Examining rural-urban disparities in perceived need for health care services among adults with disabilities

Name: Examining rural-urban disparities in perceived need for health care services among adults with disabilities
Published: 2024-08-30
License: https://creativecommons.org/licenses/by/4.0

Principal Investigator(s): View help for Principal Investigator(s) Catherine Ipsen, Rural Institute for Inclusive Communities at the University of Montana

Version: View help for Version V1

Name	File Type	Size	Last Modified
Data_Summary_Gimm_Ipsen_2022.xlsx	application/vnd.openxmlformats-officedocument.spreadsheetml.sheet	17.5 KB	08/30/2024 06:37:AM
Final Paper PDF.pdf	application/pdf	213.8 KB	08/30/2024 06:36:AM

Project Citation:

Ipsen, Catherine. Examining rural-urban disparities in perceived need for health care services among adults with disabilities. Ann Arbor, MI: Inter-university Consortium for Political and Social Research [distributor], 2024-08-30. https://doi.org/10.3886/E208783V1

Project Description

Summary: Purpose: The purpose of this study is to parse out differences between unmet need and perceived need for health care services among rural and urban adults with disabilities in the United States. While unmet need focuses primarily on environmental factors such as access to health insurance or provider availability, perceived need relates to personal choice. This distinction between unmet and perceived need is largely ignored in prior studies, but relevant to public health strategies to improve access and uptake of preventive care.

Methods: Using Wave 2 data from the National Survey on Health and Disability, we explored rural and urban differences in unmet and perceived health care needs among working-age adults with disabilities for acute and preventive services.

Findings: Although we found no significant differences in unmet needs between rural and urban respondents, we found that perceived needs for dental care and mental health counseling varied significantly across geography. Using logistic regression analysis and controlling for observable participant characteristics, we found that respondents living in noncore counties relative to metropolitan counties were more likely to report not needing dental care (OR 1.89, p = 0.028), and not needing mental health counseling services (OR 2.15, p ≤ 0.001).

Conclusion: These findings suggest additional study is warranted to understand perceived need for preventive services and the levers for addressing rural disparities.

Funding Sources: About the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) (90RTCP0002)

Scope of Project

Subject Terms: Rural; health care; unmet needs; perceived needs; preventive services; disability

Geographic Coverage: United States

Time Period(s): 10/2019 – 1/2020 (Data collection occurred between October 2019 and January 2020, Questions asked about current experiences or experiences within the last year.)

Universe: Population: Adults aged 18 to 64 years living in the U.S. with physical conditions, mental illnesses, impairments, disabilities, or chronic health conditions.

Data Type(s): survey data

Collection Notes: Information related to disability type, health status, transportation, housing, community participation, personal assistance services, public benefits, employment, insurance coverage, unmet health care needs, income, and demographics.

Methodology

Sampling: Sample Size: 2,161 adult respondents
Inclusion Criteria: Adults aged 18 to 64 years with a physical condition, mental illness, impairment, disability, or chronic health condition affecting daily activities.

Data Source: National Survey on Health and Disability (NSHD) (Wave 2)

Collection Mode(s): mail questionnaire; telephone interview; web-based survey

Scales: Socio-demographics: Various categorical scales for age, gender, race/ethnicity, education, marital status, and income.
Disability Measurement: 6-item yes/no questions adapted from the American Community Survey (ACS).
Unmet Needs: Responses categorized as “yes,” “no,” “I don’t know,” and “I did not need.”

Unit(s) of Observation: Individual respondents (adults aged 18-64 with disabilities)

Geographic Unit: United States (Based on county of residence classified as non-core, micropolitan, or metropolitan using the Office of Management and Budget's (OMB) rural-urban classification scheme.)

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Published Versions

V1 [2024-08-30]

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