Quality of Life Research

, Volume 20, Issue 6, pp 807–815

Explaining rural/non-rural disparities in physical health-related quality of life: a study of United Methodist clergy in North Carolina

  • Andrew Miles
  • Rae Jean Proescholdbell
  • Eve Puffer
Article

DOI: 10.1007/s11136-010-9817-z

Cite this article as:
Miles, A., Proescholdbell, R.J. & Puffer, E. Qual Life Res (2011) 20: 807. doi:10.1007/s11136-010-9817-z

Abstract

Purpose

Researchers have documented lower health-related quality of life (HRQL) in rural areas. This study seeks to identify factors that can explain this disparity.

Methods

United Methodist clergy in North Carolina (N = 1,513) completed the SF-12 measure of HRQL and items on chronic disease diagnoses, health behaviors, and health care access from the Behavioral Risk Factor Surveillance Survey (BRFSS). Differences in HRQL between rural (N = 571) and non-rural clergy (N = 942) were examined using multiple regression analyses.

Results

Physical HRQL was significantly lower for rural clergy (−2.0; 95% CI: −2.9 to −1.1; P < 0.001). Income, body mass index, and joint disease partially accounted for the rural/non-rural difference, though a sizable disparity remained after controlling for these mediators (−1.02; 95% CI: −1.89 to −.15; P = 0.022). Mental HRQL did not differ significantly between rural and non-rural respondents (1.0, 95% CI: −0.1 to 2.1; P = 0.067).

Conclusions

Rural/non-rural disparities in physical HRQL are partially explained by differences in income, obesity, and joint disease in rural areas. More research into the causes and prevention of these factors is needed. Researchers also should seek to identify variables that can explain the difference that remains after accounting for these variables.

Keywords

Rural healthClergyHealth-related quality of lifeObesityJoint diseasesIncome

Abbreviations

HRQL

Health-related quality of life

BMI

Body-mass index

NC

North Carolina

UMC

United Methodist Church

SF-12

MOS short-form 12 health survey

MCS

Mental component score

PCS

Physical component score

SD

Standard deviation

PHQ-9

Patient health questionnaire

HADS

Hospital anxiety and depression scale

BRFSS

Behavioral risk factor surveillance system

Copyright information

© Springer Science+Business Media B.V. 2010

Authors and Affiliations

  • Andrew Miles
    • 1
  • Rae Jean Proescholdbell
    • 2
    • 3
  • Eve Puffer
    • 2
  1. 1.Department of SociologyDuke UniversityDurhamUSA
  2. 2.Duke Global Health InstituteDuke UniversityDurhamUSA
  3. 3.Duke Center for Health PolicyDuke UniversityDurhamUSA