The Effects of Socioeconomic Status on Health in Rural and Urban America

Blumenthal, Susan J.; Kagen, Jessica

doi:10.1001/jama.287.1.109-jms0102-3-1

Cited by 62 publications

(54 citation statements)

References 1 publication

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“…Therefore, in this study, we examined national childhood disability prevalence rates by sex and disability type. Furthermore, an investigation into regional and subregional (ie, rural or urban counties) differences in childhood disability prevalence rates by sex and disability type was conducted, as rural areas tend to exhibit greater poverty prevalence and poorer health outcomes . The following research questions guided analyses in the present study: Do school‐aged (5‐17‐year‐old) boys have higher disability prevalence rates than girls of comparable age? Are childhood disability prevalence rates higher in socioeconomically disadvantaged regions of the country (ie, MDR and AR) than other areas of the country? Are childhood disability prevalence rates higher in rural areas of socioeconomically disadvantaged regions of the country than in urban areas? …”

supporting

confidence: 91%

Descriptive Epidemiology of Childhood Disability Prevalence by Sex in the Mississippi Delta and Appalachian Regions

McDaniel

Davis

Yahaya

et al. 2019

Journal of School Health

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BACKGROUND: Evidence suggests a rise in childhood disability rates across the United States with males and those with lower socioeconomic status bearing greater burden. We investigated childhood disability rates in the Mississippi Delta (MDR) and Appalachian regions (AR) in comparison to other parts of the country. METHODS:Using data from the US Census Bureau, we calculated childhood disability rates by type and sex at national, regional, and subregional levels. We used risk ratios (RR) to compare childhood disability rates by sex, type, and region. We generated choropleth maps to represent the geographic distribution of disability. RESULTS:Childhood disability was more prevalent, at the national level, among boys (6.64%) than girls (4.08%). Children in the MDR (boys = 8.60%; girls = 5.08%) and AR (boys = 7.81%; girls = 4.83%) had greater risk of disability than those elsewhere in the country (boys = 6.47%; girls = 3.98%), with rates generally higher in rural compared to urban areas in said regions. CONCLUSIONS:Childhood disability affects rural areas of the country more extensively, with the MDR and AR affected to an even greater extent. School-based health centers, in particular, which are disproportionately located in urban areas, could benefit disabled children living in the MDR and AR.

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supporting

confidence: 91%

Descriptive Epidemiology of Childhood Disability Prevalence by Sex in the Mississippi Delta and Appalachian Regions

McDaniel

Davis

Yahaya

et al. 2019

Journal of School Health

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“…Function was assessed using the 'Disability of the Arm, Shoulder, and Hand' (DASH) symptom score, range of motion, and grip strength. Demographic information and pre-injury DASH responses were obtained by interviewing the patient and questioning them on their pre-injury status, and the outcome measures described were obtained at standard follow-up intervals (3,6, and 12 months). Range of motion was recorded after measurement with a goniometer.…”

Section: Methodsmentioning

confidence: 99%

The Association of Education Level on Outcome after Distal Radius Fracture

Paksima

Pahk

Romo³

et al. 2013

Hand (New York, N,Y.)

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Background Socioeconomic factors have been found to be predictors of outcome for other ailments. The purpose of this study was to evaluate the association of patient education level on pain and disability after distal radius fracture. Methods A series of patients with distal radius fractures (n = 335) were enrolled into a prospective research registry. Standard demographic information was obtained from patients, including a five-value categorical education variable. After treatment with closed reduction, external fixation, or internal fixation patients were evaluated for pain, function (Disability of the Arm, Shoulder, and Hand score [DASH]), range of motion (ROM), and grip strength at standard intervals until 12 months post-injury. A series of linear mixed effects models were developed to evaluate the relationship between time from injury and education level with each of the outcomes measured. Results Complete demographic and 12-month follow-up data were available on 227 patients (75 %). There were neither group differences in mode of injury, severity, nor treatment modality after stratification by education level. Mixed effects model analyses revealed a significant linear association between level of education and measured outcomes at each follow-up point. Overall, each increase in education level demonstrated a doubling of improvement in pain, ROM, grip strength, and DASH score. Conclusions Outcome of distal radius fracture depends on acute care and follow-up rehabilitation; however, patientrelated factors indicative of socioeconomic status are becoming increasingly relevant as predictors of outcome and should be considered by the orthopaedist.

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“…Specifically, there are significant disparities in socioeconomic status and levels of education in rural areas compared to urban, with marked lower socioeconomic status and level of education in rural areas (Blumenthal and Kagen, 2002; Hartley, 2004). The geographic distance from central resources in addition to low socioeconomic status, may create a specific burden for affected families in rural areas, as travel costs can deter them from seeking services (Ashburner et al, 2016).…”

Section: Differential Individual and Cultural Characteristics Of Affementioning

confidence: 99%

Rural Trends in Diagnosis and Services for Autism Spectrum Disorder

et al. 2017

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Rural communities face significant challenges regarding the adequate availability of diagnostic-, treatment-, and support-services for individuals with autism spectrum disorder (ASD). Specifically, a variety of factors, including geographic distance between families and service providers, low reliance on health care professionals, and cultural characteristics, contribute to the diminished availability and utilization of services. Together, these factors lead to risks for delayed ASD screening and diagnosis, yielding lower educational and functional outcomes. The purpose of this review is to outline the specific diagnosis and treatment barriers that affect individuals with ASD and their families in rural settings. Telehealth feasibility and efficacy research is also reviewed, suggesting that telecommunication services may offer an inroad for addressing the specific service barriers faced by rural communities. Together, the current review identifies specific needs for both research and support services that address the specific access barriers characteristic of rural settings.

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The Effects of Socioeconomic Status on Health in Rural and Urban America

Cited by 62 publications

References 1 publication

Descriptive Epidemiology of Childhood Disability Prevalence by Sex in the Mississippi Delta and Appalachian Regions

Descriptive Epidemiology of Childhood Disability Prevalence by Sex in the Mississippi Delta and Appalachian Regions

The Association of Education Level on Outcome after Distal Radius Fracture

Rural Trends in Diagnosis and Services for Autism Spectrum Disorder

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