Abstract
BACKGROUND: Previous research suggests that certain populations, including rural residents, exhibit health care avoidant behaviors more frequently than other groups. Additionally, health care avoidance is related to sociodemographics, attitudes, social expectations, ability to pay for care, and prior experiences with providers. However, previous studies have been limited to specific geographic areas, particular health conditions, or by analytic methods.
METHODS: The 2008 Health Information Trends Survey (HINTS) was used to estimate the magnitude of health care avoidance nationally and, while controlling for confounding factors, identify groups of people in the United States who are more likely to avoid health care. Chi-square procedures tested the statistical significance (P < .05) of bivariate relationships. Multivariable analysis was conducted through a weighted multiple logistic regression with backward selection.
RESULTS: For 6,714 respondents, bivariate analyses revealed differences (P < .05) in health care avoidance for multiple factors. However, multiple regression reduced the set of significant factors (P < .05) to rural residence (OR = 1.69), male sex (OR = 1.24), younger age (18-34 years OR = 2.34; 35-49 years OR = 2.10), lack of health insurance (OR = 1.43), lack of confidence in personal health care (OR = 2.24), lack of regular provider (OR = 1.49), little trust in physicians (OR = 1.34), and poor provider rapport (OR = 0.94).
CONCLUSION: The results of this study will help public health practitioners develop programs and initiatives targeted and tailored to specific groups, particularly rural populations, which seek to address avoidant behavior, thereby reducing the likelihood of adverse health outcomes.
Document Type
Article
Publication Date
Winter 2014
Digital Object Identifier (DOI)
http://dx.doi.org/10.1111/jrh.12032
Repository Citation
Spleen, Angela M.; Lengerich, Eugene J.; Camacho, Fabian T.; and Vanderpool, Robin C., "Health Care Avoidance Among Rural Populations: Results From a Nationally Representative Survey" (2014). Health, Behavior & Society Faculty Publications. 4.
https://uknowledge.uky.edu/healthbehavior_facpub/4
Notes/Citation Information
Published in The Journal of Rural Health, v. 30, issue 1, p. 79-88.
© 2013 National Rural Health Association
Per journal publisher: "This is the peer reviewed version of the following article: Spleen, A. M., Lengerich, E. J., Camacho, F. T. and Vanderpool, R. C. (2014), Health Care Avoidance Among Rural Populations: Results From a Nationally Representative Survey. The Journal of Rural Health, 30: 79–88. doi: 10.1111/jrh.12032, which has been published in final form at http://dx.doi.org/10.1111/jrh.12032. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving."