The Relationship Between Rural Status, Individual Characteristics, and Self-Rated Health in the Behavioral Risk Factor Surveillance System

The Journal of Rural Health

 

The Relationship Between Rural Status, Individual Characteristics, and Self-Rated Health in the Behavioral Risk Factor Surveillance System

 

  1. Traci N. Bethea PhD1,
  2. Russell P. Lopez DSc2,
  3. Yvette C. Cozier DSc1,3,
  4. Laura F. White PhD4,
  5. Michael D. McClean ScD5

 

Article first published online: 31 MAY 2012

 

Abstract

 

Keywords:

  • Epidemiology;
  • health disparities;
  • obesity;
  • self-rated health;
  • social determinants of health

 

Abstract Purpose: To examine rural status and social factors as predictors of self-rated health in community-dwelling adults in the United States.

 

Methods: This study uses multinomial logistic and cumulative logistic models to evaluate the associations of interest in the 2006 US Behavioral Risk Factor Surveillance System, a cross-sectional survey of 347,709 noninstitutionalized adults.

 

Findings: Self-rated health was poorer among rural residents, compared to urban residents (OR = 1.77, 95% CI: 1.54, 1.90). However, underlying risk factors such as obesity, low income, and low educational attainment were found to vary by rural status and account for the observed increased risk (OR = 1.03, 95% CI: 0.94, 1.12). There was little evidence of effect modification by rural status, though the association between obesity and self-rated health was stronger among urban residents (OR = 2.50, 95% CI: 2.38, 2.64) than among rural residents (OR = 2.18, 95% CI: 2.03, 2.34).

 

Conclusions: Our findings suggest that differences in self-rated health by rural status were attributable to differential distributions of participant characteristics and not due to differential effects of those characteristics.

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