.
Source (chapter): National Academies, Children in the United States: Demographics, Health, and Wellbeing – https://www.ncbi.nlm.nih.gov/books/NBK610731/
Child poverty
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Using OECD’s relative child poverty measure, one recent analysis reports a U.S. child poverty rate of 20.8%, versus 11.2% for a group of similar wealthy countries.
Source: Peterson Foundation, “What Are the Economic Costs of Child Poverty?” – https://www.pgpf.org/article/what-are-the-economic-costs-of-child-poverty/ -
The National Academies review underscores that U.S. child poverty rates are higher than in most other industrialized nations, even after accounting for taxes and transfers.
Source: National Academies chapter – https://www.ncbi.nlm.nih.gov/books/NBK610731/
Infant mortality and early life
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The U.S. infant mortality rate is about 5.8 deaths per 1,000 live births, roughly 70% higher than the average among comparable wealthy countries at 3.4 per 1,000.
Source: KFF, “What do we know about infant mortality in the U.S. and comparable countries?” – https://www.healthsystemtracker.org/chart-collection/infant-mortality-u-s-compare-countries/ -
CDC analysis shows that even when very early births are excluded, the U.S. infant mortality rate remains nearly double that of top performers like Sweden and Norway.
Source: CDC Data Brief, “Behind International Rankings of Infant Mortality” – https://www.cdc.gov/nchs/products/databriefs/db23.htm
Child and teen deaths, especially from guns
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A 2025 KFF analysis finds the firearm mortality rate for U.S. children and teens is over 9.5 times Canada’s rate, the next highest among peer nations.
Source: KFF, “U.S. Has the Highest Rate of Gun Deaths for Children and Teens Among Peer Countries” – https://www.kff.org/mental-health/u-s-has-the-highest-rate-of-gun-deaths-for-children-and-teens-among-peer-countries/ -
Across 12 large, wealthy OECD countries, the U.S. accounts for 97% of all child and teen firearm deaths, despite having only about 46% of the combined population.
Source: KFF, “Child and Teen Firearm Mortality in the U.S. and Peer Countries” – https://www.kff.org/mental-health/child-and-teen-firearm-mortality-in-the-u-s-and-peer-countries/
Education, early childhood, and inequality
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Among 36 OECD countries, the Children’s Defense Fund reports the U.S. ranks 32nd for the percent of children in relative income poverty and 33rd for the number of 1‑year‑olds who die before their first birthday.
Source: Children’s Defense Fund, “How America Ranks in Protecting Children” – https://www.childrensdefense.org/blog/how-america-ranks-in-protecting-children/ -
The same summary notes low relative rankings for U.S. children on reading and math scores and early childhood enrollment, compared with peer nations.
Source: CDF article – https://www.childrensdefense.org/blog/how-america-ranks-in-protecting-children/
Public investment in children
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The Equity for Children analysis of UNICEF data points out that U.S. public spending on children is just over 1% of GDP, less than half the average of other rich countries, and projected to fall further.
Source: Equity for Children, “At The Bottom Again: Child Wellbeing in the U.S.” – https://equityforchildren.org/2020/10/at-the-bottom-again-child-wellbeing-in-the-u-s/
These statistics together show a consistent pattern: compared with its economic peers, the U.S. exposes children to substantially higher risks of poverty, sickness, violence, and academic struggle, while investing relatively less in their well‑being.
KIDS AT RISK ACTION / KARA / INVISIBLE CHILDREN
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