Skip to main content

Advertisement

Log in

Health Related Quality of Life in a Rural Area with Low Racial/Ethnic Density

  • Original Paper
  • Published:
Journal of Community Health Aims and scope Submit manuscript

Abstract

The purpose of this study was to compare the self-reported quality of life of racial/ethnic minorities and Caucasians living in a rural, northern New York county, where 94% of the population is Caucasian. Participants completed a 79-item survey online and in-person assessing health status, health-related quality of life, perceptions of health information, and health care access/use. Frequencies, Chi-Square, and ANOVA were used to analyze the results. A total of 1,039 surveys were completed. Racial/ethnic minorities earned significantly less income, F (1, 1031) = 29.306, P = .000, relied more on public health insurance, X 2(7, 1033) = 47.827, P = .000, were significantly less likely to see a doctor because of the cost, F(1,990) = 17.042, P = .000, and reported using health-related services significantly less often when compared to Caucasians, F(1, 1032) = 17.051, P = .000. In terms of quality of life, while there were no significant differences in self-reported physical health, racial/ethnic minorities were more likely to feel sad/blue/depressed, F(1, 1031) = 7.193, P = .011 and worried/tense/anxious, F(1, 1031) = 5.550, P = .040. Findings from this study offer some initial evidence that, while perceived health status is generally good, rural racial/ethnic minorities residing in predominantly Caucasian rural areas may experience more mental health problems that are risk factors for chronic diseases. This coupled with lower use of health care services increases the need for culturally competent health programs and services for this population.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
€32.70 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (Finland)

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Carter-Pokras, O., & Banquest, C. (2002). What is a health disparity? Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1497467/pdf/12500958.pdf .

  2. Office of Minority Health. (2009). African American profile. Retrieved from http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlid=51 .

  3. New York State Department of Health. (2010). New York State minority health surveillance report. Retrieved from http://www.health.state.ny.us/statistics/community/minority/docs/surveillance_report_2010.pdf .

  4. Keiser Family Foundation. (2009). Uninsured rates for the nonelderly by race/ethnicity, United States (2008–2009). Retrieved from http://www.statehealthfacts.kff.org/profileind.jsp?ind=143&cat=3&rgn=34&cmprgn=1&print=1 .

  5. Centers for Disease Control and Prevention. (2011). CDC health disparities and inequities report—United States, 2011. Retrieved from http://www.cdc.gov/mmwr/pdf/other/su6001.pdf .

  6. Coehn, S., Janicki-Deverst, D., Chen, E., & Matthews, K. A. (2010). Childhood socioeconomic status and adult health. Annals of the New York Academy of Sciences, 1186, 37–55. doi:10.1111/j.1749-6632.2009.05334.x.

    Article  Google Scholar 

  7. World Health Organization. (2011). Social determinants of health. Retrieved from http://www.who.int/hia/evidence/doh/en/.

  8. United States Census. (2011). American fact finder. Retrieved from http://factfinder.census.gov/home/saff/main.html?_lang=en.

  9. Wilkinson, R. G., & Pickett, K. E. (2008). Income inequality and socioeconomic gradients in mortality. American Journal of Public Health, 98, 699–704.

    Article  PubMed  Google Scholar 

  10. Neilson, R. B., & Garasky, S. (2008). Health insurance stability and health status: Do family-level coverage patterns matter? Journal of Family Issues, 29, 1471–1491. doi:10.1177/0192513X08316254.

    Article  Google Scholar 

  11. Alter, D. A., Stukel, T., Chong, A., & Henry, D. (2011). Lessons from Canada’s universal care: Socially disadvantaged patients use more health services, still have poorer health. Health Affairs, 30, 274–283.

    Article  PubMed  Google Scholar 

  12. Beiser, M., & Stuart, M. (2005). Reducing health disparities: A priority for Canada. Retrieved from http://www.cihr-irsc.gc.ca/e/documents/Volume_96-S21.pdf .

  13. Finger, C., Williams, J. E., MacLean, V., Allison, J. J., Kiefe, C. I., & Canto, J. (2004). Racial disparities in coronary heart disease: A sociological view of the medical literature on physician bias. Ethnicity and Disease, 14, 360–371.

    Google Scholar 

  14. Jha, A. K., Varosy, P. D., Kanaya, A. M., et al. (2003). Differences in medical care and disease outcomes among black and white women with heart disease. Circulation, 108, 1089–1094.

    Article  PubMed  Google Scholar 

  15. Smith-Bindman, R., Miglioretti, D. L., Lurie, N., et al. (2006). Does utilization of screening mammography explain racial and ethnic differences in breast cancer? Annals of Internal Medicine, 144, 541–553.

    PubMed  Google Scholar 

  16. Lovasi, G. S., Hutson, M. A., Guerra, M., & Neckerman, K. M. (2009). Built environments and obesity in disadvantaged populations. Epidemiological Review, 31, 7–20.

    Article  Google Scholar 

  17. Oreskovic, N. M., Kuhlthau, K. A., Romm, D., & Perrin, J. M. (2009). Built environment and weight disparities among children in high- and low-income towns. Academic Pediatrics, 9, 315–321.

    Article  PubMed  Google Scholar 

  18. Public Health Agency of Canada. (2005). Reducing health disparities—Roles of the health sector: Discussion paper. Retrieved from http://www.phac-aspc.gc.ca/ph-sp/disparities/ddp-eng.php.

  19. Reynolds, A., Smith, T. H., & Hale, P. J. (2010). A systematic review of built environment and health. Family & Community Health, 33, 68–78.

    Google Scholar 

  20. Murray, C. J. L., Kulkarni, S. C., Michaud, C., Tomijima, N., Bulzacchelli, M. T., et al. (2006). Eight Americas: Investigating mortality disparities across races, counties, and race-counties in the United States. PLoS Medicine, 3(9), 1513–1524. doi:10.1371/journal.pmed.0030260.

    Article  Google Scholar 

  21. Department of Health and Human Services. (2011). Rural minority health. Retrieved from http://www.hrsa.gov/ruralhealth/resources/minority/index.html.

  22. Bennett, K.J., Olatosi, B., & Probst, J.C. (2008). Health disparities: A rural-urban chartbook. Retrieved from http://rhr.sph.sc.edu.

  23. Probst, J.C., Samuels, M.E., Jespersen, K.P., Willert, K., Swann, S.R., & McDuffie, J.A. (2002). Minorities in rural American: An overview of population characteristics. Retrieved from http://rhr.sph.sc.edu/report/minoritiesInRuralAmerica.pdf.

  24. Onega, T., Duell, E. J., Shi, X., Demidenko, K., & Goodman, D. (2010). Influence of place of residence in access to specialized cancer care for African Americans. Journal of Rural Health, 26, 12–19.

    Article  PubMed  Google Scholar 

  25. Mainous, A. G., King, D. E., Garr, D. R., & Pearson, W. S. (2004). Race, rural residence, and control of diabetes and hypertension. American Family Medicine, 2, 563–568.

    Article  Google Scholar 

  26. Slifkin, R.T., Goldsmith, L.J., & Rickets, T.C. (2000). Race and place: Urban-rural differences in health for racial and ethnic minorities. Retrieved from http://www.shepscenter.unc.edu/rural/pubs/finding_brief/fb61.pdf.

  27. Bennett, K. J., Bellinger, J. D., & Probst, J. C. (2010). Receipt of influenza and pneumonia vaccinations: The dual disparity of rural minorities. Journal of the American Geriatric Society, 58, 1896–1902.

    Article  Google Scholar 

  28. Baldwin, L., Grossman, D. C., Casey, S., Hollow, W., Sugaman, J. R., Freeman, W. L., et al. (2002). Perinatal and infant health among rural and urban American Indians/Alaskan Natives. American Journal of Public Health, 92, 1491–1497.

    Article  PubMed  Google Scholar 

  29. House, J. S., Lepkowski, J. M., Williams, D. R., Mero, R. P., Lantz, P. M., Robert, S. A., et al. (2000). Excess mortality among urban residents: How much, for whom, and why? American Journal of Public Health, 90, 1898–1904.

    Article  PubMed  CAS  Google Scholar 

  30. Ellis, C., Grubaugh, A. L., & Egede, L. E. (2010). The effect of minority status and rural residence on actions to control high blood pressure in the U.S. Public Health Reports, 125, 801–809.

    PubMed  Google Scholar 

  31. Wickrama, K. A., Elder, G. H., & Todd Abraham, W. (2007). Rurality and ethnicity in adolescent physical illness: Are children of the growing rural Latino population at excess health risk? Journal of Rural Health, 12, 228–237.

    Article  Google Scholar 

  32. Picket, K. E., Shaw, R. J., Atkin, K., Kiernan, K. E., & Wilkinson, R. G. (2009). Ethnic density effects on maternal and infant health in the Millennium Cohort Study. Social Science and Medicine, 69, 1476–1483.

    Article  Google Scholar 

  33. Probst, J. C., Moore, C. G., Glover, S. H., & Samuels, M. E. (2004). Person and place: The compounding effects of race/ethnicity and rurality on health. American Journal of Public Health, 94, 1695–1703.

    Article  PubMed  Google Scholar 

  34. Picket, K. E., & Wilkinson, R. G. (2008). People like us: Ethnic group density effects on health. Ethnicity & Health, 13, 321–334.

    Article  Google Scholar 

  35. Benjamins, M. R., Kirby, J. B., & Bond-Huie, S. A. (2004). County characteristics and racial and ethnic disparities in the use of preventive services. Preventative Medicine, 39, 704–712.

    Article  Google Scholar 

  36. Coughlin, S. S., Leadbetter, S., Richards, T., & Sabatino, S. A. (2008). Contextual analysis of breast and cervical cancer screening and factors associated with health care access among Unites States women. Social Science and Medicine, 66, 260–275.

    Article  PubMed  Google Scholar 

  37. Erwin, P. C., Fitzhugh, E. C., Brown, K. C., & Looney, S. (2010). The interaction of race, socioeconomic status, and geography. Journal of Health Care for the Poor and Underserved, 21, 931–945.

    Article  PubMed  Google Scholar 

  38. Becares, L., Nazroo, J., & Stafford, M. (2009). The buffering effects of ethnic density on experienced racism, health. Health & Place, 15, 670–678.

    Article  Google Scholar 

  39. Shaw, R. J., Pickett, K. E., & Wilkinson, R. G. (2010). Ethnic density effects on birth outcomes and maternal smoking during pregnancy in the US linked birth and infant death data set. American Journal of Public Health, 100, 707–713.

    Article  PubMed  Google Scholar 

  40. United States Department of Health and Human Services. (2011). MUA/P by state and county. Retrieved from http://muafind.hrsa.gov/index.aspx.

  41. Centers for Disease Control and Prevention. (2009). Behavior risk factor surveillance system questionnaire. Retrieved from http://www.cdc.gov/BRFSS/questionnaires/pdf-ques/2009brfss.pdf.

  42. Centers for Disease Control and Prevention. (2010). BRFSS prevalence and trend data: General health status. Retrieved from http://apps.nccd.cdc.gov/BRFSS/display.asp?cat=HS&yr=2009&qkey=1100&state=US.

  43. Singh-Manoux, A., Dugravot, A., Shipley, M. J., et al. (2007). The association between self-rated health and mortality in different socioeconomic groups in the GAZEL cohort study. International Journal of Epidemiology, 36, 1222–1228.

    Article  PubMed  Google Scholar 

  44. Delpierre, C., Lauwers-Cances, V., Datta, G. D., Lang, T., & Berkman, L. (2009). Using self-rated health for analyzing social inequalities in health: A risk for underestimating the gap between socioeconomic groups? Journal of Epidemiology and Community Health, 63, 426–432.

    Article  PubMed  CAS  Google Scholar 

  45. Dunlop, D. D., Song, J., Lyons, J. S., Manheim, L. M., & Chang, R. W. (2003). Racial/ethnic differences in rates of depression among preretirement adults. American Journal of Public Health, 93, 1945–1952.

    Article  PubMed  Google Scholar 

  46. Skarupski, K. A., et al. (2005). Black-white differences in depressive symptoms among older adults over time. Journals of Gerontology. Series B, 60, 136–142.

    Article  Google Scholar 

  47. Chowdhury, P. P., Balluz, L., & Strine, T. W. (2008). Health-related quality of life among minority populations in the United States, BRFSS 2001–2002. Ethnicity and Disease, 18, 483–487.

    PubMed  Google Scholar 

  48. Kessler, R. C., et al. (2003). The epidemiology of major depressive disorder: Results from the national comorbidity replication survey. Journal of the American Medical Association, 289, 3095–3105.

    Article  PubMed  Google Scholar 

  49. Breslau, J., Aguilar-Gaxiola, S., Kendler, K., Su, M., Williams, D., & Kessler, R. C. (2005). Specifying race-ethnic difference in risk for psychiatric disorder in a USA national sample. Psychological Medicine, 36, 57–68.

    Article  PubMed  Google Scholar 

  50. Himle, J. A., Baser, R. E., Taylor, R. J., Campbell, R. D., & Jackson, J. S. (2009). Anxiety disorders among African Americans, blacks of Caribbean descent, and non-Hispanic whites in the United States. Journal of Anxiety Disorders, 23, 578–590.

    Article  PubMed  Google Scholar 

  51. Kaiser Family Foundation. (2010). The uninsured: A primer. Retrieved from http://www.kff.org/uninsured/upload/7451-06.pdf.

  52. Kirby, J. B., & Kaneda, T. (2010). Unhealthy and uninsured: Exploring racial differences in health and health insurance coverage using a life table approach. Demography, 47, 1035–1051.

    Article  PubMed  Google Scholar 

  53. Baker, D. W., Shapiro, M. F., & Schur, C. L. (2000). Health insurance and access to care for symptomatic conditions. Archives of Internal Medicine, 160, 1269–1274.

    Article  PubMed  CAS  Google Scholar 

  54. Bonnar-Kidd, K. K., Black, D. R., Coster, D., & Mattson, M. (2008). Physical activity on the internet: Will typical users find quality information? Health Communication, 24, 165–175.

    Article  Google Scholar 

  55. McKeehan, N., Trettin, L., & May, J. (2008). Improving access to health information in rural South Carolina. Journal of Health Care for the Poor and Underserved, 19, 484–492.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This study was funded by the Walker Fellowship Program, SUNY Potsdam Research Foundation.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kelly K. Bonnar.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bonnar, K.K., McCarthy, M. Health Related Quality of Life in a Rural Area with Low Racial/Ethnic Density. J Community Health 37, 96–104 (2012). https://doi.org/10.1007/s10900-011-9422-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10900-011-9422-2

Keywords

Navigation