The 2004 Kids Count report, which measures the well-being of children in Nebraska for the previous year, shows things are pretty much status quo when it comes to the health, education, safety and home lives of the state's children. But they continue to pay a high emotional, physical and mental price for budgetary and policy shortfalls.

"Children today are on the edge of stability and predictability," said Kathy Bigsby Moore, executive director of Voices for Children Nebraska, which puts together the annual report. "If children have to experience more budget cuts … they are on the cusp of being in much worse circumstances than they ever have before."

When it comes to child well-being, Nebraska, as a whole, ranks about 10th in the nation, according to 2002 statistics released last year by the Annie E. Casey Foundation, which funds the Kids Count Nebraska report.

But in certain areas, Nebraska children are at the bottom of the heap.

Nebraska has the highest rate of children living in foster homes or out-of-home care in the nation, Bigsby Moore said.

"We do not know if our problems are worse here or if we intervene sooner," she said.

Also Nebraska is among the bottom three states in addressing the mental health care needs of its children and youth, she said.

Life in Nebraska can be good, especially if you are white and come from a family with a decent income.

The report, which does not break down all its statistics by ethnicity and income, continues to show that poor children and minorities fare worse when it comes to living in poverty, infant mortality, juvenile arrests, drop-out rates, school expulsions and those placed in foster or out-of-home care.

Specifically the report found:

n Minority students drop out at a much higher rate than white students. In 2003, 1.3 percent of white students dropped out of school, compared to 19.3 percent of Hispanic students and 16 percent of black students.

n A disproportionate number of minority students were expelled from school, compared to white students. The 2003 statistics show that Hispanic students make up 8.5 percent of Nebraska students, but accounted for 11.3 percent of the expulsions in the 2000-01 year, and black students made up 6.5 percent of the state's K-12 student population but represented 31 percent of the expulsions.

n Although Nebraska's infant mortality rate decreased from 7 percent in 2002 to 5.4 percent in 2003, the death rate for black infants was more than three times higher (15.9 percent) than that of white infants (4.8 percent). And among Native babies the infant mortality rate was 13.2 percent. The mortality rate for Hispanic babies was 5.2 percent.

n Minority children make up 15 percent of the state's child population, but represented at least 24 percent of the children placed in out-of-home care in 2003.

n Twenty-seven percent of the state's minority children lived in poverty in 2003.

While the well-being of Nebraska's minority children remains tenuous, years of economic hardship, government budget cuts and increases in health care costs have stretched economic and child-welfare issues into middle class families who previously were spared the torment of deciding whether to pay the utility bill, put food on the table or take their child to the doctor.

Medical debt accounts for more than 50 percent of the bankruptcies in Nebraska, according to the Kids Count report.

In 2004, 89,000 Nebraskans spent more than 25 percent of their earnings on health care.

Although Kids Connection, the state's health insurance and Medicaid program for low-income children, covered 132,000 kids in 2003, another 16,000 Nebraska children were eligible but not enrolled.

And as health insurance premiums continue to rise, employers are raising deductibles, requiring higher co-payments and reducing coverage, the report found. Dr. Stacie  Bleicher, a Lincoln pediatrician said she sees a lot more families without health insurance these days.

"It's a national problem, unfortunately," Bleicher said.

One with a human face. She said she sees families who cannot afford well baby checks and immunizations, so they opt for one or the other. That means some kids are late in getting immunized, and others have developmental delays that go unnoticed until the children are in school, which puts those children even further behind, Bleicher said.

"Health walks hand in hand with education," Bleicher said.

In fact, Kids Count is a report that serves as a sort of Nebraska staircase, showing — from birth to adulthood — how state policies and programs can either help children climb to the top or topple.

"We always need to remember these numbers are about human beings," Bigsby Moore said.

Reach Erin Andersen at 473-7217 or eandersen@journalstar.com.