Texas is one of the lowest-ranked states in the nation for the well-being of children, according to a new report from the Annie E. Casey Foundation.

The AECF’s annual Kids Count Data Book evaluates national and state data across four categories—economic well-being, education, health and family/community—through the lens of children. Texas ranked 45th this year, which was consistent with recent years.

Texas’ ranking is relative to other states, Coda Rayo-Garza said. Rayo-Garza is the director of research and data for Every Texan, a nonprofit policy organization.

Texas has improved in 12 of the AECF’s 16 indicators, but Rayo-Garza said other states have experienced greater improvements.

“It's not based on how Texas performed, but based on how Texas performed compared to other states,” Rayo-Garza explained.

In 2020, 2,238 children and teens died in Texas. This equals approximately 28 deaths per 100,000 adolescents, which worsened from the 2010 rate of 26, according to the AECF.

The adolescent death rate in Massachusetts, which is ranked first for child well-being, is 14 per 100,000—half of Texas’ rate.

Texas ranked 48th in the child health indicator, while Massachusetts came in first.

And in education, Texas claimed the 33rd spot. The AECF reported that, in 2019, 70% of Texas eighth graders were not proficient in math, a six percentage-point decline from 2009. Similarly, 70% of fourth graders were not proficient in reading, a two percentage-point increase over a decade.

Texas students are still recovering from pandemic-related setbacks in math, according to the Texas Education Agency. Just 40% of students who took the State of Texas Assessments of Academic Readiness this spring met or exceeded the expectations for their grade level, the TEA reported.

These issues stem from a lack of funding for Texas schools, according to Every Texan.

“Texas can make sure that all children have access to high-quality education by establishing sustainable and predictable funding for schools,” wrote Kaitlan Wong, a research analyst for Every Texan. “Well-funded schools should be able to fairly pay and hire more teachers and school counselors; commit to smaller classroom sizes; invest in special education and bilingual/English learning programs; and offer a wider variety of courses.”

Texas students are also struggling with their mental health, Every Texan reported. Ten percent of Texas high schoolers reported attempting suicide, which is above the national average of 9%, according to a news release.

Texas ranks 28th in the nation for youth mental health, according to Mental Health America. But the state subsequently ranks 51st, below all other U.S. states and Washington, D.C., for access to mental health care.

One of Every Texan’s legislative priorities ahead of the 2023 Texas legislative session is improving access to health care, including mental health. Eleven percent of Texas children did not have health insurance between 2016 and 2020, which was more than twice the national rate of 5%.

“Policymakers must make sure every Texas child has health insurance to afford mental health services, that those services are easily accessible, and that they take into account all children’s unique experiences and identities,” Wong wrote.

In 2022, Texas ranked 36th in economic well-being, 33rd in education, 48th in health and 47th in family and community, the AECF reported. Texas’ rankings for overall child well-being and the related indicators have not changed significantly since 2020.