Racial/Ethnic Health Disparities Among Rural Adults—United States, 2012–2015: MMWR Surveillance Summaries / November 17, 2017 / 66(23);1–9

• Published in: Journal of health care for the poor and underserved 2018, Vol.29 (1), p.19-34
• Main Authors: James, Cara V, Moonesinghe, Ramal, Wilson-Frederick, Shondelle M, Hall, Jeffrey E, Penman-Aguilar, Ana, Bouye, Karen
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Adults; Age groups; Aged; Aggregate data; Binge drinking; Blood tests; Census of Population; Classification; Classification schemes; Clinical outcomes; Colorectal cancer; Community; Community health; Counties; Cultural differences; Demographics; Demography; Documentation; Drinking behavior; Economic indicators; Ethnic differences; Ethnic factors; Ethnic groups; Ethnicity; Ethnicity - statistics & numerical data; Fairness; Female; Health behavior; Health care; Health care access; Health care industry; Health care policy; Health disparities; Health needs; Health research; Health services; Health Services Accessibility; Health status; Health Status Disparities; Health surveillance; Hispanic Americans; Humans; Lifestyles; Male; Medical personnel; Medical screening; Medicare; Mental health services; Middle Aged; Minority & ethnic groups; Minority groups; Minority Groups - statistics & numerical data; Needs assessment; Obesity; Pacific Islander people; Population studies; Populations; Public health; Public opinion; Quality of life; Race; Racial Groups - statistics & numerical data; Racial inequality; Response rates; Risk analysis; Risk behavior; Risk Factors; Risk taking; Rural areas; Rural communities; Rural Population - statistics & numerical data; Rural populations; Rurality; Statistical analysis; Statistics; Surveillance; Surveillance systems; Trends; United States; Urban areas; White people; Young Adult
• ISSN: 1049-2089; 1548-6869; 1548-6869
• DOI: 10.1353/hpu.2018.0003

Rural communities often have worse health outcomes, have less access to care, and are less diverse than urban communities. Much of the research on rural health disparities examines disparities between rural and urban communities, with fewer studies on disparities within rural communities. This report provides an overview of racial/ethnic health disparities for selected indicators in rural areas of the United States. 2012-2015. Self-reported data from the 2012-2015 Behavioral Risk Factor Surveillance System were pooled to evaluate racial/ethnic disparities in health, access to care, and health-related behaviors among rural residents in all 50 states and the District of Columbia. Using the National Center for Health Statistics 2013 Urban-Rural Classification Scheme for Counties to assess rurality, this analysis focused on adults living in noncore (rural) counties. Racial/ethnic minorities who lived in rural areas were younger (more often in the youngest age group) than non-Hispanic whites. Except for Asians and Native Hawaiians and other Pacific Islanders (combined in the analysis), more racial/ethnic minorities (compared with non-Hispanic whites) reported their health as fair or poor, that they had obesity, and that they were unable to see a physician in the past 12 months because of cost. All racial/ethnic minority populations were less likely than non-Hispanic whites to report having a personal health care provider. Non-Hispanic whites had the highest estimated prevalence of binge drinking in the past 30 days. Although persons in rural communities often have worse health outcomes and less access to health care than those in urban communities, rural racial/ethnic minority populations have substantial health, access to care, and lifestyle challenges that can be overlooked when considering aggregated population data. This study revealed difficulties among non-Hispanic whites as well, primarily related to health-related risk behaviors. Across each population, the challenges vary. Stratifying data by different demographics, using community health needs assessments, and adopting and implementing the National Culturally and Linguistically Appropriate Services Standards can help rural communities identify disparities and develop effective initiatives to eliminate them, which aligns with a Healthy People 2020 overarching goal: achieving health equity.