2023 KIDS COUNT Data Book

2023 State Trends in Child Well-Being

June 14, 2023
By the Annie E. Casey Foundation
2023 KIDS COUNT Data Book cover


The 34th edition of the Annie E. Casey Foundation's KIDS COUNT® Data Book describes how the country’s lack of affordable and accessible child care negatively affects children, families and U.S. businesses.

This year’s publication continues to present national and state data across four domains — economic well-being, education, health and family and community — and ranks states in overall child well-being. The report includes pre-pandemic figures as well as more recent statistics, and shares the latest information of its kind available.

The Current State of Child Care in the United States

America's child care system is broken. Safe, reliable child care has largely been inaccessible and unaffordable for too many Americans. Disparities between who can and can't afford child care reflect long-standing structural inequities in the United States. Shift workers, single parents, student parents and families of color are particularly affected by the failings of the child care system. Children are deprived of nurturing care, and caregivers are prevented from earning money to meet basic needs.

The child care system's inadequacies hinder family economic mobility and perpetuate generational wealth gaps. Affordability impacts accessibility, and the cost of child care has tripled since the publication of the first KIDS COUNT Data Book in 1990. The inability to access care can force caregivers to have to leave work early, be late for work or miss days entirely. Even more troubling: Almost a quarter of parents report being fired because of difficulties accessing child care. It's a cycle: Child care is inaccessible, the parent loses their job, which makes affording child care to secure a new job even more difficult.

And affordability isn't the only determinant of access. Often, families can't get to child care because of distance or a lack of public transportation infrastructure.

While families face rising costs and unreliable access, child care providers confront precarious operating conditions and low wages. Labor costs account for the bulk of child care providers' expenses. With caregiver-to-child ratios mandated by law and safety best practices, operating a child care business is expensive. Though the associated costs get passed on to families, these businesses typically survive on profit margins of less than 1%. Wages are astonishingly low, with child care workers making less than 98% of the nation's other workers.

To give kids, their caregivers and child care providers the best chance to thrive, policymakers must make significant improvements to the child care system.

Recommendations to Improve Child Care in the U.S.

The need for a child care system that works for families and providers is urgent. The Foundation recommends American policymakers take action:

  • Federal, state and local governments should invest more money in child care.

    State and local governments should maximize funding and strengthen regulations that increase funding for public prekindergarten and Head Start and streamline processes for qualifying for subsidies.
  • Public and private leaders should work together to improve infrastructure for home-based child care.

    Governments should increase access to startup and expansion capital for new home-based providers. Policymakers can dismantle obstacles to those looking to open these businesses and provide additional help to those currently in operation.
  • To help young parents, Congress should expand the federal legislation that serves student parents.

    Governments also can encourage higher education and business communities to reduce transportation challenges by co-locating child care at work and learning sites.

Child Well-Being State Rankings

In terms of overall child well-being, the top-performing states have shifted slightly last year's Data Book was published. New Hampshire now holds the top spot. Utah rose to second, and Massachusetts has slightly fallen, rounding out the top three. The lowest-ranked states remained the same: Mississippi (48), Louisiana (49) and New Mexico (50).

Racial Inequities in Child Well-Being

As in previous Data Books, the 2023 KIDS COUNT Data Book reports on racial and ethnic disparities that persist in America today. New findings include:

  • Today, kids of color represent the majority of the children in the country.
  • Black children were significantly more likely to live in single-parent families and in poverty.
  • 94% of child care workers are women; 14% are Black and 4% are Asian, and across all races, 24% described their ethnicity as Hispanic or Latino.
  • Although Asian and Pacific Islander children tend to fare better than their peers, disaggregated data show the differences that exist within this population.

The stark racial and ethnic disparities shaping American childhoods today — which the KIDS COUNT Data Book series captures year after year — are indicative of why accessible, affordable and equitable child care is vital.

Data Book Extras

State Data Profiles on Child Well-Being

View the national data profile or download your state's data profile as a PDF below:

State Data Profiles on Child Well-Being in Spanish

View the 2023 U.S. Data Profile in Spanish or download your state's data profile as a PDF below:

State Trends in Overall Child Well-Being

The Foundation calculates a composite index of overall child well-being for each state by combining data across four domains: (1) Economic Well-Being, (2) Education, (3) Health and (4) Family and Community. These scores are then translated into state rankings. Explore overall child well-being in the interactive KIDS COUNT Data Book.

Economic Well-Being

To help children grow into prepared, productive adults, parents need jobs with family-sustaining pay, affordable housing and the ability to invest in their children’s future. Explore economic well-being data in the interactive KIDS COUNT Data Book.


The early years of children’s lives set the foundation for their lifelong success. Closing significant academic achievement gaps is vital to ensuring that the nation’s future workforce can continue to compete on a global scale. Explore education data in the interactive KIDS COUNT Data Book.


Good health is central to a child’s overall development and ensuring that kids are born healthy is an important first step toward lifelong success. Explore health data in the interactive KIDS COUNT Data Book.

Family and Community

Children who live in nurturing families and supportive communities have stronger personal connections and realize higher academic achievements. Explore family and community data in the interactive KIDS COUNT Data Book.

Additional Resources on Child Well-Being

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