Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #105498

Marion K. Slack, PhD and Irene Guitierrez, BS. Pharmacy Practice and Science, College of Pharmacy, University of Arizona, P.O. Box 210207, The University of Arizona, Tucson, AZ 85721-0207, 520/626-1099, slack@pharmacy.arizona.edu

The purpose of this presentation is to identify the data analysis issues associated with describing the relationship between rural residence and health status and to present the findings from a path analysis. To illustrate the issues associated with assessing the influence of rural residence on health status, we based the analysis on the theory of sparse populations which posits that rural residence is indirectly related to health status and directly related to poverty, level of education, and unemployment. A three stage path model in which county population represented the first stage, poverty, unemployment, and education, the second stage, and age-adjusted mortality the third stage was used. To illustrate issues associated with how to define rural, we repeated the analysis separating the western counties from the eastern counties along the 90th parallel. For the overall analysis, path coefficients were significant and negative for population and poverty (-0.263), unemployment (-0.111), and education (-0.380), and non-significant for population and age-adjusted mortality (-0.032). Path coefficients were significant and positive for age-adjusted mortality and poverty (0.532), and education (0.246) but negative and non-significant for unemployment (-0.015). The total indirect effect of population on age-adjusted mortality was -0.35. When eastern and western counties were analyzed separately, the indirect effect was -0.654 for eastern counties and -0.061 for western counties. We concluded that a path model represents a method to include the indirect effects of rural residence on health status and that using county population to measure rural operates differently in eastern and western counties.

Learning Objectives: Objectives

• To describe the advantages of a path model for investigating the influence of rural residence on health status
• To discuss the advantages and disadvantages of county population as a measure of rural residence
• Recognize the limitations of county based definitions and data in the western United States.

Keywords: Statistics, Rural Health

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation