Missouri lags behind most states in children’s health, report finds

by Clara Bates, Missouri Independent


Missouri ranks in the bottom third of all states for children’s health, according to a recent report using data from 2021.

The annual Kids Count Data Book from the Annie E. Casey Foundation, released this month, evaluates states on four metrics of child well-being. Those are: health, economic well-being, education and family & community.

For overall child well-being, Missouri ranks near the middle: 28th of 50 states, with 50 being the worst. Other Midwestern states, Minnesota, Iowa, Nebraska and Wisconsin, were in the top ten of all states for child well-being.

Bringing down the state’s overall ranking was one factor in particular: children’s health. 
Only 15 states in the country had a lower rating for children’s health. 

“Our health rankings are part of the problem,” said Tracy Greever-Rice, program director of Missouri KIDS COUNT. 

“We have work to do here in Missouri around infant mortality,” Greever-Rice said. “And we also have work to do, like many states with large rural populations, in terms of teen and adolescent deaths.”

Only 10 other states had the same or worse rates of child and teen deaths as Missouri, one of the factors included in the health measure.

The rate of child and teen deaths was 39 per 100,000 in Missouri in 2021 — up from 32 per 100,000 just two years earlier. The state’s trend mirrored the national trend, which increased from 25 deaths per 100,000 to 30 deaths per 100,000 from 2019 to 2021.

Greever-Rice said several factors could have contributed to the state’s relatively high rate of child and teen deaths in 2021. 

“Particularly at risk — and a change that we’ve seen over the past few years — are adolescent boys in more rural areas,” Greever-Rice said, “and of course, Missouri, like everywhere else has been impacted by the opioid and fentanyl epidemic.

“So we just have some high risk populations here that we have work to do around.”

Suicide rates among young people have increased nationally over the last several decades, particularly in rural areas, where mental health services can be scarcer, research has found.

Firearms became the leading cause of kids’ deaths in the United States in 2020, surpassing car accidents. According to Children’s Defense Fund, Missouri was one of ten states that accounted for half of all child and teen gun deaths in the nation from 2011-2020. Bills to limit access to guns failed in the legislature this session.

Other indicators of children’s health — the rates of low birth-weight babies, children without health insurance, and children who are overweight or obese — were all slightly worse in Missouri than on average, according to the report.

The best states for children’s health, according to the report, include Massachusetts, Vermont and New Hampshire, while the worst are Texas, Louisiana and Mississippi.

Missouri children fared best, out of the four broad indicators of well-being, on the measure of economic well-being. The state ranked 18th of 50 on economic well-being.

While 3 in 10 children nationally live in households with a high housing cost burden, only around 2 in 10 Missouri children do, per the report. 

The rate of kids whose parents lack secure employment is also slightly better in Missouri at  26% than nationally, 29%. 

The rate of children in poverty roughly mirrors the national average — 16% in Missouri and 17% nationally. The rate of teens not in school and not working is 7% in Missouri, equal to the national average.

The Kids Count index also included data on the cost of child care nationally, though it did not factor into the overall well-being rating. 

“For many, many families right now,” Greever-Rice said, “the cost [of child care] continues to go up and availability just decreases, particularly in rural areas and underserved areas.”

In Missouri, a single parent with a toddler attending a child care center would pay 28% of the median income on child care, according to the Kids Count report. Dozens of interviews conducted by The Independent and Muckrock indicated that that burden can be untenable for many families — even though it is actually a lower burden than in much of the rest of the country, per the report. 

As the Missouri Independent and Muckrock’s investigative collaboration, Disappearing Daycare, found, the child care crisis is one not just of cost but access: Missourians struggle to find child care openings, particularly for infants, and the situation is even worse for those seeking government assistance.
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The average cost for a toddler’s care at a center in Missouri was nearly $9,000, according to KIDS COUNT.