Urban/rural elderly health status differences: the dichotomy reexamined

Health policy research analyzes urban/rural differences as a simple dichotomy. Research characterizes the rural elderly as having a higher incidence of sickness, dysfunction, disability, restricted mobility, and acute and chronic conditions than their urban counterparts. However, population density as a dichotomy may obscure urban, rural, or urban/rural differences. Interviews measuring health status were conducted with a representative sample of 2,300 elderly people in six Northeastern Ohio counties constituting an urban/rural continuum. On medical condition, use of medical aids, and symptoms, health status improved significantly when moving from rural to urban, but correlations were small. Using dichotomies, urban elderly reported fewer medical conditions and symptoms than rural elderly, but four other health-status variables revealed no significant association and results differed depending on how dichotomies were defined. When individual communities were compared few urban/rural patterns emerged. Controlling for demographics did not change interpretations. Findings question blanket assertions about urban/rural health-status differences. Medical resources may be misallocated. Rather than assuming poor health status among the rural elderly, researchers must verify differences through community-based research.