Current State of Child Health in Rural America: How Context Shapes Children's Health

Probst, Janice C.; Barker, Judith C.; Enders, Alexandra; Gardiner, Paula

doi:10.1111/jrh.12222

Cited by 92 publications

(91 citation statements)

References 51 publications

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“…Since POHS in medical offices often occurs during well‐child visits, promoting well‐child medical visits for rural children may be another effective strategy to increase rates of POHS delivered during medical visits. Strategies recommended for promoting medical visits in rural areas include improving surveillance, as an initial step to document disparities because few data sources allow assessment of rural/urban differences of child health and health care utilization; using nontraditional providers and settings, which may include expanded use of mobile vans and school clinics; and increasing the rural workforce through recruiting and expanding the scope of practice of mid level providers …”

Section: Discussionmentioning

confidence: 99%

“…With few pediatric dentists practicing in rural areas, children in rural areas often have to travel far for a dental visit . An additional challenge to obtaining dental care for children living in rural areas, who are more likely to live in poverty and have public insurance compared to children living in urban areas, is the reluctance of many dentists to accept Medicaid …”

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confidence: 99%

“…21,22 With few pediatric dentists practicing in rural areas, 23,24 children in rural areas often have to travel far for a dental visit. [25][26][27] An additional challenge to obtaining dental care for children living in rural areas, who are more likely to live in poverty and have public insurance compared to children living in urban areas, 28 is the reluctance of many dentists to accept Medicaid. [29][30][31][32] Unsurprisingly, rates of annual preventive dental visits for children 1 to 5 years of age are lower in large rural areas (48.3%) compared with small rural areas (52.9%) and urban areas (55.3%).…”

mentioning

confidence: 99%

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Delivery of Preventive Oral Health Services by Rurality: A Cross‐Sectional Analysis

Geiger

Kranz

Dick

et al. 2018

The Journal of Rural Health

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Purpose: Integrating oral health care into primary care has been promoted as a strategy to increase delivery of preventive oral health services (POHS) to young children, particularly in rural areas where few dentists practice. Using a multistate sample of Medicaid claims, we examined a child’s odds of receiving POHS in a medical office by county rurality. Methods: We used 2012–2014 Medicaid Analytic eXtract claims data for 6,275,456 children younger than 6 years in 39 states that allowed Medicaid payment for POHS in medical offices. We used county-level characteristics from the Area Health Resources File, including a 3-level measure of county rurality. We used logistic regression to estimate a child’s odds of receiving POHS in a medical office by county rurality, while controlling for other patient and county characteristics. Findings: POHS in medical offices were received by 7.8% of children. Rates of POHS in medical offices were higher in metropolitan (metro) counties (8.4%) than non-metro adjacent to metro (5.8%) and non-metro not adjacent to metro (4.3%). In adjusted analysis, children living in non-metro not adjacent to metro (OR=0.79, 95% CI: 0.64–0.99) and adjacent to metro counties (OR=0.70, 95% C: 0.59–0.82) were significantly less likely to receive POHS in medical offices than children living in metro counties. Conclusions: In this study of POHS in medical offices among young Medicaid-enrolled children, we found POHS rates were lowest in non-metro counties. Given barriers to dental care in rural areas, states should take additional steps beyond allowing Medicaid reimbursement to increase delivery of POHS in medical offices.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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confidence: 99%

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Delivery of Preventive Oral Health Services by Rurality: A Cross‐Sectional Analysis

Geiger

Kranz

Dick

et al. 2018

The Journal of Rural Health

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“…Research indicates that Americans, including young people (Probst, Barker, Enders, & Gardiner, 2016), who live in rural areas are at higher risk of mortality from unintentional injuries when compared to Americans who live in urban areas (Centers for Disease Control and Prevention, n.d.), and we hypothesized that concussion-related health disparities would exist among young athletes based on geographic factors such that young athletes who live in rural areas would report less access to concussion education when compared with young athletes who live in urban areas. We also explored whether concussion attitudes and behaviors varied between male and female athletes.…”

Section: Introductionmentioning

confidence: 99%

Concussion attitudes, behaviors, and education among youth ages 12–17: Results from the 2014 YouthStyles survey

Donnell

Hoffman

Sarmiento

et al. 2018

Journal of Safety Research

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Introduction: This study assessed young athletes’ (ages 12 to 17) concussion attitudes and behaviors, particularly their self-reported experience learning about concussion and intentions to report a concussion and disparities in these experiences. Methods: We used data from Porter Novelli’s 2014 YouthStyles survey that is conducted each year to gather insights about American consumers. Results: Of the 1,005 respondents, 57% reported sports participation. Fourteen percent reported they may have had a previous concussion, and among them 41% reported having a concussion more than once while playing sports. Males (17.7%) were significantly more likely to report having a concussion than females (10.0%; χ2 (1) = 7.01, p = 0.008). Fifty-five percent of respondents reported having learned about what to do if they think they may have a concussion, and 92% reported that they would tell their coach if they thought they sustained a concussion while playing youth or high school sports. Youth from higher income families ($75,000–$124,999) were significantly more likely than youth from lower income families (less than $35,000) to report that they learned about what do if they suspected that they had a concussion. Conclusion: Age of athlete, parental income level, athlete’s sex, and living in a metro versus non-metro area led to disparities in athletes’ concussion education. There is a need for increased access to concussion education and an emphasis on customizing concussion education efforts to meet the needs of different groups. Practical application: We identified athletes’ self-reported previously sustained concussions and predictors of education related to concussion. Further research is needed to explore the age, gender and income gaps in concussion education among athletes.

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“…However, it is recognised that there are confounding infl uences from pre-existing social determinates that impact upon health outcomes, which needs to be considered within the context of underlying health issues in the various population and comorbidities [5]. There are of course a range of public health and socio-economic issues, which impacts upon health outcomes, especially in regard to children, linked to relative poverty [6][7][8][9]. It is however, recognised that relative poverty is a very broad category and the actual mechanism of how it affects children's health is not fully understood.…”

Section: Introductionmentioning

confidence: 99%

USA Child (0-4) and Adult (55-74) Mortality and % GDP-Health Expenditure and the Other Western Countries 1989-2015. America needs an “National Neighbourhood Health Service”

Pritchard¹,

Rosenorn-Lanng²,

Williams³

et al. 2019

Arch Community Med Public Health

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Purpose: To analyse how effective was the USA, compared to Other Western Countries (OWC) in reducing premature deaths 1989-2015.Design: This population-based study is a cost-effective model of fi scal input into health related to clinical outputs, recognising socio-economic factors infl uence health outcomes. Using World Bank data for total % GDP-Expenditure-on-Health, and, WHO data for Child (0-4), Adult (55-74) and Age-Standardised-Death-Rates rates per million America is compared with OWC. Cost-Effective Ratios (CEF) are calculated and Confi dence Intervals (95%) tests USA against each OWC. `Excess' deaths are calculated between the most and least expensive health systems. Setting: Twenty Other Western countries.Patients: National populations.Outcomes: USA highest current total %GDPEH 16.8% and highest average of 12.7% and UK lowest 7.1% over period.USA Child (0-4) highest at 1249pm, OWC averaged 803pm. Fourteen countries had signifi cantly bigger reductions than America.USA Adult (55-74) mortality was highest at 12,554pm, OWC averaged 9,835pm. Fourteen countries had signifi cantly bigger reductions than USA.Excess Deaths: America failed to match UK total mortality rates yielding 488,273 excess deaths, of which 12,613 were children.

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Current State of Child Health in Rural America: How Context Shapes Children's Health

Cited by 92 publications

References 51 publications

Delivery of Preventive Oral Health Services by Rurality: A Cross‐Sectional Analysis

Delivery of Preventive Oral Health Services by Rurality: A Cross‐Sectional Analysis

Concussion attitudes, behaviors, and education among youth ages 12–17: Results from the 2014 YouthStyles survey

USA Child (0-4) and Adult (55-74) Mortality and % GDP-Health Expenditure and the Other Western Countries 1989-2015. America needs an “National Neighbourhood Health Service”

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