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Health and health care differences and disparities between rural and metropolitan adults with asthma

Howard J. Zeitz, MD1, Joel Emery McCullough, MD, MS, MPH2, May Nawal Lutfiyya, PhD3, Eric Henley, MD, MPH4, and Jessica Lynn Kappelman, BS4. (1) National Center for Rural Health Professions, University of Illinois, 1601 Parkview Ave, Rockford, IL 61107, 815/395-5560, hzeitz@uic.edu, (2) Environment, Chicago Department of Public Health, 333 S. State St, Chicago, IL 60625, (3) Family and Community Medicine, University of Illinois at Chicago, 1601 Parkview Avenue, Rockford, IL 61107, (4) Department of Family and Community Medicine, University of Illinois College of Medicine at Rockford, 1601 Parkview Ave, Rockford, IL 61107

Purpose/Hypotheses: There is a paucity of research examining health and health care disparities by asthma severity classification and rural residency. In this project we address these issues by examining possible health and health care asthma disparities in U.S. adults living in metropolitan and rural locations. This analysis is stratified by asthma severity classification, asthma medication use, ED and unscheduled office visits for asthma, race, gender, and other socioeconomic variables. Method(s): Univariate, and stratified bivariate contingency table analyses were performed on weighted 2001 Behavioral Risk Factor Surveillance Survey (BRFSS) data. Respondents classified as residing outside metropolitan statistical areas were defined as rural. Self-reported asthma symptoms were used to code asthma severity. Result(s): Stratified analyses revealed that when compared to metropolitan adults, a significantly higher proportion of rural adults with asthma were taking asthma medications > 2 times a day despite reporting symptoms of mild intermittent asthma. A significantly greater proportion of rural as compared to metropolitan residents with both mild intermittent and mild persistent asthma reported at least one unscheduled office visit for their asthma in the preceding 12 months. All of the rural adults (100%) reporting symptoms of severe persistent asthma had at some point in the past year gone without medical care because of cost. In contrast, only 10.4% of their metropolitan counterparts reported the same. Finally, a significantly higher proportion of rural as compared to metropolitan adults reporting that they had ever had asthma were non-Caucasian. Conclusion(s): Rural adults with asthma experience identifiable health and health care disparities when compared to their metropolitan counterparts.

Learning Objectives: At the conclusion of the session, the participant/learner will be able to

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Medical Care Section Poster Session #1

The 132nd Annual Meeting (November 6-10, 2004) of APHA