Objective: The prevalence of adverse childhood experiences (ACEs) increased during the COVID-19 pandemic, but rural-urban differences have not yet been analyzed. This study examines rural-urban disparities in the prevalence of and predictors of experiencing ACEs during COVID-19.

Methods: Using data from the 2021-2022 National Health Interview Survey, rural-urban differences in the type and number of ACEs and the odds of having experienced four or more ACEs were analyzed.

Findings: Rural children were more likely to experience most ACEs; there were no significant differences for racial discrimination. After adjustment, there were no rural-urban differences in the odds of having four or more ACEs. Children with a lower household income had greater odds of experiencing four or more ACEs than those with a higher income, regardless of rurality.

Conclusions: The findings of this study may be helpful in guiding stakeholders considering the populations in need of resources for impacts of ACEs, particularly rural children and children in poverty.

目标： 在COVID-19大流行期间，不良童年经历（ACEs）的普遍率增加，但城乡差异尚未进行分析。本研究探讨了在疫情期间遭受ACEs的城乡差异及其预测因素。

方法： 利用2021-2022年全国健康访谈调查的数据，分析了农村和城市地区在ACEs类型和数量上的差异以及经历过四次或更多次ACEs的概率。

发现： 与城市儿童相比，农村儿童更有可能经历大多数ACEs；种族歧视方面没有显著差异。调整后，在城乡之间经历了四次或更多次ACEs的概率上不存在显著差异。无论生活在何处，家庭收入较低的儿童比家庭收入较高的儿童经历四次或更多次ACEs的可能性更大。

结论： 本研究的结果可能有助于指导相关利益方为受ACEs影响的人群提供资源时考虑其需求，特别是农村地区的儿童和生活在贫困中的儿童。