Vanessa Guevara

Document Type

Honors Thesis


Infant mortality rate, an indicator of community health, was 5.6 deaths per 1,000 live births in the United States in 2019. The purpose of this study was to understand rural urban relationships between healthcare resources and infant mortality at the county-level. The design was secondary, cross-sectional, descriptive, comparative, and correlational. There were 471 urban and 15 rural counties with infant mortality data. Average infant mortality rate was higher in rural (M=8.99, SD=1.59) compared to urban (M=6.19, SD=1.74) counties. There was a statistically significant difference for infant mortality, total hospitals, hospitals with NICUs, and OBGYNs in rural compared to urban counties. There was a positive, statistically significant correlation between rate of APRNs per 1,000 and infant mortality per 1,000 in urban and rural counties, indicating that more APRNs were present on average in counties with higher infant mortality. Further research is needed to determine other factors explaining the rural-urban infant mortality disparity.

Publication Date




Faculty Mentor of Honors Project

Jessica G. Smith



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