Uninsured Rural Families

Ziller, Erika C.; Coburn, Andrew F.; Anderson, Nathaniel J.; Loux, Stephenie

doi:10.1111/j.1748-0361.2008.00131.x

Cited by 24 publications

(17 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous research has established that because of a myriad of cultural and structural factors, rural areas often are overburdened by both chronic disease (especially hypertension, diabetes, and obesity) and depression (e.g., Probst et al, 2006; Smalley et al, 2010; Warren & Smalley, 2014). This is coupled with the fact that rural residents are more likely to face financial barriers to medication adherence resulting from higher rates of poverty and being uninsured among this population (Casey, Klingner, & Moscovice, 2002; Meit et al, 2014; Mitchell, Mathews, Hunt, Cobb, & Watson 2001; Mueller & Schur, 2004; Ziller, 2014; Ziller, Coburn, Loux, Hoffman, & McBride, 2003). …”

mentioning

confidence: 99%

Connection between depression and inability to fill prescriptions in rural FQHC patients with chronic disease.

Kb¹,

Jc²,

Kn³

2016

Journal of Rural Mental Health

View full text Add to dashboard Cite

The purpose of this paper was to (1) examine the rates of elevated depression symptoms among a sample of rural Federally Qualified Health Center (FQHC) patients with chronic disease and (2) determine if an inability to afford general prescription medications within the past 12 months is a significant predictor of depression symptoms among these patients. These data came from Project EDUCATE, an ongoing five-year study designed to be a large-scale, multifocal examination of the needs and experiences of rural FQHC patients with hypertension and/or diabetes. A total of 497 rural FQHC patients completed surveys (including a series of psychosocial questions, the Multigroup Ethnic Identity Measure and the Center for Epidemiologic Studies Depression scale) as part of phase one of the project; 438 of these with complete data are included in the current analytic sample. Results revealed that 53.0% of the sample screened positive for depression, and over half of those who screened positive reported not being able to afford their prescription medications at least once within the past 12 months (51.3% vs. 26.3% non-depressed). Further, even after controlling for age, ethnic identity attachment, sex, education level, employment status, income, insurance status, recent inability to afford needed medical care, hypertensive status, mental health diagnosis, and family history of mental illness, patients who could not afford to fill their prescriptions in the past 12 months were 2.6 times as likely to screen positive for depression (ORADJ = 2.476, p = 0.002) as those who could afford their medications. Overall, results of this study suggest that, among rural patients diagnosed with chronic disease, depressive symptomatology may be alarmingly high and an inability to afford medications may be an important risk factor for depression symptoms. These results highlight the need for increased attention to prescription medication affordability among rural patients with chronic disease in order to reduce the risk of comorbid depression.

show abstract

mentioning

confidence: 99%

Connection between depression and inability to fill prescriptions in rural FQHC patients with chronic disease.

Kb¹,

Jc²,

Kn³

2016

Journal of Rural Mental Health

View full text Add to dashboard Cite

show abstract

“…Future studies should replicate the model in Figure 1 using urban or nationally representative datasets to determine whether the mechanisms identified in this study are operational in other geographic contexts. One hypothesis is that marital disruption might have larger impacts on rural women’s health and use of health care because rural populations have lower rates of health insurance coverage, poorer access to medical care, and poorer overall health compared to urban populations (Ziller et al 2003). Additionally, divorced women in rural areas are perhaps even more disadvantaged than their urban counterparts, as evidenced by their poorer job prospects and higher rates of poverty (Brown and Lichter 2004).…”

Section: Discussionmentioning

confidence: 99%

“…Specifically, women, individuals in single-adult households, lower income adults, and less healthy adults have been shown to have higher rates of underinsurance than their respective counterparts (Oswald et al 2005; Schoen et al 2008). Divorce compounds the risk of underinsurance for women in rural areas, as rural populations already face an elevated risk (Ziller et al 2003). …”

Section: Literature Reviewmentioning

confidence: 99%

“…Many rural areas in the U.S. suffer from inadequate and deteriorating health infrastructures, and a corresponding shortage of physicians, nurses, and other medical personnel (Morton 2004; National Advisory Committee on Rural Health and Human Services 2008; Ziller et al 2003). As a result, rural residents in need of medical care often face problems with appointment scheduling, may be required to travel long distances to find appropriate specialists and medical services, and may lack public transportation options to reach those services (Glasgow, Morton and Johnson 2004).…”

Section: Literature Reviewmentioning

confidence: 99%

See 1 more Smart Citation

What Explains Divorced Women's Poorer Health? The Mediating Role of Health Insurance and Access to Health Care in a Rural Iowan Sample

2012

View full text Add to dashboard Cite

The economic restructuring in rural areas in recent decades has been accompanied by rising marital instability. To examine the implications of the increase in divorce for the health of rural women, we examine how marital status predicts adequacy of health insurance coverage and health care access, and whether these factors help to account for the documented association between divorce and later illness. Analyzing longitudinal data from a cohort of over 400 married and recently divorced rural Iowan women, we decompose the total effect of divorce on physical illness a decade later using structural equation modeling. Divorced women are less likely to report adequate health insurance in the years following divorce, inhibiting their access to medical care and threatening their physical health. Full-time employment acts as a buffer against insurance loss for divorced women. The growth of marital instability in rural areas has had significant ramifications for women’s health; the decline of adequate health insurance coverage following divorce explains a component of the association between divorced status and poorer long-term health outcomes.

show abstract

“…Studies of insurance coverage have consistently found differences between rural counties adjacent to urban counties and more remote ''nonadjacent'' counties. Populations in nonadjacent counties tend to be poorer, are less likely to be privately insured, and are more likely to be uninsured or publicly insured than those in rural counties adjacent to an urban area or urban counties (Larson and Hill 2005;Lenardson et al 2009;Ziller et al 2008). Constrained by the sampling frame and limited access to geographic identifiers, we were only able to examine patterns in children's Medicaid/CHIP participation according to a dichotomous rural measure, which may obscure important differences across different types of rural areas.…”

Section: Discussionmentioning

confidence: 99%

Rural and Urban Differences in Children's Medicaid and CHIP Participation

King

Holmes²,

Slifkin³

2010

INQUIRY

View full text Add to dashboard Cite

Efforts to increase enrollment in Medicaid and the Children's Health Insurance Program (CHIP) among uninsured children would benefit from an understanding of how program participation varies in rural and urban areas. Using Current Population Survey data from the period 2006–2007, rural participation rates were slightly higher than urban rates in the nation overall. There was no rural-urban difference when comparisons were based on within-state variation, independent of adjustment for individual characteristics. For researchers examining health policy issues strongly influenced by state policies or other state-level factors, this study highlights the challenges presented by national data sets with small or nonexistent samples from geographic areas within some states.

show abstract

Uninsured Rural Families

Cited by 24 publications

References 13 publications

Connection between depression and inability to fill prescriptions in rural FQHC patients with chronic disease.

Connection between depression and inability to fill prescriptions in rural FQHC patients with chronic disease.

What Explains Divorced Women's Poorer Health? The Mediating Role of Health Insurance and Access to Health Care in a Rural Iowan Sample

Rural and Urban Differences in Children's Medicaid and CHIP Participation

Contact Info

Product

Resources

About