A measles outbreak that has claimed the life of a child, increasing rates of uninsured children, and a maternal health crisis — those are all worrisome problems that put the health of kids at risk. But add in the Trump administration putting Medicaid on the chopping block, and Health and Human Services Secretary Robert F. Kennedy looking to change the childhood vaccine schedule, and suddenly the future of children’s health in the United States looks even more precarious.
But how are kids actually faring in five key states — California, Texas, Mississippi, Florida, and New Jersey? Data from nonprofits and advocacy groups reveals plenty of challenges, from racial disparities in health care access to gaps in preventative screening. And even though some states are making strides toward greater health equity, millions of children remain vulnerable. Here’s a closer look at what the data shows us, and what’s being done.
California
With more people than any other state, the Golden State is often seen as the golden standard, in terms of health care policy. About 13 million children (about twice the population of neighboring Arizona) live in California’s 58 counties.
Children Now, an Oakland-based nonprofit organization focused on improving children’s health and education, is tracking how well California kids are doing. Its 2025 statewide scorecard reveals that, on average, 31% of children with Medi-Cal were screened for lead by their second birthday. But when examining 10 counties with a Black population of more than 6%, only about 25% of children were screened for lead by age 2.
“We know that there’s no safe level of lead for kids, but some kids are more exposed to the dangers of lead — as a result of housing injustice and environmental racism,” Mike Odeh, senior director of health policy at Children Now, told us last year. “This is a result of multiple systems failing Black kids.”
From ages zero to 18, children need dozens of preventative care screenings ranging from developmental screening to autism screening to immunizations to vision screening — all to protect the health of a child. But on average, only 30% of children with Medi-Cal received a developmental screening by age 3. That leaves millions of children in the state unchecked for any number of potential health issues.
Why aren’t kids getting screened? Odeh says it’s complicated. Some of the factors include language barriers, pediatricians not having enough time with their young patients, and additional time spent on child behaviors and parenting techniques.
“I think what’s happening is that we expect a lot of services to happen at these well child visits,” he said in a February interview. “Sometimes things don’t get done, just to be frank. Not to anyone’s fault.”
Solutions: “California policymakers must make kids the first priority in health care and improve families’ access to culturally appropriate health care providers for their children in a timely way,” according to Children Now. “There must be a more proactive focus on reducing the racial, linguistic, geographic, and other disparities in children’s health care access and outcomes.”
Texas
More than 8 million children live in Texas throughout its 254 counties. But with a measles outbreak in West Texas, some of the strictest abortion bans affecting the state, and an increase in infant deaths, the Lone Star State is dealing with numerous challenges.
Every Texan, an Austin-based nonprofit policy organization, tracks the well-being of Texas children. In its 2024 Texas Kids Count Data Book, the nonprofit identified the rates of uninsured children, prenatal care, food insecurity, mental health, and death.
In 2022, Black children had the highest death rate, with 100 deaths per 100,000 children. “These statistics point to the urgent need to address systemic, unequal access to health care and the social conditions that contribute to higher death rates among Black children,” the report states.
In 2021, Black or African American mothers were the most likely to have had no prenatal care during pregnancy. A lack of prenatal care is linked to higher rates of maternal mortality, especially for Black women who are 3 times more likely to die from a pregnancy-related cause than white women.
Solutions: Every Texan’s report calls for expanded access to family planning resources and targeted efforts to address disparities in prenatal care, particularly for Black mothers.
Mississippi
The Magnolia State, home to about 800,000 children across 82 counties, faces multiple challenges, particularly around mental health and preventative care The Children’s Foundation of Mississippi, an independent foundation, produces data driven information on the welfare of these children. The 2025 Mississippi Kids Count Factbook identified the rates of childhood mental health challenges, low birth-weight babies, number of insured children, and obesity.
Between 2018 and 2023, children in Mississippi had higher rates of one or more mental, emotional, developmental, or behavioral condition than children nationally. Year over year Mississippi children ages 3 to 17 with MEBD reported rates 4% to 7% higher than kids in other states.
Similar to California, about 30% of Mississippi children have not had a well child visit. And Black children are more likely to report no preventative health care visits in the past 12 months – about 10% higher than the national average for all children.
Solutions: “Throughout their journey to adulthood, even the most mentally resilient children and youth can encounter unanticipated mental health crises,” the report states. So Mississippi is working to bolster mental health services and coordinate care across organizations to better support children’s health.
Florida
The Sunshine State is home to about 4.5 million children across its 67 counties. The Florida Policy Institute, an independent non-profit organization conducts research to drive policy change. In the 2025 Florida Child Well-Being Index, the organization tracked child food security, economic well-being, education, and health.
In five Florida counties with a population of more than 30% Black Americans, the rate of uninsured children increased between 2017 and 2022. Jefferson county saw a 2% increase within those five years.
Solutions: Florida Policy Institute’s report calls for more investments in children and families so that all Floridian children have access to affordable and quality health care.
New Jersey
The Garden State is home to about 2 million children across its 21 counties. The nonprofit Advocates for Children of New Jersey, researches issues and produces reports to inform its policymakers. In the 76-page New Jersey Kids Count 2024 pocket guide, the organization tracked family economic security, child health, child protection, and education.
In five New Jersey counties with a population of more than 15% Black Americans, Black children were the most likely to be born preterm in 2021. In Camden County, nearly 14% of Black children were born preterm compared to 9% of white children.
Solutions: Advocates for Children of New Jersey emphasize the need for data-driven policies to improve child well-being and “help inform critical decisions for children and families.”
