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Member Research & Reports

Member Research & Reports

Kentucky Researchers Report Geographic Variations in Health Access and Behaviors

The University of Kentucky Institute for Rural Health Policy has released a comprehensive report comparing and contrasting health behaviors and health care access in rural and metropolitan areas. The Institute is co-directed by Dr. Ty Borders, Professor and Foundation for a Healthy Kentucky Endowed Chair in Rural Health Policy in the University of Kentucky College of Public Health.


[Photo: Dr. Ty Borders]

The report serves as a resource for rural health researchers, policymakers and health care stakeholders interested in variations in health status and unmet health care needs in specific geographic regions. Through telephone survey surveillance data collected in 2013, the researchers analyzed health indicators including body mass index (BMI), self-reported health status, delays in medical care, avoiding medical care because of cost and health insurance coverage. Multiple statistical analyses of the data show variations in behavioral and access indicators in rural regions, with discrepancies most prominent in the Appalachian region.

The Institute for Rural Health Policy researchers distinguished counties as metropolitan, or having a population of 55,000 or more, micro-metropolitan, or having between 10,000 and 50,000 residents, and rural counties with populations of fewer than 10,000. The researchers divided the state into the Delta, Appalachia and Central Kentucky regions, reporting distinct barriers to health and health care services in each region.

The researchers found poor overall health status and health care accessibility in rural counties and the Appalachian region. Appalachians were more likely to lack health insurance or report not seeing a doctor for an extended period because of the cost than residents living in the Delta or Central Kentucky regions. However, Appalachians in micro-metropolitan and rural areas reported lower odds of poor mental and physical health than Appalachians living in metropolitan areas. The study reported different levels of association between health indicators and metropolitan, micro-metropolitan and rural counties, suggesting other socioeconomic factors create geographic differences in health and health access in Appalachia.

“Our study examined the variability of health behavior, status and service accessibility in different geographic regions of Kentucky,” Borders, principal investigator on the study, said. “Examining associations between geographic location and health status and access provided a clear picture of where discrepancies exist in Kentucky. This information can direct the future of health outreach and implementation. For instance, while overall health was poorer in Appalachia, we found that rural residents were less likely to report poor mental and physical health than those who lived in metropolitan areas.”

The Institute for Rural Health Policy conducts rural health services and policy research to inform rural health practitioners, managers, and policy-makers in Kentucky. To access the full report, titled, “Health and Health Care in Kentucky: Variations by Region and Metro/Micro/Rural Status,” click here.