In a 34-page pastoral letter released Thursday, Bransfield discusses the state's rates for low birth weight, infant mortality, child abuse and neglect, and the percentage of births to unmarried teens. All are higher than national averages.

Families often struggle to afford good housing, nutritious food and suitable clothing, Bransfield said, while children are further challenged by low academic achievement, and parents who are incarcerated or addicted to drugs.

One in four children live in poverty, he said, as do nearly one-third of children under 5.

"The measures of poverty used by the federal government ... do not adequately capture the real number of people living in poverty among us and do not describe the challenges they face each day of making ends meet,'' the bishop said.

Catholic Charities West Virginia is the second-largest direct provider of services to the poor, and Bransfield said his staff held "listening sessions'' this year at soup kitchens, shelters and schools.

People spoke of feeling "hunted,'' he said, and of being unable to accept a low-paying job for fear of losing medical care and child support. They complained of access and ability to pay for dental care, and about the lack of behavioral health treatment, including care for returning veterans.

"Concern for the poor ... continues to be a corporal work of mercy,'' Bransfield writes. "We are committed to feeding the hungry and clothing the naked; we are committed to educating our young people and tending to the physical and spiritual needs of all.''

Bransfield said the state's Catholic hospitals in Wheeling, Huntington and Buckhannon provide charity care but don't get full reimbursement from the state and federal governments. That compromises their effectiveness, he said. A similar situation exists at Good Shepherd Nursing Home in Wheeling and at St. John's Home for Children of Wheeling, a group home for boys 8-14 with conduct, affective, attention-deficit and impulse-control disorders.

Educational performance in West Virginia is poor, too, with more than three-quarters of eighth-graders in public schools performing below grade in math, reading, science and writing, Bransfield said.

Turning that around will require bold initiatives like Reconnecting McDowell, a public-private venture focused on extreme challenges in the state's southernmost county.

"Such brave thinking should be echoed in other counties throughout the state,'' Bransfield says, "especially the southern coalfields not as wounded economically and socially as McDowell.''

He also urged Catholics to support better funding for pre-kindergarten and in-home education such as the Birth-To-Three program.

"The entire community benefits when families in distress are aided,'' he said.

Bransfield became the eighth bishop of West Virginia in February 2005.

This is his fourth pastoral letter. Two others focused on health care and mental health, while the 2010 "On My Holy Mountain'' missive addressed concerns about mine safety.