Washington ? Children who live in the Northeast and Upper Midwest get better health care, on average, than those in the South and Southwest, according to a study by a private foundation released today.

The Commonwealth Fund, a nonprofit group that specializes in health care policy, ranked all 50 states and Washington, D.C., overall and in five subcategories: health care access, quality, costs, equity and health outcomes.

Iowa had the highest combined score, followed by Vermont, Maine and Massachusetts. Kansas ranked 10th, while Oklahoma ranked last overall, preceded by Florida, which ranked 50th, and Mississippi, 49th.

Better access to health care and higher insurance coverage rates translate to better quality, the study said. Children from bottom-ranked states were less likely to get vaccines, dental care and regular check-ups, and they had higher infant mortality rates, the study found.

Top scorers Iowa and Vermont expanded their insurance coverage for low-income families. They also require that local and regional children’s health care systems publicly report data on their quality of care.

Expanded insurance coverage such as Medicaid and the State Children’s Health Insurance Program is “critical” to improving the quality of health care of every state, the study said. It found that if all states achieved top-state coverage rates, 4.7 million more children would be insured and 11.8 million more would get their recommended yearly check-ups.

According to the U.S. Census Bureau, 8.7 million children were uninsured in 2006.

Kansas ranked 10th in the study, reflecting subcategory rankings of 12th in access, which is based on insurance coverage; 16th in quality, which is based on vaccination rates, unmet needs and preventive care; 16th in costs; 30th in equity, which is the income-related gap in quality of care; and 23rd in potential to lead healthy lives, which is based on infant mortality rates and risks of developmental delays.

Missouri ranked 28th, with subcategory rankings of 25th in access; 33rd in quality; 17th in costs; 27th in equity; and 29th in potential to lead healthy lives.

The complete report will be posted today at www.commonwealthfund.org.