Locations
United States
Definition and Source
PROVIDER
Definition
The KIDS COUNT Health Domain is one of four thematic domains — Economic Well-Being, Education, Health, and Family and Community — that together comprise the KIDS COUNT overall index. The domain reflects key indicators of children's physical health and access to care, including birth outcomes, health insurance coverage, mortality rates, and childhood obesity. The indicators are consistently and regularly measured, which allows for legitimate comparisons across states and over time.
The Health domain rank for each state was obtained in the following manner. First, the state numerical values for each indicator within the domain were converted into standard scores and then summed to create a domain standard score for each of the 50 states. The states were then ranked on the basis of their domain standard score in sequential order from highest/best (1) to lowest/worst (50). Standard scores were derived by subtracting the mean score from the observed score and dividing the amount by the standard deviation for that distribution of scores. All measures were given the same weight in calculating the domain standard score.
The Health domain rank for each state was obtained in the following manner. First, the state numerical values for each indicator within the domain were converted into standard scores and then summed to create a domain standard score for each of the 50 states. The states were then ranked on the basis of their domain standard score in sequential order from highest/best (1) to lowest/worst (50). Standard scores were derived by subtracting the mean score from the observed score and dividing the amount by the standard deviation for that distribution of scores. All measures were given the same weight in calculating the domain standard score.
Data Source
Population Reference Bureau, analysis of data gathered for the 2026 KIDS COUNT Data Book.
The 4 indicators of child health well-being are derived from the following government statistical agencies:
Low birth-weight babies Centers for Disease Control and Prevention, National Center for Health Statistics, Vital Statistics.
Children without health insurance U.S. Census Bureau, American Community Survey.
Child and teen deaths per 100,000 Death statistics: Centers for Disease Control and Prevention, National Center for Health Statistics, Vital Statistics. Population statistics: U.S. Census Bureau, Population Estimates.
Children and teens who are overweight or obese U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau, National Survey of Children's Health.
Notes
The year represents the year the KIDS COUNT Data Book was published. The indicators on which the indices are based reflect the most recent data available at the time of publication — the target reference year for most indicators — though some indicators may reflect prior or more recent years based on source availability.
For example, for the 2012 KIDS COUNT Data Book, most estimates are from 2010; some indicators reflect earlier years such as 2008-2009, and a couple from 2011—the most current year available at the time.
Break in trend
The 2022 Overall Index Rankings and the 2022 Domain Rankings should not be compared to prior year rankings. The data source for 8 of the indicators changed to the 5-year American Community Survey data because of the COVID-19 pandemic’s impact on data quality in 2020.
The 2020 to 2021 Health Domain Rankings should not be compared to prior year rankings. The indicator “Children and teens ages 10 to 17 who are overweight or obese” has replaced “Teens ages 12 to 17 who abused alcohol or drugs in the past year”.
The 2019 Health Domain Rankings should be compared with caution to prior year rankings. The indicator “Children 18 and below without health insurance” had previously been “Children 17 and below without health insurance”. With the release of the 2017 American Community Survey data, the Census Bureau made changes to the health insurance tables so that the categories better align with the current health insurance landscape. Age categories changed such that the age group for children now includes age 18.
The 2018 Health Domain Rankings should not be compared to prior year rankings. The indicator “Teens who abuse alcohol or drugs” underwent significant changes in 2015. Whether a change in ranking is due to this methodological change or real changes in children’s well-being is unknown. In 2015, the questionnaire for the National Survey on Drug Use and Health (NSDUH) underwent significant changes to improve quality of the data collected, expand the number of prescription drugs covered, and address changing substance use and mental health policy and research needs. Much of the 2015 data is not comparable to the data from previous years. The 2015 data will provide a new baseline with which data collected in subsequent years can be compared.
For a summary of changes in the 2015 NSDUH see: National Survey on Drug Use and Health: 2014 and 2015 Redesign Changes at https://www.samhsa.gov/data/population-data-nsduh
For example, for the 2012 KIDS COUNT Data Book, most estimates are from 2010; some indicators reflect earlier years such as 2008-2009, and a couple from 2011—the most current year available at the time.
Break in trend
The 2022 Overall Index Rankings and the 2022 Domain Rankings should not be compared to prior year rankings. The data source for 8 of the indicators changed to the 5-year American Community Survey data because of the COVID-19 pandemic’s impact on data quality in 2020.
The 2020 to 2021 Health Domain Rankings should not be compared to prior year rankings. The indicator “Children and teens ages 10 to 17 who are overweight or obese” has replaced “Teens ages 12 to 17 who abused alcohol or drugs in the past year”.
The 2019 Health Domain Rankings should be compared with caution to prior year rankings. The indicator “Children 18 and below without health insurance” had previously been “Children 17 and below without health insurance”. With the release of the 2017 American Community Survey data, the Census Bureau made changes to the health insurance tables so that the categories better align with the current health insurance landscape. Age categories changed such that the age group for children now includes age 18.
The 2018 Health Domain Rankings should not be compared to prior year rankings. The indicator “Teens who abuse alcohol or drugs” underwent significant changes in 2015. Whether a change in ranking is due to this methodological change or real changes in children’s well-being is unknown. In 2015, the questionnaire for the National Survey on Drug Use and Health (NSDUH) underwent significant changes to improve quality of the data collected, expand the number of prescription drugs covered, and address changing substance use and mental health policy and research needs. Much of the 2015 data is not comparable to the data from previous years. The 2015 data will provide a new baseline with which data collected in subsequent years can be compared.
For a summary of changes in the 2015 NSDUH see: National Survey on Drug Use and Health: 2014 and 2015 Redesign Changes at https://www.samhsa.gov/data/population-data-nsduh
Last Updated
May 2026