Alabama regressed in child well-being ranking but could improve in future post-pandemic data

Alabama fell four ranks in overall child well-being in the national Kids Count numbers released last week. 

Alabama ranks 43rd in overall child well-being, according to the data. That ranking is determined by four sub groups: economic well-being, education, health, and family and community. Alabama declined in all four indicators. 

Apriell Hartsfield, director of Voices for Alabama Children, said in an interview Wednesday that it is important to look at how the state has improved or regressed independently, rather than how the state ranks nationally.

“There’s two different stories there. One is looking at the ranking, how we compare to other states,” Hartsfield said. “The other story is the one that we try to focus on more. That’s how we compare against ourselves from year to year.”

The state-level Kids Count data was released in February and showed an improvement overall. The state data book has more indicators than the 16 in the national book.

Health

The state’s largest fall compared with last year was in the health category, from 39th to 44th. The indicators for the category are low birth-weight babies, children without health insurance, child and teen deaths, and children and teens who are overweight or obese. The data for the health category is from 2023. 

Dr. Wes Stubblefield, district health officer for the Alabama Department of Public Health, said in an interview Wednesday that data like KidsCount informs public health policy.

“This is something that we need to make sure that we’re keeping an eye on when it comes to children and their health, their ongoing health, their education, and getting the best start as possible,” Stubblefield said.

The state improved from 2019 to 2023 in one area of the health category. According to the Kids Count data, 10.4% of babies born in Alabama in 2023 were underweight, which is down 0.1% from 2019 and 2% higher than the national average. Stubblefield said there are many factors in low birth weight, including chronic health issues in mothers, which he said need to be managed before and during pregnancy.

“Sometimes these individuals may not be covered by Medicaid,” he said. “Programs to treat moms with chronic health conditions, either before they get pregnant or during pregnancy, is very important.”

Making sure people with chronic conditions get in to see their obstetricians and ensuring they’re not on medications that affect the health of the fetus are also key, he said.

Four percent of Alabama children did not have health insurance in 2023, according to the research, and that’s one point more than the year before. Stubblefield said that data point is historically low because of a program called All Kids funded through the state and federal government for children who are above the threshold for Medicaid but still can’t afford private health insurance.

“We’re better than the national average, although it did go up. I’m not exactly sure what contributed to that,” he said.

Hartsfield said the end of a pandemic-era policy that prevented states from disenrolling Medicaid beneficiaries was one factor. That resulted in about 370,000 Alabamians losing Medicaid coverage. Although the number of children that lost Medicaid coverage in 2023 is not available, those who did likely qualified for All Kids coverage.

“There just weren’t the resources there to provide for children, or there was some kind of administrative barrier, as far as the unwinding process,” she said.

Education

The second largest decline in the rankings was in education, from 34th to 38th. The indicators for the category are young children not in school (data from 2019-2023), fourth graders not proficient in reading (2024), eighth graders not proficient in math (2024), and high school students not graduating on time (data from 2021-2022). 

The Kids Count data showed that 82% of eighth graders were not proficient in math, which is 3% more than the 2019 data. Hartsfield said the regression and general lack of proficiency is likely due to the cohort of eighth graders missing the classroom instruction of foundational math during the pandemic.

Hartsfield said the recent gains in education, like the improved National Assessment of Educational Progress and Alabama Comprehensive Assessment of Progress scores, are directly related to the Numeracy and Literacy acts of 2022 and 2019, respectively. 

Still, according to the Kids Count data, 72% of fourth graders are not proficient in reading, which is consistent with data from the NAEP scores released in January. The state did not improve or regress in this category.

Those rankings may improve next year, Hartsfield said. Scores released by the Alabama State Department of Education last week showed that third-grade reading proficiency has improved, despite an increased cutoff score.

“I do anticipate that it will show some improvements in the kids count data next summer, hopefully,” Hartsfield said.

Preschool is not required in the United States, and the research shows 57% of young children in Alabama are not in school. Hartsfield said the state’s First Class Pre-K program has helped get 4-year-olds in school, and the federally funded Head Start program has helped prepare 3-year-olds.

She said that the pre-K program often has waiting lists. If a family is able to travel to a different location without a waiting list, she recommended they do it. 

“Don’t let your child miss the program if you are able to get them down the road a little bit, in the next community over,” she said.

Economy

The state lost one rank in economic well-being over the year from 35th to 36th. The state did not see a shift in the number of children in poverty, and Hartsfield said there is a much bigger picture to look at.

“More than 1 in 5 children in Alabama live in poverty,” she said. “As I’ve said before, poverty does not define a child. However, the challenges that children in poverty face can have lifelong, really harsh effects.”

Family and community

Although Alabama’s rank did not change in the family and community category, the state improved in all four indicators within the category.

“In the family and community domain, I really feel like the investments that we’ve made in the education domain, especially in pre-K through 12, there’s tangible evidence of those policies and those investments that we’ve made in those policies working,” Hartsfield said. 

Most of the improvements were minor, but the largest was the number of teen births per 1,000 teens, falling from 26 to 20, according to the data. Children living in high-poverty areas also fell, 15% to 11%.

“While progress is uneven, the direction is clear. We know what kids need to grow up healthy and connected: stable homes, strong schools, nutritious food, meaningful relationships and opportunities to learn, play and grow,” Lisa Lawson, Annie E. Casey Foundation CEO and president, wrote in the data book’s foreword. “This moment calls for focus, creativity and commitment. It calls on leaders at every level to act boldly where improvement is needed and rely on what we know works.”