There are a couple of ways to look at a poor report card. One is to consider it a sign of failure and throw in the towel. The other is to take it as a challenge to roll up your sleeves, get to work and try to post better scores the next time.

The bottom 10 states in the 2017 Best States for Children's Health Care study, conducted by WalletHub know what they need to do. Many of these states are in the Midwest and South.

"Different authorities have reported state rankings for children's health care over time to help families make informed choices and to advocate for expanded access to quality health care," Melissa D. Carter, clinical professor of law at Emory University, told WalletHub. "Indicators commonly include indicators such as the quality of treatment and access to physicians, including the availability of pediatric specialties, as well as cost efficiencies. The existence of children's health insurance programs is often highlighted as a key factor distinguishing high-performing states from low-performing states."

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WalletHub researchers ranked all 50 states and the District of Columbia using 28 relevant metrics in three general areas:

Each metric was evaluated on a scale of 0 to 100, with 100 representing the best health care for children. States and the district then were ranked from one to 51 based on composite scores. (The complete study methodology and criteria are available here.)

Oklahoma

No. 42: Oklahoma

The Sooner State weighs in with a combined score of 44.26. It ranks near the bottom 20 percent in the key areas of oral health (36th), health and access to health care (41st) and nutrition, physical activity and obesity (45th).

The state offers coverage to low-income children through Medicaid and the Children's Health Insurance Program.

South Carolina

No. 43: South Carolina

South Carolina comes in nearly dead last (50th) for nutrition, physical activity and obesity. It ranks 40th for health and access to health care and 24th for oral health. Its total score is 43.43.

The Palmetto State's Partners for Healthy Children is a free health insurance program for children from low-income families.

Arkansas

No. 44: Arkansas

Arkansas earns a cumulative score of 43.26. It is consistently near the bottom of rankings for nutrition, physical activity and obesity (No. 43); health and access to health care (No. 44); and oral health (No. 45).

ARKids First health insurance offers two options for more than 70,000 children who otherwise might be uninsured. ARKidsA is Medicaid package of comprehensive benefits for low-income families. ARKidsB provides coverage for families with higher incomes.

Georgia

No. 45: Georgia

The Peach State does well in oral health with a national ranking of 14th. However, low marks for health and access to health care (42nd) and nutrition, physical activity and obesity (49th) bring its total score down to 43.22 Georgia also ranks 47th for infant mortality rates.

Georgia offers PeachCare for Kids, a comprehensive health-care program for uninsured children. Health benefits include primary, preventive, specialist, dental care and vision care. PeachCare for Kids also covers hospitalization, emergency room services, prescription medications and mental health care.

Montana

No. 46: Montana

Big Sky Country earns a total score of 42.94. This includes rankings of 41st for oral health; 44th for nutrition, physical activity and obesity; and 45th for health and access to health care.

Montana offers coverage to low-income children through Medicaid and the Children's Health Insurance Program.

Texas

No. 47: Texas

Health and access to health care is the lowest-ranking category (No. 47) for the Lone Star State. It ranks 35th for oral health and 39th for nutrition, physical activity and obesity for an overall score of 40.77. It also ranks 49th for the percentage of insured children ages 17 or younger.

Texas Children's Hospital founded the Texas Children's Health Plan in 1996 to cover children, as well as pregnant women and adults. It provides access to more than 6,250 doctors and 211 hospitals in the state.

Alaska

No. 48: Alaska

The Last Frontier ranks near last (50th) for health and access to health care. It does better in oral health (34th) and nutrition, physical activity and obesity (35th). These scores combine for a cumulative 39.92.

Alaska, like many states, provides Medicaid and the Children's Health Insurance Program as options.

Arizona

No. 49: Arizona

The Grand Canyon State earns a total score of 39.16. This includes low marks for health and access to health (49th) and slightly belter sores for nutrition, physical activity and obesity (42nd) and oral health (38th). Arizona also ranks 49th for the percentage of insured children 17 and younger.

The Arizona Health Care Cost Containment System offers health insurance through KidsCare for eligible children (under age 19) who are not eligible for other health insurance through the system.

Mississippi

No. 50: Mississippi

The Magnolia State comes in dead last in rankings for nutrition, physical activity and obesity; 48th in heath and access to health; and 30th in oral health. It also has the highest infant mortality rate in the nation.

Mississippi Health Benefits offers two health insurance options for low-income children –the Children's Health Insurance Program and Medicaid.

Nevada

No. 51: Nevada

Nevada compiles a last-place total score of 31.97 by ranking 51st in both oral health and health and access to health care. It fares slightly better in nutrition, physical activity and obesity (48th). It also has the nation's lowest percent of insured children ages 17 and younger.

Experts say Nevada's challenges range from a shortage of pediatricians and family care physicians to a transient population that can make obtaining regular preventive care for kids a secondary concern.

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Alan Goforth

Alan Goforth is a freelance writer in suburban Kansas City. In addition to freelancing for several publications, he has written a dozen books about sports and other topics.