The report from the Robert Wood Johnson Foundation Commission to Build a Healthier America also said even middle-class children and children in the best-off families are not as healthy as they could be.

"This report shows us just how much a child's health is shaped by the environment in which he or she lives," commission Co-Chairwoman Alice M. Rivlin said in a statement.

In the United States, 16 percent of children ages 17 and younger are in less than optimal health based on their parents' reports -- this rate varies widely across states from a high of 22.8 percent in Texas to a low of 6.9 percent in Vermont.

However, these rates also vary dramatically by income, both nationally and within states. For example, in Texas, 44 percent of children in poor families are in less than optimal health compared with 6.7 percent of children in higher income families.

In New Hampshire 13 percent of poor children are in less than optimal health compared with 6.4 percent of children in higher-income families.

The report can be found at: www.commissiononhealth.org/statedata.