The purpose of this research is to perform an analysis of childhood obesity in rural New York state using the social determinants of health model outlined by H.L. Blum. This model aims to explain health outcomes through behavior, social and physical environment, genetic endowment, and access to healthcare. Prior research has explored the causes of childhood obesity in urban regions but the differentially higher rate of childhood obesity in rural areas relative to urban settings is largely understudied. Quantitative data from the New York State Department of Health, the American Community Survey, and County Health Rankings & Roadmaps were analyzed in an attempt to identify trends in childhood obesity among the seven New York counties of interest: Clinton, Essex, Franklin, Hamilton, Jefferson, St. Lawrence, and Warren. Three public health officials were recruited for phone interviews to discuss childhood obesity within their county in addition to clinical and public health efforts implemented to address the issue. This study supports the environmental determinants of childhood obesity relative to issues of access. Specifically, rural residence and number of individuals per primary care provider were positively correlated with childhood obesity in the region of interest, whereas access to exercise, access to healthy foods, and socioeconomic status were negatively correlated. The individuals interviewed felt that family and school districts are influential in establishing health promoting behaviors from a young age. Increased state and federal funding to improve school wellness policies and the complete streets initiative, which will allow for safe, active transportation, may provide students with increased opportunities to access energy dense foods and exercise opportunities. Future work is required to refine these policies and establish an equitable health environment for children living in rural areas.