Is health status related to residence in medically underserved areas? Evidence and implications for policy

This study sought to compare the health status of adult residents of medically underserved areas (MUAs) with adult residents of nonshortage areas (non-MUAs). A random digit dialing telephone survey was used. Respondents were subsequently classified by their county of residence as residing in an MUA or non-MUA. A sample of 421 adults (aged 18 years or older) residing in Kentucky during 1993 were included in the analysis. Health status was measured by the Medical Outcomes Study 20-item Short-Form Health Survey's (SF-20) six subscales. After controlling in the multiple regression for demographic variables there were no significant differences between residents of MUAs and non-MUAs for the physical functioning, role functioning, general mental health, self-perception of health, or pain subscales. The social functioning subscale was significantly related to the residence in an MUA. The demographic variable "education" was a consistent predictor of each of the health status subscales. Excepting the social functioning subscale, residents of MUAs do not have significant differences in health status when compared to residents of non-MUAs. Future policy may need to focus on other health services shortage area designators that are more highly associated with the health status of residents. Consideration should be given to including the education demographics of areas or populations in health services shortage designation criteria.