Hawai'i slipped five spots from last year — to 18th in the nation — in a state-by-state ranking based on key child well-being indicators, according to the annual Kids Count Data Book released yesterday.

It was the third year in a row that Hawai'i's ranking in the report has declined.

Hawai'i slipped in child and teen death rates, percentage of low-birthweight babies and teen birth rate.

"It's not the best, but at least we're not in the bottom third," said Sylvia Yuen, director of the University of Hawai'i's Center on the Family, which collected data for the study. She added that some simple measures could improve the ranking, from ensuring that pregnant women get prenatal care so their babies are born healthy, to raising awareness about teen driving safety.

"The takeaway message is if we are concerned about our future, then we have to take care of the kids," she said.

The study is based on 2006 and 2007 figures, and advocates say the actual picture today — with the economic downturn throwing more families into poverty and putting kids at risk — is likely worse.

In the study, Hawai'i had the second-lowest percentage in the nation of children in poverty (just 10 percent, compared with 18 percent nationally). But Yuen said she suspects that figure has increased significantly, as more parents lose their jobs or see their hours cut. Poverty has implications for children's health, she said, and how they fare in school.

"There's just no doubt in my mind that we will find more of Hawai'i's children in financially stressed households," Yuen said. "As we find more kids in poverty, some of these bad outcomes are going to play out."

Advocates say the most concerning indicators in the report are the child and teen death rates in the Islands.

In the study, the state ranked 26th in the nation for its child death rate — with 21 deaths per 100,000 children ages 1 to 14 in 2006, compared with 15 in 2000. Hawai'i ranked sixth-best in the nation for its child death rate in last year's study, which used 2005 figures.

The rate is based on any deaths of children, a large number of which include babies who are born prematurely, have low birthweights or die from Sudden Infant Death Syndrome. Car accidents are the fourth-highest cause of death for children and the leading cause of death for teens in Hawai'i, said Loretta Fuddy, Family Health Services Division chief at the state Health Department.

"I think those are areas that we really need to pay attention," she said.

TEEN DEATHS RISING

Suicide and homicide are also leading causes of death for teens locally and nationally. In this year's report, Hawai'i ranked 13th in the nation for its teen death rate, with 57 deaths per 100,000 teenagers from ages 15 to 19 in 2006, compared with 41 in 2000. Nationally, the rate was 64 deaths per 100,000 teens in 2006.

Yuen said the figures are concerning, especially since some of the deaths are preventable.

"These are things people can do something about," she said.

Meanwhile, Hawai'i also ranked poorly in another key indicator for teens, coming in 31st in the nation for the percentage of those ages 16 to 19 who are not going to school or working. In Hawai'i, about 9 percent of teens fit into the category in 2007, compared with 8 percent nationally. Hawai'i's teen birth rate ranked 27th in the nation — with 41 teens giving birth per 1,000 females ages 15 to 19, compared with 42 teen births nationally.

But there is a bright spot for Hawai'i teens: The state had the third-lowest percentage of teenagers in the nation who dropped out of high school. Four percent of those ages 16 to 19 in 2007 dropped out of high school, according to the study, compared with 5 percent in 2000. Nationally, about 7 percent of teens dropped out.

POVERTY CONCERNS

This is the 20th year the Annie E. Casey Foundation has produced Kid Count, and officials with the organization yesterday said that while national trends show child well-being has improved slightly since 2000, there are still several areas of concern, including the number of children in poverty.

"The poverty rate for children ... of 18 percent in 2007 means 900,000 more children were living in poverty nationally than in 2000, a number that spurs our call for change," said Laura Beavers, coordinator for the national Kids Count project.

The teen birth rate nationally is also trending upward after more than a decade of decline.

In the state-by-state comparisons, New Hampshire ranked first, followed by Minnesota and Utah. The bottom three, in order, were Alabama, Louisiana and Mississippi.

Debbie Spencer-Chun, president and CEO of Adult Friends for Youth, which helps high-risk youth, said the report highlights some distressing trends in child welfare. And she fears those trends are only worsening as more families struggle because of the economic downturn.

"Families are falling on tough times," Spencer-Chun said.

Last year, Hawai'i ranked 13th in the nation, and the year before it was No. 11.

In 2006, it ranked 21st.

In this year's report, other positive indicators for child well-being included the state's infant mortality, which was the 10th-lowest in the nation (at 5.6 per 1,000 births, compared with 6.7 nationally), and the percent of kids living in single-parent families, which was 28 percent in 2007. That's up from 24 percent in 2000, but still lower than the national average.

Hawai'i also ranked 20th this year for the percentage of children living in families where no parent has full-time, year-round employment. That's up from No. 37 last year.