Rural and urban comparisons of access to health care and preventive health practices: Results from the 2008 Montana Behavioral Risk Factor Surveillance System (BRFSS)

Multiple studies have demonstrated that where you live has an impact on your health. Rural populations face significantly different economic and social environments than their urban counterparts. Rural communities are generally poorer, more likely to be elderly and have higher proportion of the population uninsured or underinsured. These risk factors all point toward poorer health outcomes and a greater need for health care services. With roughly 85% of its population living in rural or frontier counties Montana is no exception. However, it is unclear whether Montana's rural communities are limited in their access to health care or preventive measures due to their relative isolation. We analyzed 2008 Montana BRFSS data to further explore this question. Using the Rural-Urban Continuum Codes developed by the USDA to group counties according to their degree of rurality, we compared the health care access measures: not having health insurance, having health insurance but being unable to see a doctor due to cost in the past year (underinsured), having a personal health care provider, reporting a routine checkup within the past 12 months, and the preventive health care measures: receiving recommended influenza and pneumonia vaccinations, and being up to date on recommended routine cancer screening tests (breast, cervical, colorectal and prostrate) among urban, rural adjacent, and rural non-adjacent counties in Montana. The implications of the degree of rurality in Montana communities and corresponding health care measures will be discussed.