Nearly half of young children in Minnesota risk a rocky start to life.

According to a new report by the Wilder Foundation, nearly 200,000 children under age 6 live in Minnesota counties where poverty and unemployment rates are high, education and health coverage may be inadequate and other risk factors to healthy development are common.

The foundation produced a county-by-county survey of these risk factors, then invited Minnesotans to a public forum Wednesday to discuss what can be done to improve early childhood outcomes.

“It’s really not meant to point fingers. It’s meant to start the conversation: ‘OK, what can we learn from this? What counties are doing better, and what can we learn from them?’ ” said Richard Chase, one of the report’s co-authors.

The report singled out 15 high-risk counties where children can face a series of hurdles — from higher-than-average rates of parental unemployment to lower-than-average rates of prenatal care.

High-risk counties ranged from urban Ramsey County, where 28 percent of children under 6 live in poverty, to Mahnomen County, where the infant mortality rate is nearly three times the state average.

In an otherwise prosperous state, researchers found pockets of stark disparity, particularly in areas with large American Indian communities or larger minority populations.

In north-central Wadena County, a quarter of young children had no working parents. In Mahnomen, nearly a quarter of babies were born to mothers who had not finished high school. In Mille Lacs, children under 5 were three times more likely to have had a maltreatment report filed with the county than the state average.

In Todd County, 16 percent of young children had no health insurance. Barely a third of 2-year-olds in Chisago County have had their recommended immunizations. In Beltrami County, 45 out of every 1,000 children under 6 were living in foster care.

What the study could not quantify, Chase said, were the intangible factors working in children’s favor: The “strength and resilience” of families and communities and the broad network of public agencies and private nonprofits working to stretch out a safety net.

Working to even out those odds are a small army of state, county, community and nonprofit groups that offer assistance ranging from child care to health care to literacy programs. In central Minnesota, the Little Falls-based Initiative Foundation — one of six independent regional foundations around the state — serves five of the 15 highest-risk counties.

The foundation’s programs range from early literacy programs to a program designed to ensure poor children have access to dental care. The foundation’s $120,000 early childhood program budget, stretches across a service area that ranges from reservations to immigrant communities in St. Cloud to rural Pine County. The foundation works to help not only the children and their parents, but their support networks in the communities, like child care providers.

“If we can help both sides in that equation, we can really make a difference,” said Terri Konczak, who is working on the foundation’s dental outreach program. “If we can improve the quality of life for the caregivers and the children, we can really move the needle. That’s really exciting.”