States' Scorecard Finds Big Differences in Kids' H...('s vice president for child development ...),Health

"In this study, we found a four-fold difference in the rates at which children are uninsured," Schor said.

The number of uninsured children varied widely across the states, from a low of 5 percent in Michigan to a high of 20 percent in Texas. States that had the most insured children tended to have the highest scores on quality of care, Schor said.

If all states performed as well as Michigan when it came to providing insurance, then 4.6 million more children would have health insurance, Schor said. "That would cut the rate of uninsured children in half," he said.

Using vaccinations as a measure of access to care, the scorecard again found substantial variation among the states, Schor said. "In Massachusetts, 94 percent of children were up-to-date on their immunizations, whereas in Nevada it was only 67 percent," he said.

Another key is having a "medical home" -- a regular source of care, Schor said. "Whereas 77 percent of children in New Hampshire had a medical home, in Mississippi, 34 percent had a medical home," he said. "We know that children who have a medical home have a better quality of care."

The scorecard took into account 13 indicators of children's health, including access, quality, costs, equity and the potential to lead a long and healthy life. While no state scored high on all categories, some regions surpassed others. For example, states in the Northeast and Upper Midwest often ranked higher in several areas, while the lowest rankings were in the South and Southwest, the report found.

Studies have shown that in states with high numbers of uninsured children, those children are less likely to get recommended health care, vaccines, dental care and regular checkups. These children are also at greater risk for developmental delays and infant mortality, Davis said.

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