Quality of Life Research

, Volume 20, Issue 6, pp 807–815 | Cite as

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

  • Andrew MilesEmail author
  • Rae Jean Proescholdbell
  • Eve Puffer



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


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.


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).


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.


Rural health Clergy Health-related quality of life Obesity Joint diseases Income 



Health-related quality of life


Body-mass index


North Carolina


United Methodist Church


MOS short-form 12 health survey


Mental component score


Physical component score


Standard deviation


Patient health questionnaire


Hospital anxiety and depression scale


Behavioral risk factor surveillance system



We are deeply indebted to the clergy persons who completed this survey. We also thank The Reverend Jeremy Troxler for his insightful comments on rural ministry and John James for assistance with the conference data. This research was funded by a grant from the Rural Church Area of The Duke Endowment.


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Copyright information

© Springer Science+Business Media B.V. 2010

Authors and Affiliations

  • Andrew Miles
    • 1
    Email author
  • 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

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