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.

Main Findings

Source: WalletHub

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

Artwork-2018-Best-&-Worst-States-for-Child-Health-v1

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.

Reprinted with permission from WalletHub. The original post can be found here.

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