Recorded presentation

Sharon K. Long, PhD¹, Jennifer King, BA¹, and Teresa A. Coughlin, MPH². (1) Health Policy Center, The Urban Institute, 2100 M Street, NW, Washington, DC 20037, 202-261-5725, jking@ui.urban.org, (2) Health Policy Center, Urban Institute, 2100 M Street, NW, Washington, DC, DC 20037

Despite being an important and vulnerable population, very little research has been done on the health care experiences of low-income rural adults. In large part this is because of data limitations. In this paper, we use data from the 1997, 1999 and 2002 National Survey of America’s Families (NSAF), a survey that contains an over-sample of the low-income population, to examine rural-urban differences in access to health care for low-income adults and for the overall adult population. Through regression-based decomposition methods, we determine the share of observed disparities in access to care that can be explained by differences in individual and family characteristics, health and disability status, the local health care market, and community characteristics and the share which cannot be attributed to differences in observed characteristics. Preliminary findings indicate that adults in rural areas have less access to health care than those in urban areas, both in the overall population and the low-income population. Some, but not all, of this disparity can be attributed to differences in the characteristics of the individuals in rural areas and the communities in which they reside. It appears that adults in rural areas face additional access barriers compared to adults with similar characteristics in urban areas. Public efforts to reduce disparities in access to health care for rural residents should take into account the unique circumstances of those individuals and their communities. These include the greater share of elderly persons (and their long term care needs) and the more dispersed and small scale of providers that are available in rural areas.

Learning Objectives:

To document (
• the extent of differences in access to care between adults in urban and rural areas and (
• the degree to which those differences are explained by differences across areas in the characteristics of the adults who live there and/or the characteristics of the local communities.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation