Rural-urban disparities in healthcare factors and long-term health outcomes in individuals with pediatric-onset spinal cord injury

Front. Rehabil. Sci., 2023 · DOI: 10.3389/fresc.2023.1102441 · Published: May 19, 2023

Spinal Cord Injury Pediatrics Public Health

Simple Explanation

This study examines the differences in healthcare access and long-term health outcomes between adults with spinal cord injuries that began in childhood, comparing those who live in rural areas to those in urban areas. The research found that individuals in rural areas reported lower education, income, and employment, alongside reduced access to private health insurance and community involvement. They also experienced more pressure injuries, urinary tract infections, and sleep difficulties. The study suggests that addressing these disparities could improve treatment outcomes and prevent secondary health complications for adults with pediatric-onset SCI living in rural environments.

Study Duration

Nearly thirty years

Participants

N = 490 adults with pediatric-onset SCI

Evidence Level

Original Research

Key Findings

1
Individuals residing in rural regions report lower levels of education, income, employment rates, private health insurance, and community integration.
2
Rural residents experienced increased incidence of pressure injuries, urinary tract infections, hospitalizations, bowel incontinence, sleep difficulties, and perceived physical health.
3
No differences in incidence of psychosocial functioning were identified between rural and urban residents with pediatric-onset SCI.

Research Summary

This study investigated the impact of rural versus urban living on healthcare access and long-term health outcomes in adults with pediatric-onset spinal cord injury (SCI). The findings indicated that rural-living individuals with pediatric-onset SCI face greater structural and healthcare challenges, including lower education, income, and employment rates, as well as limited access to private health insurance and community integration. These disparities contribute to higher rates of secondary health conditions such as pressure injuries, urinary tract infections, and sleep difficulties among rural-living individuals with pediatric-onset SCI, highlighting the need for targeted interventions and support services.

Practical Implications

Telehealth Expansion

Increase telehealth options to provide specialized healthcare services and health education to rural residents with pediatric-onset SCI.

Community Outreach Programs

Implement outreach services and small outpatient clinics in rural areas to improve access to preventive care and reduce long-term health complications.

Financial Support Services

Address financial barriers by providing resources and support for education, employment, and health insurance coverage to improve the socioeconomic status of rural-living individuals with pediatric-onset SCI.

Study Limitations

1
Generalizability is limited as participants were predominantly Caucasian and male.
2
Using zip codes as a measurement of rurality may be a crude approximation.
3
High number of outcomes included in this study, numerous statistical models were performed to compare the differences between the two groups

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