Geographic Differences in School Success Among Children and Adolescents in the United States.

The purpose of this study was to examine the relationship between rurality and challenges to school success: lack of school engagement, school absenteeism, and repeated grade. Cross-sectional data from the 2020 to 2021 National Survey of Children's Health, children ages 6 to 17 ( n  = 42,089), was used. Bivariate and multivariable logistic regression models were used to examine the associations between residence rurality and each outcome of interest. In bivariate analysis, rural children were more likely to have school absenteeism and repeat a school grade. In our adjusted models, there were no differences between rurality and the three measures of school success. Rural and urban children may be vulnerable to different risk factors for school failure. Findings from this study may be used by school nurses and policymakers as they design and implement programs in rural schools.