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To determine if child physical abuse hospitalization rates vary across urban-rural regions overall and after accounting for race/ethnicity and poverty demographics.

This was a retrospective cross-sectional study of black, Hispanic, and non-Hispanic white children <5 years of age living in all US counties. US counties were classified as central metro, fringe/small metro, and rural. Incidence rates were calculated using child physical abuse hospitalization counts from the 2012 Kids' Inpatient Database and population statistics from the 2012 American Community Survey. Counties' race/ethnicity demographics and percent of children living in poverty were used to adjust rates.

We identified 3082 child physical abuse hospitalizations occurring among 18.2 million children. Neither crude nor adjusted overall rates of child physical abuse hospitalizations varied significantly across the urban-rural …