Do children in rural areas still have different access to health care? Results from a statewide survey of oregon's food stamp population

Jennifer Devoe, Lisa Krois, Rob Stenger

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33 Citations (Scopus)

Abstract

Purpose: To determine if rural residence is independently associated with different access to health care services for children eligible for public health insurance. Methods: We conducted a mail-return survey of 10,175 families randomly selected from Oregon's food stamp population (46% rural and 54% urban). With a response rate of 31%, we used a raking ratio estimation process to weight results back to the overall food stamp population. We examined associations between rural residence and access to health care (adjusting for child's age, child's race/ethnicity, household income, parental employment, and parental and child's insurance type). A second logistic regression model controlled for child's special health care needs. Findings: Compared with urban children (reference = 1.00), rural children were more likely to have unmet medical care needs (odds ratio [OR] 1.48, 95% confidence interval [CI] 1.07-2.04), problems getting dental care (OR 1.36, 95% CI 1.03-1.79), and at least one emergency department visit in the past year (OR 1.42, 95% CI 1.10-1.81). After adjusting for special health care needs (more prevalent among rural children), there was no rural-urban difference in unmet medical needs, but physician visits were more likely among rural children. There were no statistically significant differences in unmet prescription needs, delayed urgent care, or having a usual source of care. Conclusions: These findings suggest that access disparities between rural and urban low-income children persist, even after adjusting for health insurance. Coupled with continued expansions in children's health insurance coverage, targeted policy interventions are needed to ensure the availability of health care services for children in rural areas, especially those with special needs.

Original languageEnglish (US)
Pages (from-to)1-7
Number of pages7
JournalJournal of Rural Health
Volume25
Issue number1
DOIs
StatePublished - Jan 2009

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Food Assistance
Health Services Accessibility
Population
Health Insurance
Odds Ratio
Confidence Intervals
Delivery of Health Care
Logistic Models
Surveys and Questionnaires
Insurance Coverage
Dental Care
Postal Service
Rural Population
Ambulatory Care
Insurance
Health Services
Prescriptions
Hospital Emergency Service
Public Health

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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Do children in rural areas still have different access to health care? Results from a statewide survey of oregon's food stamp population. / Devoe, Jennifer; Krois, Lisa; Stenger, Rob.

In: Journal of Rural Health, Vol. 25, No. 1, 01.2009, p. 1-7.

Research output: Contribution to journalArticle

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