Alabama ranks 48th in the nation for total child well being, according to a new state by state study released by the Annie E. Casey Foundation.

The findings are in the recently released "KIDS COUNT Data Book" report and include nationwide and statewide statistics on health, education, social and economic status.

The study showed that Alabama drastically improved the child death rate, moving from 49th place last year to 39th place this year and the number of children insured.

In the are of infant mortality, however, Alabama still ranks 49th despite a slight increase.

Although the improvements are promising, health care still has a long way to go and the improvements start in places like Pike County.

According to the Alabama Department of Public Health, in 2001 9.2% per 1,000 babies in Pike County had low birthweight.

Low birthweight has a direct impact on child health.

Dr. Albert Woolbright, who works in the Center for Health Statistics within the ADPH, said infants with low birthweight are susceptible to many health problems.

"Babies born with low birthweight are 22 times more likely to die than a normal, healthy baby," Woolbright said.

Woolbright said low birthweight babies are commonly the result of teen pregnancy, which was also sited in the KIDS COUNT study.

"It is especially common among young teenagers who aren't fully developed themselves," he said.

"The babies and the moms are competing for nutrition."

He also said teenagers are "notorious for their nutrition" and don't eat healthy diets while they are pregnant.

In 1998, 76 percent per 1,000 unmarried teens gave birth and 21.6 percent of teens gave birth.

In 2001, the percent of unmarried teenage mothers increased to 80.6 percent.

Woolbright said teen pregnancies are higher in rural counties than in suburban counties.

"It tends to be higher because a lot of the times a lot of the girls don't see anything else," he said.

"They live in poverty and quite often their own mothers had them as teenagers."

On the other hand, girls living in wealthier counties see themselves going to college and being successful and are less likely to risk getting pregnant.

Marty Sheppard, administrative assistant at the AIM Project, said two other factors are the lack of education and drugs and alcohol.

"There is certainly the lack of education," she said.

"Some girls are just not educated about pregnancy and some have no idea how you get pregnant in the first place."

She said drugs and alcohol also play an important role because they impair judgement, even in the teens that know the facts.

On the economic side of child well being, the study showed that too many children are living in poverty.

The Casey Foundation says there is a "high cost of being poor."

The report maintains that low-income families are on the verge of economic crisis and financial security is needed to make a better future for children.

Agreeing with Woolbright's reason for the difference in teen pregnancies of wealthy and poor Alabama counties, William O'Hare, coordinator of the Casey Foundation's KIDS COUNT project, said it is hard for children who grow up in poverty break the cycle.

"Over the years, our research has shown that children who grow up in poverty face tough odds," he said.

"Data show they are more likely to drop out of school, become parents while still teenagers and repeat the cycle of poverty."

More specific study results can be found on the Casey Foundation website, www.kidscount.org.

Pike County statistics are available on the ADPH website, www.adph.org.

The Casey Foundation is a private charitable organization that fosters public policies, human service reforms and community supports that meet the needs of vulnerable children and families.

The Casey Foundation also supplies grants to states, cities and neighborhoods to meet those needs.