Purpose: Rural children in developing countries have poor health outcomes in comparison with urban children. This paper considers 4 questions regarding the rural/urban difference, namely: (1) do individual-level characteristics account for rural/urban differences in child nutritional status; (2) do community-level characteristics account for rural/urban differences net of individual-level characteristics; (3) does type of residence alter the influence of individual characteristics; and (4) does the rural/urban difference vary across national contexts?
Method: Analysis is based on Demographic and Health Survey data from 35 developing countries. Multilevel regression is used to examine rural/urban differences in nutritional status net of individual, community and national determinants of health status.
Findings: Rural children have a substantially higher risk of poor nutrition. Much of this disadvantage is because of socioeconomic disadvantage, reproductive norms favoring early and more rapid childbearing, and lack of access to modern medicine. Rural residence also structures the nature of the relationships between socioeconomic status, access to medical care, and nutrition. Finally, the rural/urban gap declines as countries develop.
Conclusion: Rural/urban differences in child nutritional status are substantial, and some—but not all—of the differences are attributable to socioeconomic status, access to medical care, and reproductive norms.