Louisiana and Vermont may be part of the same nation, but they are worlds apart when it comes to the well-being of children.  Across the United States, where a child is born and raised can make a shockingly large difference to their chances of getting and staying healthy and then surviving into adulthood, according to a major new report, Geography Matters: Child Well-Being in the States.

The report by the nonprofit and nonpartisan Every Child Matters Education Fund (ECMEF) concludes: “There exists a huge gap among states on a wide variety of child well-being indicators. The state they live in should not adversely influence the life and death of children—but it does. Such inequalities affect all Americans, rich and poor alike, and weaken both our economy and our democracy.  Children in the lowest ranking state are:

•   Twice as likely to die in their first year as children in the highest ranking state.
•   Three times more likely to die between the ages of one-14.
•   Roughly three times more likely to die between the ages of 15-19.
•   Three times more likely to be born to a teenage mother.
•   Five times more likely to have mothers who received late or no prenatal care.
•   Three times more likely to live in poverty.
•   Five times more likely to be uninsured.
•   Eight times more likely to be incarcerated.
•   13 times more likely to die from abuse and neglect.”
 
Michael R. Petit, author of “Geography Matters; Child Well-Being in the States,” and founder of Every Child Matters, said: “Every Presidential candidate and state-office seeker should be asked to speak to these stark findings.  Some of us may live in pockets of relative affluence, but that does not mean that there are entire segments of this nation with crushing circumstances for children. Nearly 13 million American children live in poverty today.  Over eight million U.S. children have no health insurance.  Nearly three million children nationwide each year are reported abused and neglected.  As Americans, we need to ask ourselves:  Does every child in the U.S. deserve an equal opportunity to be healthy and survive to adulthood? Is there a floor below which no American child should fall, regardless of the accident of geography that accounts for where they are born and raised? It should no longer be politically acceptable to permit – or simply ignore -- the vast differences in life chances that exist for children today.”

Elizabeth J. Clark, Ph.D., ACSW, MPH, executive director, National Association of Social Workers, Washington, D.C., said: “As social workers working with the most troubled children and families across the country, we have always known about the disparate treatment of children from state to state.  We look forward to a national commitment to protect all children, to create equal opportunities, and to strengthen families and communities.  We know that more can be done to ensure that our children have the supports they need to thrive, no matter what state they call home.”
 
KEY REPORT FINDINGS
 
• Infant mortality.  Children born in the bottom 10 states are 70 percent more likely to die before their first birthday than children in the top 10. In Louisiana, the infant mortality rate is more than twice as high as in Montana and Vermont.
 
• Child mortality.  A child in the bottom 10 states is twice as likely to die by the age of fourteen as a child in the top 10. In South Dakota, the child mortality rate is 3.5 times higher than in Rhode Island.
 
• Inadequate prenatal care. Women in the bottom 10 states are more than twice as likely to receive inadequate prenatal care as women in the top 10 states. In New Mexico, women are more than 5 times as likely to receive inadequate prenatal care as women in Rhode Island or Vermont.
 
• Child poverty.  A child living in the bottom 10 states is twice as likely to live in poverty as a child in the top 10.  In Mississippi, the child poverty rate is 3 times greater than in Maryland or New Hampshire.
 
• Child abuse and neglect.  Children in the bottom 10 states are 6.7 times more likely to die from abuse and neglect as children in the top states. In Oklahoma, children are 13 times more likely to die from abuse or neglect as those in Maine. 
 
• Lack of health insurance.  Children in the bottom 10 states are 2.8 times as likely to be uninsured as children in the top 10. In Texas, a child is 5 times as likely to be uninsured as a child in Rhode Island.
 
• Teen pregnancy.  Teens in the bottom 10 states give birth at a rate twice as high as those in the top 10. In Texas, the teen birth rate is 3.5 times that of New Hampshire.
 
• Teen death.  Teens in the bottom 10 states are more than twice as likely to die between 15-19 as those in the top 10. In Alaska, the teen death rate is more than 2.5 times higher than in Hawaii.
 
• Teen incarceration.  Juveniles in the bottom 10 states are more than twice as likely to be incarcerated as juveniles in the top 10.  In Wyoming, the juvenile incarceration rate is more than 8 times Vermont’s.
 
What explains the differences between the states on key child well-being standards?  

In addition to poverty, race and educational achievement, the Every Child Matters Education Fund identifies the following factors:

•  Political Culture: The bottom states generally have a narrower view of the role of government in addressing social issues.

•  Taxes: The bottom states generally tax themselves at much lower rates, leaving themselves without the revenue needed to make adequate investments in children. There is a close correlation between state tax burdens and child wellbeing 

•  Weak Federal Policy: Federal initiatives to address the well-documented needs of children across the country -- health care, child abuse, poverty -- have been scant.

•  Declining Federal Investments: Federal investments in children, historically structured in a way meant to level differences between states, have declined sharply as a percentage of the federal budget in recent years -- and they are projected to decline more sharply in the decade ahead.”

RECOMMENDED ACTION STEPS
 
The following recommendations are contained in the ECMEF report to make this issue a greater priority moving forward: 
 
•  Congressional hearings; 
 
•  Policy positions on children’s issues should be put forward by the presidential candidates; 
 
•  The new administration in 2009, led by the Department of Health and Human Services, should convene a national conference to examine the disparities in child well-being among the states and make recommendations for closing this gap to the new president; 
 
•  The national associations that represent state and local governments—mayors, governors, legislatures, counties—should place differences in child well-being on their policy agendas for review and action; 
 
•  The private sector--corporations, professional associations, and foundations -- should consider the issue for review and action; and 
 
•  Scholars and the press should conduct a deeper review of the issue.
 
As the ECMEF report notes:  “Closing the disparities in child well-being among the states is achievable. Targeted investment strategies over a decade and longer will be required, strategies whose chances of success are greater if they are jointly arrived at between state and federal lawmakers. But as necessary as joint partnership is, it cannot rely solely on voluntary cooperation -- the lives of too many children are at stake.”