Rural-urban disparities in healthcare factors and long-term health outcomes in individuals with pediatric-onset spinal cord injury.
Kyle C Deane, Nikhil Kurapati, Emma Gill and 2 others
PMID 37275403WHAT IT FOUND
Adults with pediatric-onset spinal cord injury living in rural areas reported more pressure injuries, urinary tract infections, bowel incontinence, hospitalizations, and sleep difficulties than their urban counterparts.
They also faced lower employment and insurance rates. However, there were no differences in depression, anxiety, or life satisfaction between the groups.
Key findings
01Rural-living individuals had significantly higher rates of pressure injuries, urinary tract infections, bowel incontinence, hospitalizations, and sleep difficulties compared to urban-living individuals.
02No significant differences were found between rural and urban groups in psychosocial outcomes, including depressive symptoms, anxiety, happiness, life satisfaction, or perceived mental health.
03Rural participants were significantly less likely to have a college degree, were more likely to be unemployed, and had lower personal and household incomes than urban participants.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study used zip codes to define rurality, which is a crude approximation of actual access to care or community assets. Multiple statistical comparisons were made without correction, increasing the risk of false-positive findings. The sample was predominantly Caucasian and male, which may limit generalizability to other demographics. The study is observational and cannot prove that living in rural areas causes these health outcomes; other unmeasured factors may contribute.
Declared interests
The research was supported by Shriners Children's. The participants received care at Shriners Children's programs, which provide care free of charge, potentially influencing the sample's characteristics regarding financial burden.
The easy way to misread this
Do not assume that rural living negatively impacts mental health or life satisfaction. This study found no significant differences in depression, anxiety, or happiness between rural and urban groups, suggesting that the primary disparities are physical health and structural access rather than psychosocial well-being.