Child Health USA 2003

 Child Health USA 2003

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Home | Table of Contents | Preface | Introduction | Population Characteristics |
Health Status-Infants
| Health Status-Children | Health Status-Adolescents |
Health Services Financing and Utilization
| State Data | City Data | References | Contributors

State Data

In this Section:
Low Birth Weight and Prenatal Care | Medicaid Enrollees | CHIP |
Health Insurance Status | Uninsured | Infant and Neonatal Mortality

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.

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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

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.

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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).

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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

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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.

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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

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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****

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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