Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.
College of Nursing, University of Cincinnati, Cincinnati, Ohio, USA.
J Rural Health. 2024 Mar;40(2):314-325. doi: 10.1111/jrh.12802. Epub 2023 Oct 20.
Children in rural communities experience higher mortality rates and less access to health care services than those in urban communities. Protective factors like social support also vary by geography, but their contribution to differences in child health is understudied. Understanding geographic variation in protective health factors could provide insight into their impact on health and guide future intervention strategies.
To examine protective factors' association with child flourishing and child health status in rural and urban communities.
Publicly available data from the National Survey of Children's Health, 2018-2021, with nonmissing geographic data (N = 150,493) were used to assess the relationship between protective factors and child flourishing and health by rurality. Multivariate survey-weighted probit models examined these relationships, adjusting for child and caregiver characteristics.
More than a third of children were not flourishing, according to parental report. An estimated 62% of rural children were flourishing compared to 66% of urban children (P<0.001). Urban caregivers also were more likely to report better adult mental and physical health status. Nevertheless, rural children were reported to receive more social support than urban children, while their caregivers reported more emotional support and living in supportive and safe neighborhoods (P<0.001). Rural caregivers reported more support from places of worship and less from counselors/other mental health care providers than urban caregivers.
Despite higher reported caregiver emotional support and child social support, fewer rural children are flourishing. Health systems and community organizations able to leverage these existing social and emotional protective factors in rural communities could help close this gap.
农村社区的儿童死亡率和获得医疗保健服务的机会均高于城市社区的儿童。社会支持等保护因素也因地理位置而异，但它们对儿童健康差异的贡献尚未得到充分研究。了解保护健康因素的地域差异可以深入了解其对健康的影响，并为未来的干预策略提供指导。
研究保护因素与农村和城市社区儿童健康的关系。
利用 2018-2021 年全国儿童健康调查中公开的、具有完整地理位置数据的（N=150493）数据，按农村和城市社区评估保护因素与儿童健康的关系。多变量调查加权概率模型检验了这些关系，并根据儿童和照顾者的特征进行了调整。
根据父母的报告，超过三分之一的儿童没有茁壮成长。估计有 62%的农村儿童茁壮成长，而城市儿童有 66%（P<0.001）。城市照顾者也更有可能报告自己的心理健康和身体健康状况更好。然而，农村儿童获得的社会支持比城市儿童多，而他们的照顾者报告说得到了更多的情感支持，生活在支持和安全的社区中（P<0.001）。农村照顾者报告说从礼拜场所获得的支持更多，而从辅导员/其他心理健康护理提供者获得的支持较少，而城市照顾者则相反。
尽管农村照顾者报告的情感支持和儿童社会支持较高，但农村儿童茁壮成长的比例较低。能够利用农村社区现有社会和情感保护因素的卫生系统和社区组织可以帮助缩小这一差距。
