A cross-sectional, multi-year examination of rural and urban Veterans Administration users: 2002-2006

We compared demographic profiles across two rural-urban classification schemes to determine whether rural-urban disparities in health status persisted among Veterans Administration (VA) users over time. Using demographic and SF-12 survey data collected from 2002 to 2006, we conducted serial cross-sectional analyses of demographic variables and health status for veterans residing in VA- and rural-urban commuting area (RUCA)-defined rural-urban groups. VA and RUCA definitions yielded similar results for the "urban" population; however, VA- and RUCA-defined "rural" categories represent dissimilar populations. Compared to earlier years, the VA user population in 2006 was younger, more educated, wealthier, and more likely to be employed and privately insured. For all years and using both VA and RUCA rural-urban definitions, physical component summary (PCS) scores were lower but mental component summary (MCS) scores were slightly higher for more rural compared to urban veterans. Anticipating and meeting the needs of rural VA users will require accurate identification of those who lack access to services and therefore defining "rural" appropriately.