This is an archived article that was published on sltrib.com in 2013, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.

For three years running, Forbes has ranked Utah No. 1 for business, an accolade that elected officials love to tout.

However, child advocates — armed with a slew of statistics — are asking why Utah settles for less when it comes to its kids.

The Baltimore-based Annie E. Casey Foundation released the 2013 KIDS COUNT Data Book Monday, charting 16 indicators of child well-being throughout the 50 states. Utah ranks overall at 14th, a slip from last year's 11th position.

"We need to value our children as much as we value our businesses," said Terry Haven, deputy director of Voices for Utah Children. "They are 33 percent of our population and 100 percent of our future."

As a state, Utah has always done "fairly well" by its children, Haven acknowledged. However, with close to one in six kids in poverty, Utah could improve by emulating policies that the nation's top five states have enacted. New Hampshire tops the list as number one, Vermont ranks second, Massachusetts third, Minnesota fourth and New Jersey comes in at number five.

Haven found a common thread among the top five — they focused on health care and preschool, and also used a state-earned income tax credit.

"They're making sure that kids are insured," Haven said. While 11 percent of Utah's children lack health insurance, only 2 percent in Massachusetts and Vermont are uninsured.

For Joy Pizzuto of Lehi — a single, working mother of three — having insurance is critical. Her middle daughter, Avery, was diagnosed with Type 1 diabetes three years ago and now also battles Hashimoto syndrome. Her eldest, Taylor, suffered from epileptic seizures that subsided about a year ago. And Pizzuto survived cancer in 2008.

Pizzuto, an independent contractor who inspects homes, discovered Medicaid through a social worker that helped her navigate the system when Avery was hospitalized before receiving her diabetes diagnosis. Avery is now thriving but relies on lifesaving medications that cost about $1,100 per month.

"I think about insurance every day that I wake up," Pizzuto said. "It's life or death for Avery."

Under current regulations, Pizzuto said she's had to pass up income-generating opportunities because if she makes more than $1,650 per month, she loses Medicaid. While her children could apply for coverage under Utah's Children's Health Insurance Program (CHIP), there would be at least a one-month gap without coverage and she herself would not be insured.

"I wouldn't mind if there were different brackets in Medicaid, where if I make more one month, my co-pay goes up," Pizzuto said. "I just wish there were more options."

According to Lincoln Nehring, senior health policy analyst for Voices for Utah Children, other states that fare more favorably promote their options through outreach.

"Utah has been very hesitant to do that," Nehring said. "We've prohibited our Department of Health from doing any outreach to families to inform them about Medicaid and CHIP. So while some states are going one direction, we're … going the other."Nehring also objects to Utah's requirement that legal immigrant families must wait five years before they can enroll their children in Medicaid or CHIP — even though the state's annual cost would be about $300,000.

"It's not a lot of money when we're talking about health care and the impact it has on the economic well-being and health of families," Nehring said.

Under current practices, Utah has successfully limited the number of people on Medicaid and CHIP, he added.

"We have the lowest uptake rate in the country in terms of eligible kids who get on Medicaid and CHIP," Nehring said. "Best states are 95 percent, we're about 70 percent."

Twitter: @catmck —

How Utah kids measure up

R Utah's ranking in the four KIDS COUNT categories and some of the factors leading to those rankings are:

Economic well-being • 11th (16% of Utah children live in poverty, 25% have parents who lack secure employment)

Education • 30th (60% of Utah children do not attend preschool, 67% of fourth-graders are not proficient in reading)

Family and community • Second (21% of Utah children are in single-parent families, 9 percent live in families where the household head lacks a high school diploma)

Health • 14th (7% of babies have low birth weight), 11% of Utah children lack health insurance)

For more information, visit datacenter.kidscount.org.