Wednesday, August 31, 2011

Child Wellness State By State and the Uninsured

The Huffington Post posted a summary of the Annie E. Casey foundation's report of Child Wellness State By State.  It lists New Hampshire as the best state for child wellness and Mississippi as the worst.  The rankings are based on ten indicators which are:

1. Percentage of low-birthweight babies
2. Infant mortality rate
3. Child death rate
4. Teen death rate
5. Teen birth rate
6. Percent of teens not in school and not high school graduates
7. Percent of teens not attending school or working
8. Percent of children living in homes where no parent has full-time employment
9. Percent of children in poverty
10. Percent of children in single-parent families
The overall rankings might be interesting for lay people who are considering where to live but for health researchers the specific health variables used are more interesting because they provide specific information.  Information is lost when it is summed across different measures to create a summary score.  Of course which measures are appropriate to use is often subject to debate and highly dependent on what is available.  One measure which is not considered is the per cent uninsured in each state.  The chart at the left indicates that the state's ranking correlates very well with the percent uninsured (Census Bureau estimate) in that state accounting for 44% of the variance (The District of Columbia was not included in the Casey Foundation's overall wellness rankings).  This high correlation suggests that there is some validity to their ranking method.  This makes sense as many of the measures listed above relate to parent as well as child wellness.  This suggests that the higher the percent uninsured in that state, the lower its wellness ranking is.

The data for each each state and sometimes DC and Puerto Rico are available from the Annie E Casey Foundation to compart to the data I have for each state.  Of particular interest is the % of low birthweight babies and the infant mortality rates because they tell about the health of the child and the mother. The graph at the left (the District of Columbia was included in this graph) suggests a weaker relationship between % low birthweight babies and the uninsured which, while still statistically significant with p=.037, accounts for only 9% of the variability.  For this specific measure the states of Mississippi and Louisiana exert considerable positive influence on the best fit regression line with the top two highest % low birthweight rates and the 7th and 4th highest rates of uninsured in the US.  The three states with the highest rates of uninsured were near the national low birthweight rate.

There are many other measures that can be looked at and it's best to look at them one at a time. Adults as well as children being uninsured, whether they have children or not, has negative consequences for children and everyone else by draining resources which could be used for more productive activities when seeking treatment is put off until a health problem becomes too serious.

**Relevant Posts**

A Statistical Profile of the Uninsured in Washington, DC, New Mexico, and Texas


Income and Life Expectancy. What does it Tell Us About US?


Correlating Pennsylvania’s Uninsured with Other Health Measures | Healthcare 4 All PA Education Fund