Kentucky ranks 40th in child well-being, 3 slots lower than 2021; child obesity and underweight births up, child death rate way up

By Melissa Patrick
Kentucky Health News

Kentucky, where nearly one in four people are children, ranked 40th among states for the overall well-being of its children, dropping three slots from the last report, according to the 2023 Kids Count Data Book.

“As we look ahead to a contentious gubernatorial race this fall and a state-budget year for the General Assembly, now is the time to look more deeply at the needs of the child care sector and what it will cost the commonwealth – what it will cost our kids – if there’s no action,” Terry Brooks, executive director of Kentucky Youth Advocates, said in a news release. "The Data Book shows concerning trends in education, health, and family economics as we enter a post-pandemic world. Our elected officials must use this as a place of common ground and as a springboard for action in 2024."

The Data Book, released June 14 by KYA and the Annie E. Casey Foundation, rates children's overall well-being through 16 indicators in four major domains: health, economic security, education and family and community.

Overall, Kentucky saw improvements in four of the 16 indicators, all of them in the family and community category, did worse in nine of them and and stayed the same in three. Here is a look at each domain. 

Health: Kentucky's ranking dropped for the third year in a row, with three indicators used to measure health worsening. This year's report ranks the state 40th, down from 35th last year. 

This year's report shows 41% of Kentucky's children are either overweight or obese in 2020-21, up from 37% in 2018-19.  The national rate is 33%. 

The state also saw a big increase in the rate of deaths of children. It rose to 37 deaths per 100,000 in 2021, up from 29 per 100,000 in 2019. 

It also saw an increase in the rate of babies born weighing less than 5.5 pounds, which is considered underweight. That rate increased to 9.1% in 2021 from 8.7% in 2019. 

The only good news in this section is that the share of Kentucky's children with health insurance stayed the same between 2019 and 2021, 4%.

Education: Kentucky ranked 29th in the report's Education domain, down from 26th last year.  The good news was  that 91% of the state's high school students graduate on time, well above the national rate of 86%. And, this rate has held steady between 2018-19 and 2019-20. 

The other three indicators of education worsened. By far, the biggest change was seen in the percentage of eighth-graders not proficient in math, increasing to 79% in 2022 from 71% in 2019.  The percentage of fourth-graders not proficient in reading also increased, to 69% in 2022, up from 65% in 2019. And the share of preschool-age children not in nursery school, preschool or kindergarten increased to 60% in 2017-21, up from 58% in 2012-16. 

Economic well-being: Kentucky ranks 41st in economic well-being, down from 38th in last year's report, with three indicators worsening since 2019. 

The percentage of children whose parents lacked secure employment increased to 33% in 2021 from 31% and teens not in school or working increased to 9% from 8%. Also, the percentage of Kentucky children living in households with a high housing cost burden increased to 24% in 2021 from 23% in 2019. A high housing-cost household is defined as one where more than 30% of monthly household pre-tax income is spent on housing-related expenses, including rent, mortgage payments, taxes and insurance.

The report says that in 2021, 22% of Kentucky's children lived in families with incomes below the poverty threshold, defined then as a family of two adults and two children with an income below $27,479. This rate was the same in 2019. 

Family and Community: Kentucky ranked 42nd in this domain, the same as last year. It showed improvement in all indicators, including children living in high-poverty areas (12%), children living in families where the household head lacks a high school diploma (10%), children living in a single-parent household (33%), and teen births. In 2021, there were 22 teen births per 1,000 females aged 15-19. In 2019, that number was 25 per 1,000. In 2021, the national rate was 14 per 1,000. 

The Kids Count Data Center provides current and trend data for child well-being indicators related to each of the four domains in the report, at both a state and county level. It also offers a feature to create customized tables, maps, bar charts and graphs.

Focus on child care

This year's report also explores how the lack of affordable and accessible child care shortchanges children and causes parents to frequently miss work or even quit their jobs, and those who can find child care pay dearly for it. 

Brooks said, “Without safe child care they can afford and get to, parents face impossible choices, affecting not only their families, but their employers as well. These consistent challenges facing the child care infrastructure – accessibility, cost, and low wages for the workforce – impact the commonwealth’s economy, parents’ ability to advance in careers, and the early learning of our youngest Kentuckians.”

KYA called on the state to invest in child care in the same way it does other core infrastructure, like roads and emergency-response systems. 

It also called on public and private leaders to work together to improve the infrastructure for family child-care homes by increasing access to startup and expansion capital. 

And it called on Congress to reauthorize and strengthen the Child Care and Development Block Grant Act, to increase funding for public pre-kindergarten and Head Start and to expand the federal Child Care Access Means Parents in School program, which serves student parents.