Abstract
The objective of this study was to identify differences in child care availability by rural–urban location for all counties in Wisconsin, and describe implications for recruitment and retention of health care workforce. We used data on licensed child care slots for young children (age <5), socio-demographic characteristics, women’s and men’s labor force participation, and household structure for all counties in Wisconsin in 2013 (n = 72). Data came from KIDS COUNT, County Health Rankings, and the American Community Survey. We used t tests to analyze bivariate differences in child care availability and community characteristics by metropolitan, micropolitan, and non-core rural location. We then used ordinary least squares regression to analyze the relationship between geographic location and child care slots, adjusting for labor force participation and household structure. Rural counties had significantly fewer licensed child care slots per child than metropolitan and micropolitan counties. These counties also had, on average, higher rates of poverty and higher unemployment than micropolitan and metropolitan counties. The association between geographic location and child care availability remained, even after adjusting for household structure and labor force participation. The number of hours men worked and the percentage of men not working were both negatively associated with available child care slots, whereas there was not a significant relationship between women’s labor force participation and child care availability. Rural areas face health care workforce shortages. Recruitment strategies to overcome shortages must move beyond individual-level incentives to focus on community context and family support, including availability of child care in rural counties.
Similar content being viewed by others
References
Douthit, N., Kiv, S., Dwolatzky, T., & Biswas, S. (2015). Exposing some important barriers to health care access in the rural USA. Public Health, 129(6), 611–620.
Kenfield, S. A., Geller, A. C., Richter, E. M., Shuman, S., O’Riordan, D., Koh, H. K., & Colditz, G. A. (2005). Sun protection policies and practices at child care centers in Massachusetts. Journal of Community Health, 30(6), 491–503.
Nandi, A., Glymour, M. M., Kawachi, I., & VanderWeele, T. J. (2012). Using marginal structural models to estimate the direct effect of adverse childhood social conditions on onset of heart disease, diabetes, and stroke. Epidemiology (Cambridge, MA), 23(2), 223–232.
Rural Assistance Center. (2015). Rural health disparities. Retrieved from https://www.raconline.org/topics/rural-health-disparities.
Beverly, C. J., Mcatee, R., Costello, J., Chernoff, R., & Casteel, J. (2005). Needs assessment of rural communities: A focus on older adults. Journal of Community Health, 30(3), 197–212.
Atkinson, N. L., Billing, A. S., Desmond, S. M., Gold, R. S., & Tournas-Hardt, A. (2007). Assessment of the nutrition and physical activity education needs of low-income, rural mothers: Can technology play a role? Journal of Community Health, 32(4), 245–267.
Berry, D., Blair, C., Ursache, A., Willoughby, M., Garrett-Peters, P., Vernon-Feagans, L., et al. (2014). Child care and cortisol across early childhood: Context matters. Developmental Psychology, 50(2), 514–525.
Kozhimannil, K. B., Casey, M. M., Hung, P., Han, X., Prasad, S., & Moscovice, I. S. (2015). The rural obstetric workforce in US hospitals: Challenges and opportunities. The Journal of Rural Health: Official Journal of the American Rural Health Association and the National Rural Health Care Association, 31(4), 365–372.
MacDowell, M., Glasser, M., Fitts, M., Nielsen, K., & Hunsaker, M. (2010). A national view of rural health workforce issues in the USA. Rural and Remote Health, 10(3), 1531.
MacDowell, M., Glasser, M., Fitts, M., Fratzke, M., & Peters, K. (2009). Perspectives on rural health workforce issues: Illinois-Arkansas comparison. The Journal of Rural Health: Official Journal of the American Rural Health Association and the National Rural Health Care Association, 25(2), 135–140.
Brooks, R. G., Walsh, M., Mardon, R. E., Lewis, M., & Clawson, A. (2002). The roles of nature and nurture in the recruitment and retention of primary care physicians in rural areas: A review of the literature. Academic Medicine: Journal of the Association of American Medical Colleges, 77(8), 790–798.
Shoffner, S. M. (1986). Child care in rural areas: Needs, attitudes, and preferences. American Journal of Community Psychology, 14(5), 521–539.
Atkinson, A. M. (1994). Rural and urban families’ use of child care. Family Relations, 43(1), 16–22.
Gordon, R. A., & Chase-Lansdale, P. L. (2001). Availability of child care in the United States: A description and analysis of data sources. Demography, 38(2), 299–316.
Pungello, E. P., & Kurtz-Costes, B. (1999). Why and how working women choose child care: A review with a focus on infancy. Developmental Review, 19(1), 31–96.
Hunsberger, M., Baumann, A., Blythe, J., & Crea, M. (2009). Sustaining the rural workforce: Nursing perspectives on worklife challenges. The Journal of Rural Health: Official Journal of the American Rural Health Association and the National Rural Health Care Association, 25(1), 17–25.
Daniels, Z. M., Vanleit, B. J., Skipper, B. J., Sanders, M. L., & Rhyne, R. L. (2007). Factors in recruiting and retaining health professionals for rural practice. The Journal of Rural Health: Official Journal of the American Rural Health Association and the National Rural Health Care Association, 23(1), 62–71.
Pepper, C. M., Sandefer, R. H., & Gray, M. J. (2010). Recruiting and retaining physicians in very rural areas. The Journal of Rural Health: Official Journal of the American Rural Health Association and the National Rural Health Care Association, 26(2), 196–200.
Hancock, C., Steinbach, A., Nesbitt, T. S., Adler, S. R., & Auerswald, C. L. (2009). Why doctors choose small towns: A developmental model of rural physician recruitment and retention. Social Science & Medicine (1982), 69(9), 1368–1376.
Pathman, D. E., Fryer, G. E., Jr, Phillips, R. L., Smucny, J., Miyoshi, T., & Green, L. A. (2006). National health service corps staffing and the growth of the local rural non-NHSC primary care physician workforce. The Journal of Rural Health: Official Journal of the American Rural Health Association and the National Rural Health Care Association, 22(4), 285–293.
Dolea, C., Stormont, L., & Braichet, J. M. (2010). Evaluated strategies to increase attraction and retention of health workers in remote and rural areas. Bulletin of the World Health Organization, 88(5), 379–385.
Lehmann, U., Dieleman, M., & Martineau, T. (2008). Staffing remote rural areas in middle- and low-income countries: A literature review of attraction and retention. BMC Health Services Research, 8, 19.
American Planning Association. (2011). Child care and sustainable community development (No. Family-Friendly Communities Briefing Papers 01). Chicago, IL: American Planning Association.
Del Boca, D. (2002). The effect of child care and part time opportunities on participation and fertility decisions in Italy. Journal of Population Economics, 15(3), 549–573.
Rindfuss, R. R., Guilkey, D. K., Morgan, S. P., & Kravdal, O. (2010). Child-care availability and fertility in Norway. Population and Development Review, 36(4), 725–748.
Rindfuss, R. R., Guilkey, D., Morgan, S. P., Kravdal, O., & Guzzo, K. B. (2007). Child care availability and first-birth timing in Norway. Demography, 44(2), 345–372.
McGill, B., & Sullivan, A. (2014). You may be surprised by the states that support pre-K. National Journal. Retrieved from http://www.nationaljournal.com/s/92209/democratic-primaries-bernie-sanders-taddevine-mulvey-longabaugh?mref=scroll.
Fuller, B., Coonerty, C., Kipnis, F., & Choong, Y. (1997). An unfair start: California families face gaps in preschool and child care availability. Berkeley, CA: Berkeley-Stanford PACE Center, Yale University, and the California Child Care Resource and Referral Network: Growing Up in Poverty Project.
Annie E. Casey Foundation. (2015). KIDS COUNT data center. Retrieved from http://datacenter.kidscount.org/.
U.S. Census Bureau. (2015). American FactFinder. Retrieved from http://factfinder.census.gov/faces/nav/jsf/pages/index.xhtml.
University of Wisconsin Population Health Institute. (2015). County health rankings & roadmaps. Retrieved from http://www.countyhealthrankings.org/.
National Center for Health Statistics. (2014). NCHS urban-rural classification scheme for counties. Retrieved from http://www.cdc.gov/nchs/data_access/urban_rural.htm.
U.S. Census Bureau. (2013). Metropolitan and micropolitan statistical areas main. Retrieved from http://www.census.gov/population/metro/.
Diamond, D. (2014). Women make up 80% of health care workers—but just 40 % of executives. Retrieved from https://www.advisory.com/daily-briefing/blog/2014/08/women-in-leadership.
Institute for the Future of Aging Services, prepared for the National Commission for Quality Long-Term Care. (2007). The long-term care workforce: Can the crisis be fixed? Problems, causes, and options. Washington, DC: Institute for the Future of Aging Studies.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Henning-Smith, C., Kozhimannil, K.B. Availability of Child Care in Rural Communities: Implications for Workforce Recruitment and Retention. J Community Health 41, 488–493 (2016). https://doi.org/10.1007/s10900-015-0120-3
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10900-015-0120-3