Posted by: Richie Bernardo

Raising a child in America is extremely expensive, costing the average parent over $230k, and health care accounts for a big chunk of the bill. And while more kids are insured today than at any other point in history, the higher coverage rate hasn’t translated to lower health costs for parents. For example, out of pocket costs for patients aged 0 to 18 increased by 18% between 2012 and 2016.

But it’s a different story in every state. WalletHub therefore compared the 50 states and the District of Columbia across 30 key indicators of cost, quality and access to children’s health care. Our data set ranges from share of children aged 0 to 17 in excellent or very good health to pediatricians and family doctors per capita. Read on for our findings, expert insight from a panel of researchers and a full description of our methodology.

1. Main Findings
2. Ask the Experts
3. Methodology

Main Findings

Embed on your website<iframe src="//d2e70e9yced57e.cloudfront.net/wallethub/embed/34455/geochart-child-health.html" width="556" height="347" frameBorder="0" scrolling="no"></iframe> <div style="width:556px;font-size:12px;color:#888;">Source: <a href="https://ift.tt/2qGPBwI>  

Best States for Children’s Health

Overall Rank (1=Best)	State	Total Score	‘Kids’ Health & Access to Health Care’ Rank	‘Kids’ Nutrition, Physical Activity & Obesity’ Rank	‘Kids’ Oral Health’ Rank
1	Vermont	73.40	1	1	9
2	District of Columbia	64.09	2	14	8
3	Massachusetts	61.98	5	7	15
4	Connecticut	61.84	6	6	28
5	New York	60.15	8	12	17
6	Maryland	60.13	4	25	4
7	Hawaii	59.91	3	13	44
8	New Hampshire	58.23	10	17	10
9	New Jersey	58.17	9	15	43
10	California	57.95	15	2	39
11	Delaware	57.70	7	32	13
12	Illinois	57.36	19	3	7
13	Minnesota	56.79	14	22	5
14	Oregon	56.61	21	5	21
15	Pennsylvania	56.53	13	16	22
16	Virginia	56.06	12	26	20
17	Iowa	55.54	16	21	6
18	Washington	55.31	18	9	37
19	Colorado	55.20	24	8	19
20	Rhode Island	54.99	11	35	16
21	Utah	54.72	26	4	23
22	Michigan	52.74	17	29	18
23	Wisconsin	52.41	29	10	24
24	Maine	52.09	34	11	2
25	Missouri	51.89	22	20	49
26	Kansas	51.53	23	33	14
27	Idaho	51.22	25	23	30
28	Kentucky	50.93	20	42	11
29	Nebraska	49.95	28	24	33
30	Ohio	48.76	27	40	35
31	South Dakota	48.21	30	28	32
32	North Carolina	47.96	31	39	27
33	West Virginia	46.84	32	44	1
34	New Mexico	45.70	37	30	38
35	North Dakota	45.58	44	18	26
36	Tennessee	45.32	33	48	29
37	South Carolina	44.36	36	49	3
38	Florida	44.06	39	34	48
39	Indiana	43.80	40	41	25
40	Alabama	43.64	35	46	46
41	Georgia	43.57	38	50	12
42	Arizona	43.39	47	19	36
43	Alaska	43.13	45	27	40
44	Wyoming	42.82	42	37	41
45	Oklahoma	40.92	43	43	42
46	Montana	40.45	48	31	47
47	Arkansas	40.41	41	47	45
48	Mississippi	37.80	46	51	51
49	Texas	37.02	50	38	31
50	Louisiana	35.86	49	45	34
51	Nevada	35.60	51	36	50

 

Ask the Experts

There are steps that parents, health-care organizations and the government can take to ensure the best health for children in the U.S. For insight and advice, we asked a panel of experts to share their thoughts on the following key questions:

1. Is there evidence that children’s hospitals produce better health outcomes for children?
2. What are the most important steps parents can take to help their children grow up healthy?
3. Do you believe children are prescribed too much medication in the U.S. today?
4. Do you think the government should mandate all children have health-insurance coverage?
5. In evaluating the best states for children’s health care, what are the top five indicators?

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• Cindy Cisneros Vice President of Education Programs at the Committee for Economic Development
• Michael Montoya Associate Professor Emeritus in the Department of Anthropology at the University of California, Irvine
• Swati Mukherjee Professor of Economics at Bentley University
• Lorie H. Judson Professor Emerita in the Patricia A. Chin School of Nursing and Executive Director of the Chin Family Institute for Nursing at California State University, Los Angeles
• Candice Belanoff Clinical Assistant Professor in the Department of Community Health Sciences at Boston University School of Public Health
• Christina M. Dalton Assistant Professor in the Department of Economics at Wake Forest University

Cindy Cisneros Vice President of Education Programs at the Committee for Economic Development

What are the most important steps parents can take to help their children grow up healthy?

During the earliest years of a child’s life, 700-1,000 new neural connections form every second. These connections are influenced by genes and experiences.

If children are provided a stimulating and supportive learning environment as part of child care or pre-K education programs, they have a greater chance of starting school ready to succeed. Parents can explore and learn about the impact of early childhood education experiences beginning at birth through pre-school age. This is a time in which the brain is built rapidly, laying the foundation for social, emotional, cognitive, and physical development. Understanding that this is a critical period in a child’s development is a great first step.

When kids start school ready to learn, they are shown to have more positive health and academic outcomes. A follow up to the Chicago Longitudinal Study determined that children who had access to early education were more likely to stay in school and attend college; have health insurance coverage; lower rates of incarceration and depressive symptoms; higher rates of full-time employment; and, lower rates of disability. This is especially important for the growing proportion of American children living in poverty. Only a fraction of these children accesses such services.

Michael Montoya Associate Professor Emeritus in the Department of Anthropology at the University of California, Irvine

Is there evidence that children's hospitals produce better health outcomes for children?

These are fighting words. Huge debates on this. And lack of hospitals, children's or otherwise, does not lead to poor health. So, more hospitals won't improve it.

What are the most important steps parents can take to help their children grow up healthy?

Get rich or move to a wealthier zip code and be active in your own self development and your children's. Evidence is pretty clear on these points. Sounds harsh, but inequity drives poor health. Since our safety net is anemic, and our idea of health is about lack of symptoms, this answer challenges us to think more critically about our living conditions and those of our children.

Do you believe children are prescribed too much medication in the U.S. today?

Not just children. Everyone. Lack of medication didn't make us sick, so more medication won't make us better. A deeper conversation here about the important role of medication when needed.

Do you think the government should ensure all children have health insurance coverage?

Who else? Ridiculous we even need this debate. Shameful.

In evaluating the best states for children's health care, what are the top 5 indicators?

Great question, also fighting words. Huge debates on this. Depends on how you define health care. We don't have health care in the U.S. We have sick care. So, health care would be something like a livable wage and paternity leave, and good schools and GINI coefficient that shows lower wealth disparity between the richest and poorest in the state.

Swati Mukherjee Professor of Economics at Bentley University

What are the most important steps parents can take to help their children grow up healthy?

The concept of “health” is being increasingly viewed as a complex of physical, mental, emotional, and lately, spiritual, domains not only in academic research, but also by concerned parents, teachers, health care-givers, hospitals and other relevant institutions.

The research in these domains is extensive. My attempt below is to craft out a set of guidelines that I think is important, indicating some research findings and readings that might be interesting to you. What follows, therefore, is a blend of both established research, my knowledge as a health care researcher leavened liberally with a mother’s experience. If I could travel back in time, I would give the following set of guidelines to my own past, younger self.

Physical health:

• An excellent pediatrician is a treasure. Find someone with whom you can relate and who actually listens to you. Covering the basics like regular checkups, up-to-date immunizations, etc. are a given. It is also important to be pro-active in partnership with the doctor. In other words, please do your own research if you are puzzled, share your findings with your doctor and be open to using common-sense remedies that you know would help your child.
• Encourage physical activity and take extra precautions in sports involving head contact and higher than usual rates of serious injury. There is compelling evidence of both short-run and long-run negative impact of concussions. A recent (2015) article in Pediatrics by Ransom et al. looked at the academic effects of concussions and a 2017 article in The American Journal of Sports Medicine by Martini et al. examined long-term effects.
• Teach the child to love healthful food. If necessary, explore different cuisines to make vegetables interesting and learn to cook without cream and a lot of butter. Personally, I believe in balance and would rather not forbid pizza or ice-cream. There are several books (and videos) that will teach parents how to “sneak” in vegetables by creating sauces from cauliflower and so on. However, I know it is possible to make children enjoy vegetables without hiding them. You just need to make them “yummy” by their standards.
• It is not advisable to make food a reward. There is excellent research on the role of parents in influencing food preferences, as well as medical research which has found that obesity can be linked to a heightened desire for food as a reward. This is similar to how a drug affects the brain (See Scaglioni et al. in “British Journal of Nutrition,” 2008; Benton in “International journal of obesity,” 2004; Volkow et. al. in “Brain imaging in behavioral neuroscience,” 2011).

Mental and emotional:

• Growing up in India, we were taught that what we feed our minds is just as important as what we feed our bodies; one must nurture and strengthen the mind and be careful what it is fed. From that perspective, many from that cultural mindset feel that children need heroes and ideals and books can feed that hunger. It is wonderful to teach a child to love reading and to enjoy books dealing with fun, innocent and uplifting themes. Sadly, a child today has to deal with very dark events. There is literature on how to build the resilience of a child and we, parents, can work on that. Every child is unique and special. One child can witness a tragedy and the effects can be so deep and damaging that it can destroy their life. Another child can go through the process of shock, denial and grief but eventually will recover and may even be impelled to do something that will change the world they live in. As parents, we can do our best to help our children build mental strength and learn about making wise choices. This may not be enough, as many factors determine the differential responses, but we just have to do our best.
• In this regard, since WWII, there has been quite a bit of research on what is termed “resilience science.” With a series of devastating events even from the birth of this century, a study of what makes children resilient is more important than ever. Ann Masten (in “Child Development,” 2014) has looked at global perspectives on resilience in children and youth.
• We need to be alert to sudden changes which could be a warning signal. Could your child be depressed? Or wrestling with a drug problem? Or being bullied? Or being sexually abused? All these are very difficult situations and will need all your wisdom and strength to tackle head-on. If you feel helpless, take advantage of the many resources available for the particular problem that faces you. You may be surprised to not only find helpful resources, but also to find support groups that can give you strength and practical tips.
• In a recent book published in 2018, “Child’s Play,” Irene Athey mentions that academic thinking has neglected the role of play in human development. I agree and feel that parents can do much to encourage play by participating in varied and interesting activities that also provide mental and tactile stimulation. Playing games, taking nature walks, starting a nature journal, having spontaneous picnics, starting a family wall newspaper are just some examples of the endless things a parent can do to ignite wonder and a lifelong love of learning in a child.
• Music is very important. There is plenty of research showing the myriad benefits of music. A fascinating article by Susan Hallam in the “International Journal of Music Education” (2010) explains the permanent changes in the brain that can occur through music. Helping a child develop a love for music that can inspire and soothe can confer life-long benefits and be an invaluable gift.
• Talk to your child. Let them know that there is nothing you will be shocked at, that you love your child unconditionally. Tell stories of your childhood, show how you overcame your fears and lack of confidence. Far from diminishing you, this serves as an inspiring role model. Help your child to express the love in their heart.
• Children learn values quickly. Research (for instance, see Halstead and Taylor in “Cambridge Journal of Education,” 2000) has shown that not only do they have a value system by the age of two but that this influences their subsequent social and emotional development.
• Apart from teaching a child to be honest and truthful, many parents consider it important to teach the value and joy of helping others. From an early age, a child can be involved in giving -- to the immediate family, relatives, friends, and then those whom they do not know. There are many ways of doing this. Helping you to cook a meal for a sick friend, planning a surprise appreciation party for someone who is lonely can be as valuable as giving to people they do not know. A child will understand that you can give not just in terms of money, but also in terms of your time, your caring, your ability to listen. By teaching a child the value of service, we give the gift of joy (see, for instance, Eyre and Eyre, “Teaching your children values,” 2010).
• Teach your child to laugh, to look at the funny side of things. This is another great gift. Laughter therapy and laughter yoga are getting to be known and there is research on their efficacy. The first laughter club started in Mumbai by Dr. Madan Kataria and now there are thousands worldwide. Personally, I don’t need research in this; I know a good hearty laugh can make me feel better instantly. Apparently, regular laughter also has many permanent benefits (see Paul McGhee and Mary Frank, “Humor and children’s development: A guide to practical applications,” 2014).

Spiritual:

• There is research on the importance of spirituality (Michaelson et al. in “SSM-population health,” 2016, look at the developmental patterns of adolescent spiritual health in six countries). However, rather than go into an academic debate on what exactly spirituality means, I will give my own subjective interpretation of spirituality (which does not need to be tied to the practice of any religion) that may be a product of the particular culture in which I was raised.
• If the world outside is confusing and disturbing to us, imagine how a child today will struggle to make sense of it and navigate their own life currents successfully. That is where spirituality or a strong sense of being connected to your inner self helps.
• A child needs to understand the value of being good, of having a moral compass. However, simultaneously, they need to understand the importance of accepting and embracing differences. We need to model for the child our belief in the equality of all nations, all colors, all races, all creeds. Let us teach our children that we are all brothers and sisters with the privilege of living in the wonderful home of this planet Earth. What is difficult to teach is how to deal with situations when people do not behave that way. If our children can resist giving way to hating even when resisting hateful actions with all their might; if they recognize and follow their own drummer even though all others are marching to wildly drumming discordant notes; if they can get back up again and again and never give up their personal quest, then you know you have truly succeeded in making your child healthy, in every sense of the term.

Do you believe children are prescribed too much medication in the U.S. today?

There are children who need medication and do not get it. There are children who need medication, get it and do not take it. This constitutes one set of problems.

A second set of problems can be seen from the controversy on whether children are being labelled and diagnosed with whatever is the current popular label and given medication without diagnosing the cause. For instance, if a child is showing signs of attention deficit disorder, there are those who feel that it should be seen as a symptom rather than an illness. We need good studies that can separate causality showing whether better nutrition and less TV at young ages can help.

All this ties into the medical system today where doctors are pressured and harried into quick decisions. Not everything can be fixed by a pill. There can be many factors leading to a depressed child, a hyperactive child, an overweight child, or a child with many behavioral problems. We need a system that can coordinate the expertise of physicians, mental health specialists, and other practitioners to arrive at lasting solutions with minimal side-effects.

A third set of problems concerns serious issues regarding overmedication in the case of children in the custody of child welfare and the juvenile justice system. Drugs are being prescribed as a behavior control mechanism and not tied solely to the children’s actual medical needs. Please see Allison Flood (2015) “American bar association commission on youth at risk, commission on homelessness and poverty, health law section report to the house of delegates: Overuse of psychotropic medication among children and youth in state custody.” Mary Wilson has written “Overmedicated: Foster Kids in Crisis” (2016).

Do you think the government should ensure all children have health insurance coverage?

Absolutely.

Lorie H. Judson Professor Emerita in the Patricia A. Chin School of Nursing and Executive Director of the Chin Family Institute for Nursing at California State University, Los Angeles

Is there evidence that children's hospitals produce better health outcomes for children?

Here I would point you to this research which shows that this most likely is the case for a number of reasons. From my point of view, additional factors are: the physicians, nurses and ancillary staff work in a pediatric facility because they chose to care for children and have been prepared to do just that, whereas in a general hospital, many staff are not prepared to care for children. The education of the nursing staff also plays into this and it is evident that children’s hospitals have a higher percentage of baccalaureate prepared nurses, which also relates to safety (see Linda Aiken’s studies). Drug dosages are very different for the pediatric population, and when in a facility that cares for both adults and children, safe drug dosages may be overlooked. The different levels of growth and development are important to keep in mind when therapeutically relating to children, and staff may not be as aware of those differences when caring for adults as well.

What are the most important steps parents can take to help their children grow up healthy?

In my opinion, the best steps are those that ensure the child gets enough sleep, the right nutrition, immunizations and, of course, psychological support that is age/stage appropriate. Safety can never be overemphasized and a working knowledge of the safety hazards at each stage of development and how to prevent injury is imperative.

Do you believe children are prescribed too much medication in the U.S. today?

There may be a tendency to prescribe too much medication.

Do you think the government should ensure all children have health insurance coverage?

In my opinion, it is imperative that all children be covered with health insurance, particularly for the immunizations needed to prevent life-threatening childhood illnesses and for the diagnosis and treatment of chronic illness, such as asthma and diabetes.

In evaluating the best states for children's health care, what are the top 5 indicators?

Top five indicators for children’s health are most often linked to the social determinants of health, which include education of parents, family income, housing and environment, including healthy food and exercise and access to health care.

Candice Belanoff Clinical Assistant Professor in the Department of Community Health Sciences at Boston University School of Public Health

Is there evidence that children's hospitals produce better health outcomes for children?

My feeling is that any hospital (or health care setting) where the interests and needs of families and children are centralized and well-coordinated, where culturally respectful care is delivered, and where access to the highest-quality care is delivered regardless of social class, race, immigrant status, etc., will produce better health outcomes for children than settings which lack any of these. Certainly, top-ranked hospitals (like Boston Children’s Hospital et al.) attract some of the most skilled and well-prepared health care providers in the world, but that can mean little if a family’s needs are not adequately assessed and attended to. There is certainly ample, recent evidence of social biases in the delivery of pediatric care across the nation (See Flores, Pediatrics Volume 125, Number 4, April 2010).

What are the most important steps parents can take to help their children grow up healthy?

The most important determinants of children’s adverse health outcomes are exposure to poverty, poor educational and economic opportunity and racism. Just about every children’s health outcome is differently patterned by these factors in this country. These include (but are certainly not limited to) asthma, unintentional injury, obesity, child maltreatment and more. As such, the best things one can do to ensure the health of one’s children are reducing exposure to poverty, low-quality education and racial bias. Of course, individual parents do not always have the power to shield their children from these factors, necessitating larger social action to reduce these risks.

Do you believe children are prescribed too much medication in the U.S. today?

I would say yes, but noting that there are differences in access to wholly appropriate medications by, you guessed it, race and income. The current medical culture may be quick to prescribe Ritalin for a particularly energetic child, or to put an obese child on statins (instead of ensuring that said child’s family has access to healthy foods and safe, affordable recreational opportunities), but there are many children with chronic conditions (like asthma) who are lacking access to the medications and coordinated care they need to maintain their health. On the whole, we need to do more to help our children avoid the need for medication, while ensuring access to medications where they are needed.

Do you think the government should ensure all children have health insurance coverage?

Absolutely. Every single child in our country should be insured. As Martin Luther King, Jr. said, “Of all the forms of inequality, injustice in health is the most shocking and the most inhuman.”

In evaluating the best states for children's health care, what are the top 5 indicators?

To identify the best states for children’s health care, I would look to states that have the lowest levels of racial segregation and sorting into low-opportunity areas, (see the Child Opportunity Index for more on this topic, at DiversityDataKids.org), the lowest reports of discrimination by race and immigrant status (see the National Survey of Children’s Health for some good data on this topic), the lowest rates of child poverty, (see example map), and the highest access to state Medicaid/CHIP programs as well as services like WIC and Early Intervention.

Christina M. Dalton Assistant Professor in the Department of Economics at Wake Forest University

Is there evidence that children's hospitals produce better health outcomes for children?

I've seen a limited study of general versus children's hospitals in New York versus Pennsylvania. There, they found only slight differences between the two hospitals in discharge rates for pediatric asthma, but emphasized that the much more relevant differences were across state lines. The U.S. has a great range of health outcomes across states. The broad differences can be delved into here.

Do you think the government should ensure all children have health insurance coverage?

There have certainly been documented positive effects of some targeted federal programs for children. A 2016 study in Health Economics found that the Temporary Assistance to Needy Families (TANF) program improved children's health status, both by what the parents self-reported, as well as in objective measures, such as the number of times a parent consulted the doctor and the number of nights a child spent in a hospital. They also find that the maternal employment status is important in improving a child's health outcomes, where having a mother actively employed, and presumably better able to care for her family financially, reduced welfare caseloads as well.

Another 2005 study in the Journal of Public Economics found that a 10-percentage point Medicaid expansion for children increased their ability to use hospital care by 8.4 percent. We would hope that increased insurance would also lead to better care that could prevent hospitalizations, as well. The study found some evidence of this, that hospitalizations for unavoidable conditions grew much more than that for avoidable conditions. However, it should be noted that the cost effects they found were ambiguous -- that the average length of stay in a hospital went down, decreasing costs, but utilization within the hospital was more intense, increasing costs.

Children's health coverage has important potential to improve health and economic outcomes in the future, since early good health enables children to learn better in school. However, any expansion of public options needs to take into account the idea that public insurance can end up taking enrollees away from the private market, which means the government is now paying for insurance which was previously covered by the private sector enrollees themselves. It's always a trade-off of increasing coverage while not attracting too many of the enrollees that would have already bought insurance without government funding. This is called "crowding out," where the public sector crowds out the enrollees from the private sector.

In evaluating the best states for children's health care, what are the top 5 indicators?

Frankly, the best indicators are likely parental employment and education. There is a lot of evidence that points to the importance of parents in creating good health conditions for children and, of course, steady employment can provide financially for the children, as well as have a higher likelihood of regular insurance coverage.

Methodology

In order to determine the best and worst states for children’s health care, WalletHub compared the 50 states and the District of Columbia across three key dimensions: 1) Kids’ Health & Access to Health Care, 2) Kids’ Nutrition, Physical Activity & Obesity and 3) Kids’ Oral Health.

We evaluated these categories using 30 relevant metrics, which are listed below with their corresponding weights. Each metric was graded on a 100-point scale, with 100 representing the best health care for children.

We then determined each state and the District’s weighted average across all metrics to calculate its overall score and used the resulting scores to rank-order our sample.

Kids’ Health & Access to Health Care – Total Points: 55

• Share of Children Aged 0 to 17 in Excellent/Very Good Health: Double Weight (~9.17 Points)
• Infant-Death Rate: Full Weight (~4.58 Points)Note: “Infant” includes children who are less than 1 year old.
• Child-Death Rate: Full Weight (~4.58 Points)Note: “Child” includes children aged 1 to 14 years.
• Share of Children Aged 19 to 35 Months with All Recommended Vaccines: Full Weight (~4.58 Points)Note: Recommended vaccines include the following: DTaP vaccine; polio vaccine; measles, mumps and rubella (MMR) vaccine; Haemophilus influenzae type b (Hib) vaccine; varicella (chicken pox) vaccine; hepatitis B (HepB) vaccine; and pneumococcal conjugate vaccine (PCV).
• Share of Uninsured Children Aged 0 to 17: Double Weight (~9.17 Points)
• Share of Children Aged 0 to 17 with Unaffordable Medical Bills: Full Weight (~4.58 Points)Note: This metric measures the percentage of children aged 0 to 17 whose families had problems paying or were unable to pay their child’s medical bills.
• Pediatricians & Family Doctors per Capita: Full Weight (~4.58 Points)
• Cost of Doctor’s Visit: Full Weight (~4.58 Points)
• Out-of-Pocket Cost for Children’s Health Care: Full Weight (~4.58 Points)
• Number of Children’s Hospitals per Total Number of Children: Full Weight (~4.58 Points)

Kids’ Nutrition, Physical Activity & Obesity – Total Points: 40

• Healthy-Food Access: Full Weight (~3.08 Points)Note: This metric measures the percentage of census tracts that have at least one healthier food retailer located within the tract or within 1/2-mile of tract boundaries.
• Sugar-Sweetened Beverage Consumption Among Children Aged 14 to 18: Full Weight (~3.08 Points)
• Share of Children Aged 14 to 18 Who Consume Fruits/Vegetables Less than Once Daily: Full Weight (~3.08 Points)
• Fast-Food Restaurants per Capita: Full Weight (~3.08 Points)
• Dietitians & Nutritionists per Capita: Full Weight (~3.08 Points)
• Share of Children Aged 6 to 17 Who Exercise at Least 20 Minutes per Day: Full Weight (~3.08 Points)
• Share of Overweight Children Aged 10 to 17: Double Weight (~6.15 Points)
• Share of Obese Children Aged 10 to 17: Double Weight (~6.15 Points)
• Presence of Obesity-Related School Standards: Full Weight (~3.08 Points)Note: This metric considers the presence or absence of obesity-related school standards in areas such as school-meal nutrition, physical education and health education.
• Presence of Obesity-Related State Initiatives: Full Weight (~3.08 Points)Note: This metric considers the presence of absence of obesity-related state initiatives such as menu-labeling laws and soda taxes.
• Share of Children Aged 1-17 Who Live Near a Park/Playground & Recreation/Community Centre: Full Weight (~3.08 Points)

Kids’ Oral Health – Total Points: 5

• Share of Children Aged 1 to 17 with Excellent/Very Good Teeth: Double Weight (~0.91 Points)
• Share of Children Aged 0 to 17 With Recent Medical & Dental Checkups: Double Weight (~0.91 Points)
• Share of Children Aged 0 to 17 Lacking Access to Fluoridated Water: Full Weight (~0.45 Points)
• Presence of State Oral Health Plan: Full Weight (~0.45 Points)Note: This binary metric considers the presence or absence of state oral health plans. According to the Centers for Disease Control and Prevention, “A state oral health plan is a roadmap for accomplishing the goals and objectives that have been developed in collaboration with partners and stakeholders, including the state oral health coalition, and members from the public health, dental and medical communities. A comprehensive state oral health plan should be used to direct skilled personnel and funding decisions to reduce the prevalence of oral disease.”
• Presence of School-Based Dental-Sealant Programs: Full Weight (~0.45 Points)Note: This binary metric considers the presence or absence of school-based dental sealant programs. According to the Centers for Disease Control and Prevention, “School-based sealant programs provide pit and fissure sealants to children in a school setting. These programs generally target vulnerable populations that may be at greater risk for developing decay and less likely to receive preventive care.”
• Dental Treatment Costs: Full Weight (~0.45 Points)Note: “Dental Treatment” includes children’s braces, cleanings, crowns, root canals and tooth extractions.
• Presence of State Mandate for Dental-Health Screening: Full Weight (~0.45 Points)Note: This binary metric considers the presence or absence of a mandatory dental-health screening or certification of a dental-health assessment as a condition of school entry.
• Share of Dentists Participating in Medicaid for Child Dental Services: Full Weight (~0.45 Points)
• Dentists per Capita: Full Weight (~0.45 Points)

 

Sources: Data used to create this ranking were collected from U.S. Census Bureau, Bureau of Labor Statistics, Child and Adolescent Health Measurement Initiative, Centers for Disease Control and Prevention, Council for Community and Economic Research, County Health Rankings, American Dental Association, Trust for America's Health, Robert Wood Johnson Foundation, The Annie E. Casey Foundation, Healthy Grid and U.S. News & World Report.

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