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Intersection of living in a rural versus urban area and race/ethnicity in explaining access to health care in the United States

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  • Caldwell, J.T.
  • Ford, C.L.
  • Wallace, S.P.
  • Wang, M.C.
  • Takahashi, L.M.

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) andcervical 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. © 2013 American Public Health Association.

Suggested Citation

  • Caldwell, J.T. & Ford, C.L. & Wallace, S.P. & Wang, M.C. & Takahashi, L.M., 2016. "Intersection of living in a rural versus urban area and race/ethnicity in explaining access to health care in the United States," American Journal of Public Health, American Public Health Association, vol. 106(8), pages 1463-1469.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2016.303212_6
    DOI: 10.2105/AJPH.2016.303212
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    Cited by:

    1. Elizabeth Lawrence & Robert A. Hummer & Kathleen Mullan Harris, 2017. "The Cardiovascular Health of Young Adults: Disparities along the Urban-Rural Continuum," The ANNALS of the American Academy of Political and Social Science, , vol. 672(1), pages 257-281, July.
    2. Megan E. Gandy & Kacie M. Kidd & James Weiss & Judith Leitch & Xavier Hersom, 2021. "Trans*Forming Access and Care in Rural Areas: A Community-Engaged Approach," IJERPH, MDPI, vol. 18(23), pages 1-13, December.
    3. Donna L. Schminkey & Xiaoyue Liu & Sandra Annan & Erika Metzler Sawin, 2019. "Contributors to Health Inequities in Rural Latinas of Childbearing Age: An Integrative Review Using an Ecological Framework," SAGE Open, , vol. 9(1), pages 21582440188, January.
    4. Radney, Angelise & Lee, Joyce Y. & Xu, Amy & Steinke, Hannah R. & Mengo, Cecilia & Johnson-Motoyama, Michelle, 2024. "Racial and ethnic disparities in healthcare utilization among children in U.S. foster care: Recommendations to challenge the status quo based on a scoping review," Children and Youth Services Review, Elsevier, vol. 162(C).
    5. Whitney E. Zahnd & Cathryn Murphy & Marie Knoll & Gabriel A. Benavidez & Kelsey R. Day & Radhika Ranganathan & Parthenia Luke & Anja Zgodic & Kewei Shi & Melinda A. Merrell & Elizabeth L. Crouch & Hea, 2021. "The Intersection of Rural Residence and Minority Race/Ethnicity in Cancer Disparities in the United States," IJERPH, MDPI, vol. 18(4), pages 1-26, February.
    6. Thorsen, Maggie L. & Harris, Sean & Palacios, Janelle F. & McGarvey, Ronald G. & Thorsen, Andreas, 2023. "American Indians travel great distances for obstetrical care: Examining rural and racial disparities," Social Science & Medicine, Elsevier, vol. 325(C).
    7. Jeffrey E. Hall & Ramal Moonesinghe & Karen Bouye & Ana Penman-Aguilar, 2019. "Racial/Ethnic Disparities in Mortality: Contributions and Variations by Rurality in the United States, 2012–2015," IJERPH, MDPI, vol. 16(3), pages 1-18, February.
    8. Ortiz, Gabriela & Rodriguez, Sophia & Pozar, María & Moran, Ashley & Cheney, Ann, 2024. "Seeking care across the US-Mexico border: The experiences of Latinx and Indigenous Mexican caregivers of children with asthma or respiratory distress," Social Science & Medicine, Elsevier, vol. 347(C).
    9. Kyu-Tae Han & SeungJu Kim, 2021. "Regional Prevalence of Dyslipidemia, Healthcare Utilization, and Cardiovascular Disease Risk in South Korean: A Retrospective Cohort Study," IJERPH, MDPI, vol. 18(2), pages 1-11, January.
    10. Doogan, Nathan J. & Roberts, Megan E. & Wewers, Mary Ellen & Tanenbaum, Erin R. & Mumford, Elizabeth A. & Stillman, Frances A., 2018. "Validation of a new continuous geographic isolation scale: A tool for rural health disparities research," Social Science & Medicine, Elsevier, vol. 215(C), pages 123-132.
    11. Cui, Chengsen & Zhang, Yue & Ding, Ruoxi & He, Ping, 2024. "Impact of the Essential Public Health Service program on financial protection and health outcomes among hypertensive patients: A quasi-experimental study in China," Social Science & Medicine, Elsevier, vol. 345(C).
    12. Heewon Chea & Hyun Kim & Shih-Lung Shaw & Yongwan Chun, 2022. "Assessing Trauma Center Accessibility for Healthcare Equity Using an Anti-Covering Approach," IJERPH, MDPI, vol. 19(3), pages 1-21, January.
    13. Cheryl Dye & Deborah Willoughby & Begum Aybar-Damali & Carmelita Grady & Rebecca Oran & Alana Knudson, 2018. "Improving Chronic Disease Self-Management by Older Home Health Patients through Community Health Coaching," IJERPH, MDPI, vol. 15(4), pages 1-23, April.

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