Health needs and health care utilization among rural, low-income women

Background/Significance: Research demonstrates that rural residents experience health disparities, including higher rates of chronic health problems and lower rates of health service utilization. Objective/Purpose: We used Andersen's Model of Behavioral Health to examine the prevalence and correlates of health service utilization in a sample of low-income, rural women. Methods: Data were from Rural Families Speak (RFS) (N=317), a multi-state study of low-income, rural women in the U.S. Health service utilization was measured by frequency of physician visits (high/low) and use of the emergency department (ED) because a regular source of care was unavailable (yes/no). Predictor variables included: predisposing factors (age, marital status, education, ethnicity, perceived availability of health services); enabling factors (poverty, health insurance, regular source of care, social support, rurality); and perceived need (chronic health problems, depression, newly diagnosed health problem, injuries/illnesses in the last year, pregnancy, substance use). Chi-square and multiple logistic regression were utilized. Results: Participants were between 18 and 59 years; 49.2% reported high frequency of physician visits and 31.9% reported using the ED. Women reporting high frequency of physician visits were likelier to have more chronic health problems, injuries or illnesses in the last year, and recent pregnancy. Women reporting ED use were likelier to have clinically significant depressive symptoms. Discussion/Conclusions: Rural low-income women may use health services primarily for acute needs. Public health professionals should work with rural communities to improve the health infrastructure, including educating residents about accessing preventive care and establishing urgent and ready care facilities to improve cost-effective utilization.