Which are the best states for children's health care?

WalletHub has released its latest analysis of the best and worst states for children’s health care.

In order to determine which states offer the most cost-effective and highest-quality health care for children, WalletHub compared the 50 states and the District of Columbia across 33 key metrics. The data set ranges from the share of children in excellent or very good health to pediatricians and family doctors per capita. 

Key findings:

• Massachusetts has the lowest share of uninsured children aged 0 to 18, which is 7.8 times lower than in Texas, the highest. 
• Rhode Island has the lowest share of children aged 0 to 17 with unaffordable medical bills, which is three times lower than in Texas, the highest. 
• The District of Columbia has the most pediatricians per 100,000 residents, which is 25.4 times more than in Oklahoma, the fewest. 
• New Hampshire has the lowest share of obese children aged 10 to 17, which is 2.3 times lower than in Mississippi, the highest.

“The quality of children’s health care should be one of the most important considerations for parents when deciding where to live. Having access to quality pediatric and dental care, nutritious food and good spaces for recreation from a young age can give children a much better chance of growing up healthy and forming good habits that will last into their adult life,” said Cassandra Happe, a WalletHub analyst. “Massachusetts is the best state for children’s health, boasting the highest percentage of children who had both a medical and a dental preventative care visit in the past 12 months. Massachusetts also has one of the lowest infant mortality rates in the country, and one of the lowest death rates for children ages 14 and under. In the Bay State, only 1.5% of children lack health insurance, the lowest uninsured rate of any state.”

[Read more: Which cities are the healthiest?]

What are the most important steps parents can take to help their children grow up healthy?

“Making sure that children have periodic health checks, including well-baby care and all CDC-recommended vaccines, is very important to their healthy development," said Lawrence Gostin, university professor; founding O'Neill chair in global health law; co-faculty director, O'Neill Institute; director, WHO Collaborating Center on Global Health Law, Georgetown Law. "Dental care is just as important. But just as important is to ensure they lead healthy and safe lives at home, at school and in their daily lives. That means eating nutritious foods including fruits, vegetables and lean protein. It also means playing and getting physical activity. And finally, it means avoiding harmful behaviors like using illicit drugs, alcohol and tobacco. Children's mental health is also very important, and parents should give children a loving and safe environment and avoid excessive use of social media and screens.”

Abram Brummett, assistant professor of the Oakland University William Beaumont School of Medicine, offered this advice: “There are at least three actions that parents, healthcare providers, and the state can take to mitigate the mental health crisis among America's youth. The first would be to improve access via telehealth. Unlike some other forms of medical treatment, mental health services can be delivered via telehealth without compromising the standard of care. The telehealth option is especially useful for minors with limited transportation."

Brummett continued, "The second would be increasing the number of providers able to deliver this care. Becoming a therapist requires graduate training, and graduate school is expensive. Increasing financial assistance for therapists will help current students complete school at a higher rate and attract more students into these programs. Third would be raising awareness among youth that they can access mental health treatment without the involvement of their parents. While there is variability between states on issues like the minimum age, duration and the kind of mental health services available, states have used a ‘public health exception’ justification to grant minors access to treatment they might not otherwise pursue if their parents must be involved.” 

[Read more: Which states vaccinate the most?]

With America’s youth facing an ongoing mental health crisis, and nearly 60% of them with major depression not receiving treatment, what actions can parents and healthcare providers take to mitigate this crisis? 

"Children and teens are feeling socially isolated with increased rates of depression and anxiety. Government, organizations, schools and the healthcare system need to help facilitate social connections for youth. Schools working with parents and caregivers need to facilitate better social emotional learning tools and skills starting in the early grades," said Michael Doonan, professor at Brandeis University. 

Doonan added, "We need to address the adverse impact [of] social media. Rates of alienation and depression correlate not just with the pandemic but with universal access to smartphones in middle school. While social media can have a positive effect in supporting some children who feel marginalized, the impact on self-esteem and mental health are increasing[ly] well documented. Even if there weren’t such negative content, the number of hours children spend on devices including social media often leave no time for traditional real-world engagement with friends and family, for play, for being outdoors all of which are connect[ed] to good mental health…The healthcare systems need to be part of the solution. Screening children for mental health issues needs to be universal, but only in coordination with community base solutions. Problems need to be addressed before the pediatric psych ward. Physicians and other providers work with the patient in front of them assuming the given conditions of the person’s life. Increasingly they are doing this job under duress including time constraints, work overloads, inadequate staff and complex administrative burdens. We need to break out of this loop.”