Approximately 1 million infants and toddlers live in ruralⁱ areas in the United States. While some rural communities offer certain protective factors that support positive health and development, many children in rural areas are more likely to face a unique combination of challenges that impact their health and development—for instance, fewer health care providers, barriers to accessing care, and higher rates of poverty.¹ Understanding the unique opportunities and challenges that very young children and their families living in rural areas encounter is an important step for any policymaker working to improve outcomes for all children in their state.

While many public reports provide indicator data on rural health care access at the national level, this brief uses data from the State of Babies Yearbook: 2020ⁱⁱ to examine state-level differences in how infants and toddlers living in rural areas are faring. Equipped with these data, state policymakers can explore strategies to support the needs of very young children and their families.

Key findings include the following:

• Mothers in rural areas are less likely to receive timely prenatal care and more likely to have births that occur outside of hospitals than mothers in urban areas.
• Infants and toddlers in rural areas are less likely to receive a preventive medical or dental visit and less likely to receive recommended vaccines; low-income infants and toddlers in rural families with low incomes are less likely to have health insurance than their peers in urban areas.

Key health outcomes for infants and toddlers in rural areas:

• Infant mortality and preterm birth rates are higher in rural communities than in urban areas.
• Low birth weight is a significant challenge in rural areas for some states, compared to more urban areas.
• Infants in rural areas are less likely than urban infants to be breastfed.