Arizona once again ranks among the worst places in the country for child wellbeing.

The Annie E. Casey Foundation considers education, health, family and economic factors in its annual Kids Count Data Book report. In this year's report, Arizona fell to 44th place among states. Last year, Arizona had ranked 40th. 

“We have high levels of poverty in the state of Arizona, we have issues with our education system in the state of Arizona, we have problems with affordable housing and a lack of access to basic needs, and all of those things contribute to our low ranking,” said Kelley Murphy, vice president of policy with the Arizona nonprofit, Children's Action Alliance.

And Murphy said Arizona has ranked toward the bottom of the list for years. 

“It’s a pattern, it’s not a one-time thing and it’s not something that happened just because of COVID, but it becomes a choice that you make over time if you never move higher in those rankings," Murphy said. 

Arizona’s lowest scores are in the report's education category. The report says 69% of Arizona fourth graders are not proficient in reading and 69% of the state's eighth graders are not proficient in math. 22% of Arizona high school students do not graduate on-time, a figure that has not improved in more than a decade.

The state also scores poorly in several measures of health. Arizona is among states with the highest percentage of children without health insurance. And Arizona's child and teen death rate has also risen. In 2010, the state saw 28 deaths for every 100,000 children and teens; now the rate is 36 per 100,000. Only three other states have higher rates. 

"We can do better than that in Arizona for our children," Murphy said. "We should do better than that."