Exploring inequalities in health care coverage by degree of rurality in western North Carolina

Wil Gesler, Jill E. Sherman, John Spencer, John S. Preisser, Thomas A. Arcury, Jamie L. Perin

Research output: Contribution to journalArticle

Abstract

The purpose of this study is to examine whether or not there is poorer geographic access to health care in more rural counties. Possible inequalities in health care access and utilization were examined for populations living in twelve counties in the mountain region of North Carolina with different degrees of rurality, defined by Beale Code groupings based on urban population size and adjacency to a metro area. Several measures of availability, geographic accessibility, and utilization of practitioners were employed in the study. Data were derived from the U.S. Census, public and proprietary physician databases, and a household survey of 1,059 households. Overall, with some small exceptions, there was little difference in access by degree of rurality at the Beale Code level of analysis. Some types of access were better for more rural populations and some were better for less rural populations. Health Professional Shortage Area (HPSA) guidelines for population to primary care physician ratios, and Health and Services Administration (Bureau of Health Professions) guidlines for travel time and distace were met for the majority of the population. The related issues of how to measure rurality and appropriate geographic scales of analysis are discussed.

Original languageEnglish (US)
Pages (from-to)97-120
Number of pages24
JournalSoutheastern Geographer
Volume46
Issue number1
StatePublished - May 2006
Externally publishedYes

Fingerprint

health care
coverage
rural population
utilization
physician
mountain region
household survey
urban population
health
health professionals
grouping
accessibility
travel time
shortage
population size
census
profession
travel
county
code

Keywords

  • Accessibility
  • Health care
  • Inequalities
  • Rurality
  • Scale
  • Western North Carolina

ASJC Scopus subject areas

  • Geography, Planning and Development
  • Earth and Planetary Sciences(all)

Cite this

Gesler, W., Sherman, J. E., Spencer, J., Preisser, J. S., Arcury, T. A., & Perin, J. L. (2006). Exploring inequalities in health care coverage by degree of rurality in western North Carolina. Southeastern Geographer, 46(1), 97-120.

Exploring inequalities in health care coverage by degree of rurality in western North Carolina. / Gesler, Wil; Sherman, Jill E.; Spencer, John; Preisser, John S.; Arcury, Thomas A.; Perin, Jamie L.

In: Southeastern Geographer, Vol. 46, No. 1, 05.2006, p. 97-120.

Research output: Contribution to journalArticle

Gesler, W, Sherman, JE, Spencer, J, Preisser, JS, Arcury, TA & Perin, JL 2006, 'Exploring inequalities in health care coverage by degree of rurality in western North Carolina', Southeastern Geographer, vol. 46, no. 1, pp. 97-120.
Gesler, Wil ; Sherman, Jill E. ; Spencer, John ; Preisser, John S. ; Arcury, Thomas A. ; Perin, Jamie L. / Exploring inequalities in health care coverage by degree of rurality in western North Carolina. In: Southeastern Geographer. 2006 ; Vol. 46, No. 1. pp. 97-120.
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