June 20, 2019

Map: The best (and worst) states for children's health

Daily Briefing

    The overall well-being of U.S. children has improved over the past nearly three decades, but certain indicators of child health have worsened, suggesting policymakers could do more to address the issues affecting children's health, according to the Annie E. Casey Foundation's 2019 Kids Count Data Book released Monday.

    Report details

    For the report, researchers assessed the overall well-being of U.S children in 2017 by examining 16 indicators of childhood well-being grouped into four categories:

    • Economic well-being, which includes indicators such as the percentage of children in poverty and the percentage of children whose parent lack secure employment;
    • Education, which includes indicators such as the percentage of young children—ages three and four—who are not in school and the percentage of high school students not graduating on time;
    • Health, which includes the percentage of infants born with a low-birth weight, the percentage of uninsured children, the number of child and teen deaths per 100,000, and the percentage of teens who misuse alcohol or drugs; and
    • Family and community, which includes indicators such as the percentage of children in single-parent families and the number of teen births per 1,000.

    The researchers used 2017 data because in most cases it represented the most recent data available.

    How healthy were US children in 2017?

    Overall, the researchers found U.S. children had a better chance of thriving in 2017 than they did in 1990, when the first report was published.

    The researchers found improvements across 11 of the 16 indicators of childhood well-being, but they also noted the United States lacked progress on child poverty and racial and ethnic disparities persisted in 2017.

    When looking at the report's four indicators for child health, the researchers found some improvements.

    For example, the researchers found the percentage of teens who misused drugs or alcohol fell to 4% in 2017, while the number of child and teen deaths per 100,000 remained unchanged at 26. The researchers also found the uninsured rate for children fell to 5%, or 3,925,000 children, in 2017, down from 8% in 2010. The researchers said the improvement is due in large part to the Affordable Care Act, CHIP, and state Medicaid expansions. In 37 states, the rate of uninsured children was lower than 5%. However, the researchers noted 2017 marked the first year the number of uninsured U.S. children increased since 2010.

    One area where the United States failed to make progress is the number of low birth weight infants. According to the report, 318,873 babies were born at low-birth weights in 2017, reaching 2006's four-decade high of 8.3%. The researchers found African-American babies were the most likely to be born with a low birth weight at 13.4% of live births in 2017.

    State rankings

    The researchers found New Hampshire ranked first for overall childhood well-being, followed by:

    1. Massachusetts;
    2. Iowa;
    3. Minnesota; and
    4. New Jersey.

    New Mexico ranked last for overall childhood well-being, followed by:

    1. Louisiana;
    2. Mississippi;
    3. Nevada; and
    4. Arizona.

    In terms of the four children's health indicators, the researchers found Massachusetts ranked first, followed by:

    1. New Hampshire;
    2. New Jersey;
    3. Rhode Island; and
    4. New York.

    The researchers found Massachusetts had the lowest rate of uninsured children. Meanwhile, New Jersey and Rhode Island had the lowest rate of child and teen deaths at 16 deaths per 100,000 children.

    The researchers found Alaska ranked the lowest for children health, followed by:

    1. Wyoming;
    2. New Mexico;
    3. Mississippi;
    4. Nevada.

    The researchers found Alaska had the highest rate of child and teen deaths at 52 per 100,000 and the highest rate of teen alcohol and drug misuse at 7%, while Mississippi had the highest percentage of low birthweight babies, at 11.6% of live births.

    Policy recommendations

    The researchers found direct connections between improvements in areas of children's well-being, including a decrease in the uninsured rate, and policies. The researchers recommended policymakers continue to support the well-being of children by:

    • Ensuring the 2020 Census count all children to ensure federal programs, including CHIP, can appropriately allocate funds;
    • Expanding programs such as Medicaid, which are designed to keep children healthy;
    • Providing families with access to earned income tax credits, child tax credit programs, and other financial resources that would allow parents to allocate more of their money toward their children's needs; and
    • Reducing and eliminating obstacles disproportionately affecting African Americans, Latinos, Native Americans, and other children of color, including barriers such as not having health insurance and living in high-poverty areas (AP/U.S. News & World Report, 6/17; Foertsch McKinney, St. Louis Public Radio/NPR, 6/18; Zdun, Austin American-Statesman, 6/17; Finch, Sacramento Bee, 6/17; Annie E. Casey Foundation release, 6/17; Annie E. Casey Foundation report, 6/17).

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    To be successful, population health programs must invest heavily in partnerships with local organizations and health departments.

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