Post Author
Sydney Mason
Communications Intern
Throughout my time interning at NC Child, I’ve heard from advocates across the state about why they’re invested in this work.
For some, they feel called to push for accessible and affordable early childhood education. For others, they want to protect children from addictive nicotine or advocate for more mental health resources in schools.
No matter their “why”, they are all united by their “who.” They are united by their shared belief that every North Carolina child deserves the opportunity to reach their full potential. They believe that making North Carolina “First in Children” means putting the well-being and needs of children first.
But you can’t change what you don’t measure—and that’s where the 2026 KIDS COUNT Data Book comes in.
A 50-state annual report published by the Annie E. Casey Foundation, the KIDS COUNT Data Book analyzes metrics related to child health and well-being and assigns rankings based on their performance relative to other states.
This year’s Data Book tells us where we’re improving and where we have some room to grow.
To learn more about this data, I sat down with Ashtin Crawford, NC Child’s Data Product Manager, to discuss key insights from this year’s data book and what trends we are seeing for North Carolina’s children.
SYDNEY: Hi Ashtin! What can you tell me about the KIDS COUNT Data Book and how North Carolina stands compared to other states?
ASHTIN: This year’s Data Book found that, overall, North Carolina had modest improvement between 2019 and 2024, with a rise in rankings from 34th to 32nd. Additionally, for the first time this year, states received a comprehensive score (from 0 to 1,000) in the Data Book. The scores tracked 16 indicators in four domains — economic well-being, education, health, and family and community factors — over a five-year period from 2019 to 2024. The new scoring system showed whether policies and public investment are actually improving children’s lives, not merely how states compare to each other.
Using this system, North Carolina received an overall score of 537, slightly below the national score of 547, with the state’s highest scores coming in the family and community and economic well-being domains.
SYDNEY: Education post-pandemic is a pressing topic. Can you speak to educational trends over the past few years, including this most recent data?
ASHTIN: The coronavirus pandemic created a significant drop in proficiency in math and reading, and we haven’t gotten back to pre-pandemic levels in either category. But what’s notable is that instead of steady improvement in reading, we keep getting worse. The 2024 data showed that 70% of fourth graders are not proficient in reading, compared to 68% not proficient in 2022. Math is a slightly better story, where 69% of eighth graders are below proficient, and we have seen a rebound from 2022’s low of 75% below proficient.
Despite these numbers, North Carolina is still in the upper half of overall rankings for reading and math at 24th and 14th, respectively. This is worrisome as we consider overall educational proficiency nationwide, indicating potential larger issues of educational proficiency in the post-Covid era. These indicators are important as they are strong signals for future educational performance, such as high school graduation and other academic achievement.
SYDNEY: Although this data doesn’t reflect the healthcare policy changes of the last year and a half, what have you seen in trends for healthcare and health for North Carolina’s children?
ASHTIN: We have seen healthcare coverage for children go down slightly, with 6% of children uninsured in 2024 compared to 5% in 2023.
However, in health, we’ve seen a slight improvement in some metrics over recent years with small declines in the percentage of babies born at a low birth weight (9.2% in 2024 compared to 9.5%). Low birth weight increases the risk that a child will have long-term health issues, including developmental delays, heart disease, and diabetes, among others.
But even with these modest improvements in the data, there’s still more work we can do to improve birth outcomes, and that starts with ensuring access to maternal health care.
Overall, North Carolina’s health rankings have gone up dramatically from 37th in 2022 to 32nd in 2024. However, it’s worth noting that, like education, many of the other individual indicators have trended negatively, suggesting a potential broader nationwide decline rather than large-scale improvement for North Carolina.
SYDNEY: Looking now at economic well-being, what major insights can we glean from the 2024 data?
ASHTIN: This is an area where we’ve seen some marginal improvement. North Carolina’s ranking went from 32nd pre-pandemic to 28th now, and many of the indicators have shown some slight improvements. However, the rankings themselves are based on how North Carolina stacks up against other states, not necessarily drastic changes in the measures of child well-being themselves. Child poverty decreased from 18% in 2022 to 17% in 2024, and the share of children in households without a full-time working parent has declined overall in the past several years. However, families are now spending more on housing, with the share of families spending greater than 30% of their income on housing rising from 25% in 2021 to 28% in 2024. This reduces the income that families have available to spend on other necessities, including food, health care, and child care, which in turn impacts long-term outcomes for children in those categories. Overall, the state’s ranking suggests modest improvement, but many families continue to face significant economic strain, particularly as housing costs outpace income growth.
SYDNEY: What are some improvements we saw in the most recent data?
ASHTIN: In the family and community category, we actually saw some great improvements. Every indicator that we used showed positive long-term movement, and North Carolina’s overall ranking increased from 35th in 2022 to 32nd in 2024 for family and community.
Key changes that led to this improvement were the teen birth rate that went down substantially, from 18 births per 1000 to 14, and the percentage of children living in high poverty areas decreased from 8% to 6%. These are all encouraging signs for families and communities in North Carolina; however, we still trail many states in several key metrics, indicating that we still have the opportunity to pass policies that build a better North Carolina for families.
SYDNEY: What opportunities do we have to improve these metrics and make North Carolina the best place to both be a child and raise a child?
ASHTIN: Ultimately, this data is a starting point. It gives us an idea of where we need to go to make the biggest impact we can for North Carolina’s children and families.
In the State budget, our legislators invested $100.8 million in a statewide child care subsidy reimbursement rate floor at the 2021 rate and raised subsidy rates to the 2023 market rate. This is huge.
By investing in a statewide subsidy floor and adjusting rates to approach the true cost of care, we’re making care more affordable for parents, which helps families to afford other essentials for their children, and we’re helping more children access the learning opportunities that set them up for a lifetime of success.
Ensuring that we keep NC Medicaid strong is another way that we can improve outcomes for children and families and improve our national ranking. We know that when parents have health coverage, their children are more likely to access care. We also know that when parents and caregivers are healthy and can work, they’re able to provide for their families—which matters for child well-being. Medicaid also covers 50% of all births in North Carolina, and continued access to prenatal and postnatal care matters for infant and maternal health outcomes.
We said at our State of the Child Summit that we want North Carolina to be “First in Children,” not because of a ranking or an indicator, but because we want to be a state that puts children first.
But the irony is: passing policies and making investments that put children first will literally make us “First in Children.”