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Bar graph: Children by Location Bar graph: Children by Location and Age Bar graph: Children by Location and Poverty Status

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Preventive Health Care

The Bright Futures guidelines for health supervision of infants, children, and adolescents recommend that children visit a physician six times during the first year, three times in the second year, and annually thereafter for preventive health care visits.1 An annual preventive health care visit provides an opportunity to monitor a child’s growth and development, to assess his or her behavior, to provide appropriate immunizations, to discuss important issues regarding nutrition and prevention of injury and violence, and to answer parents’ questions about their children’s health and care.

Overall, 88.5 percent of children received a preventive care visit in the past year. This percentage was slightly higher in urban areas (89.0 percent) than in rural areas (86.3 percent of children in large rural areas and 85.9 percent of those in small rural areas).

Among younger children, urban children were the most likely to receive an annual preventive health visit. This discrepancy was greatest among children aged 6-11; within this age group, 86.5 percent of urban children received an annual visit, compared to less than 81 percent of rural children. Among adolescents, the proportion who received an annual preventive visit did not vary by location.

Among children in low-income households, the likelihood of having an annual preventive health visit did not vary substantially across locations. Among children with higher household incomes, however, urban children were more likely than those in rural areas to receive an annual visit. For example, among children with household incomes of 400 percent of the Federal poverty level or more, 91.9 percent of those in urban areas had an annual visit, compared to 84.9 percent of those in small rural areas.

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1 Hagan JF, Shaw JS, Duncan PM, eds. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents. 3rd edition. Elk Grove Village, IL: American Academy of Pediatrics, 2008.


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