Massachusetts ranks first in the nation for education and children's health but a lack of quality child care poses great challenges for families, according to a new report.

The 2023 Kids Count Data Book from the Annie E. Casey Foundation gives the Commonwealth high marks for child well-being overall. However, it said there is not enough child care and too many families can't afford it, which ultimately affects the state's economy.

Adam Jones, policy analyst at the Massachusetts Budget and Policy Center, said a lack of child care options is negatively affecting too many couples' family planning.

"People who may really love certain parts of the state, love certain cities, love where they even grew up are making hard choices about raising families there," Jones observed.

The report found 12% of Massachusetts' children under age six lived in families in which someone quit, changed, or refused a job due to problems getting child care in the past few years. It showed women are five to eight times more likely than men to experience negative employment consequences related to caregiving.

Despite Massachusetts' high ranking in the categories of education and health care, the benefits are not experienced equally across the Commonwealth.

Jones cited Massachusetts' historic racial wealth gap as preventing too many families from reaching their full potential.

"Yeah, we're number one, but is everyone experiencing number one quality, in terms of affordability?" Jones asked. "Black families in Massachusetts are more likely to live in poverty than white families, so are Latinx families."

Jones acknowledged the creation of MassHealth and the Student Opportunity Act focused on equity and made Massachusetts a national leader in education and health care.

He added now, it is time for the Commonwealth to lead by example in solving the child care crisis and continue such efforts as its Child Care Stabilization Grants, which were a lifeline to child care centers throughout the pandemic.


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Whooping cough, or pertussis, is making a comeback and a Tennessee medical expert stressed the preventable, highly contagious bacterial infection requires urgent attention.

The Centers for Disease Control and Prevention reported, year-to-date, Tennessee has recorded more than 200 cases, while more than 25,000 cases have been reported nationwide.

Dr. Anthony Flores, professor of pediatrics and director of pediatric infectious diseases at Vanderbilt University Medical Center, said rising cases are largely due to vaccine hesitancy, and taking action now is essential to combat the serious illness.

"I think of our severe cases that we're seeing here in Tennessee, and nationwide as well, almost all of those severe hospitalized cases are in unvaccinated children," Flores explained. "I think the lower vaccination rate, kind of the periodicity with which we see whooping cough come back and surges, are contributing to the current numbers we're seeing."

Flores noted typical symptoms include a runny nose and low-grade fever, although fever is less prominent. The cough can develop and persist for weeks, becoming particularly bothersome in older children and adults. The name "whooping cough" comes from the severe coughing fits, which cause difficulty breathing, followed by a "whoop" sound as the afflicted person gasps for air.

Flores pointed out in newborns, especially before they begin receiving their initial vaccinations at 2, 4, and 6 months, their protection relies solely on the antibodies passed to them by the mother during pregnancy.

"In pregnant women, it's actually recommended that if they haven't received a booster, that they receive a booster in their third trimester, and that's again to pass on those antibodies to the newborn baby," Flores emphasized. "But then what can protect them from severe disease?"

Flores recommended children receive the whooping cough vaccine as part of their routine immunizations. He added as they grow, they get booster shots, and adults receive a different formulation called Tdap every 10 years to maintain immunity. He added it is important to follow a schedule to prevent waning immunity over time.


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CLARIFICATION: We updated language to clarify the timing for when the study's authors began tracking certain outcome measures for children within the foster care system. (9:30 a.m. CST, Nov. 22, 2024)

This Saturday is National Adoption Day and the latest findings showed Minnesota has made progress in helping kids in the foster care system secure a better future.

Aaron Sojourner, labor economist at the W.E. Upjohn Institute for Employment Research, helped lead a study of reforms Minnesota approved in 2015. He said states often provide financial support to children in foster care but support ends when a child is adopted or placed in a kin guardianship.

Minnesota decided to continue payments to households who take a child in permanently. Sojourner pointed out three years after foster cases started, positive outcomes became clear.

"The kids were scoring much higher on standardized achievement tests," Sojourner reported. "They were experiencing less turnover in schools and school instability."

He noted the incentives also boosted the chances of kids age 6 and older exiting the foster care system and moving into permanent home settings by 29%. Sojourner added while the results are encouraging, it is just one aspect of the child welfare landscape. Other research has shown racial disparities in Minnesota's foster care system, especially when looking at reducing entry rates.

Sojourner stressed if state lawmakers revisit the extended monthly payments in budget talks, they will need to realize the long-term payoff from these investments.

"The state is paying more money now but they're going to reap the benefits down the road," Sojourner contended. "In terms of increased earnings and employment."

His team's study said prolonged exposure to foster care is tied to poor transitions into adulthood, including homelessness.


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Nearly one in four Kentucky kids has experienced at least two Adverse Childhood Experiences, or ACEs, including abuse, neglect or household dysfunction, according to the latest Kids Count County Data Book.

Experts said the findings should prompt policymakers to better measure risk and pave the way for prevention.

Terry Brooks, executive director of Kentucky Youth Advocates, said the impact of ACEs on children can leave a lifetime imprint.

"When we think about Kentucky in 20 years, data around ACEs today is going to be a leveraged factor that we're going to be seeing the results of," Brooks projected.

According to the Centers for Disease Control and Prevention, ACEs trigger a toxic stress response in the body, which can change brain development and can lead to chronic health problems, mental illness and substance use disorders in adulthood.

Mentorship, guidance and support from adults and community members can help foster positive childhood experiences and buffer the impact of ACEs.

Aleah Stigall, a student at Boyle County High School, said a network of mentors participating in pageantry has helped her cope with loneliness.

"I was able to gain a lot of mentors," Stigall explained. "Some I like to even call my sisters, because of how they've impacted me and really show me what a true titleholder looks like and how you can make a strong impact on your community."

The findings also show more families are transient and struggling to stay housed. Brooks explained the state has seen significant increases in rental cost burdens.

"That eight-year-old little girl going to school has inevitably heard her mom and dad worrying about, are they going to get evicted, and are the lights going to stay on?" Brooks observed. "I don't think any of us can fully measure the impact it has on that little kid."

According to the research, Kentucky is short around 200,000 housing units. And between 2018 and 2022, 44% of Kentucky households spent 30% or more of their income on rent and utilities. In 20 counties, residents' rental cost-burden rates have reached 50%.