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. 2016 Aug;106(8):1463-9.
doi: 10.2105/AJPH.2016.303212. Epub 2016 Jun 16.

Intersection of Living in a Rural Versus Urban Area and Race/Ethnicity in Explaining Access to Health Care in the United States

Julia T Caldwell  1 , Chandra L Ford  1 , Steven P Wallace  1 , May C Wang  1 , Lois M Takahashi  1
Affiliations

Intersection of Living in a Rural Versus Urban Area and Race/Ethnicity in Explaining Access to Health Care in the United States

Julia T Caldwell et al. Am J Public Health. 2016 Aug.

Abstract

Objectives: To examine whether living in a rural versus urban area differentially exposes populations to social conditions associated with disparities in access to health care.

Methods: We linked Medical Expenditure Panel Survey (2005-2010) data to geographic data from the American Community Survey (2005-2009) and Area Health Resource File (2010). We categorized census tracts as rural and urban by using the Rural-Urban Commuting Area Codes. Respondent sample sizes ranged from 49 839 to 105 306. Outcomes were access to a usual source of health care, cholesterol screening, cervical screening, dental visit within recommended intervals, and health care needs met.

Results: African Americans in rural areas had lower odds of cholesterol screening (odds ratio[OR] = 0.37; 95% confidence interval[CI] = 0.25, 0.57) and cervical screening (OR = 0.48; 95% CI = 0.29, 0.80) than African Americans in urban areas. Whites had fewer screenings and dental visits in rural versus urban areas. There were mixed results for which racial/ethnic group had better access.

Conclusions: Rural status confers additional disadvantage for most of the health care use measures, independently of poverty and health care supply.

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References

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