Albuquerque, N.M. • As the number of children living in poverty and without health insurance increased in New Mexico, the state fell to last place nationwide in child well-being, a new report released Wednesday showed.

The state’s standing in the Annie E. Casey Foundation’s annual Kids Count report marked a five-year low for New Mexico, which has struggled for years in the rankings and historically has had one of the nation’s highest poverty rates. The state slipped from 49th to 50th in the recent analysis for the first time since 2013, when the effect of long-term unemployment on children was a lingering concern in the country after the recession.

James Jimenez, the executive director for New Mexico Voices for Children, said the report based on 2016 data reflects the reality that poverty and other economic factors from the downturn have had a prolonged effect on New Mexico and its children.

The Kids Count data showed 145,000 children in the state, or 30 percent, were living at or below the federal poverty level in 2016.

Education statistics also were a factor in the state’s bottom-rung ranking, with officials struggling to significantly improve a high school graduation rate of about 71 percent, as well as reading levels among fourth-graders that showed three-fourths of them were not proficient at their grade level. The state ranked last on both fronts in the education category.

“We believe that as the public hears of this, they’ll say enough is enough; this is unacceptable,” said Jimenez, whose Albuquerque-based nonprofit is the state partner of the Annie E. Casey Foundation. “It’s not acceptable that we rank last.”

New Mexico’s slip came as the report’s national economic outlook for children continued to improve, according to the report. The child poverty rate in the United States was at 19 percent in 2016, down 4 points from when it had peaked in 2013.

New Hampshire was ranked highest overall in the report. Mississippi, a state that since 2014 had held the last-place spot, moved up two spots to 48th.

Gov. Susana Martinez’s administration indicated it understood well the need for improving circumstances for children, while seeking to highlight marginal improvements it says emerged in New Mexico during her time as governor.

For example, the state’s high school graduation rate — still hovering just above 71 percent — marks an all-time high for New Mexico at a time when the state has raised standards for receiving a diploma, the administration said.

The U.S. high school graduation rate has recently reached an all-time high, too.

“We know there is still work to be done,” said Benjamin Cloutier, a Martinez spokesman. “That’s why the governor is continuing to fight for better schools, teachers and outcomes for our children — every day.”

Martinez, a Republican, is in the last year of her second and final term.

Her spokesman said progress also could be found in early childhood programs, where enrollment and funding have increased since 2011.

In the upcoming school year, funding for prekindergarten programs for 4-year-olds will be $33.6 million, and for 3-year-olds it will be $28 million, according to the New Mexico Public Education Department.

Early childhood education marked one of the few areas of improvement between 2015 and 2016 in the Kids Count report. The rate of children not attending preschool fell slightly in New Mexico from 58 percent to 57 percent, resulting in the state moving up two spots in the category to 31st place.

Meanwhile, the rate of New Mexico children with health insurance — a bright spot in last year’s report — slipped. The state dropped from 16th place to 33rd in the category, as 5 percent of the state’s children went without health insurance in 2016.