Health care avoidance among rural populations: results from a nationally representative survey
Open accessAbstract
BACKGROUND: Previous research suggests that certain populations, including rural residents, exhibit health care avoidant behaviors more frequently than other groups. Additionally, health care avoidance is related to sociodemographics, attitudes, social expectations, ability to pay for care, and prior experiences with providers. However, previous studies have been limited to specific geographic areas, particular health conditions, or by analytic methods. METHODS: The 2008 Health Information Trends Survey (HINTS) was used to estimate the magnitude of health care avoidance nationally and, while controlling for confounding factors, identify groups of people in the United States who are more likely to avoid health care. Chi-square procedures tested the statistical significance (P < .05) of bivariate relationships. Multivariable analysis was conducted through a weighted multiple logistic regression with backward selection. RESULTS: For 6,714 respondents, bivariate analyses revealed differences (P < .05) in health care avoidance for multiple factors. However, multiple regression reduced the set of significant factors (P < .05) to rural residence (OR = 1.69), male sex (OR = 1.24), younger age (18-34 years OR = 2.34; 35-49 years OR = 2.10), lack of health insurance (OR = 1.43), lack of confidence in personal health care (OR = 2.24), lack of regular provider (OR = 1.49), little trust in physicians (OR = 1.34), and poor provider rapport (OR = 0.94). CONCLUSION: The results of this study will help public health practitioners develop programs and initiatives targeted and tailored to specific groups, particularly rural populations, which seek to address avoidant behavior, thereby reducing the likelihood of adverse health outcomes.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
A 1-day workshop ensures treatment adherence and completion for patients with functional limitations and practical barriers.
“First, for patients with functional limitations and practical barriers such as transportation difficulties or family and work responsibilities [36], a 1-day workshop ensures treatment adherence and completion.”
From One-Day Acceptance and Commitment Therapy Compared to Support for Depressed Migraine Patients: a Randomized Clinical Trial. (2020) · cites this paper as [36]
The Discussion (page not available) identifies transportation barriers, and the introductory passage links care avoidance to social and work expectations. The copy does not establish functional limitations or family responsibilities as barriers. Citation [36] is attached to the barriers clause; the statement that a 1-day workshop ensures adherence and completion is the citing authors’ own proposal, not a finding attributed to this source. (LLM, conf=0.82)
Experimental — accuracy not yet measuredA 1-day workshop may be particularly useful for patients with barriers to accessing care.
“Finally, a 1-day workshop may be particularly useful for patients with barriers to accessing care, a significant challenge in the United States, where one fourth of the population live in rural areas [6].”
From One-day acceptance and commitment training workshops in medical populations (2015) · cites this paper as [6]
The Discussion (page unavailable) describes barriers to care in rural communities and reports that rural residents were 1.7 times more likely than metropolitan residents to report avoiding care. The citation appears to support that background challenge, rather than the citing authors’ proposed 1-day workshop. Our copy does not substantiate the attached claim that one fourth of the U.S. population lives in rural areas. (LLM, conf=0.84)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
The citation lists haven’t been fetched yet
References 33 · Cited by 143
- Authors
- Spleen, A. M., Lengerich, E. J., Camacho, F. T., & Vanderpool, R. C.
- Affiliations
- Pennsylvania State University (US)
- University of Kentucky (US)
- Corresponding author
- Spleen, Angela M.
- Venue
- The Journal of Rural Health
- Publisher
- Wiley
- Published
- 2013-06-24
- Volume
- 30
- Issue
- 1
- Pages
- 79-88
- ISSN
- 0890-765X (ISSN-L)
- 1748-0361
- PMC
- PMC3882339
- OpenAlex
- W1954638764
- Cited by
- 143
- References
- 33
- Citations by year
- 2026: 8 · 2025: 15 · 2024: 19 · 2023: 18 · 2022: 16 · 2021: 16 · 2020: 6 · 2019: 14 · 2018: 4 · 2017: 10 · 2016: 5 · 2015: 6 · 2014: 4
- FWCI
- 5.69
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Journal of Rural Health (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- UKnowledge (University of Kentucky) (submittedVersion)
- Funders
- Appalachia Community Cancer Network (5 U54 CA 153604)
- Topics
- Social Sciences › Health › Public Health and Social Inequalities
- Social Sciences › Health › Health disparities and outcomes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- healthcare avoidance, rural population, lack of health insurance, trust in physicians, sociodemographic factors, young adults
- MeSH terms
- Adolescent, Adult, Aged, Female, Health Services Accessibility, Humans, Male, Middle Aged, Patient Acceptance of Health Care, Surveys and Questionnaires, Rural Population, Socioeconomic Factors, United States, Rural Health Services
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
