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Maryland showed the second biggest gap in the nation between median income and overall child well-being in an annual survey released Tuesday by the Baltimore-based Annie E. Casey Foundation.

Maryland is the wealthiest state in the nation, according to the 2010 Kids Count survey, yet ranks 25th overall on 10 indicators of health and well-being. It is the second straight year the state has ranked 25th.

The disparity gap is second only to Alaska's, which ranked fourth in income and 38th overall in the survey.

Maryland ranked 42nd out of 50 states in most infant deaths, with eight deaths per 1,000 live births in 2007 and in 2008.

Recent data from the state Department of Health and Mental Hygiene is more positive. According to that data, the rate fell to 7.2 deaths before a first birthday per 1,000 live births in 2009.

Dorchester County had the worst ranking among the 14 Maryland counties surveyed in 2009, with an infant death rate of 21.9, followed by Baltimore city with a rate of 13.5. Montgomery County ranked ninth worst with a rate of 5.5.

"For Maryland to improve its national ranking in infant mortality and other areas of child well-being, it needs to invest more in proven, preventive programs, instead of waiting for problems to occur and then throwing money at the problem," Matthew H. Joseph, executive director of Advocates for Children and Youth, said in a news release.

ACY plans to unveil a series of "cost-neutral" strategies in the coming weeks, aimed at improving outcomes in education, children's health, juvenile justice, child welfare, economic security and racial equity.