A closer look at the rural-urban health disparities: Insights from four major diseases in the Commonwealth of Virginia.

Health disparities are increasingly recorded in literature, but are much less understood in a rural-urban context. This study help bridges this gap through investigation of four major diseases in the Commonwealth of Virginia: cancer, stroke, cardiovascular disease and chronic obstructive pulmonary d...

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Published in:Social Science & Medicine Vol. 140; pp. 62 - 69
Main Authors: Zeng, Di, You, Wen, Mills, Bradford, Alwang, Jeffrey, Royster, Michael, Anson-Dwamena, Rexford
Format: Article
Published: Elsevier B.V. Sep2015
Subjects:
Online Access:View this record in EBSCOhost
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      dt: Sep2015
      vid: 140
      pid: 2410
      pub: Elsevier B.V.
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        108787767
        10.1016/j.socscimed.2015.07.011
      ppf: 62
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      tig:
        atl: A closer look at the rural-urban health disparities: Insights from four major diseases in the Commonwealth of Virginia.
      aug:
        au:
          Zeng, Di
          You, Wen
          Mills, Bradford
          Alwang, Jeffrey
          Royster, Michael
          Anson-Dwamena, Rexford
        affil:
          Department of Agricultural and Applied Economics, Virginia Tech, Blacksburg, VA 24061, United States
          Institute for Public Health Innovation, Richmond, VA 23218, United States
          Virginia Department of Health, Richmond, VA 23218, United States
      su:
        Virginia
        Metropolitan areas
        Population geography
        Rural conditions
        Stroke
        Health equity
        Cardiovascular diseases
        Longitudinal method
        Obstructive lung diseases
        Regression analysis
        Tumors
        Health insurance reimbursement
        Statistical significance
        Discharge planning
        Descriptive statistics
      sug:
        subj:
          Metropolitan areas
          Population geography
          Rural conditions
          Stroke
          Health equity
          Virginia
          Cardiovascular diseases
          Longitudinal method
          Obstructive lung diseases
          Regression analysis
          Tumors
          Health insurance reimbursement
          Statistical significance
          Discharge planning
          Descriptive statistics
      keyword:
        Count data
        Decomposition
        Health disparities
        Rural
        Urban
        Count data
        Decomposition
        Health disparities
        Rural
        Urban
      ab: Health disparities are increasingly recorded in literature, but are much less understood in a rural-urban context. This study help bridges this gap through investigation of four major diseases in the Commonwealth of Virginia: cancer, stroke, cardiovascular disease and chronic obstructive pulmonary disease. We utilize a unique inpatient hospital discharge billing dataset, and construct average patient counts at ZIP-code level over 2006–2008 where covariates from alternative sources are merged (806 ZIP-code areas, 190 urban, 616 rural). Count data regressions are first fitted to identify possible regional-level factors that affect disease incidences. A system of equations with rural-urban specification are then estimated via seemingly unrelated regression techniques to account for possible associations among these diseases and correlations of errors, which is followed by disease-specific nonlinear Blinder-Oaxaca decompositions that compare the respective explanatory powers of observed characteristics and unobserved mechanisms. Results suggest that regional-level factors are significantly correlated with health outcomes in both rural and urban areas. The unknown mechanisms behind these linkages are different between rural and urban areas, and explain even larger proportions of the observed disparities. These findings confirm the role of regional-level factors in generating rural-urban health disparities, and call for further investigations of the causal mechanisms of such disparities that remain largely unknown.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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