Rural Children More Likely to Have Serious Emotional or Behavioral Difficulties

Children and teenagers living outside U.S. metropolitan areas were more likely to have serious emotional or behavioral difficulties than those in cities and suburbs. During 2016–2018, 6.7% of 4- to 17-year-olds in nonmetropolitan areas had them, compared with 5.3% in metropolitan areas — and the difference came from boys.

Children aged 4–17 with serious emotional or behavioral difficulties, 2016–2018; error bars show 95% confidence intervals. Credit: CDC, Morbidity and Mortality Weekly Report*.*

• Boys in nonmetropolitan areas were more likely than boys in metropolitan areas to have serious difficulties.
• Girls showed a smaller difference between the two, and it was not statistically significant.
• In both kinds of area, boys were more likely than girls to have serious difficulties.

How it was measured

Parents in the National Health Interview Survey's Sample Child component — household interviews with a sample of the civilian, noninstitutionalized U.S. population — were asked: "Overall, do you think that (child) has difficulties in any of the following areas: emotions, concentration, behavior, or being able to get along with people?" Answers of "yes, definite difficulties" or "yes, severe difficulties" counted as serious.

Urbanization follows the Office of Management and Budget's February 2013 delineation of metropolitan statistical areas, each of which must contain at least one urbanized area of 50,000 or more people; areas with fewer than 50,000 people are nonmetropolitan.

Sources

Based on "QuickStats: Percentage of Children and Adolescents Aged 4–17 Years with Serious Emotional or Behavioral Difficulties, by Sex and Urbanization Level — National Health Interview Survey, 2016–2018," reported by Jessly Joy and Deepthi Kandi, Morbidity and Mortality Weekly Report, volume 69, Centers for Disease Control and Prevention; a work of the United States government in the public domain. Data: National Health Interview Survey, 2016–2018.