SALT LAKE CITY — During the first three years of life, a baby's brain develops faster than at any other time, laying a foundation on which the child will thrive or falter, the impact lifelong.

And the state where the baby is born can make a huge difference.

That's according to national, nonpartisan nonprofits Zero to Three and Child Trends. During a Tuesday press briefing streamed live from Washington, D.C., the organizations released a first-of-its-kind look at states where babies get the start they need and states where programs and policies have gaps that hurt child development.

In general, states in the Northeast ranked the highest across measures, while those in the South ranked near the bottom.

For many states, rankings were mixed. Utah earned the equivalent of two of four stars overall, earning its highest score in the "good health" category and a low score for "positive learning experiences."

The State of Babies Yearbook: 2019 finds that America is home to 12 million infants and toddlers. "The foundation we lay for them today is the most important investment we can make for our society tomorrow." Those three years, the report adds, "are a period of incredible growth and opportunity that shape every year that follows."

An inadequate food supply, unstable housing and being around violence are among factors that undermine a baby or toddler's development. And the report finds that "as many as 45 percent of infants and toddlers live in poor or low-income households" that have a hard time providing basics.

As a result of those and other challenges, the report says, "These children may fall behind early, lag in later education and earnings achievements and experience health problems later in life or even have a shorter lifespan."

Amid those negatives, it's important to view the actual child through a positive frame, according to Myra Jones-Taylor, chief policy officer for Zero to Three. "Rather than labeling babies 'at risk,' we should stamp 'unlimited potential' on each tiny onesie," she said, to change how policymakers view issues that can stunt children and instead will tackle policy challenges.

"Our work is rooted in the belief that every child deserves to live the best, healthiest life possible," said Jamie Bussel, senior program officer at the Robert Woods Johnson Foundation, who was among child advocates who spoke at the event. She said her organization has invested heavily in learning what families need to be healthy; her list includes access to high quality health care, child care and nutritious foods.

Caregivers who have experienced trauma need support, Bussel added, and families need "enough paid family leave to bond." That's the recipe to help not just children but their families thrive, she added.

Bussel and others emphasized a need to work with communities — including individual families, but also policymakers — to be sure that "no babies start and stay behind because of where they live."

Data-driven findings

The yearbook takes data across 60 indicators and groups them under three headings with separate scores: Good Health, Strong Families and Positive Early Learning Experiences.

They found big differences between states on specific measures. For example:

Infant mortality rates range from 0 in Vermont to 9.1 per 1,000 in Alabama. Nationally, the average is 6 deaths per 1,000 infants.

Child maltreatment rates range from 1.6 per 1,000 babies in Pennsylvania to 38.9 in Massachusetts.

The number of children who experience adverse childhood experiences known to follow children into teen years and beyond, creating challenges in adulthood, also varies greatly. In most states, fewer than 10 percent of very young children have had two or more of those adverse experiences, with the low of 2 percent in Massachusetts and a high in Arizona of 27.3 percent.

Rankings for the report are expressed using the word "GROW." The lowest ranking on any of the measures is G, for "getting started," then GR for "reaching forward." States who do better than that are ranked GRO for "improving outcomes." The best score is GROW, the W representing "working effectively."

Massachusetts, New Hampshire, Rhode Island and Vermont were the only states to earn the full GROW ranking in all three measures.

There is no better way to predict the future of our nation than to look at how we are treating our babies today. – Myra Jones-Taylor, chief policy officer for Zero to Three

Other states did better on some measures than others. For example, Utah didn't receive a top score on any category, but was GRO for "good health." In the "strong families" category it earned a GR. The Beehive State earned its lowest mark, a G, for "positive early learning experiences."

Thirteen states got the lowest overall ranking, G: Alabama, Arizona, Arkansas, Florida, Illinois, Kentucky. Mississippi, Nevada, Oklahoma, Tennessee, Texas, West Virginia and Wyoming.

Policy blueprint

Nationally, there's been a demographic shift, and 51 percent of babies are now children of color, the report says. It also notes about half of children under age 3 receive medical care through Medicaid. "Those who are covered have better long-term health, education and employment outcomes than those who are uninsured."

"There is no better way to predict the future of our nation than to look at how we are treating our babies today. It is a bundle of unlimited potential. We cannot afford to squander that," Jones-Taylor said.

Helping babies and infants and their families is incredibly important, said Sen. Steve Daines, a Republican from Montana, who also made a pitch for having more babies. The United States has a birth rate of 1.7 children per woman of childbearing age, below the replacement rate of 2.1. "We have a baby shortage in this country. We need more babies. We need more healthy families," he said.

But babies need adults to step up.

"We know that kids do better when they get a better start," said Terry Haven, interim CEO of Utah Children. She said the Utah Legislature recently appropriated more money for maternal mental health, which is great news for Utah families.

Haven called poverty a major issue reaching deep into family struggles: "We know it's important to read to kids, but if you're working two or three jobs to put food on the table — and that's vital, too — you don't have time to do those important things."

Preschool programs are a great tool to help low-income families, she said, adding first-time parents may also benefit from home visitation programs to answer questions and assess needs.

While the report shows mixed results in terms of helping babies and toddlers, it offers some guidance on what policymakers can do.

Advocates during the press conference highlighted the need to fund family friendly programs and policies, particularly those that help low-income families, such as early childhood development programs, mental health services for low-income parents and more.

States don't all need to do the same things; the goal is to get each state to look at its own rankings and gaps and then address them, Jones-Taylor said.

"Let us take the areas of strength as a national source of pride and the areas of weakness as a national call to action," said Rep. Rosa DeLauro, D-Connecticut.