Twelve million children in the United States lived in poverty in 2019, and states that faced challenges in child well-being before the COVID-19 pandemic appear to have continued to struggle in 2020, a report from the Annie E. Casey Foundation finds.

Now in its thirty-second edition, the KIDS COUNT Data Book: 2021 State Trends in Child Well-Being found that even as the child poverty rate declined slightly, from 18 percent to 17 percent, the estimated number of uninsured children increased to 4.4 million (6 percent), up from 4.1 million (5 percent) in 2018 — the first increase in a decade. The COVID-19 pandemic exacerbated the situation; based on 2020 survey data, more than one in eight adults with children in the household (13 percent) lacked health insurance, although by March 2021, the percentage had fallen to 11 percent. In addition, 22 percent of survey respondents with children said they had slight or no confidence that they would be able to make their next rent or mortgage payment on time, although this figure also had fallen to 18 percent by March.

At the same time, the report found that in 2019, the percentage of children living in high-poverty areas fell for the fourth consecutive year, to 9 percent from 10 percent in 2018, and the share of high school students who failed to graduate on time fell to 14 percent from 15 percent in 2018.

On a state-by-state basis, Massachusetts ranked first in overall child well-being, followed by New Hampshire and Minnesota, as in 2018; Mississippi, New Mexico, and Louisiana ranked at the bottom of the list. Thirteen states in the bottom twenty in pre-pandemic rankings also appeared among the worst-performing states in most indicators in the 2020 survey, reflecting a connection between the states that were struggling before the pandemic and those that have struggled during it.

The foundation's policy recommendations for investing in children, families, and communities to ensure an equitable recovery include making the expansion of the child tax credit permanent, prioritizing the recovery of hard-hit communities of color, and expanding income support that helps families care for their children.

"The COVID-19 pandemic is the most extraordinary crisis to hit families in decades," said Annie E. Casey Foundation president and CEO Lisa Hamilton. "Deliberate policy decisions can help them recover, and we're already seeing the beginnings of that. Policy makers should use this moment to repair the damage the pandemic has caused — and to address long-standing inequities it has exacerbated."

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