The Best States For Children’s Health

As a parent, one of your top priorities is your child’s health. But as children grow and mature, they become more likely to encounter health issues. For example, 1.5% of children between the ages of 0 and 4 are in fair or poor health, compared to 3.8% of adolescents between the ages of 12 and 17 who are in fair or poor health. Keeping them covered with one of the best health insurance companies can help save on healthcare costs.

The cost of health insurance is often a barrier to coverage for many families, often leaving children without policies to get the care they need. However, the number of uninsured children has been falling in recent years; an estimated 3.9% (2.8 million) of children were uninsured in 2023, compared to 5.1% (3.7 million) in 2019. However, depending on their location, not all children have equal access to quality healthcare or may be impacted by different risk factors.

Forbes Advisor set out to uncover the best and worst states for children’s health by analyzing all 50 states and the District of Columbia across 17 health-related metrics pertaining to children. The data metrics span three categories: access to care, disease and risk factor prevalence, and lifestyle habits.

Key Takeaways:

• The best state for children’s health is Massachusetts and the worst state is Arkansas.
• Six of the 10 best places for children’s health are on the East Coast: Connecticut, the District of Columbia, Maryland, Massachusetts, New Hampshire and Vermont.
• Seven of the 10 worst states for children’s health are in the South: Arkansas, Kentucky, Louisiana, Mississippi, Oklahoma, Texas and West Virginia.
• Utah ranked as the state with the highest percentage of children in excellent or very good health (93.9%) and Mississippi ranked lowest (83.7%).
• Children were most likely to obtain needed health care in the past year in Ohio (with 1.8% of children being unable to receive care) and least likely in New Mexico (with 6.4% of children being unable to receive care).

The Best States For Children’s Health

1. Massachusetts

Massachusetts’ score: 100 out of 100

• Massachusetts ranked as the best state in our access to care category, including strong performance in the following metrics:
• The highest percentage of children that have health insurance (98.7%)
• The lowest percentage of children with private health insurance that didn’t cover mental or emotional problems (1.9%)

• Additionally, Massachusetts ranked in the top three states for the following:

• The second-lowest percentage of children who live in a household where someone smokes (7.5%)
• The third-lowest percentage of children who had decayed teeth or cavities in the past year (8.5%)

2. Maryland

Maryland’s score: 97.03 out of 100

• Maryland ranked as the best state in our disease and risk factor prevalence category, including strong performance in the following metrics:
• The second-lowest percentage of children who had decayed teeth or cavities in the past year (8.4%)
• The third-highest percentage of vaccinated children (85.5%)

• Additionally, Maryland ranked in the top five states in the following metrics:

• The third-lowest percentage of children who were unable to obtain needed health care in the past year (2.6%, tying with Minnesota and Pennsylvania)
• The fifth-lowest percentage of youth with a major depressive episode that didn’t receive mental health services (44.7%).

3. New Hampshire

New Hampshire’s score: 96.04 out of 100

• New Hampshire ranked as the second-best state in our access to care category, with the third-highest percentage of children that have health insurance (97.5%).
• Additionally, New Hampshire ranked in the top 10 states in the following:

• The lowest percentage of adolescents who are overweight and obese (21.9%)
• The lowest percentage of babies with a low birth weight (6.7%)
• The second lowest percentage of children that slept less than the recommended age-appropriate hours (25.9%)
• The sixth most children’s hospitals per 10,000 children (0.8)

4. Minnesota

Minnesota’s score: 92.70 out of 100

• Minnesota ranked in the top 10 states for the following:

• The third-lowest percentage of children who were unable to obtain needed healthcare in the past year (2.6%, tying with Maryland and Pennsylvania)
• The third-lowest percentage of children that slept less than the recommended age-appropriate hours (27.1%, tying with Washington)
• The sixth-lowest percentage of children who had decayed teeth or cavities in the past year (9.9%)
• The ninth-highest percentage of children who are physically active at least four days a week (56%)

5. Utah

Utah’s score: 91.84 out of 100

• Utah ranked as the best state in our lifestyle habits category, including strong performance in the following:
• The highest percentage of children in excellent or very good health (93.9%)
• The lowest percentage of children that slept less than the recommended age-appropriate hours (25.1%)

• Utah also ranked as the best state in the following:
• The lowest percentage of children who live in a household with someone who smokes (5.5%)
• The highest percentage of vaccinated children (86.4%)

• However, Utah ranked on the lower end in the following metrics, which kept the state from scoring higher overall:

• The sixth-highest percentage of youth with at least one major depressive episode (17.8%)
• The ninth-lowest percentage of children that have health insurance (93.7%)

6. Vermont

Vermont’s score: 86.8 out of 100

• Vermont ranked as the best state in the following metrics:
• The highest percentage of children who are physically active at least four days a week (62.3%)
• The lowest percentage of children who are physically active zero days a week (4.9%)
• The second-lowest percentage of children with private insurance that didn’t cover mental or emotional problems (2.1%).

• Additionally, Vermont has the third most children’s hospitals per 10,000 children (1.3)

7. Iowa

Iowa’s score: 82.27 out of 100

• Iowa ranked in the top 10 states in the following metrics:

• The lowest percentage of children with pre-existing conditions (20.1%)
• The second-lowest percentage of children who are physically active zero days a week (5.7%)
• The eighth-lowest percentage of children who were unable to obtain needed health care in the past year (2.8%, tying with Nebraska and West Virginia)
• The ninth-lowest percentage of youth who experienced a major depressive episode and didn’t receive mental health services (49.3%)

8. Washington

Washington’s score: 79.18 out of 100

• Washington ranked fourth best in our lifestyle habits category, including strong performance in the following:
• The second-highest percentage of children in excellent or very good health (93.6%)
• The third-lowest percentage of children that slept less than the recommended age-appropriate hours (27.1%, tying with Minnesota)

• Additionally, Washington ranked in the top five states in the following:

• The third-lowest percentage of babies with a low birth weight (7%, tying with Idaho)
• The fifth-highest percentage of vaccinated children (84.1%)

9. Connecticut

Connecticut’s score: 78.35 out of 100

• Connecticut ranked as the second best state in our disease and risk factor prevalence category, including strong performance in the following underlying metrics:
• The fifth-lowest percentage of children who had decayed teeth or cavities in the past year (9.8%)
• The 11th highest percentage of vaccinated children (81%)

• Additionally, Connecticut ranked in the top 10 states in the following:

• The third-lowest percentage of children with private insurance that didn't cover mental or emotional problems (3.5%)
• The 10th highest percentage of children that have health insurance (96.9%, tying with Delaware)

10. District of Columbia

District of Columbia’s score: 77.69 out of 100

• D.C. ranked third best in our access to care category, including strong performance in the following:
• The second most children’s hospitals per 10,000 children (3.1)
• The third-lowest percentage of youth with a major depressive episode who didn’t receive mental health services (41%)

• D.C. also ranked fourth best in our disease and risk factor prevalence category, including strong performance in the following:
• The lowest percentage of youth with at least one major depressive episode (11.4%)
• The fifth-lowest percentage of children who live in a household with someone who smokes (8.2%)

• Additionally, D.C. had the fifth highest percentage of children in excellent or very good health (92.5%, tying with Idaho, Maryland, Massachusetts and Montana)

The Worst States For Children’s Health

1. Arkansas

Arkansas’ score: 0.00 out of 100

• Arkansas ranked as the second worst state in our disease and risk factor prevalence category, including poor performance in the following:
• The fourth-highest percentage of children who live in a household where someone smokes (18.6%)
• The fifth-highest percentage of children with pre-existing conditions (31.1%)

• Arkansas ranked as the fourth worst state in our access to care category, including poor performance in the following:

• The highest percentage of children with private insurance that didn’t cover mental or emotional problems (17.7%)
• The fifth fewest children’s hospitals per 10,000 children (0.2)

2. Mississippi

Mississippi’s score: 1.81 out of 100

• Mississippi ranked as the third worst state in our access to care category, including poor performance in the following:
• The second-highest percentage of youth with a major depressive episode who didn’t receive mental health services (71.7%)

• Mississippi also ranked in the bottom five states in the following metrics:

• The highest percentage of babies with a low-weight (12.7%)
• The lowest percentage of children in excellent or very good health (83.7%)
• The second-highest percentage of adolescents who are overweight and obese (42.4%)

3. Oklahoma

Oklahoma’s score: 4 out of 100

• Oklahoma ranked as the third worst state in our lifestyle habits category, including poor performance in the following:
• The second-highest percentage of children who are physically active zero days a week (17.3%)
• The third-highest percentage of adolescents who are overweight and obese (40.5%)

• Oklahoma also ranked in the bottom five states in the following metrics:

• The third-lowest percentage of vaccinated children (61.2%)
• The fifth-lowest percentage of children that have health insurance (92.4%)

4. Arizona

Arizona’s score: 11.88 out of 100

• Arizona ranked as the second worst state in our access to care category, including poor performance in the following:
• The third-lowest percentage of children that have health insurance (91.6%)
• The fourth-highest percentage of youth with a major depressive episode who didn’t receive mental health services (70.1%)

• Arizona also ranked in the bottom 10 states in the following:

• The fourth-lowest percentage of children in excellent or very good health (87.6%)
• The tenth-lowest percentage of children who are physically active at least four days a week (44%)

5. New Mexico

New Mexico’s score: 12.25 out of 100

• New Mexico ranked as the second worst state in our lifestyle habits category, including poor performance in the following:
• The sixth-highest percentage of children who slept less than the recommended age-appropriate hours (41.3%)
• The seventh-highest percentage of youth with substance use disorder (5.4%)
• The eighth-lowest percentage of children in excellent or very good health (88.7%)

• New Mexico also ranked in the bottom five states in the following:

• The highest percentage of children who were unable to obtain needed health care in the past year (6.4%)
• The second-highest percentage of youth with at least one major depressive episode (18.6%)

6. Louisiana

Louisiana’s score: 14.31 out of 100

• Louisiana ranked in the bottom five states in the following:

• The highest percentage of children who have decayed teeth or cavities in the past year (15.8%)
• The highest percentage of children that slept less than the recommended age-appropriate hours (47.5%)
• The second-lowest percentage of children in excellent or very good health (86.8%)
• The second-highest percentage of babies with a low birth weight (11.5%)

7. Texas

Texas’ score: 14.64 out of 100

• Texas ranked as the worst state in our access to care category, including poor performance in the following:

• The lowest percentage of children with health insurance (89.1%)
• The highest percentage of youth with a major depressive episode who didn’t receive mental health services (73.1%)
• The highest percentage of children who are physically active zero days a week (19.3%)
• The third-lowest percentage of children in excellent or very good health (86.9%)

8. Kentucky

Kentucky’s score: 18.43 out of 100

• Kentucky ranked in the bottom 15 states in the following:

• The second-highest percentage of children who live in a household where someone smokes (23.5%)
• The fourth-highest percentage of children who slept less than the recommended age-appropriate hours (44.4%)
• The sixth-lowest percentage of vaccinated children (62.9%)
• The 12th highest percentage of adolescents who are overweight and obese (35.7%, tying with Alabama)

9. Nevada

Nevada’s score: 21.98 out of 100

• Nevada ranked as the worst state in our lifestyle habits category, including poor performance in the following:
• The lowest percentage of children who are physically active at least four days a week (36.2%)
• The third-highest percentage of youth with a substance use disorder (5.6%)

• Nevada also ranked in the bottom 10 states in the following:

• The fifth-highest percentage of youth with at least one major depressive episode (17.9%, tying with Alaska)
• The seventh-lowest percentage of children with health insurance (92.7%)

10. West Virginia

West Virginia’s score: 22.19 out of 100

• West Virginia ranked as the worst state in our disease and risk factor prevalence category, including poor performance in the following:
• The highest percentage of children who live in a household where someone smokes (26.8%)
• The fourth-lowest percentage of vaccinated children (62.2%)
• The sixth-highest percentage of children with pre-existing conditions (30.2%)
• The sixth-highest percentage of low-birth weight babies (10%)

• West Virginia also had the fourth-highest percentage of children who are overweight and obese (38.2%)

Children and Youth Health Statistics

• On average, 95.3% of children have health insurance in America.
• Nearly a third (31.3%) of American adolescents are overweight or obese.
• About three-quarters (74.4%) of American children are fully vaccinated.
• Children are nearly five times more likely to be physically active four days a week (49.2%) than zero days a week (10.4%).
• Just over 4% of youth report having a substance use disorder nationwide (4.3%).
• Accidents are the leading cause of death for children and adolescents between the ages of 1 to 17 years old.

Youth Mental Health Statistics

• 15.5% of youth experienced a major depressive episode in 2022.
• Over half (57.2%) of youth who experienced a major depressive episode in 2022 didn’t receive mental health services.
• About 8% of children with private health insurance didn’t cover mental or emotional problems.
• The District of Columbia had the lowest percentage of youth with at least one major depressive episode (11.4%) and Oregon had the highest (18.6%).
• Intentional self-harm (suicide) is the second leading cause of death for children between the ages 10 to 14 years old, and the third leading cause of death for adolescents between the ages 15 to 19 years old.

Health Insurance for Children

If you recently had a child or your child isn’t yet insured, it’s recommended that you get health insurance to keep your loved ones covered. The best health insurance companies cover doctor and hospital visits, medications, treatments and more.

Your child qualifies as one of your dependents and can be added to your current health insurance plan if you have one. They may remain on your plan as a dependent until age 26.

If you don’t yet have health insurance, search for the best affordable health insurance or look into child-only insurance plans, which are policies that cover only your children for medical bills or preventative care. You can get health insurance for children through the Affordable Care Act (ACA) at HealthCare.gov, Medicaid, the Children’s Health Insurance Program (CHIP), or directly through individual insurance companies.

According to Forbes Advisor's analysis of ACA rates, child-only plans cost an average of $300 per month for a child 15 years or younger. However, it’s important to note that the exact cost of health insurance for children varies depending on the type of plan, the specific coverage, the company, and other factors.

It’s also recommended that you get dental insurance and vision insurance for your child, as this essential care is often not covered by standard health insurance plans.

Methodology

To determine the best and worst states for children's health, Forbes Advisor compared all 50 states and the District of Columbia across 17 metrics spanning three categories: access to care, disease and risk factor prevalence, and lifestyle habits. Metrics and their corresponding weights are listed below.

Access to care - total points: 30

• The percentage of children who were unable to obtain needed health care in the past year: 7% of score. Data comes from the Data Resource Center for Child and Adolescent Health.
• The percentage of children that have health insurance in each state: 6% of score. Data comes from the Kaiser Family Foundation.
• The number of children's hospitals per 10,000 children: 6% of score. Data comes from Google and the Children’s Bureau.
• The percentage of children with private insurance that did not cover mental or emotional problems: 5% of score. Data comes from Mental Health America.
• The percentage of youth with a major depressive episode who did not receive mental health services: 6% of score. Data comes from Mental Health America.

Disease and risk factor prevalence - total points: 35

• The percentage of low birth-weight babies (>5.5lbs, note that data reflects the mother's place of residence, not where the baby is born): 6% of score. Data comes from the Annie E. Casey Foundation.
• The percentage of youth with at least one major depressive episode: 6% of score. Data comes from Mental Health America.
• The percentage of children with pre-existing conditions: 6% of score. Data comes from the Kaiser Family Foundation.
• The percentage of children who live in a household where someone smokes: 6% of score. Data comes from the Data Resource Center for Child and Adolescent Health.
• The percentage of vaccinated children: 5% of score. Data comes from the Kaiser Family Foundation.
• The percentage of children who have decayed teeth or cavities in the past year: 6% of score. Data comes from the Data Resource Center for Child and Adolescent Health.

Lifestyle habits - total points: 35

• The percentage of children who are physically active at least four days a week: 7% of score. Data comes from the Kaiser Family Foundation.
• The percentage of children who are physically active zero days a week: 4% of score. Data comes from the Kaiser Family Foundation.
• The percentage of adolescents who are overweight and obese: 6% of score. Data comes from the Kaiser Family Foundation.
• The percentage of children that slept less than the recommended age-appropriate hours: 5% of score. Data comes from the Data Resource Center for Child and Adolescent Health.
• The percentage of children in excellent or very good health: 7% of score. Data comes from the Data Resource Center for Child and Adolescent Health.
• The percentage of youth with substance use disorder: 6% of score. Data comes from Mental Health America.