Cargando…
Rural-urban disparities in health outcomes, clinical care, health behaviors, and social determinants of health and an action-oriented, dynamic tool for visualizing them
While rural-urban disparities in health and health outcomes have been demonstrated, because of their impact on (and intervenability to improve) health and health outcomes, we sought to examine cross-sectional and longitudinal inequities in health, clinical care, health behaviors, and social determin...
Autores principales: | , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10547156/ https://www.ncbi.nlm.nih.gov/pubmed/37788228 http://dx.doi.org/10.1371/journal.pgph.0002420 |
_version_ | 1785115000101142528 |
---|---|
author | Weeks, William B. Chang, Ji E. Pagán, José A. Lumpkin, Jeffrey Michael, Divya Salcido, Santiago Kim, Allen Speyer, Peter Aerts, Ann Weinstein, James N. Lavista, Juan M. |
author_facet | Weeks, William B. Chang, Ji E. Pagán, José A. Lumpkin, Jeffrey Michael, Divya Salcido, Santiago Kim, Allen Speyer, Peter Aerts, Ann Weinstein, James N. Lavista, Juan M. |
author_sort | Weeks, William B. |
collection | PubMed |
description | While rural-urban disparities in health and health outcomes have been demonstrated, because of their impact on (and intervenability to improve) health and health outcomes, we sought to examine cross-sectional and longitudinal inequities in health, clinical care, health behaviors, and social determinants of health (SDOH) between rural and non-rural counties in the pre-pandemic era (2015 to 2019), and to present a Health Equity Dashboard that can be used by policymakers and researchers to facilitate examining such disparities. Therefore, using data obtained from 2015–2022 County Health Rankings datasets, we used analysis of variance to examine differences in 33 county level attributes between rural and non-rural counties, calculated the change in values for each measure between 2015 and 2019, determined whether rural-urban disparities had widened, and used those data to create a Health Equity Dashboard that displays county-level individual measures or compilations of them. We followed STROBE guidelines in writing the manuscript. We found that rural counties overwhelmingly had worse measures of SDOH at the county level. With few exceptions, the measures we examined were getting worse between 2015 and 2019 in all counties, relatively more so in rural counties, resulting in the widening of rural-urban disparities in these measures. When rural-urban gaps narrowed, it tended to be in measures wherein rural counties were outperforming urban ones in the earlier period. In conclusion, our findings highlight the need for policymakers to prioritize rural settings for interventions designed to improve health outcomes, likely through improving health behaviors, clinical care, social and environmental factors, and physical environment attributes. Visualization tools can help guide policymakers and researchers with grounded information, communicate necessary data to engage relevant stakeholders, and track SDOH changes and health outcomes over time. |
format | Online Article Text |
id | pubmed-10547156 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-105471562023-10-04 Rural-urban disparities in health outcomes, clinical care, health behaviors, and social determinants of health and an action-oriented, dynamic tool for visualizing them Weeks, William B. Chang, Ji E. Pagán, José A. Lumpkin, Jeffrey Michael, Divya Salcido, Santiago Kim, Allen Speyer, Peter Aerts, Ann Weinstein, James N. Lavista, Juan M. PLOS Glob Public Health Research Article While rural-urban disparities in health and health outcomes have been demonstrated, because of their impact on (and intervenability to improve) health and health outcomes, we sought to examine cross-sectional and longitudinal inequities in health, clinical care, health behaviors, and social determinants of health (SDOH) between rural and non-rural counties in the pre-pandemic era (2015 to 2019), and to present a Health Equity Dashboard that can be used by policymakers and researchers to facilitate examining such disparities. Therefore, using data obtained from 2015–2022 County Health Rankings datasets, we used analysis of variance to examine differences in 33 county level attributes between rural and non-rural counties, calculated the change in values for each measure between 2015 and 2019, determined whether rural-urban disparities had widened, and used those data to create a Health Equity Dashboard that displays county-level individual measures or compilations of them. We followed STROBE guidelines in writing the manuscript. We found that rural counties overwhelmingly had worse measures of SDOH at the county level. With few exceptions, the measures we examined were getting worse between 2015 and 2019 in all counties, relatively more so in rural counties, resulting in the widening of rural-urban disparities in these measures. When rural-urban gaps narrowed, it tended to be in measures wherein rural counties were outperforming urban ones in the earlier period. In conclusion, our findings highlight the need for policymakers to prioritize rural settings for interventions designed to improve health outcomes, likely through improving health behaviors, clinical care, social and environmental factors, and physical environment attributes. Visualization tools can help guide policymakers and researchers with grounded information, communicate necessary data to engage relevant stakeholders, and track SDOH changes and health outcomes over time. Public Library of Science 2023-10-03 /pmc/articles/PMC10547156/ /pubmed/37788228 http://dx.doi.org/10.1371/journal.pgph.0002420 Text en © 2023 Weeks et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Weeks, William B. Chang, Ji E. Pagán, José A. Lumpkin, Jeffrey Michael, Divya Salcido, Santiago Kim, Allen Speyer, Peter Aerts, Ann Weinstein, James N. Lavista, Juan M. Rural-urban disparities in health outcomes, clinical care, health behaviors, and social determinants of health and an action-oriented, dynamic tool for visualizing them |
title | Rural-urban disparities in health outcomes, clinical care, health behaviors, and social determinants of health and an action-oriented, dynamic tool for visualizing them |
title_full | Rural-urban disparities in health outcomes, clinical care, health behaviors, and social determinants of health and an action-oriented, dynamic tool for visualizing them |
title_fullStr | Rural-urban disparities in health outcomes, clinical care, health behaviors, and social determinants of health and an action-oriented, dynamic tool for visualizing them |
title_full_unstemmed | Rural-urban disparities in health outcomes, clinical care, health behaviors, and social determinants of health and an action-oriented, dynamic tool for visualizing them |
title_short | Rural-urban disparities in health outcomes, clinical care, health behaviors, and social determinants of health and an action-oriented, dynamic tool for visualizing them |
title_sort | rural-urban disparities in health outcomes, clinical care, health behaviors, and social determinants of health and an action-oriented, dynamic tool for visualizing them |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10547156/ https://www.ncbi.nlm.nih.gov/pubmed/37788228 http://dx.doi.org/10.1371/journal.pgph.0002420 |
work_keys_str_mv | AT weekswilliamb ruralurbandisparitiesinhealthoutcomesclinicalcarehealthbehaviorsandsocialdeterminantsofhealthandanactionorienteddynamictoolforvisualizingthem AT changjie ruralurbandisparitiesinhealthoutcomesclinicalcarehealthbehaviorsandsocialdeterminantsofhealthandanactionorienteddynamictoolforvisualizingthem AT paganjosea ruralurbandisparitiesinhealthoutcomesclinicalcarehealthbehaviorsandsocialdeterminantsofhealthandanactionorienteddynamictoolforvisualizingthem AT lumpkinjeffrey ruralurbandisparitiesinhealthoutcomesclinicalcarehealthbehaviorsandsocialdeterminantsofhealthandanactionorienteddynamictoolforvisualizingthem AT michaeldivya ruralurbandisparitiesinhealthoutcomesclinicalcarehealthbehaviorsandsocialdeterminantsofhealthandanactionorienteddynamictoolforvisualizingthem AT salcidosantiago ruralurbandisparitiesinhealthoutcomesclinicalcarehealthbehaviorsandsocialdeterminantsofhealthandanactionorienteddynamictoolforvisualizingthem AT kimallen ruralurbandisparitiesinhealthoutcomesclinicalcarehealthbehaviorsandsocialdeterminantsofhealthandanactionorienteddynamictoolforvisualizingthem AT speyerpeter ruralurbandisparitiesinhealthoutcomesclinicalcarehealthbehaviorsandsocialdeterminantsofhealthandanactionorienteddynamictoolforvisualizingthem AT aertsann ruralurbandisparitiesinhealthoutcomesclinicalcarehealthbehaviorsandsocialdeterminantsofhealthandanactionorienteddynamictoolforvisualizingthem AT weinsteinjamesn ruralurbandisparitiesinhealthoutcomesclinicalcarehealthbehaviorsandsocialdeterminantsofhealthandanactionorienteddynamictoolforvisualizingthem AT lavistajuanm ruralurbandisparitiesinhealthoutcomesclinicalcarehealthbehaviorsandsocialdeterminantsofhealthandanactionorienteddynamictoolforvisualizingthem |