NC Drops in Child Health Rankings Amid Rising Infant Deaths

North Carolina has dropped to 34th place in the 2025 KIDS COUNT Data Book, which ranks all 50 U.S. states based on child well-being. The report, released by the Annie E. Casey Foundation, shows the state is struggling in critical areas like health, education, and economic well-being.

One of the most alarming issues highlighted is the high number of babies born with low birth weight. In 2023, 9.4 percent of infants in North Carolina weighed less than 5.5 pounds at birth, compared to 8.6 percent nationwide. This condition is a major factor in infant deaths.

Black infants in the state continue to face significantly higher risks. In 2023, they were 3.02 times more likely to die within their first year than white infants. That’s a sharp increase from 2022, when the rate was 2.74. The widening gap is due to a rise in Black infant deaths and a drop in white infant deaths.

Infant mortality is a major concern in North Carolina, which had the 10th highest rate in the country last year. Premature births and low birth weight were the top causes, followed closely by birth defects. Experts say Black babies are 1.6 times more likely to be born early and 2.2 times more likely to be underweight compared to white babies.

The report also reveals an increase in deaths among older children and teens. Between 2014 and 2023, the death rate for children aged 1 to 17 went up slightly across all age groups. The biggest rise, 31 percent, was among teens aged 15 to 17. In 2023, firearm violence caused more teen deaths than traffic accidents.

State officials have acknowledged the ongoing disparities and say more needs to be done. Programs like Healthy North Carolina 2030 and the Perinatal Health Strategic Plan are trying to close the health gap between Black and white babies, but the data shows the gap has grown wider over the past decade.

Health disparities became more visible during the COVID-19 pandemic, with families facing more challenges in accessing care and support. Experts say the stress and economic strain of the pandemic have made it harder to improve health outcomes for children.

Nationwide, the KIDS COUNT authors warn of a growing child health crisis, driven by rising rates of chronic illness, mental health problems, and deaths from guns, drug overdoses, and suicide. They emphasize that early childhood care and preventive health services are key to reversing these trends.

North Carolina’s leaders are being urged to make smarter, earlier investments in child health and family support. With infant deaths accounting for nearly half of all child deaths in the state, many believe that improving maternal and newborn care must be a top priority.