Washington fares better than most U.S. states in taking care of its children, especially when it comes to health, according to a new report by Kids Count.

But child advocates say those gains could be hurt if the Census Bureau doesn’t take steps to make sure children are accurately counted in the 2020 decennial census.

Just 3 percent of Washington children did not have health insurance in 2016, according to the report, published last week by the Annie E. Casey Foundation. (County-level data isn’t yet available for that year.)

Overall, Washington ranked 15th nationally in overall childhood well-being, based on a range of economic, health, community and educational metrics. The state ranked fifth in health and 26th in education, just below Wyoming.

Kids Count is a national partnership between the foundation and local child advocacy groups. In Washington, it works with Seattle-based Children’s Alliance and the Washington Budget and Policy Center, a liberal group.

Paola Maranan, executive director of Children’s Alliance, said Washington is doing well overall to expand programs like Apple Health and early childhood education.

“We’re seeing the results of smart investments in kids,” Maranan said. “We end up both cutting the uninsurance rate and the racial and ethnic gap in insurance coverage.”

She said ongoing work is needed to ensure children in rural areas and in Eastern Washington have access to school-readiness programs, which influence elementary school test scores and reading levels. Persistent gaps between white students and students of color also remain an issue, she said.

“We have a long way to go to make sure all 3- and 4-year-olds in our state have access to preschool,” said Misha Werschkul, executive director of the Washington Budget and Policy Center.

Funding and support for children’s programs often relies on census data, and young children in particular often are undercounted, according to the U.S. Census Bureau.

A 2017 Census Bureau report on the 2010 census estimated 1 million children younger than 5 were not counted, about 4.6 percent of the children in that age group. That rate has increased since the 1980 census, while adults were likely to be slightly overcounted in 2010.

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