SALT LAKE CITY — Utah again ranks among the top 10 states for overall child well-being, according to an annual report by the Annie E. Case Foundation published this week.
That includes positive trends for family and community resources, economic prosperity, education and other factors. But the state's ranking for health dropped from seventh in 2015 to 27th this year, having one of the largest rates in the country of uninsured children.
The change in ranking also comes as more states fully expand Medicaid, a move Utah has yet to make, leaving federal money on the table.
"It wasn't that we were getting a lot worse, it was that everybody else was getting a lot better," said Terry Haven, deputy director for Voices for Utah Children.
In 2014, 9.4 percent of children in Utah lacked health insurance, compared with a national average of 6 percent. Utah also had the highest rate of uninsured Hispanic children at 23.4 percent, compared with 9.7 percent nationally. Overall, 17 percent of Utah families living below the poverty line didn't have health insurance, more than twice the national rate of 7 percent, according to the report.
Child and teen suicide rates in the state have more than doubled, with 27 suicides in 2008 and 60 in 2014. Utah is also one of only two states that haven't lowered the child death rate since 2008, Haven said.
But the state is making progress toward removing barriers to health care for children and families. Lawmakers this year removed the mandatory five-year waiting period for lawfully residing immigrant children to enroll in health insurance. The Legislature also appropriated one-time funding for improving enrollment among eligible Utahns.
"That money is going to help us reach out to communities where we know there's a lot of uninsured kids," Haven said.
Other key indicators are trending positively on a national scale, despite societal setbacks from the Great Recession. From 2008 to 2014, teen birth rates fell by 40 percent, drug and alcohol abuse dropped by 38 percent, and the portion of teens graduating from high school increased by 28 percent, according to the foundation report.
"With more young people making smarter decisions, we must fulfill our part of the bargain by providing them with the educational and economic opportunity that youth deserve," Patrick McCarthy, president and CEO of the Casey Foundation, said in a prepared statement.
Utah maintained strong rankings in other domains examined by the report. The state ranked second in family and community thanks to its low percentage of children living in high-poverty areas and having only 9 percent of families where the household head lacks a high school diploma.
Economic well-being proved another success for Utah, which ranked eighth overall. While the percentage of children living in poverty has increased since 2008 to 13 percent — about 119,000 children — the percentage of children living in households with a high housing cost burden has dropped to 28 percent, the report states.
But further improvements will likely be contingent on lowering the poverty rate among families, Haven said.
"Everything that we look at is affected by poverty. So whatever we can do to reduce our poverty rate is going to help everything else that we do," Haven said. "I firmly believe that."
Utah improved its achievement in each of the report's metrics of education, traditionally the state's point of lowest performance. Those include preschool enrollment, reading and math proficiency, and high school graduation. The state's rank improved from 29th last year to 21st this year.
Results from NAEP, a national assessment given to a sample of fourth- and eighth-graders, showed that Utah improved its proficiency in math and reading last year despite a national decline. Utah's high school graduation rate has increased by 15 percent since 2008, reaching 84 percent last year.
Education leaders, however, say they envision higher achievement for students. For decades, Utah has notoriously had the lowest per-pupil spending rates in the country. But Sydnee Dickson, who was appointed as the new state superintendent of public instruction Thursday, said the rhetoric behind school funding has to change.
"When we think of infrastructure, we tend to think about transportation and roads. Those spaces of infrastructure get everybody's attention because those things belong to all of us," Dickson said. "I think the same about our public school children, and all children in the state of Utah. We have to start thinking about funding as a source of economic and civic infrastructure."
Shifting the conversation about funding, Dickson said, will help state leaders see education as more of an investment in areas of high need, such as early childhood education and teacher salaries.
It's also part of improving educational equity for students, Haven said, ensuring that academic outcomes aren't predetermined by geographic origins or pecuniary circumstance.
"The biggest concern is making sure that every child in Utah has the same kind of opportunities," Haven said. "I think it's really about making sure that those opportunities that we want for our children are available for everyone's children. And when that happens, we're going to be No. 1."