The health of Missouri’s children ranks near the bottom third among all states, according to newly published data from the Annie E. Casey Foundation and a contributing factor to that is a death rate that exceeds the national average by about 30 percent.

In the latest edition of the KIDS COUNT data book, released last week, Missouri ranked 33rd in the health category.

Among children between the ages of 1 and 19, Missouri had a death rate of 35 per 100,000 children. The national average was 27 per 100,000 children.

In the overall ranking – which also factored in economic wellbeing, education and indicators of family and community strength – Missouri ranked 26th.

Kansas ranked 16th overall, but a health ranking that came in one notch ahead of Missouri disappointed child advocates in that state.

Under an old methodology, which the foundation updated this year, Missouri ranked 34th last year and Kansas came in 19th.

Partnership for Children, an advocacy group based in Kansas City, Mo., expects to release more detailed county-level data for Missouri in a couple weeks, according to the organization’s president, Charron Townsend.

As for the national figures, the group’s officials expressed alarm at an 80 percent increase in the number of Missouri children living in high-poverty areas within the first decade of the 2000s, though they also noted some recent strides in education.

Given its middle-of-the-pack ranking overall, Missouri is a “pretty good bellwether about what’s going on across the country, for better or for worse,” said Laura Speer, associate director for policy reform and data at the Annie E. Casey Foundation.

For example, Missouri was right in line with the national average in the percentage of teens not working or in school (9 percent) and in children in single-parent families (34 percent).

Dr. Denise Dowd, director of research for emergency and urgent care with Children’s Mercy Hospitals and Clinics, said she was troubled by the overall findings.

“Our state just doesn’t protect kids like it should,” she said.

Heavily rural states such as Missouri struggle in the child death category because longer distances between destinations generally mean outstate children spend more time in vehicles, Speer said.

Accidents are the leading cause of death for children and teens, she said, and auto accidents are a significant factor.

And when accidents happen, Speer said, rural children also tend to be farther from an emergency room than their urban counterparts.

Between 2005 and 2009, according to the data book, Missouri’s death rate for children decreased by 10 percent. But the national rate decreased by 16 percent.

In the Kansas City area, the Mother & Child Health Coalition offers various programs to reduce injuries and deaths among children, including training on proper storage of medication and procedures to avoid backing over children in driveways.

Regina Weir, the coalition’s immunization and childhood injury prevention coordinator, noted the national drive to reduce childhood obesity. But, she said, “If we don’t keep kids alive, health and wellness just doesn’t matter.”

Speer also noted that Missouri’s teen pregnancy rate of 42 per 1,000 females between the ages of 15 and 19 was unchanged in the five-year period ending in 2009.

The national rate of 39 per 1,000 females in that age range is at an historical low. Speer said that reflected “some success on all fronts,” including less sex among teens and increased use of birth control.

Whether it’s teen pregnancy or any of the other indicators, Dowd at Children’s Mercy said socioeconomic status was a key determinant in child wellbeing.

“When kids live in poverty,” she said, “the effect on health is manifest in things like injury deaths and child abuse deaths and early teen pregnancy – (and) dental health, that’s one they don’t have on here.”

For instance, she said, low-income parents are less likely to take proper precautions buckling their children into vehicles before driving.

According to the data book, about 1 in 5 Missouri children live in poverty, which is about the same as the national average.

But, Dowd said, southern Missouri has some of the highest child poverty rates in the country.

“They have very tough lives down there,” she said.

The Health Care Foundation of Greater Kansas City is proud to partner with the Kansas Health Institute news service to provide weekly health stories about health and policy issues impacting the greater Kansas City region. This News Service is an editorially independent program of the Kansas Health Institute and the Health Care Foundation of Greater Kansas City and is committed to objective coverage of health issues.