Wednesday, August 19, 2009

New USDA report offers plenty of chapters, lots of verses and data on the state of rural health

As the debate over health-insurance reform intensifies, we have fresh data to remind us of how critical an issue health is in rural America: a new report, right, from the Economic Research Service of the U.S. Department of Agriculture. Health-care access and health status in rural areas tend to lag behind that in metropolitan areas. Rural populations are older, have lower education and income levels, and are more likely to be living in medically underserved areas. They have higher mortality rates, even when adjusted for age, and that gap with urban areas "has continually widened" since 1990, ERS reports.

Rural people tend to be less healthy because they make less money, are more likely to smoke, and are more likely to be obese and have lower levels of physical activity. Farmers, a small minority of the rural population, make more money than their neighbors, are more physically active and less likely to smoke, but "Farming has one of the highest occupational fatality rates of all occupations, and farm children also have high fatal accident rates," the report summary notes. "In addition, farmers are at high risk for work-related lung diseases, noise-induced hearing loss, skin diseases, and certain cancers associated with chemical use and prolonged sun exposure."

The report found no urban-rural gap in rates of health-insurance coverage, but "Because nonmetro incomes are lower than metro incomes, nonmetro nonelderly populations pay a greater share of household income for health care than their metro counterparts," the summary points out. "Nonmetro households are more likely than metro households to report that health care costs limit their medical care." And because their communities tend to lack many medical services, rural residents "incur higher financial and travel-time costs than urban residents for specialized treatment. As an alternative, they may substitute local generalists for specialists, or reduce their usage of health care." The Census Bureau has county-by-county estimates of health coverage.

The very detailed USDA report, which includes county-by-county maps on such topics as mortality and disability, is the subject of the main feature in the latest issue of ERS's publication, Amber Waves. For the full report, by Carol Adaire Jones, Timothy S. Parker, Mary Ahearn, Ashok K. Mishra and Jayachandran N. Variyam, click here. To listen to a 7-minute interview with Jones, senior economist in ERS's Resource and Rural Economics Division, click here.

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