As the state continues to struggle with a high infant mortality rate that undercuts its relative wealth, Maryland's overall rank in child well-being remained in the middle of the pack nationally, according to an annual report released by the Baltimore-based Annie E. Casey Foundation.
The 2010 Kids Count Databook released Tuesday placed Maryland 25th in overall child well-being, the same ranking as a year ago. Although Maryland has the second-lowest percentage of children living in poverty (10 percent), the state placed 42nd in infant mortality rate, a statistical discrepancy that puzzled the report's authors.
Maryland "doesn't act like other states, as far as the connection between overall well-being and child poverty rate," said Laura Beavers, national Kids Count coordinator for the foundation. "Both median income and child poverty tend to drive the indicators. Children born into poverty tend to have low birth rates and are less likely to graduate from high school."
Based on 2007 and 2008 data used in the report, Maryland's rate of 8 infant deaths per 1,000 births is more than one death higher than the national average. In 2008, about 10 percent of children statewide lived below the poverty line — income less than $21,834 for a family of two adults and two children — trailing New Hampshire nationally.
State officials say the numbers are dated and that data released last week show the state has improved. In 2009, the infant mortality rate stood at 7.2 per 1,000 births, a decrease of nearly 10 percent, according to the state's numbers.
But even using that figure would still place Maryland in the bottom half of the country in that category, a preventable outcome if officials reallocated the way the way money was distributed, according to Matthew Joseph, executive director of Advocates for Children and Youth.
Joseph and his organization have pushed the state to create an initiative that would get women who ordinarily have little access to health care to see specialists before they become pregnant.
"There is a consistently huge performance gap that has existed over the last eight years. It's the state's continued persistence into investing into programs that don't work," Joseph said. "It's not the case that the state is not spending money. We're just not getting the results that the other states are getting."
The Kids Count Databook uses 10 indicators to measure how children are faring nationally in health, education and safety. Indicators include death rates of children and teenagers, parents' employment and income, and teen pregnancy and school dropout rates. The report compares years since 2000, and its most recent findings are from 2007 and 2008.
Beavers said the state could use the data to target specific areas where pregnant mothers are struggling with underlying health issues. "Even before they get pregnant, if they're obese, smoke or have high levels of stress and depression, they're more likely to have babies with worse outcomes," she said.
State officials say they are already targeting areas in Prince George's County, Baltimore City and Somerset County. Gov. Martin O'Malley has included reducing the infant mortality rate among his priorities to improve the quality of life in the state.
About 4.7 per 1,000 Maryland women gave birth in 2009 with late or no prenatal care, and the rate for African-American women stood at about 6.3 per 1,000, according to the state's numbers.
In other categories, Maryland ranked 38th in low-birth-weight babies (9.1 percent). The birth rate for girls ages 15 to 19 is 34 per 1,000 births, a 17 percentage-point decrease since 2000. And the proportion of children living in single-parent families remained at 33 percent, the same as in 2000.
"We're pleased the rate is decreasing, but we're not complacent," said Frances Phillips, Maryland's deputy secretary for public health. "The numbers are still too high, particularly the numbers for African-American babies."