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Jeannette Manger


Background: Rural populations comprise of 20% of the American population and 19% of those individuals are over the age of 65 (compared to 15% in urban areas).1,2 There has been an increase in discussion surrounding the social determinants of health (SDOH), and the literature shows that the SDOH often disproportionately impact individuals based on where they live, including rural areas. The rural-urban mortality rate disparity within the United States has been growing and has been attributed to levels of poverty.3 The SDOH also include access to healthcare and insurance, and insurance coverage is associated with higher healthcare access and quality.4 Objective: This study aims to explore the relationship between uninsurance rates and health outcomes between rural and urban counties in Ohio in 2022. This study also aims to explore how uninsurance rates are correlated with the rates of various types of health care providers. Methods: County-level data from Ohio in 2022 were used from the County Health Rankings (CHR) website. Statistical analysis utilized Spearman correlations, ANOVA tests, independent t-tests, multiple regression analyses, and comparisons via cocor. Results: Rural Ohio has a slightly lower but not statistically significant difference in life expectancy. Rural Ohio has a higher prevalence of obesity and diabetes compared to urban Ohio but not statistically significantly so. There is a negative correlation between PCP rate and rate of uninsurance within Ohio generally and rural Ohio (r = -0.379, p = < 0.001). There is a positive correlation between dentist rate and rate of uninsurance within Ohio generally and rural Ohio (r = -0.394, p = < 0.001). There was no correlation between rate of uninsurance and MH provider rate in Ohio. The rate of PCP’s and dentists were higher in urban Ohio (p = < 0.001), and no statistically significant difference between rates of MH providers in urban and rural Ohio was found. The rate of PCP’s and rate of uninsurance was not found to be predictive of preventable hospital stays.

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