Pediatric mortality rates in the US have declined since 1999, although rates among non-Hispanic black and American Indian/Alaska Native children remain higher than those among non-Hispanic white children. We used mortality data from the Centers for Disease Control and Prevention to ascertain whether children living in rural areas experienced declines in mortality over the period 1999-2017 that paralleled those for the nation as a whole. Throughout the study period and across all age groups, rural children experienced higher mortality rates than their urban peers. Among rural children, non-Hispanic black infants and American Indian/Alaska Native children were particularly at risk. To reduce unnecessary rural pediatric and adolescent deaths, we recommend ongoing surveillance of rural children's health accompanied by policies targeting the leading causes of death in this population: unintentional injury and suicide.
Keywords: Access to care; Children’s health; Emergency medical care; Health disparities; Health policy; Hospital closures; Mortality rates; Rural health care; Young adults; mortality.