The differential effects of rural health care access on race-specific mortality

Abstract

We examined the relationship between race-specific rural mortality and the health infrastructure of rural counties in light of America’s recent emergence of a rural mortality penalty. Using the Compressed Mortality File from National Center for Health Statistics (2008–2012) and county-level demographic, socioeconomic, and health care indicators from the Area Health Resource File and the US Census, we created a rural public health infrastructure index which encompasses four types of health care access (public health employees, critical access hospital/rural referral centers, rural health clinics, and emergency departments) within counties. We found that each unit increase in the index is associated with a decline in rural Black mortality, but is associated with an increase in rural White mortality. Policymakers could benefit from focusing on the declining rate of mortality improvement in many rural regions, specifically by trying to better understand how decisions concerning public health spending may influence mortality differently for Black and White residents.

Persistence of death in the United States: The remarkably different mortality patterns between America’s Heartland and Dixieland

“…This literature takes many different forms, particularly regarding the way 'place' is conceptualized, operationalized, and measured. Death rates (and life expectancy) differ markedly between urban and rural counties (Cosby et al 2008;Cossman et al 2010), proximity to urban centers (James 2014), race and region combinations (Singh and Siahpush 2014;James and Cossman 2017;Cossman, James, and Wolf 2017), and race, region, population density, and homicide combinations (Murray et al 2005(Murray et al , 2006. No matter how scientists differ in their various definitions, one thing remains clear: place matters.…”

Framework for a Community Health Observing System for the Gulf of Mexico Region: Preparing for Future Disasters

“…Gender-specific information, including pregnancy status, will be obtained via questionnaires and examinations. Because health status and health-care access differ between rural and non-rural areas ( 57 ), and socioeconomic factors may increase vulnerability of rural residents ( 58 ), we propose a clustered, stratified random sampling design with urban and rural shoreline counties as the initial strata. Target counties and parishes would be stratified by either the Rurality Level ( 54 ) ( Figure 2C ) or the Center for Disease Control and Prevention (CDC)'s Urban-Rural Classification Scheme for Counties ( 59 ).…”

Neighborhood’s locality, walkability, and residents’ multimorbidity: Evidence from the China’s middle-aged and older population

“…The number of primary care institutions in the neighborhood (community health centers, community health care medical posts, township health clinics, and village medical posts) were obtained to measure residents' access to primary care since prior studies have documented that access to health care resources could be associated with population health (Autier et al 2011;Chen et al 2010;Cossman et al 2017). Data were derived from the question "How many community health centers, community health care medical posts, township health clinics or village medical posts in the village or community?".…”