Current State of Child Health in Rural America: How Context Shapes Children's Health

UMMS Affiliation

Center for Integrated Primary Care; Department of Family Medicine and Community Health

Publication Date


Document Type



Epidemiology | Health Psychology | Health Services Administration | Health Services Research | Integrative Medicine | Maternal and Child Health


PURPOSE: Children's health is influenced by the context in which they live. We provide a descriptive essay on the status of children in rural America to highlight features of the rural environment that may affect health.

DESCRIPTION: We compiled information concerning components of the rural environment that may contribute to health outcomes. Areas addressed include the economic characteristics, provider availability, uniquely rural health risks, health services use, and health outcomes among rural children.

ASSESSMENT: Nearly 12 million children live in the rural United States. Rural counties are economically disadvantaged, leading to higher rates of poverty among rural versus urban children. Rural and urban children are approximately equally likely to be insured, but Medicaid insures a higher proportion of children in rural areas. While generally similar in health, rural children are more likely to be overweight or obese than urban children. Rural parents are less likely to report that their children received preventive medical or oral health visits than urban parents. Rural children are more likely to die than their urban peers, largely due to unintentional injury.

CONCLUSION: Improving rural children's health will require both increased public health surveillance and research that creates solutions appropriate for rural environments, where health care professionals may be in short supply. Most importantly, solutions must be multisectoral, engaging education, economic development, and other community perspectives as well as health care.


children's health, epidemiology, health disparities, rural, social determinants of health

DOI of Published Version



J Rural Health. 2018 Feb;34 Suppl 1:s3-s12. doi: 10.1111/jrh.12222. Epub 2016 Sep 28. Link to article on publisher's site

Journal/Book/Conference Title

The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association


At the time of publication, Paula Gardiner was not yet affiliated with the University of Massachusetts Medical School.

Related Resources

Link to Article in PubMed

PubMed ID