Swipe om te navigeren naar een ander artikel
Researchers have documented lower health-related quality of life (HRQL) in rural areas. This study seeks to identify factors that can explain this disparity.
United Methodist clergy in North Carolina (N = 1,513) completed the SF-12 measure of HRQL and items on chronic disease diagnoses, health behaviors, and health care access from the Behavioral Risk Factor Surveillance Survey (BRFSS). Differences in HRQL between rural (N = 571) and non-rural clergy (N = 942) were examined using multiple regression analyses.
Physical HRQL was significantly lower for rural clergy (−2.0; 95% CI: −2.9 to −1.1; P < 0.001). Income, body mass index, and joint disease partially accounted for the rural/non-rural difference, though a sizable disparity remained after controlling for these mediators (−1.02; 95% CI: −1.89 to −.15; P = 0.022). Mental HRQL did not differ significantly between rural and non-rural respondents (1.0, 95% CI: −0.1 to 2.1; P = 0.067).
Rural/non-rural disparities in physical HRQL are partially explained by differences in income, obesity, and joint disease in rural areas. More research into the causes and prevention of these factors is needed. Researchers also should seek to identify variables that can explain the difference that remains after accounting for these variables.
Log in om toegang te krijgen
Met onderstaand(e) abonnement(en) heeft u direct toegang:
Weeks, W. B., Kazis, L. E., Shen, Y., et al. (2001). Differences in health-related quality of life in rural and urban veterans. American Journal of Public Health, 94(10), 1762–1767. CrossRef
Oguzturk, O. (2008). Differences in quality of life in rural and urban populations. Clinical and Investigative Medicine, 31(6), E346–E350. PubMed
Krivo, L. J., Peterson, R. D., Rizzo, H., & Reynolds, J. R. (1998). Race, segregation, and the concentration of disadvantage: 1980–1990. Social Problems, 45(1), 61–80. CrossRef
Laditka, J. N., Laditka, S. B., & Probst, J. C. (2009). Health care access in rural areas: Evidence that hospitalization for ambulatory care-sensitive conditions in the United States may increase with the level of rurality. Health & Place, 15(3), 731–740. CrossRef
Merwin, E., Snyder, A., & Katz, E. (2006). Differential access to quality rural healthcare: Professional and policy challenges. Family & Community Health, 29(3), 186–194.
Probst, J. C., Laditka, S. B., Wang, J., Johnson, A. O. (2007). Effects of residence and race on burden of travel for care: Cross sectional analysis of the 2001 US National Household Travel Survey. BMC Health Services Research, 7(40).
Zollinger, T., Saywell, R., Smith, M., Robinson, R., & Knudson, N. (2000). Children’s special health care services program: Impact of administrative changes on rural needs. Children’s Health Care, 29(4), 295–311. CrossRef
(2008). The book of discipline of the United Methodist Church (pp. 398–401). Nashville, T.N.: The United Methodist Publishing House.
Ware, J. E., Kosinski, M., & Keller, S. (1998). SF-12: How to score the SF-12 physical and mental health summary scales. 3rd. Lincoln, RI: QualityMetric Inc.
Sheps, C. G. (n.d.) Persistent Health Professional Shortage Areas (PHPSAs) North Carolina, 2005. Available at: ( http://www.shepscenter.unc.edu/research_programs/rural_program/maps.html). Accessed 2 June 2009.
Long, J. S., & Ervin, L. H. (2000). Using heteroscedasticity consistent standard errors in the linear regression model. The American Statistician, 54(3), 217–224. CrossRef
Bliese, P. (2008). multilevel: Multilevel functions. R package version 2.3. Available at: http://cran.r-project.org/package=multilevel. Accessed 4 Oct 2010.
DebRoy, S., Bivand, R., et al. (2009). foreign: Read data stored by Minitab, S, SAS, SPSS, Stata, Systat, dBase,…. R package version 0.8-37. Available at: http://cran.r-project.org/package=foreign. Accessed 4 Oct 2010.
Fox. J. (2009). car: Companion to applied regression. R package version 1.2-15. Available at: http://cran.r-project.org/package=car. Accessed 4 Oct 2010.
Harrell, F. E., with contributions from many other users. (2009). Hmisc: Harrell miscellaneous. R package version 3.7-0. Available at: http://cran.r-project.org/package=Hmisc. Accessed 4 Oct 2010.
Warnes, G. R. (2006). gregmisc: Greg’s miscellaneous functions. R package version 2.1.1. Available at: http://cran.r-project.org/package=gregmisc. Accessed 4 Oct 2010.
Zeileis, A. (2004). Econometric computing with HC and HAC covariance matrix estimators. Journal of Statistical Software, 11(10), 1–17.
Zeileis, A. (2006). Object-oriented computation of sandwich estimators. Journal of Statistical Software, 16(9), 1–16.
R Development Core Team. (2009). R: A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing. ISBN 3-900051-07-0. Available at: http://www.r-project.org. Accessed 4 Oct 2010.
Ware, J., Kosinski, M., Turner-Bowker, D., & Gandek, B. (2002). SF-12v2: How to score version 2 of the SF-12 health survey (with a supplement documenting version 1). Lincoln, RI: QualityMetric Inc.
Brambor, T., Clark, W. R., & Golder, M. (2005). Understanding interaction models: Improving empirical analyses. Political Analysis, 14(1), 63–82. CrossRef
Tickamyer, A. R., & Duncan, C. M. (1990). Poverty and opportunity structure in rural America. Annual Review of Sociology, 16(1), 67–86. CrossRef
(2010). Rural poverty persists. State Legislatures, 36(4), 6.
- Explaining rural/non-rural disparities in physical health-related quality of life: a study of United Methodist clergy in North Carolina
Rae Jean Proescholdbell
- Springer Netherlands