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Gepubliceerd in: Quality of Life Research 6/2011

01-08-2011

Explaining rural/non-rural disparities in physical health-related quality of life: a study of United Methodist clergy in North Carolina

Auteurs: Andrew Miles, Rae Jean Proescholdbell, Eve Puffer

Gepubliceerd in: Quality of Life Research | Uitgave 6/2011

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Abstract

Purpose

Researchers have documented lower health-related quality of life (HRQL) in rural areas. This study seeks to identify factors that can explain this disparity.

Methods

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.

Results

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).

Conclusions

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.
Literatuur
1.
go back to reference 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 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
2.
go back to reference Weeks, W. B., Wallace, A. E., Wang, S., Lee, A., & Kazis, L. E. (2006). Rural-urban disparities in health-related quality of life within disease categories of veterans. Journal of Rural Health, 22(3), 204–211.PubMedCrossRef Weeks, W. B., Wallace, A. E., Wang, S., Lee, A., & Kazis, L. E. (2006). Rural-urban disparities in health-related quality of life within disease categories of veterans. Journal of Rural Health, 22(3), 204–211.PubMedCrossRef
3.
go back to reference Kovac, S. H., Mikuls, T. R., Mudano, A., & Saag, K. G. (2006). Health-related quality of life among self-reported arthritis sufferers: Effects of race/ethnicity and residence. Quality of Life Research, 15(3), 451–460.PubMedCrossRef Kovac, S. H., Mikuls, T. R., Mudano, A., & Saag, K. G. (2006). Health-related quality of life among self-reported arthritis sufferers: Effects of race/ethnicity and residence. Quality of Life Research, 15(3), 451–460.PubMedCrossRef
4.
go back to reference Oguzturk, O. (2008). Differences in quality of life in rural and urban populations. Clinical and Investigative Medicine, 31(6), E346–E350.PubMed Oguzturk, O. (2008). Differences in quality of life in rural and urban populations. Clinical and Investigative Medicine, 31(6), E346–E350.PubMed
5.
go back to reference 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 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
6.
go back to reference Hausdorf, K., Rogers, C., Whiteman, D., et al. (2008). Rating access to health care: Are there differences according to geographical region? Australian and New Zealand Journal of Public Health, 32(3), 246–249.PubMedCrossRef Hausdorf, K., Rogers, C., Whiteman, D., et al. (2008). Rating access to health care: Are there differences according to geographical region? Australian and New Zealand Journal of Public Health, 32(3), 246–249.PubMedCrossRef
7.
go back to reference 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 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
8.
go back to reference Litaker, D., Koroukian, S. M., & Love, T. E. (2005). Context and healthcare access: Looking beyond the individual. Medical Care, 43(6), 531–540.PubMedCrossRef Litaker, D., Koroukian, S. M., & Love, T. E. (2005). Context and healthcare access: Looking beyond the individual. Medical Care, 43(6), 531–540.PubMedCrossRef
9.
go back to reference Merwin, E., Snyder, A., & Katz, E. (2006). Differential access to quality rural healthcare: Professional and policy challenges. Family & Community Health, 29(3), 186–194. Merwin, E., Snyder, A., & Katz, E. (2006). Differential access to quality rural healthcare: Professional and policy challenges. Family & Community Health, 29(3), 186–194.
10.
go back to reference 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). 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).
11.
go back to reference Reschovsky, J. D., & Staiti, A. B. (2005). Access and quality: Does rural America lag behind? Health Affairs, 24(4), 1128–1139.PubMedCrossRef Reschovsky, J. D., & Staiti, A. B. (2005). Access and quality: Does rural America lag behind? Health Affairs, 24(4), 1128–1139.PubMedCrossRef
12.
go back to reference Stearns, S. C., Slifkin, R. T., & Edin, H. M. (2000). Access to care for rural medicare beneficiaries. Journal of Rural Health, 16(1), 31–42.PubMedCrossRef Stearns, S. C., Slifkin, R. T., & Edin, H. M. (2000). Access to care for rural medicare beneficiaries. Journal of Rural Health, 16(1), 31–42.PubMedCrossRef
13.
go back to reference 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 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
14.
go back to reference (2008). The book of discipline of the United Methodist Church (pp. 398–401). Nashville, T.N.: The United Methodist Publishing House. (2008). The book of discipline of the United Methodist Church (pp. 398–401). Nashville, T.N.: The United Methodist Publishing House.
15.
go back to reference Bronstein, J. M., Johnson, V. A., & Fargason, C. A. (1997). How rural physicians compare on cost and quality measures for Medicaid ambulatory care episodes. Journal of Rural Health, 13(2), 126–135.PubMedCrossRef Bronstein, J. M., Johnson, V. A., & Fargason, C. A. (1997). How rural physicians compare on cost and quality measures for Medicaid ambulatory care episodes. Journal of Rural Health, 13(2), 126–135.PubMedCrossRef
16.
go back to reference 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. 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.
17.
go back to reference Andrews, G., Henderson, S., & Hall, W. (2001). Prevalence, comorbidity, disability and service utilization: Overview of the Australian National Mental Health Survey. British Journal of Psychiatry, 178, 145–153.PubMedCrossRef Andrews, G., Henderson, S., & Hall, W. (2001). Prevalence, comorbidity, disability and service utilization: Overview of the Australian National Mental Health Survey. British Journal of Psychiatry, 178, 145–153.PubMedCrossRef
18.
go back to reference Ciechanowski, P. S., Katon, W. J., & Russo, J. E. (2000). Depression and diabetes: Impact of depressive symptoms on adherence, function, and cost. Archives of Internal Medicine, 160(21), 3278–3285.PubMedCrossRef Ciechanowski, P. S., Katon, W. J., & Russo, J. E. (2000). Depression and diabetes: Impact of depressive symptoms on adherence, function, and cost. Archives of Internal Medicine, 160(21), 3278–3285.PubMedCrossRef
19.
go back to reference Sanderson, K., Andrews, G., & Jelsma, W. (2001). Disability measurement in the anxiety disorders: Comparison of three brief measures. Journal of Anxiety Disorders, 15(4), 333–344.PubMedCrossRef Sanderson, K., Andrews, G., & Jelsma, W. (2001). Disability measurement in the anxiety disorders: Comparison of three brief measures. Journal of Anxiety Disorders, 15(4), 333–344.PubMedCrossRef
20.
go back to reference Zigmond, A., & Snaith, R. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67, 361–370.PubMedCrossRef Zigmond, A., & Snaith, R. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67, 361–370.PubMedCrossRef
21.
go back to reference Bjelland, I., Dahl, A. A., Haug, T. T., & Neckelmann, D. (2002). The validity of the Hospital Anxiety and Depression Scale. An updated literature review. Journal of Psychosomatic Research, 52(2), 69–77.PubMedCrossRef Bjelland, I., Dahl, A. A., Haug, T. T., & Neckelmann, D. (2002). The validity of the Hospital Anxiety and Depression Scale. An updated literature review. Journal of Psychosomatic Research, 52(2), 69–77.PubMedCrossRef
22.
go back to reference Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606–613.PubMedCrossRef Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606–613.PubMedCrossRef
23.
go back to reference Stafford, L., Berk, M., & Jackson, H. J. (2007). Validity of the Hospital Anxiety and Depression Scale and Patient Health Questionnaire-9 to screen for depression in patients with coronary artery disease. General Hospital Psychiatry, 29(5), 417–424.PubMedCrossRef Stafford, L., Berk, M., & Jackson, H. J. (2007). Validity of the Hospital Anxiety and Depression Scale and Patient Health Questionnaire-9 to screen for depression in patients with coronary artery disease. General Hospital Psychiatry, 29(5), 417–424.PubMedCrossRef
25.
go back to reference MacKinnon, D. P., Fairchild, A. J., & Fritz, M. S. (2007). Mediation analysis. Annual Review of Psychology, 58, 593–614.PubMedCrossRef MacKinnon, D. P., Fairchild, A. J., & Fritz, M. S. (2007). Mediation analysis. Annual Review of Psychology, 58, 593–614.PubMedCrossRef
26.
go back to reference Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173–1182.PubMedCrossRef Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173–1182.PubMedCrossRef
27.
go back to reference 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 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
33.
go back to reference Zeileis, A. (2004). Econometric computing with HC and HAC covariance matrix estimators. Journal of Statistical Software, 11(10), 1–17. Zeileis, A. (2004). Econometric computing with HC and HAC covariance matrix estimators. Journal of Statistical Software, 11(10), 1–17.
34.
go back to reference Zeileis, A. (2006). Object-oriented computation of sandwich estimators. Journal of Statistical Software, 16(9), 1–16. Zeileis, A. (2006). Object-oriented computation of sandwich estimators. Journal of Statistical Software, 16(9), 1–16.
35.
go back to reference 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. 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.
36.
go back to reference 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. 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.
37.
go back to reference Brambor, T., Clark, W. R., & Golder, M. (2005). Understanding interaction models: Improving empirical analyses. Political Analysis, 14(1), 63–82.CrossRef Brambor, T., Clark, W. R., & Golder, M. (2005). Understanding interaction models: Improving empirical analyses. Political Analysis, 14(1), 63–82.CrossRef
38.
go back to reference Hosler, A. S. (2009). Retail food availability, obesity, and cigarette smoking in rural communities. Journal of Rural Health, 25(2), 203–210.PubMedCrossRef Hosler, A. S. (2009). Retail food availability, obesity, and cigarette smoking in rural communities. Journal of Rural Health, 25(2), 203–210.PubMedCrossRef
39.
go back to reference Jackson, J. E., Doescher, M. P., Jerant, A. F., & Hart, L. G. (2005). A national study of obesity prevalence and trends by type of rural county. Journal of Rural Health, 21(2), 140–148.PubMedCrossRef Jackson, J. E., Doescher, M. P., Jerant, A. F., & Hart, L. G. (2005). A national study of obesity prevalence and trends by type of rural county. Journal of Rural Health, 21(2), 140–148.PubMedCrossRef
40.
go back to reference Joens-Matre, R. R., Welk, G. J., Calabro, M. A., et al. (2008). Rural–urban differences in physical activity, physical fitness, and overweight prevalence of children. Journal of Rural Health, 24(1), 49–54.PubMedCrossRef Joens-Matre, R. R., Welk, G. J., Calabro, M. A., et al. (2008). Rural–urban differences in physical activity, physical fitness, and overweight prevalence of children. Journal of Rural Health, 24(1), 49–54.PubMedCrossRef
41.
go back to reference Patterson, P. D., Moore, C. G., Probst, J. C., & Shinogle, J. A. (2004). Obesity and physical inactivity in rural America. Journal of Rural Health, 20(2), 151–159.PubMedCrossRef Patterson, P. D., Moore, C. G., Probst, J. C., & Shinogle, J. A. (2004). Obesity and physical inactivity in rural America. Journal of Rural Health, 20(2), 151–159.PubMedCrossRef
42.
go back to reference Cha, E. S., Kong, K. A., Moon, E. K., & Lee, W. J. (2009). Prevalence and changes in chronic diseases among South Korean farmers: 1998 to 2005. BMC Public Health, 9, 268.PubMedCrossRef Cha, E. S., Kong, K. A., Moon, E. K., & Lee, W. J. (2009). Prevalence and changes in chronic diseases among South Korean farmers: 1998 to 2005. BMC Public Health, 9, 268.PubMedCrossRef
43.
go back to reference Joshi, V. L., & Chopra, A. (2009). Is there an urban-rural divide? Population surveys of rheumatic musculoskeletal disorders in the Pune region of India using the COPCORD Bhigwan model. The Journal of Rheumatology, 36(3), 614–622.PubMedCrossRef Joshi, V. L., & Chopra, A. (2009). Is there an urban-rural divide? Population surveys of rheumatic musculoskeletal disorders in the Pune region of India using the COPCORD Bhigwan model. The Journal of Rheumatology, 36(3), 614–622.PubMedCrossRef
44.
go back to reference Callahan, L. F., Shreffler, J., Mielenz, T., et al. (2008). Arthritis in the family practice setting: Associations with education and community poverty. Arthritis and Rheumatism, 59(7), 1002–1008.PubMedCrossRef Callahan, L. F., Shreffler, J., Mielenz, T., et al. (2008). Arthritis in the family practice setting: Associations with education and community poverty. Arthritis and Rheumatism, 59(7), 1002–1008.PubMedCrossRef
45.
go back to reference Cvijetić, S., Kurtagić, N., & Ozegović, D. D. (2004). Osteoarthritis of the hands in the rural population: A follow-up study. European Journal of Epidemiology, 19(7), 687–691.PubMedCrossRef Cvijetić, S., Kurtagić, N., & Ozegović, D. D. (2004). Osteoarthritis of the hands in the rural population: A follow-up study. European Journal of Epidemiology, 19(7), 687–691.PubMedCrossRef
46.
go back to reference Lee, D., Steffes, M., & Jacobs, D. R. (2007). Positive associations of serum concentration of polychlorinated biphenyls or organochlorine pesticides with self-reported arthritis, especially rheumatoid type, in women. Environmental Health Perspectives, 115(6), 883–888.PubMedCrossRef Lee, D., Steffes, M., & Jacobs, D. R. (2007). Positive associations of serum concentration of polychlorinated biphenyls or organochlorine pesticides with self-reported arthritis, especially rheumatoid type, in women. Environmental Health Perspectives, 115(6), 883–888.PubMedCrossRef
47.
go back to reference Tickamyer, A. R., & Duncan, C. M. (1990). Poverty and opportunity structure in rural America. Annual Review of Sociology, 16(1), 67–86.CrossRef Tickamyer, A. R., & Duncan, C. M. (1990). Poverty and opportunity structure in rural America. Annual Review of Sociology, 16(1), 67–86.CrossRef
48.
go back to reference (2010). Rural poverty persists. State Legislatures, 36(4), 6. (2010). Rural poverty persists. State Legislatures, 36(4), 6.
Metagegevens
Titel
Explaining rural/non-rural disparities in physical health-related quality of life: a study of United Methodist clergy in North Carolina
Auteurs
Andrew Miles
Rae Jean Proescholdbell
Eve Puffer
Publicatiedatum
01-08-2011
Uitgeverij
Springer Netherlands
Gepubliceerd in
Quality of Life Research / Uitgave 6/2011
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-010-9817-z

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