Changes in Health Insurance Coverage Within Rural and Urban Environments—1977 to 1987

Abstract

This study examines changes in the health insurance coverage of the nonelderly population in rural and urban areas between 1977 and 1987, using data from the National Medical Care Expenditure Survey (NMCES) and the National Medical Expenditure Survey (NMES). It was designed to test the hypothesis that differences in the rates of health insurance coverage in rural and urban areas have diminished over time, and to explore the composition of changes in coverage within rural and urban environments. The data suggest that the proportions of the populations that are without health insurance in rural and urban areas have converged since 1977. Although both rural and urban settings witnessed increases in the proportion of their populations without health insurance from any source, urban regions experienced a greater increase than did rural areas. These changes occurred among most subgroups within the population. In no subgroup did the percentage of the population without insurance in urban areas exceed that found in rural areas in either 1977 or 1987.

Rural-Urban Differences in Health Insurance Coverage and Patterns Among Working-Age Adults in Kentucky

“…An earlier national study found that the overall rates of uninsured in rural and urban areas have converged since 1977. 11 This study found little or no rural-urban difference in the percent of residents with health insurance for the United States as a whole. However, national patterns do not necessarily reflect the experiences of individual states.…”

Do Health Insurance and Residence Pattern the Likelihood of Tubal Sterilization among American Women?

“…Rural place of residence has been shown to have an independent effect on the type of health insurance coverage even when controlling for income level (Duncan et al 1995). Indeed, more people are insured by Medicaid in rural areas, 15.6%, compared with urban areas, 12.5% (King et al 2007).…”

“…The debate has centered on the relative contributions of race and ethnicity, as well as socioeconomic status to disparities in health, such as ambulatory visits, insurance coverage, and prenatal care. One study (Duncan et al 1995) finds that the likelihood of having health insurance differs across racial subgroups and health disparities are more severe in rural than in urban areas. Other research (Probst et al 2004) finds that the clustering of economically disadvantaged racial and ethnic minorities in rural areas is compounded by the context itself, which offers limited education and economic opportunity.…”

Comparison of urban and rural non-fatal injury: the results of a statewide survey

“…A larger proportion of rural than urban residents are known to be uninsured. [26][27][28] Would having sought medical care for an injury for which others with less access to care would not have sought such care result in more accurate recall among urban residents? Harel et al in their study of recall of childhood injuries found that doctor visits due to injuries could not explain the variation in recall for the various time periods.…”