Posted by: Adam McCann

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 around 95% of children ages 0-18 have health insurance, the high coverage rate hasn’t translated to lower health costs for parents. For example, out of pocket costs for patients increased by 2.5% during 2017 alone, and total spending for individuals aged 0-18 jumped 19.9% between 2013 and 2017.

But it’s a different story in every state. WalletHub therefore compared the 50 states and the District of Columbia across 33 key indicators of cost, quality and access to children’s health care. Our data set ranges from share of children aged 0 to 17 years 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="http://bit.ly/2v9hO1D>  

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	65.65	1	14	12
2	Massachusetts	65.55	2	3	18
3	Rhode Island	61.28	3	25	4
4	District of Columbia	59.99	5	12	2
5	Connecticut	59.86	6	2	33
6	New Hampshire	59.50	4	29	29
7	New York	58.79	9	4	9
8	California	56.08	10	10	30
9	New Jersey	55.89	8	13	50
10	Maryland	55.63	7	26	16
11	Virginia	54.66	11	23	20
12	Minnesota	54.55	14	7	15
13	Hawaii	53.05	12	24	51
14	Michigan	52.72	13	21	14
15	Nebraska	52.68	17	9	21
16	Delaware	52.53	15	18	17
17	Washington	51.97	18	8	47
18	North Dakota	51.41	35	1	8
19	Pennsylvania	49.96	22	15	25
20	Oregon	49.52	31	5	13
21	Maine	49.25	19	35	23
22	Illinois	48.98	21	36	6
23	Iowa	48.55	28	22	1
24	New Mexico	48.18	16	43	38
25	Wisconsin	47.86	40	6	26
26	Utah	47.63	37	11	10
27	West Virginia	46.93	24	44	3
28	Missouri	46.59	30	19	45
29	South Carolina	46.58	25	37	11
30	Florida	45.23	27	41	40
31	South Dakota	45.05	32	33	31
32	Colorado	44.97	43	17	5
33	Alabama	44.91	26	45	39
34	Kentucky	44.84	20	51	22
35	Tennessee	44.63	23	50	19
36	North Carolina	44.49	33	39	32
37	Arizona	44.42	39	30	35
38	Kansas	44.26	36	40	24
39	Montana	43.88	46	16	42
40	Idaho	43.81	45	20	34
41	Nevada	43.78	41	28	49
42	Ohio	43.71	29	46	43
43	Louisiana	43.48	38	34	46
44	Georgia	43.11	42	38	7
45	Arkansas	42.39	44	32	36
46	Wyoming	41.72	34	47	48
47	Texas	39.15	47	42	28
48	Indiana	38.69	50	27	37
49	Alaska	37.21	51	31	41
50	Oklahoma	36.15	48	49	44
51	Mississippi	36.06	49	48	27

 

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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• J. Paul Leigh Ph.D. – CHPR Core Faculty & Professor of Health Economics, Department of Public Health Sciences, University of California, Davis
• Cindy Cisneros Vice President of Education Programs at the Committee for Economic Development

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 33 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 Years in Excellent/Very Good Health: Double Weight (~8.46 Points)
• Share of Children Aged 3 to 17 Years Suffering from Depression: Full Weight (~4.23 Points)
• Infant-Death Rate: Full Weight (~4.23 Points)Note: “Infant” includes children who are less than 1 year old.
• Child-Death Rate: Full Weight (~4.23 Points)Note: “Child” includes children aged 1 to 14 years.
• Share of Children Aged 19 to 35 Months with All Recommended Vaccines: Full Weight (~4.23 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 18 Years: Double Weight (~8.46 Points)
• Share of Children Aged 0 to 17 Years with Unaffordable Medical Bills: Full Weight (~4.23 Points)Note: This metric measures the percentage of children aged 0 to 17 years whose families had problems paying or were unable to pay their child’s medical bills.
• Pediatricians & Family Doctors per Capita: Full Weight (~4.23 Points)
• Cost of Doctor’s Visit: Full Weight (~4.23 Points)
• Out-of-Pocket Cost for Children’s Health Care: Full Weight (~4.23 Points)
• Number of Children’s Hospitals per Total Number of Children: Full Weight (~4.23 Points)

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

• Healthy-Food Access: Full Weight (~2.86 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 Years: Full Weight (~2.86 Points)
• Share of Children Aged 14 to 18 Years Who Consume Fruits/Vegetables Less than Once Daily: Full Weight (~2.86 Points)
• Fast-Food Restaurants per Capita: Full Weight (~2.86 Points)
• Dietitians & Nutritionists per Capita: Full Weight (~2.86 Points)
• Share of Children Aged 6 to 17 Years Who Exercise at Least 60 Minutes per Day: Full Weight (~2.86 Points)
• Share of Overweight Children Aged 10 to 17 Years: Double Weight (~5.71 Points)
• Share of Obese Children Aged 10 to 17 Years: Double Weight (~5.71 Points)
• Presence of Healthy Eating and Physical Activity Policies in Schools: Full Weight (~2.86 Points)Note: This binary metric considers the presence or absence of Early Childhood Education (ECE) programs required to have healthy eating policies and Physical Education requirements for elementary, middle and high school.
• Schools Meeting Nutrition Standards: Full Weight (~2.86 Points)Note: This metric measures 1) the share of eligible school districts adopting the Community Eligibility Provision Take-Up, 2) the share of certified school food authorities and 3) the School Breakfast Program schools as % of National School Lunch Program schools.
• Presence of Obesity-Related State Initiatives: Full Weight (~2.86 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 to 17 Years Who Live Near a Recreation Area: Full Weight (~2.86 Points)Note: This metric measures the share of children aged 1 to 17 years who live near a park/playground and recreation/community center.

Kids’ Oral Health – Total Points: 5

• Share of Children Aged 1 to 17 Years with Excellent/Very Good Teeth: Double Weight (~0.83 Points)
• Share of Children Aged 0 to 17 Years with Recent Medical & Dental Checkups: Double Weight (~0.83 Points)
• Share of Children Aged 0 to 17 Years Lacking Access to Fluoridated Water: Full Weight (~0.42 Points)
• Presence of State Oral Health Plan: Full Weight (~0.42 Points)Note: This 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 (~0.42 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 (~0.42 Points)Note: “Dental Treatment” includes children’s braces, cleanings, crowns, root canals and tooth extractions.
• Number of Free or Low-Cost Dental Clinics per Capita: Full Weight (~0.42 Points)
• Presence of State Mandate for Dental-Health Screening: Full Weight (~0.42 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 (~0.42 Points)
• Dentists per Capita: Full Weight (~0.42 Points)

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 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, Free Dental Care, The Annie E. Casey Foundation, Healthy Grid and U.S. News & World Report.

Image: gpointstudio / Shutterstock.com

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