The health and well-being of Hawaii's children declined in recent years and an annual report warns that their plight is much worse than national data indicate. It is likely to become more bleak with the recession-prompted cutbacks of state programs aimed at helping vulnerable keiki at a time when they are most in need.

The Annie E. Casey Foundation's annual Kids Count report, based on 2007 statistics, ranks Hawaii 18th-best in the nation in well-being of children, down from 13th in last year's ratings, based on 2006 information. Hawaii's teen death rate, lowest in the country in last year's report at 37 per 100,000 teens, rose to 57 per 100,000, falling to 13th-lowest.

The report ranks states on infant mortality, child and teen deaths, high-school dropouts and teens not in school and not working. It reports with concern that the national teen birth rate rose; Hawaii's rate stayed about the same.

The most distorted statistics regard children living in poverty. Hawaii placed second-lowest at 11 percent, which is misleading because it is based on children in four-member families with incomes of less than $21,027, and is especially distorted when applied to Hawaii.

The Casey Foundation said “;perhaps the most glaring shortfall comes in our efforts to measure poverty, the key performance indicator that rises above the others in its impact on children's futures.”; Casey pointed out that the formula was developed in the 1960s, calculating the cost of a basic grocery budget for a certain family size and multiplying it by three, because it represented one-third of a typical family budget.

The was nearly a half-century ago and fails to account for today's cost of child care, transportation, health insurance and government assistance. Food now accounts for about one-seventh of a typical family budget. Differences in the cost of living in Hawaii is reflected but not nearly enough.

Children are most vulnerable during an economic crisis. During a slump in 1995, cases of serious child abuse in Hawaii requiring hospital care rose from an average of 30 a year to 175, said Dr. Steven Choy, director and clinical psychologist for the Kapiolani Child Protection Center. “;These are not monsters; these are families in trouble,”; he said.

Choy and others are justifiably concerned about the dropping from the Department of Health's budget about $10 million that had been designated in the current fiscal year for Healthy Start, a child-abuse prevention project that began in 1985. Two programs providing $1.3 million to needy families in Leeward Oahu and East Hawaii from the Department of Human Services continue, but the overall setback remains troublesome at a critical time.