Kids Count report: Alabama still 45th in childhood well-being

The most recent Kids Count report ranked Alabama 45th in the well-being of children, due to infant mortality rates and difficulties accessing child care. (Getty Images)

Alabama ranked 45th overall among U.S. states for childhood well-being, the same rank as the previous year, according to the latest Kids Count Data Book.

“For years, we have discussed how the face of our state continues changing – we are aging and growing more diverse,” wrote VOICES for Alabama’s Children Executive Director Rhonda Mann in an opening letter with the report, released earlier this month. “More than ever, it is critical to be mindful of the opportunity gaps in child well- being that disproportionately affect child populations of color and the implications as we shift to a minority-majority.”

The report ranks the states based on indicators including within health, education, safety and economic security. According to the report, the infant mortality rate has decreased overall in Alabama since 1992 but went up year-over-year, with Black infant mortality rates remaining much higher than rates in white communities. More children in the state have health insurance since 1990, but fewer have access to health care facilities due to closures in rural areas.

 Oklahoma, Nevada, Mississippi, Louisiana and New Mexico placed behind Alabama.

Apreill Hartsfield, a policy and data analyst for VOICES for Alabama’s Children, said that the change in demographics is what stands out the most in this year’s book.

The child population is declining and becoming more diverse. Children made up 28.2% of Alabama’s population in 2000; it was 24.6% in 2002.

“The Hispanic population of children — they’re the ones that are going the fastest, and as far as demographics, and they tripled from 2000 to 2022,” she said.

Hartsfield said that child poverty rates have been steadily rising since 2000 across all age groups in Alabama, but the Hispanic and Black childhood demographics have been the most impacted.

“Both of those are affected at more than two times the rate of the white child population,” she said.

In 2000, 12.0% of white children lived in poverty. That number went up to 13.5% between 2017-2021, per the report. In 2000, 29.1% of Hispanic children lived in poverty compared to 36.7% in 2017-2021.

Poverty among Black children declined during the period but remains substantially high. In 2000, 40.5% of Black children lived in poverty; from 2017-2021, the number was 38.3%.

Shelby County had the highest median household income by hourly wage at $41.09 per hour. Sumter County had the lowest at $14.18 per hour.

Infant mortality increased from seven deaths per 1,000 live births in 2020 to 7.6 deaths per 1000 in 2021. She said that small increase represents 443 babies.

“Almost 25 First Class pre-K classes, just to kind of put that in terms of what does this really look like,” Hartsfield said.

In 2022, the number decreased to 6.7 per 1000 live births, but was still at 12.4 per 1000 for Black infants.

Kids Count cites a 2023 March of Dimes report that estimates that more than a third of Alabama counties could be considered maternity care deserts. More than a fourth of women in Alabama do not live within 30 minutes of a birthing hospital.

“It tells a deeper story about infant mortality rate if you don’t have the access to care,” Hartfield said. “If moms can’t be healthy, then they can’t bring healthy babies into the world.”

She said that infant mortality rates are good predictors of overall health for children in a general society.

“Because it’s looking at all of the indicators, all the factors that go into what makes a baby healthy, what helps the baby live past their first year of life,” she said. “All the different indicators, factors such as the environment, environmental factors, the economy. So it can give us a different look at not just children but also society in general.”

A similar indicator is low-weight birth, she said, which was 10.5% in 2021, compared to 8.5% nationally.

“That goes back to the health of the mom, factors relating to before she even gets pregnant,” she said.

Hartsfield said that one of VOICES’ priorities in the 2024 legislative session was expanding access to health care for those in the “coverage gap:” people who aren’t eligible for Medicaid but can’t . She said that women without health care are likely not going to the doctor before they are pregnant.

“If there’s any kind of issues going on, those are not addressed, so we have to kind of take a step back and look at all of the whole lifespan of that mom before she gets pregnant,” she said. “So while it’s important to have that care, during pregnancy and immediately after pregnancy, it’s also important for her to have access to health care before she gets pregnant.”

While there are growing gaps in access to health care, the report found that 97% of children are covered by some form of health insurance. Early intervention services for children three and under with development delays have also increased.

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