Child Health USA 2003

State Data

State Data

While the indicators presented in the previous sections of this book are representative of the U.S. as a whole, the next section presents State-level health and health care indicators; specifically, data on infant, neonatal, and perinatal mortality, low birth weight, early prenatal care, births to women under 18, health care financing for children, Medicaid enrollment and expenditures, and CHIP enrollment.

The following pages reveal stark differences in the health status of children living in different states. Women living in the District of Columbia and the southern States of Alabama, Louisiana, Mississippi, and South Carolina, were more likely to give birth to low birth weight babies (less than 2,500 grams or 5 pounds 8 ounces) than women in other regions of the country. These States, in addition to New Mexico and Texas, also had the highest rates of births to women under 18 years of age.

Poverty in the U.S. continued to rise steadily during the last three decades. Poverty affects living conditions and access to health care and nutrition, all of which contribute to health status. Title XIX of the Social Security Act (Medicaid) and the Children's Health Insurance Program (CHIP) were designed to assure that children living in low-income families have access to insurance coverage and receive adequate health care services. In 2002, Mississippi, New Mexico and the District of Columbia had the greatest proportion of children with Medicaid/CHIP coverage (over 40 percent), while Colorado had the smallest proportion (10.6 percent). Vermont had the lowest proportion of uninsured children (3.5 percent) while Texas led the Nation with the highest proportion of uninsured children at 21.5 percent.

The challenge to health care providers and policy-makers continues to be eliminating the differences among States while improving the health status of children throughout the entire Nation.

Low Birth Weight and Prenatal Care

Percentage of Infants Born at Low Birth Weight, Women Receiving First Trimester Prenatal Care, and Births to Women Under 18, by State and Race of Mother: 2001
Source (IV.1, IV.2): National Center for Health Statistics

States	Low Birthweight			Early Prenatal Care			Births Under 18
States	All**	White	Black	All**	White	Black	All**	White	Black	Hispanic
United States***	7.7	6.7	13.0	83.4	85.2	74.5	3.8	3.3	7.3	5.8
Alabama	9.6	7.6	14.0	82.4	87.4	71.7	5.2	3.8	8.3	5.6
Alaska	5.7	5.2	10.9	80.5	84.2	82.3	3.2	1.8	3.9	4.3
Arizona	7.0	6.7	13.7	76.7	77.4	75.8	5.0	4.9	7.5	7.6
Arkansas	8.8	7.5	14.1	79.8	82.4	69.9	5.2	4.1	9.5	6.2
California	6.3	5.8	11.6	85.4	85.4	82.5	3.4	3.6	5.1	5.0
Colorado	8.5	8.2	14.0	79.8	80.2	72.7	3.7	3.6	5.8	7.4
Connecticut	7.4	6.7	12.1	88.7	89.7	81.9	2.5	2.2	5.5	7.2
Delaware	9.3	7.7	13.7	87.2	88.9	81.5	4.3	3.2	8.1	7.0
DC	12.1	6.3	15.3	74.4	84.2	68.7	5.0	1.7	7.0	3.9
Florida	8.2	6.8	12.5	84.1	87.0	75.1	4.1	3.2	7.5	4.4
Georgia	8.8	6.7	12.9	86.2	88.9	80.6	4.6	3.6	7.0	5.0
Hawaii	8.1	6.5	11.4	84.2	88.5	92.0	3.0	0.9	0.9	4.9
Idaho	6.4	6.4	*	81.8	82.0	81.0	3.0	3.0	3.5	8.1
Illinois	8.0	6.6	13.7	84.0	86.5	72.9	3.8	2.7	9.1	5.2
Indiana	7.6	7.0	12.9	80.6	82.1	68.9	3.7	3.1	8.0	4.9
Iowa	6.4	6.1	13.7	88.4	88.9	79.0	2.9	2.6	9.3	7.3
Kansas	7.0	6.5	12.4	86.9	87.6	79.5	3.6	3.4	7.6	6.8
Kentucky	8.3	7.8	13.4	86.7	87.5	79.3	4.0	3.7	7.5	4.5
Louisiana	10.4	7.7	14.4	83.2	90.4	73.4	5.6	3.2	9.0	3.0
Maine	6.0	6.0	*	88.2	88.3	79.7	2.4	2.3	2.6	2.3
Maryland	9.0	7.0	12.9	83.7	87.7	76.5	3.4	2.1	6.1	4.4
Massachusetts	7.2	6.8	10.2	89.7	91.3	79.5	2.1	1.8	4.4	7.2
Michigan	8.0	6.6	14.1	84.5	87.8	69.3	3.4	2.5	7.5	5.7
Minnesota	6.3	5.9	9.8	84.5	87.1	66.5	2.4	1.9	6.0	5.3
Mississippi	10.7	7.8	14.3	82.7	89.3	74.9	6.5	4.0	9.5	6.3
Missouri	7.6	6.7	12.6	87.7	89.2	78.7	3.9	3.2	8.3	6.0
Montana	6.9	6.9	*	82.6	85.3	82.9	3.6	2.8	4.8	5.0
Nebraska	6.6	6.3	12.4	83.2	84.5	68.0	3.2	2.7	9.8	6.0
Nevada	7.6	7.0	13.0	75.7	76.3	67.6	4.1	3.9	8.0	5.6
N. Hampshire	6.5	6.4	13.9	90.6	91.0	79.5	1.8	1.9	3.4	5.1
New Jersey	7.9	6.8	12.6	79.8	83.3	63.4	2.3	1.7	5.7	4.8
New Mexico	7.9	7.9	13.1	69.0	70.3	65.8	6.4	6.5	7.8	8.6
New York	7.7	6.7	11.3	80.5	83.9	70.3	2.7	2.3	5.0	4.7
North Carolina	8.9	7.3	13.8	84.4	87.3	75.9	4.2	3.2	7.3	5.8
North Dakota	6.2	6.1	*	85.8	88.4	78.4	2.3	1.8		5.7
Ohio	8.0	7.0	13.4	87.3	89.1	77.2	3.6	2.8	8.4	6.5
Oklahoma	7.8	7.3	13.6	77.4	79.5	69.2	4.8	4.1	8.5	7.5
Oregon	5.5	5.4	10.1	81.5	81.8	76.6	3.4	3.4	5.8	6.4
Pennsylvania	7.9	6.9	13.7	85.2	87.4	72.9	3.2	2.4	8.7	8.0
Rhode Island	7.3	6.7	11.8	91.4	92.4	84.5	3.5	3.1	6.2	7.4
South Carolina	9.6	7.3	14.0	79.2	84.3	69.5	5.0	3.5	8.2	5.9
South Dakota	6.4	6.3	*	78.3	82.2	59.0	3.4	2.1	5.9	3.9
Tennessee	9.2	8.0	13.6	82.8	85.7	72.2	4.6	3.8	8.0	6.0
Texas	7.6	6.9	12.9	80.3	80.5	77.0	5.4	5.3	7.6	7.2
Utah	6.4	6.4	10.8	79.3	80.3	61.7	2.3	2.3	4.7	5.7
Vermont	5.9	5.9	*	89.3	89.3	77.4	2.2	2.2	6.5	5.7
Virginia	7.9	6.5	12.5	85.1	87.8	76.5	3.1	2.2	6.7	3.6
Washington	5.8	5.5	9.8	83.2	83.8	77.0	3.0	2.9	4.3	6.3
West Virginia	8.5	8.4	11.5	86.3	86.8	76.2	4.0	3.9	8.1	1.2
Wisconsin	6.6	5.9	13.1	83.8	86.2	69.6	3.3	2.2	11.1	6.5
Wyoming	8.3	8.0	*	82.9	83.4	83.1	3.7	3.6	4.6	7.9

* Figure does not meet standards of reliability or precision.
** Includes races other than White or Black.
*** Excludes data for the territories.

Medicaid Enrollees

Medicaid Enrollees, Expenditures, and Reported Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Utilization for Children Under Age 21: FY 2000
Source (IV.3, IV.4): Centers for Medicare and Medicaid Services

States	Medicaid Enrollees*	Per Enrollee Expenditure**	Participant Ratio***
Alabama	387,482	931	0.43
Alaska	72,558	2,665	0.51
Arizona	436,164	1,882	N/A
Arkansas	289,370	1,755	0.25
California	3,849,152	1,143	N/A
Colorado	221,109	2,101	N/A
Connecticut	230,067	1,657	0.57
Delaware	66,316	2,415	0.65
DC	82,701	2,489	N/A
Florida	1,245,949	1,449	0.45
Georgia	780,145	1,301	0.43
Hawaii	N/A	N/A	0.67
Idaho	103,015	1,641	N/A
Illinois	1,042,649	1,510	0.68
Indiana	478,900	1,444	0.50
Iowa	172,243	1,985	N/A
Kansas	162,695	1,555	N/A
Kentucky	401,986	2,056	N/A
Louisiana	513,346	1,202	0.58
Maine	103,265	3,641	N/A
Maryland	427,123	2,439	N/A
Massachusetts	499,912	1,825	0.70
Michigan	809,240	1,050	N/A
Minnesota	330,045	2,224	0.50
Mississippi	350,486	1,273	N/A
Missouri	572,899	1,354	0.52
Montana	53,451	2,234	N/A
Nebraska	151,568	1,611	0.64
Nevada	94,746	1,672	N/A
N. Hampshire	67,541	2,058	0.40
New Jersey	491,360	1,936	0.32
New Mexico	270,588	1,670	0.47
New York	1,525,759	2,681	N/A
North Carolina	688,402	1,692	0.68
North Dakota	33,364	1,750	N/A
Ohio	822,277	1,570	N/A
Oklahoma	384,761	1,169	0.31
Oregon	263,455	1,670	0.54
Pennsylvania	861,341	1,874	0.58
Rhode Island	92,938	2,113	N/A
South Carolina	453,295	1,452	0.34
South Dakota	62,572	1,755	0.40
Tennessee	709,954	1,543	0.30
Texas	1,706,960	1,534	N/A
Utah	131,408	1,808	N/A
Vermont	69,596	2,118	N/A
Virginia	398,334	1,424	N/A
Washington	568,245	1,235	N/A
West Virginia	196,345	1,441	N/A
Wisconsin	331,047	1,630	N/A
Wyoming	32,193	1,594	0.39

* Unduplicated number of individuals under the age of 21 determined to be eligible for EPSDT services (FY 2000 416 Report).
** Represents total Medicaid vendor payments by age divided by Medicaid eligibles under 21 (FY 2000 MSIS Report).
*** This ratio indicates the extent to which Medicaid eligibles receive any initial and periodic screening services during the year (FY 2000 416 Report).

CHIP

Children's Health Insurance Program (CHIP) Aggregate Enrollment Statistics: 2002
Source (IV.5): Centers for Medicare and Medicaid Services

States	Type of CHIP*	Date Implemented	Upper Eligibility Level**	Total CHIP Enrollment
Alabama	COMBO	02/01/98	200%	83,359
Alaska	MEDICAID	03/01/99	200%	22,291
Arizona	SEPARATE	11/01/98	200%	92,705
Arkansas	MEDICAID	10/01/98	100%	1,912
California	COMBO	03/01/98	200%	856,994
Colorado	SEPARATE	04/22/98	185%	51,826
Connecticut	COMBO	07/01/98	300%	21,346
Delaware	SEPARATE	02/01/99	200%	9,691
DC	MEDICAID	10/01/98	200%	5,060
Florida	COMBO	04/01/98	200%	368,180
Georgia	SEPARATE	11/01/98	235%	221,005
Hawaii	MEDICAID	07/01/00	200%	8,474
Idaho	MEDICAID	10/01/97	150%	16,895
Illinois	COMBO	01/05/98	185%	68,032
Indiana	COMBO	10/01/97	200%	66,225
Iowa	COMBO	07/01/98	200%	34,506
Kansas	SEPARATE	01/01/99	200%	40,783
Kentucky	COMBO	07/01/98	200%	93,941
Louisiana	MEDICAID	11/01/98	200%	87,675
Maine	COMBO	07/01/98	200%	22,586
Maryland	COMBO	07/01/98	300%	125,180
Massachusetts	COMBO	10/01/97	200%	116,699
Michigan	COMBO	05/01/98	200%	71,882
Minnesota	MEDICAID	10/01/98	280%	NR
Mississippi	COMBO	07/01/98	200%	64,805
Missouri	MEDICAID	09/01/98	300%	112,004
Montana	SEPARATE	01/01/99	150%	13,875
Nebraska	MEDICAID	05/01/98	185%	16,227
Nevada	SEPARATE	10/01/98	200%	37,878
N. Hampshire	COMBO	05/01/98	300%	8,138
New Jersey	COMBO	03/01/98	350%	117,053
New Mexico	MEDICAID	03/31/99	235%	19,940
New York	COMBO	04/15/98	250%	807,145
North Carolina	SEPARATE	10/01/98	200%	120,090
North Dakota	COMBO	10/01/98	140%	4,463
Ohio	MEDICAID	01/01/98	200%	183,034
Oklahoma	MEDICAID	12/01/97	185%	84,490
Oregon	SEPARATE	07/01/98	170%	42,976
Pennsylvania	SEPARATE	05/28/98	200%	148,689
Rhode Island	MEDICAID	10/01/97	250%	19,515
South Carolina	MEDICAID	10/01/97	150%	68,928
South Dakota	COMBO	07/01/98	200%	11,183
Tennessee	MEDICAID	10/01/97	100%	NR
Texas	COMBO	07/01/98	200%	727,452
Utah	SEPARATE	08/03/98	200%	33,808
Vermont	SEPARATE	10/01/98	300%	6,162
Virginia	COMBO	10/22/98	200%	67,974
Washington	SEPARATE	02/01/00	250%	8,754
West Virginia	SEPARATE	07/01/98	200%	35,949
Wisconsin	MEDICAID	04/01/99	185%	62,391
Wyoming	SEPARATE	12/01/99	133%	5,059

* Program type as of January 30, 2003.
**Reflects upper eligibility level approved and in effect as of July 19, 2002.
NR - State did not report data

Health Insurance Status

Health Insurance Status of Children Through Age 18: 2001*
Source (IV.6): American Academy of Pediatrics

States	Percent with Private/Employer-Based Insurance	Percent Enrolled in Medicaid/CHIP	Percent Uninsured**
Alabama	64.7	26.1	9.1
Alaska	55.9	36.9	7.2
Arizona	59.5	22.8	17.7
Arkansas	53.4	34.2	12.4
California	58.6	26.0	15.3
Colorado	76.4	10.6	12.9
Connecticut	77.9	14.1	7.9
Delaware	77.0	14.4	8.6
DC	48.5	42.5	9.0
Florida	59.6	24.1	16.3
Georgia	61.5	23.2	15.2
Hawaii	68.0	22.4	9.6
Idaho	61.8	26.3	11.9
Illinois	70.4	18.9	10.7
Indiana	74.0	15.0	11.0
Iowa	79.2	15.9	4.8
Kansas	73.1	19.6	7.4
Kentucky	64.4	25.5	10.1
Louisiana	59.8	26.9	13.3
Maine	65.0	29.0	5.9
Maryland	78.8	11.8	9.4
Massachusetts	70.1	24.4	5.5
Michigan	71.7	20.1	8.1
Minnesota	79.5	14.9	5.6
Mississippi	46.6	41.9	11.5
Missouri	71.0	23.7	5.3
Montana	66.0	23.8	10.2
Nebraska	71.5	21.2	7.3
Nevada	71.9	13.1	15.1
N. Hampshire	77.7	14.9	7.4
New Jersey	74.3	14.2	11.5
New Mexico	43.0	41.7	15.3
New York	60.8	29.6	9.6
North Carolina	62.9	25.6	11.5
North Dakota	70.7	25.0	4.3
Ohio	71.0	21.1	7.9
Oklahoma	56.8	29.8	13.5
Oregon	66.0	23.2	10.9
Pennsylvania	72.6	19.5	8.0
Rhode Island	70.7	24.7	4.7
South Carolina	65.1	24.6	10.3
South Dakota	76.2	18.2	5.6
Tennessee	61.2	32.5	6.2
Texas	56.4	22.1	21.5
United States	65.3	22.8	11.9
Utah	72.9	15.4	11.6
Vermont	62.6	33.9	3.5
Virginia	79.6	12.2	8.2
Washington	65.6	23.1	11.3
West Virginia	56.2	35.2	8.7
Wisconsin	76.4	18.8	4.9
Wyoming	67.6	19.9	12.5

* Estimates for 2001 should not be compared directly with estimates prior to 2000 due to changes in survey design that decreased the uninsured estimate by about 8 percent.
**See map in next section.

Uninsured

Percentage of Children Under the Age of 19 Who Are Uninsured: 2001
Source (IV.6): American Academy of Pediatrics

Map: Percentage of Children Under the Age of 19 Who Are Uninsured: 2001

Infant and Neonatal Mortality

Infant and Neonatal Mortality Rates, by State and Race of Mother: 2000
Source (IV.7): National Center for Health Statistics

States	Infant Mortality***			Neonatal Mortality****
States	All*	White	Black	All*	White	Black
Alabama	9.4	6.6	15.4	5.8	4.0	9.8
Alaska	6.8	5.8	*	3.5	3.3	*
Arizona	6.7	6.2	17.6	4.3	4.0	9.7
Arkansas	8.4	7.0	13.7	4.8	3.7	9.2
California	5.4	5.1	12.9	3.7	3.5	8.3
Colorado	6.2	5.6	19.5	4.3	3.9	14.2
Connecticut	6.6	5.6	14.4	5.0	4.4	9.9
Delaware	9.2	7.9	14.8	6.4	5.4	10.6
DC	12.0	*	16.1	8.9	*	11.8
Florida	7.0	5.4	12.6	4.5	3.5	8.1
Georgia	8.5	5.9	13.9	5.7	3.9	9.4
Hawaii	8.1	6.5	*	6.1	5.5	*
Idaho	7.5	7.5	*	5.4	5.3	*
Illinois	8.5	6.6	17.1	5.8	4.7	10.8
Indiana	7.8	6.9	15.8	5.3	4.9	9.2
Iowa	6.5	6.0	21.1	4.2	3.9	*
Kansas	6.8	6.4	12.2	4.4	4.1	9.1
Kentucky	7.2	6.7	12.7	4.6	4.2	9.0
Louisiana	9.0	5.9	13.3	5.8	3.8	8.6
Maine	4.9	4.8	*	3.5	3.5	*
Maryland	7.6	4.8	13.2	5.6	3.6	9.8
Massachusetts	4.6	4.0	9.9	3.5	3.1	7.7
Michigan	8.2	6.0	18.2	5.7	4.2	12.9
Minnesota	5.6	4.8	14.6	3.7	3.2	9.9
Mississippi	10.7	6.8	15.3	6.6	3.9	9.8
Missouri	7.2	5.9	14.7	4.7	3.9	9.9
Montana	6.1	5.5	*	4.0	3.4	*
Nebraska	7.3	6.4	20.3	4.9	4.4	*
Nevada	6.5	6.0	12.7	4.1	4.0	*
N. Hampshire	5.7	5.5	*	4.0	3.9	*
New Jersey	6.3	5.0	13.6	4.3	3.5	8.9
New Mexico	6.6	6.3	*	3.7	3.7	*
New York	6.4	5.4	10.9	4.6	3.8	7.8
North Carolina	8.6	6.3	15.7	6.2	4.6	11.2
North Dakota	8.1	7.5	*	5.3	4.9	*
Ohio	7.6	6.3	15.4	5.3	4.4	10.7
Oklahoma	8.5	7.9	16.9	5.2	5.0	9.6
Oregon	5.6	5.5	*	3.6	3.6	*
Pennsylvania	7.1	5.8	15.7	5.0	4.2	10.3
Rhode Island	6.3	5.9	*	5.0	4.4	*
South Carolina	8.7	5.4	14.8	6.1	3.8	10.3
South Dakota	5.5	4.3	*	3.1	2.8	*
Tennessee	9.1	6.8	18.0	5.9	4.3	12.0
Texas	5.7	5.1	11.4	3.4	3.0	6.7
Utah	5.2	5.1	*	3.5	3.3	*
Vermont	6.0	6.1	*	3.8	3.9	*
Virginia	6.9	5.4	12.4	4.8	3.8	8.4
Washington	5.2	4.9	9.4	3.0	2.9	*
West Virginia	7.6	7.4	*	4.9	4.8	*
Wisconsin	6.6	5.5	17.2	4.4	3.7	10.5
Wyoming	6.7	6.5	*	4.6	4.6	*

* Figure does not meet standards of reliability or precision.
** Includes races other than White or Black.
*** Rates are deaths under one year per 1,000 live births in specified group.
**** Rates are deaths under 28 days per 1,000 live births in specified group.

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