System- and Individual-Level Barriers to Accessing Medical Care Services Across the Rural-Urban Spectrum, Washington State

Graves, Janessa M.; Abshire, Demetrius A.; Alejandro, Art G

doi:10.1177/11786329221104667

Cited by 10 publications

(5 citation statements)

References 41 publications

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“…[10][11][12] These disparities have been shown to be a result of both structural racism and social determinants of health which place racial-ethnic minorities at higher risk for both contracting COVID-19 and having worse outcomes once infected. 11,13,14 Rural adults are also at increased risk for COVID-related morbidity and mortality because they are more likely to have comorbid conditions, 15,16 less likely to have access to health facilities, 17,18 and are on average older than those living in urban areas. 19 These risk factors, among others, make rural adults more susceptible to COVID-19, particularly without the protection afforded with vaccination.…”

Section: Introductionmentioning

confidence: 99%

COVID‐19 vaccination willingness and uptake among rural Black/African American, Latino, and White adults

Strassle

Green

Colbert

et al. 2023

The Journal of Rural Health

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PurposeThe purpose of this study was to assess differences in COVID‐19 vaccine willingness and uptake between rural and nonrural adults, and within rural racial‐ethnic groups.MethodsWe utilized data from the COVID‐19's Unequal Racial Burden online survey, which included 1,500 Black/African American, Latino, and White rural adults (n = 500 each). Baseline (12/2020‐2/2021) and 6‐month follow‐up (8/2021‐9/2021) surveys were administered. A cohort of nonrural Black/African American, Latino, and White adults (n = 2,277) was created to compare differences between rural and nonrural communities. Multinomial logistic regression was used to assess associations between rurality, race‐ethnicity, and vaccine willingness and uptake.FindingsAt baseline, only 24.9% of rural adults were extremely willing to be vaccinated and 28.4% were not at all willing. Rural White adults were least willing to be vaccinated, compared to nonrural White adults (extremely willing: aOR = 0.44, 95% CI = 0.30‐0.64). At follow‐up, 69.3% of rural adults were vaccinated; however, only 25.3% of rural adults who reported being unwilling to vaccinate were vaccinated at follow‐up, compared to 95.6% of adults who were extremely willing to be vaccinated and 76.3% who were unsure. Among those unwilling to vaccinate at follow‐up, almost half reported distrust in the government (52.3%) and drug companies (46.2%); 80% reported that nothing would change their minds regarding vaccination.ConclusionsBy August 2021, almost 70% of rural adults were vaccinated. However, distrust and misinformation were prevalent among those unwilling to vaccinate at follow‐up. To continue to effectively combat COVID‐19 in rural communities, we need to address misinformation to increase COVID‐19 vaccination rates.

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Section: Introductionmentioning

confidence: 99%

COVID‐19 vaccination willingness and uptake among rural Black/African American, Latino, and White adults

Strassle

Green

Colbert

et al. 2023

The Journal of Rural Health

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“…This finding aligns with previous studies documenting reduced network adequacy and provider scheduling availability for Medicaid services, especially in rural areas, as a significant barrier to care [18] , [29] , [30] . Additionally, disparities associated with social determinants of health, such as race/ethnicity, gender, age, and geography further underscore the validity of the causal relationship between childhood well-being and low income as a structural inequity [8] , [31] , [32] . Provider shortages, especially in rural counties, further exacerbate vision loss and vision care issues in existing medically underserved areas [32] .…”

Section: Discussionmentioning

confidence: 99%

Evaluating the network adequacy of vision care services for children in Arizona: A cross sectional study

Biviji,

Vora,

Thomas

et al. 2024

AIMSPH

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<abstract><sec> <title>Background</title> Vision challenges are among the most prevalent disabling conditions in childhood, affecting up to 28% of school-age children. These issues can impact the development, learning, and literacy skills of affected children. While vision problems are correctable with timely diagnosis and treatment, insufficient networks can impede children's access to comprehensive, and high-quality care. </sec><sec> <title>Objective</title> The study aims to determine where pediatric vision care network adequacy exists in the state of Arizona and where there are gaps in receiving vision care for children. </sec><sec> <title>Methods</title> This cross-sectional study assessed the adequacy of pediatric vision care networks in Arizona through a “secret shopper” phone survey. Calls were made to practices that accept Arizona's Medicaid program, Arizona Health Care Cost Containment System (AHCCCS) and/or commercial insurance. Providers were contacted following a standardized script to schedule routine appointments on behalf of 10 and 3-year-old patients enrolled in either Medicaid or commercial health insurance plans. The study examined various components of children's access to vision care services, including the reliability of provider directory information, time until the next available appointment, bilingual service offerings, ages served, region of practice and types of care available. </sec><sec> <title>Results</title> A total of 556 practices in Arizona were evaluated through simulations as patients on AHCCCS, and 510 practices were assessed through simulations as patients with commercial health insurance plans. The average wait time for the next available appointment was 13 days for both insurance types. Alarmingly, up to 74% of vision care practices in Arizona do not serve children covered by AHCCCS. Furthermore, only 41% provide services to children 5 years and younger. </sec><sec> <title>Conclusions</title> Our findings underscore the need to improve access to vision care services for children in Arizona, especially racial/ethnic minorities, low-income groups, and rural residents. </sec></abstract>

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“…The study analyzed several obstacles to healthcare access across rural and urban areas, revealing notable disparities in barriers at the system level but not at the individual level. After accounting for the characteristics of the respondents ( 51 ), data indicates that rural physicians manage a greater volume of medical consultations per person compared to the national average. Since secondary, tertiary, and special-grade hospitals are concentrated in large and medium-sized cities, rural patients with complex conditions generally seek treatment directly at these urban hospitals ( 52 ).…”

Section: Discussionmentioning

confidence: 99%

Survey and analysis on the resource situation of primary health care institutions in rural China

Zhang

2024

Front. Public Health

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BackgroundChina’s rural population is immense, and to ensure the well-being of rural residents through healthcare services, it is essential to analyze the resources of rural grassroots healthcare institutions in China. The objective is to examine the discrepancies and deficiencies in resources between rural grassroots healthcare institutions and the national average, providing a basis for future improvements and supplementation of rural healthcare resources.MethodologyThe study analyzed data from 2020 to 2022 on the number of healthcare establishments, the capacity of hospital beds, the number of healthcare professionals, and the number of physicians in both rural and national settings. Additionally, it examined the medical service conditions and ratios of township health centers in rural areas to assess the resource gap between rural areas and the national average.ResultsHealthcare establishments: On average, there were 2.2 fewer healthcare institutions per 10,000 persons in rural areas compared to the national average over three years. Hospital beds: On average, there were approximately 36 fewer hospital beds per 10,000 persons in rural areas compared to the national average over three years. Healthcare professionals and physicians: On average, there were about 48 fewer healthcare technical personnel and 10 fewer practicing (including assistant) physicians per 10,000 persons in rural areas compared to the national average over three years.ConclusionCompared to the national average, there are significant discrepancies and deficiencies in grassroots healthcare resources in rural China. This underscores the necessity of increasing funding to progressively enhance the number of healthcare institutions in rural areas, expand the number of healthcare personnel, and elevate medical standards to better align with national benchmarks. Improving rural healthcare resources will strategically equip these institutions to cater to rural communities and effectively handle public health emergencies. Ensuring that the rural population in China has equal access to healthcare services as the rest of the country is crucial for promoting the well-being of rural residents and achieving health equity.

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System- and Individual-Level Barriers to Accessing Medical Care Services Across the Rural-Urban Spectrum, Washington State

Cited by 10 publications

References 41 publications

COVID‐19 vaccination willingness and uptake among rural Black/African American, Latino, and White adults

COVID‐19 vaccination willingness and uptake among rural Black/African American, Latino, and White adults

Evaluating the network adequacy of vision care services for children in Arizona: A cross sectional study

Survey and analysis on the resource situation of primary health care institutions in rural China

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