LOUISVILLE -- Life for Kentucky kids has improved in some areas -- including fewer children in poverty and more children with health coverage, according to "Kids Count," the annual state-by-state ranking of child well-being released Monday by the Annie E. Casey Foundation.

But both Kentucky and Indiana remained in the bottom half among 50 states when it came to overall ranking of child well-being.

Kentucky ranked 34 among states, improving from 37 in 2018. Indiana dropped a notch, ranking at 29, compared with 28 last year.

Terry Brooks, Kentucky Youth Advocates executive director, said the report shows Kentucky needs to continue to work in areas such as the economic well-being of children.

For example, Kentucky showed fewer children in poverty, 22% compared with 26% in past years. But that still means more than 230,000 of the state's children live in poverty, he said.

"When you look at the progress on that data point, you absolutely have to celebrate," Brooks said. "But what are you going to do in 2020 to accelerate it?"

The national child poverty rate is 18%, an improvement from 22% of past years.

The report cites the overall decline in unemployment as a factor in improving household income but lists child poverty as an ongoing concern for states.

"Growing up in child poverty is one of the greatest threats to healthy child development," the report said. "It increases the likelihood that a child will be exposed to factors that can impair brain development and lead to poor academic, cognitive and health outcomes."

The Kids Count report ranks states by their performance in four key areas of child welfare: economic well-being, education, health, and family and community. Such measures include parents' employment, household income, educational attainment and health outcomes.

It examines changes over the period from about 2010 to 2017.

Brooks said Kentucky should be concerned that the Kids Count report showed no significant improvement in fourth-grade reading and eighth-grade math proficiency. It found 62% of fourth graders are below proficient in reading and 71% of eighth graders are below proficient in math.

But the "good news," Brooks said, is that nine of 10 Kentucky high school students are graduating on time. The report found 10% of students don't graduate on time, compared with 15% in 2010.

Another "bright spot" for Kentucky is the high rate of children who have health coverage, increasing their access to health care, Brooks said.

Just 4% of Kentucky's children lacked health coverage in 2017, compared with 7% in 2010, the report said.

Brooks said that's likely a result of an emphasis on adding more children to the Kentucky Children's Health Program, or KCHIP, a Medicaid program for low-income children whose parents earn too much to qualify for Medicaid, a state program for those who are very poor or disabled.

Efforts to recruit more eligible children began under former Gov. Steve Beshear, a Democrat, and have continued under the administration of Gov. Matt Bevin, a Republican, Brooks said.

"It's a great example that everything in health care doesn't have to be partisan," Brooks said.

Kentucky covers about 1.3 million people through Medicaid, about 600,000 of them children.

Kentucky added nearly 500,000 individuals to Medicaid through the 2014 expansion under the Affordable Care Act, which allowed more low-income adults to enroll in Medicaid. That also served to increase the number of eligible children enrolled.

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