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Journal of Environmental and Public Health
Volume 2013, Article ID 960157, 11 pages
http://dx.doi.org/10.1155/2013/960157
Research Article

The Utility of Rural and Underserved Designations in Geospatial Assessments of Distance Traveled to Healthcare Services: Implications for Public Health Research and Practice

1The University of Georgia, College of Public Health, Department of Health Promotion and Behavior, 330 River Road, 315 Ramsey Center, Athens, GA 30602, USA
2Texas A&M Health Science Center, School of Rural Public Health, Department of Health Promotion and Community Health Sciences, TAMU 1266, College Station, TX 77843, USA
3HSR Health Services, LLC, P.O. Box 571357, Murray, UT 84157, USA
4Texas A&M Health Science Center, School of Rural Public Health, Department of Health Policy and Management, TAMU 1266, College Station, TX 77843, USA
5The University of Memphis, School of Public Health, Division of Health Systems Management and Policy, Robison Hall 133, Memphis, TN 38152-3530, USA
6Texas A&M Health Science Center, School of Rural Public Health, Center for Community Health Development, TAMU 1266, College Station, TX 77843, USA

Received 6 March 2013; Accepted 10 May 2013

Academic Editor: Edward Trapido

Copyright © 2013 Matthew Lee Smith et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Health disparities research in rural populations is based on several common taxonomies identified by geography and population density. However, little is known about the implications of different rurality definitions on public health outcomes. To help illuminate the meaning of different rural designations often used in research, service delivery, or policy reports, this study will (1) review the different definitions of rurality and their purposes; (2) identify the overlap of various rural designations in an eight-county Brazos Valley region in Central Texas; (3) describe participant characteristic profiles based on distances traveled to obtain healthcare services; and (4) examine common profile characteristics associated with each designation. Data were analyzed from a random sample from 1,958 Texas adults participating in a community assessment. K-means cluster analysis was used to identify natural groupings of individuals based on distance traveled to obtain three healthcare services: medical care, dental care, and prescription medication pick-up. Significant variation in cluster representation and resident characteristics was observed by rural designation. Given widely used taxonomies for designating areas as rural (or provider shortage) in health-related research, this study highlights differences that could influence research results and subsequent program and policy development based on rural designation.