A comprehensive national assessment reveals that children's wellbeing has deteriorated since 2019, with nearly three-fifths of U.S. states reporting measurable declines across health, education, and economic security measures.
The Annie E. Casey Foundation's latest Kids Count Data Book found the nation's overall child wellbeing score fell from 553 to 547 between 2019 and 2024. Conditions worsened in 29 states while only 15 showed improvement, signaling a troubling trajectory for young Americans as they approach adulthood.
The deterioration spans critical areas. Deaths among children and teens jumped 8 percent during the five-year window, reflecting what researchers describe as an intensifying mental health crisis among youth. Education performance dropped sharply, with reading and math proficiency declining in 47 states. The health category score fell from 624 to 607, driven partly by the mortality increase and broader wellness challenges.
Economic pressure on families housing children has worsened noticeably. The share of kids living in cost-burdened households climbed from 30 percent to 31 percent, affecting 22.4 million children. This marks the first increase since 2010 and arrives as food and housing costs continue rising across the country.
Leslie Boissiere, vice president of external affairs at the Casey Foundation, emphasized that children's current circumstances shape future economic capacity. "We know that today's children are tomorrow's workforce so the strength of the economy in the future is tied to the wellbeing of kids today," she said.
A separate data snapshot from Georgetown University's Center for Children and Families raised additional alarms about insurance coverage. Fewer children are now enrolled in Medicaid while the number of uninsured young people has grown, a shift that Boissiere said raises concerns about economic security during a period of elevated costs for necessities.
Regional variation in child wellbeing remained stark. Five of the seven highest-ranked states clustered in the Northeast, while eleven of the fifteen lowest-ranked states were located in the South. Yet the South also demonstrated that progress is achievable. South Carolina posted the largest statewide improvement, rising 38 points, and eight Southern states overall improved their rankings.
The report credits targeted government investment with driving measurable gains in struggling regions. Mississippi, ranked 50th nationally, nonetheless achieved an education score of 448 through sustained investment following a 2013 law emphasizing third-grade reading proficiency and teacher training. New Mexico, ranked 49th, saw its child wellbeing score rise 22 points largely from economic improvements.
One bright spot emerged consistently across the nation. The teen birth rate fell 24 percent during the study period and remains near historic lows at 13 births per 1,000 teens ages 15 to 19, down nearly 80 percent since 1990. Boissiere attributed the decline directly to decades of targeted investment in pregnancy prevention programs.
Boissiere underscored the policy implications of the data. "There's a direct correlation between how states invest in children and how kids are doing," she said, pointing to concrete evidence that strategic funding produces tangible results in child health, safety, education, and family stability.
Author James Rodriguez: "The data reveals a troubling truth: children's futures are being sold short even as some policymakers trim the safety nets that stabilize young lives."
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