142nd APHA Annual Meeting and Exposition

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300729
Constructing the 2013 NCHS Urban-Rural Classification Scheme for Counties: A tool for examining health in rural and nonrural areas

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014 : 2:30 PM - 2:50 PM

Deborah D. Ingram, PhD , Office of Analysis and Epidemiology, CDC National Center for Health Statistics, CDC National Center for Health Statistics, Chevy Chase, MD
Sheila Franco, MS , Office of Analysis and Epidemiology, CDC National Center for Health Statistics, CDC National Center for Health Statistics, Hyattsville, MD
Urbanization level of place of residence has long been associated with differences in health outcomes, health behaviors, and health care access and utilization. Identifying these urban-rural health differences is important now and will be even more important in assessing the effects of the Affordable Care Act. This talk will describe construction and validation of the 2013 NCHS Urban-Rural Classification Scheme for Counties. The NCHS scheme was developed specifically for use in studying urban-rural differences in health measures. It has four levels for metropolitan counties (large central metro, large fringe metro, medium metro, and small metro) and two for nonmetropolitan counties (micropolitan and noncore). An important distinguishing feature of the NCHS scheme is its distinction between suburban and central counties of the largest metropolitan areas. Failure to separate these two types of counties can mask important health differences because: 1) residents of suburban counties tend to fare better than residents of central counties and better than residents of other urbanization levels, and 2) residents of central counties tend to fare worse than residents of suburban and smaller metro areas. The 2013 NCHS scheme, an update of the 2006 NCHS scheme; incorporates the 2013 delineation of metropolitan and micropolitan statistical areas and 2010 census data. The usefulness of the NCHS scheme for identifying urban-rural health differences will be illustrated using health measures from the National Health Interview Survey and National Vital Statistics System. Analytic issues encountered when using urban-rural schemes will be discussed.

Learning Areas:

Biostatistics, economics
Conduct evaluation related to programs, research, and other areas of practice
Epidemiology
Program planning
Provision of health care to the public

Learning Objectives:
Name 2 levels of the NCHS Urban-RUral scheme. Describe one mportant feature of the NCHS urban-rural scheme.

Keyword(s): Rural Health, Urban Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have studied urban-rural health differences for over 30 years. I developed the 2013 NCHS Urban-Rural Classification Scheme for Counties showcased in this session, as well as its two predecessors. I co-authored the 2001 Health, United States Chartbook on Urban and Rural Health and the methodology reports for the NCHS schemes.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.