Tennessee slipped farther down the ranks as one of the worst states in the nation for child well-being, according to an annual report released Tuesday.
Based on 10 indicators such as the number of children living in poverty and rates of infant mortality and high school graduates, Tennessee ranked 46th in the nation, down from 42nd last year.
"We are in the bottom five in the country," said Linda O'Neal, executive director of the Tennessee Commission on Children and Youth. "Some of the messages for us are that, in areas where we have implemented good public policies, we've seen improvement."
* Infant death rate: 8.3 (per 1,000 births)
* High school dropout rate: 9.6 percent
* Teen birth rate: 28.6 (per 1,000 females ages 15-19)
* Low birth-weight (less than 5.5 pounds) babies: 1.8 percent
Source: Kids Count report
Tennessee policies mandating school attendance until age 18 and linking driver licensing to student attendance have helped raise the state's high school graduation rate, which now stands at 82.2 percent, she said.
The 20th annual Kids Count report is compiled by the Annie E. Casey Foundation, a private Baltimore-based organization that supports initiatives to help disadvantaged children and families. The state commission helps collect Tennessee data to give to the Casey Foundation for its Kids Count Report.
The report released Tuesday uses health and education data from 2006 and 2007.
Georgia fared only slightly better than Tennessee at 42nd in the country, down from 40th the year before.
According to the report, Tennessee continues to struggle with issues of infant mortality and low birth weight.
Diana Kreider, maternal child health program manager with the Chattanooga-Hamilton County Health Department, called the county's infant mortality rate "a huge problem."
According to the department's own numbers, Hamilton County's infant mortality rate -- defined as a child dying during its first year -- was 11.2 per 1,000 births in 2009. The rate was nearly twice as high among black children.
"Hamilton County is higher than the state rate, the national rate and higher than many Third World country rates," she said.
In 2007, Tennessee's infant mortality rate was 8.3 per 1,000 deaths, state figures show. In 2004, the latest year in which figures are available, the United States' infant mortality rate was 6.78 per 1,000 births, according to the Centers for Disease Control and Prevention.
Casey Foundation officials said the national report also shows an increase in the teen birth rate for the first time in 14 years. In 41 states, more teenagers gave birth in 2007 than in 2006, said Laura Beavers, coordinator of the Kids Count project.
The percentage also increased in Tennessee and Georgia.
"It's especially disconcerting because we know it can have a long-term effect on the teen parent and the newborn," Ms. Beavers said. "This is truly a disturbing shift in this indicator."
Tennessee's low rankings are not a surprise to most health officials, Ms. O'Neal said.
Tennessee -- and many Southern states -- struggle similarly every year, due largely to the region's poverty level.
"There is what's called the 'Southern deficit,' and it's closely related to the poverty in the South," she said. "When we do things to help increase education levels ... that will help."