States Providing the Most Support for Children

There are over 73 million children in the U.S., and only 10% of the federal budget goes toward supporting them. Ensuring their health, safety and development is critical for the continued growth of our country, but the quality of the support systems in place for children varies greatly from state to state.

In order to highlight the states providing the most support for children and the ones that need to improve the most, SmileHub compared each of the 50 states based on 27 key metrics. The data set ranges from the quality of public hospitals to the child well-being index ranking to spending per child enrolled in preschool.

If you want to support children in your community but don’t know where to donate, check out our picks for the Best Charities for Children in 2024.

• Main Findings
• Methodology

Main Findings

States Providing the Most Support for Children

Overall Rank*	State	Total Score	Health & Wellness Rank	Support System Strength Rank	Education System Rank	Family & Working Life Rank
1	Massachusetts	65.43	7	2	13	6
2	Minnesota	63.60	8	1	37	4
3	Rhode Island	62.56	4	6	23	7
4	Utah	61.83	12	3	41	1
5	New Hampshire	60.44	9	9	31	5
6	Nebraska	60.31	17	8	5	9
7	Virginia	58.89	11	4	19	25
8	Iowa	58.76	13	14	17	8
9	Pennsylvania	58.66	1	20	11	29
10	Vermont	57.48	2	43	4	16
11	Colorado	57.47	3	7	42	27
12	New Jersey	57.33	47	11	2	2
13	Idaho	56.60	5	5	48	11
14	Wisconsin	56.42	23	10	6	21
15	Washington	56.12	6	18	39	14
16	Connecticut	55.36	28	12	7	17
17	North Dakota	55.04	15	19	24	12
18	Maryland	53.07	16	22	14	24
19	Illinois	52.79	33	21	12	13
20	Delaware	52.50	18	24	20	18
21	California	51.14	14	41	30	10
22	Maine	50.19	26	13	9	44
23	Kansas	50.12	36	27	8	23
24	New York	49.46	34	15	15	36
25	Hawaii	48.98	19	34	28	26
26	Georgia	48.71	27	33	27	20
27	South Dakota	48.68	39	35	43	3
28	Michigan	48.35	35	17	29	34
29	Tennessee	47.40	30	32	21	31
30	Oregon	47.14	31	31	34	22
31	Texas	46.99	22	28	26	40
32	Ohio	46.98	21	36	33	30
33	Florida	46.59	20	16	38	46
34	Kentucky	46.43	38	23	10	37
35	Missouri	45.49	40	46	22	15
36	Arkansas	45.04	44	30	3	41
37	North Carolina	44.75	24	37	32	38
38	Wyoming	44.70	42	29	35	28
39	Alabama	44.01	37	40	18	39
40	Montana	43.46	10	44	45	43
41	Indiana	42.24	49	26	44	19
42	South Carolina	41.00	46	39	36	33
43	Mississippi	39.94	43	48	16	42
44	Louisiana	39.58	41	25	40	48
45	Arizona	39.54	29	38	50	35
46	Oklahoma	38.69	45	47	25	45
47	West Virginia	37.15	50	45	1	47
48	Alaska	36.48	32	50	47	32
49	Nevada	31.07	25	49	49	49
50	New Mexico	30.96	48	42	46	50

Notes: *1 = Best

With the exception of “Total Score,” all of the columns in the table above depict the relative rank of that state, where a rank of 1 represents the best conditions for that metric category.

Methodology

In order to identify the states providing the most support for children, SmileHub compared the 50 states across four key dimensions: 1) Health & Wellness, 2) Support System Strength, 3) Education System and 4) Family & Working Life.

We evaluated those dimensions using 27 relevant metrics, which are listed below with their corresponding weights. Each metric was graded on a 100-point scale, with a score of 100 representing the highest level of support for children. For metrics marked with an asterisk (*), the square root of the population was used to calculate the population size in order to avoid overcompensating for population differences across states.

We then determined each state’s weighted average across all metrics to calculate its overall score and used the resulting scores to rank-order the states.

Health & Wellness - Total Points: 30

• Share of Maltreated Children: Full Weight (~4.29 Points)

• Share of Children with All Seven Recommended Vaccines: Full Weight (~4.29 Points)

• Pediatricians & Family Doctors per Capita: Full Weight (~4.29 Points)

• State Policy for Medicaid-Covered Dyadic Treatment: Full Weight (~4.29 Points)

Note: This is a binary metric:

• 1 – The state covers services.
• 0 – The state does not cover services.

38 states cover
Dyadic treatment can help parents develop responsive, nurturing styles of interaction with their child that promote positive behavior and a parent- child relationship that fosters the child’s social-emotional growth.

• Life Expectancy at Birth: Full Weight (~4.29 Points)

• Quality of Public Hospitals: Full Weight (~4.29 Points)
  Note: This metric is based on public-hospital ratings from the Centers for Medicare & Medicaid Services.

• Quality of Pediatric Neonatology Facilities: Full Weight (~4.29 Points)
  Note: This metric is based on U.S. News & World Report’s “Best Hospitals for Neonatology” score.
  Neonatology consists of the medical care of newborn infants, especially the ill or premature newborn infant.
  

Support System Strength - Total Points: 25

• Children’s Charities per Capita*: Full Weight (~3.13 Points)

• Child Well-Being Index Rank: Double Weight (~6.25 Points)
  Note: The Annie E. Casey Foundation calculates a composite index of overall child well-being for each state by combining data across four domains: Economic Well-Being, Education, Health and Family and Community.

• Share of Nationally Accredited Child Care Centers: Full Weight (~3.13 Points)

• Number of Childcare Workers per Total Number of Children: Full Weight (~3.13 Points)
  Note: Childcare workers attend to the basic needs of children, such as dressing, bathing, feeding, and overseeing play. They may help younger children prepare for kindergarten or assist older children with homework.

• Unaccompanied Homeless Children & Youth Rate: Full Weight (~3.13 Points)

• Share of Children in Foster Care: Full Weight (~3.13 Points)

• State Policy for Medicaid-Covered Parenting Programs: Full Weight (~3.13 Points)

Note: This binary metric measures if a state has or does not have a Medicaid-covered parenting program.

• 1 – The state covers services;
• 0 – The state does not cover services.

17 states (34 percent) reported that Medicaid pays for parenting programs designed to help parents of young children promote children’s social-emotional development and address child mental health needs;
Evidence-based group parenting programs can help parents with young children acquire knowledge about children’s needs and increase their use of positive parenting behavior.

Education System - Total Points: 15

• State Spending per Child Enrolled in Preschool: Full Weight (~3.00 Points)

• Public High School Graduation Rate: Full Weight (~3.00 Points)

• Share of 3- and 4-year-olds Enrolled in Pre-K, Pre-K Special Education and Head Start Programs: Full Weight (~3.00 Points)
  Note: High-quality prekindergarten programs can improve school readiness, with the greatest gains accruing to the highest-risk children. Head Start and the expansion of state-funded programs since the 1990s have greatly increased access to preschool. But many children, especially 3-year-olds, continue to be left out, exacerbating socioeconomic differences in educational achievement.

  Total enrollment includes children in all three programs: Head Start, Early Head Start, and Migrant/Seasonal Head Start. Pregnant women are included in the “0 to 2” age category. The Early Head Start program serves children from birth to 3 years of age. The Head Start program includes children ages 3 to 5 years. Migrant/Seasonal Head Start includes those children from birth to 5 years old whose families earn their income primarily from agricultural work. Migrant families must have changed residence within the last two years; Seasonal families have not changed their residence in the last two years, but temporarily move for work.

• Teacher-per-Student Ratios in Elementary and Secondary School Classrooms: Full Weight (~3.00 Points)

• Share of Children Aged 6 to 17 Who Go to Safe Schools: Full Weight (~3.00 Points)
  Note: Share of children aged 6-17 years whose parents definitely agree that their children are safe at school.

Family & Working Life - Total Points: 30

• Low or Very Low Food Security for Babies: Full Weight (~3.75 Points)

• Share of Teens Neither Attending School, Nor Working: Full Weight (~3.75 Points)
  Note: “Teens” include the population aged 16 to 19.

• Share of Families with Young Children: Full Weight (~3.75 Points)
  Note: “Young Children” includes the population aged 0 to 17.

• Childcare Costs Relative to Household Income: Full Weight (~3.75 Points)

• Percentage of Children Whose Family Had Job Changes Due to Child Care Problems: Full Weight (~3.75 Points)
  Note: Job changes include quitting a job, not taking a job or greatly changing a job in the previous year.

• Child Food-Insecurity Rate: Full Weight (~3.75 Points)

• Parental-Leave Policy Score: Full Weight (~3.75 Points)

Note: This metric is based on the report card from Expecting Better: A State-by-State Analysis of Laws That Help Expecting and New Parents.
This report focuses on the federal and state workplace policies that expecting and new parents need just before and after the arrival of a child. These policies include:

• Paid and unpaid family and medical leave laws that allow people time away from work to care for a new child, address their own pregnancy- or childbirth-related disability or care for a spouse with a pregnancy- or childbirth-related disability;
• Laws that allow workers to use paid sick time to care for a spouse or partner recovering from childbirth and to attend prenatal and postnatal medical appointments;
• Laws that help nursing mothers continue to provide breast milk to their babies after returning to work;
• Pregnancy accommodation laws that allow pregnant women to continue working.
  

• Share of Children Aged 0 to 17 Who Live in a Supportive Neighborhood: Full Weight (~3.75 Points)
  Note: Percentage of children aged 0 to 17 who live in neighborhoods where people help each other out, watch out for each other’s children and know where to go for help in the community.
  “The concept of supportive neighborhoods, also referred to as neighborhood cohesion and social capital, describe communities that work together to create safe and orderly environments. Positive relationships and social connectedness within neighborhoods are important for both the social development and physical health of children and adolescents. Supportive neighborhoods can help parents by easing the burden of raising their children alone.”
  

 
Sources: Data used to create this ranking were collected from the U.S. Census Bureau, U.S. Department of Housing and Urban Development, Internal Revenue Service, Children’s Bureau, Bureau of Labor Statistics, Centers for Medicare & Medicaid Services, The Commonwealth Fund, National Center for Children in Poverty, County Health Rankings, Roadmaps, The Annie E. Casey Foundation, ChildCare Aware of America, U.S. News & World Report, National Institute for Early Education Research, Data Resource Center for Child & Adolescent Health, National Center for Education Statistics, National Partnership for Women & Families, Feeding America and ZERO to THREE.