The purpose of this annual publication is to heighten awareness of the health of our children by summarizing data on important child health indicators. The NCIOM, in collaboration with NC Child (formerly Action for Children North Carolina), produces the report card to assist health administrators, legislators, and child and family advocates in their efforts to improve the health and safety of children statewide. During the second half of the 1990s, the state’s infant and child uninsured rates and immunization rate improved, but the rate of obesity among low-income children and the use of tobacco and illegal substances increased.