Examining rural-urban disparities in perceived need for health care services among adults with disabilities.
Gilbert Gimm, Catherine Ipsen
PMID 36188990WHAT IT FOUND
Rural adults with disabilities were more likely to say they did not need dental or mental health services than urban adults.
This perceived lack of need, rather than access barriers alone, suggests public health campaigns must address community norms and expectations to improve uptake.
Key findings
01Unmet need for doctors, specialists, and prescriptions was similar across rural and urban groups, but perceived need for dental and mental health services was significantly lower in rural areas.
02After controlling for demographics, adults in non-core rural areas had higher odds of reporting they did not need dental care compared to urban residents.
03Adults in both non-core and micropolitan rural areas had higher odds of reporting they did not need mental health services compared to those in metropolitan areas.
STILL TO COME
How it was doneWhat they found
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The sample was recruited via online surveys and Amazon Mechanical Turk, which likely excluded adults with disabilities who have limited digital literacy or inadequate broadband access, potentially biasing the results against the most isolated rural populations. The study is cross-sectional, so it can only show associations between rural living and perceived need, not cause and effect. Data relied on self-reported answers about the past 12 months, which may be subject to recall bias. The survey did not measure the quality of care received or the specific reasons behind the decision to forego services, only the participants' stated need.
Declared interests
The research was funded by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR). The authors declared no commercial or financial conflicts of interest.
The easy way to misread this
Do not interpret the lower 'perceived need' as evidence that rural patients have better health or fewer needs. The study shows that rural adults are more likely to say they do not need services, which may reflect cultural norms, stigma, or long-standing provider shortages shaping expectations, rather than an actual absence of clinical need.