Rural maternal, child, and adolescent health

Abstract

Authors cite recommendations for research in light of a general lack of current literature on health status, health services utilization, organization and delivery of health services, and health care financing in this field.

PIP: This article summarizes the most current US national information on rural maternal, child, and adolescent health. Its purpose is to present a state-of-the-art overview of rural demographics and fertility, health status, health services utilization, and health care financing from which future research recommendations can be developed. The research reviewed is extremely limited. Most of the literature uses 1970s data, with few exceptions (rural perinatal care). Published information from the surveys of the National Center for Health Statistics (NCHS) is usually not organized into useful groupings by metro/nonmetro status, such as 3-year child age intervals. Not even micro-data from the NCHS data bases can be considered very useful for rural analysis, because metro/nonmetro status does not adequately take into account variation in population density within and outside of metropolitan statistical areas. Children in nonmetro areas, as compared to children in metro areas, are more likely to be 1) white, living in 2-parent families, residing in the South, and poor; 2) as healthy or slightly healthier, as measured by mortality, acute and chronic conditions, bed days, and drug use; 3) similar or slightly lower users of physician services; 4) served by family or general practitioners rather than pediatricians; and 5) uninsured or underinsured, residing in the least generous Medicaid states, and liable for greater out-of-pocket medical costs relative to their family income.