Challenges Associated With Rural-Urban Stratification for Generalizing Birth Outcomes: Insights From the ECHO Cohort

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Analyzes the validity of preterm birth (PTB) prevalence and generalizability related to rural versus urban stratification within the Environmental influences on Child health Outcomes (ECHO) Cohort. Examines PTB prevalence during the 2017-2019 and 2020-2022 ECHO cohorts as compared to county-level PTB prevalence from the National Center for Health Statistics (NCHS), further broken down by rural versus urban location and demographic variables. Discusses similarities and differences in PTB prevalence proportions using ECHO versus NCHS and the importance of further context when defining rural places.

Daniel Beene, Debra A. MacKenzie, Carlos A. Camargo Jr., et al.

Journal of Rural Health, 42(2), e70163

05/2026

Children and youth · Maternal health and prenatal care · Rural definitions · Rural-urban differences · Statistics and data