A cross-sectional study on health differences between rural and non-rural U.S. counties using the County Health Rankings.
A cross-sectional study on health differences between rural and non-rural U.S. counties using the County Health Rankings.
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DOI：
10.1186/s12913-015-1053-3
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发表时间：
2015-10-01
影响因子：
2.8
通讯作者：
Lutfiyya MN
中科院分区：
文献类型：
--
作者：
Anderson TJ;Saman DM;Lipsky MS;Lutfiyya MN
通过研究来自威斯康星大学和罗伯特·伍德·约翰逊基金会的 2013 年县健康排名和路线图数据，本文旨在补充关于居住在农村和非农村地区的美国居民之间健康差异的现有文献。我们相信，这是第一项使用排名数据来衡量美国农村和城市健康差异的研究，因此强调了国家需要解决农村医疗保健和整体健康方面的不足。数据表明，居住在农村县的美国居民的健康状况普遍比城市居民差。我们使用 2013 年县健康排名数据来评估美国农村和非农村县六个关注领域（死亡率、发病率、健康行为、临床护理、社会和经济因素以及自然环境）的差异。这是一项采用卡方分析和逻辑回归的横断面研究。我们发现，根据构成县健康排名健康质量索引领域的各种衡量标准，居住在美国农村县的居民的健康状况更有可能较差。这些人群在健康行为、发病因素、临床护理和物理环境等方面的得分显着较低（p≤0.05）。我们将这种差异归因于多种因素，包括基础设施的限制、社会经济差异、保险覆盖范围不足以及交通死亡和事故率较高。农村县和非农村县之间最大的差异在于死亡率和临床护理的索引领域。我们的分析揭示了美国农村和非农村县之间县健康排名索引领域的健康结果差异。我们还描述了局限性，并就农村和非农村术语分类中需要更统一的衡量标准提供了评论。这些结果可以影响从业者和政策制定者指导未来的研究和决定资金分配。
By examining 2013 County Health Rankings and Roadmaps data from the University of Wisconsin and the Robert Wood Johnson Foundation, this paper seeks to add to the available literature on health variances between United States residents living in rural and non-rural areas. We believe this is the first study to use the Rankings data to measure rural and urban health differences across the United States and therefore highlights the national need to address shortfalls in rural healthcare and overall health. The data indicates that U.S. residents living in rural counties are generally in poorer health than their urban counterparts. We used 2013 County Health Rankings data to evaluate differences across the six domains of interest (mortality, morbidity, health behaviors, clinical care, social and economic factors, and physical environment) for rural and non-rural U.S. counties. This is a cross-sectional study employing chi-square analysis and logit regression. We found that residents living in rural U.S. counties are more likely to have poorer health outcomes along a variety of measurements that comprise the County Health Rankings’ indexed domains of health quality. These populations have statistically significantly (p ≤ 0.05) lower scores in such areas as health behavior, morbidity factors, clinical care, and the physical environment. We attribute the differences to a variety of factors including limitations in infrastructure, socioeconomic differences, insurance coverage deficiencies, and higher rates of traffic fatalities and accidents. The largest differences between rural and non-rural counties were in the indexed domains of mortality and clinical care. Our analysis revealed differences in health outcomes in the County Health Rankings’ indexed domains between rural and non-rural U.S. counties. We also describe limitations and offer commentary on the need for more uniform measurements in the classification of the terms rural and non-rural. These results can influence practitioners and policy makers in guiding future research and when deciding on funding allocation.