Differences in Select Measures of Health Care Access, Utilization, and Financial Burden by Urbanicity, 2017

Objective-This report examines select measures of health care access, utilization, and financial burden by metropolitan statistical area (MSA) status among adults aged 18-64. Methods-Data from the 2017 National Health Interview Survey were used to examine how a usual place to go for care, visits to a doctor or emergency room in the past year, unmet medical need due to cost, inability to afford prescription medications, and problems paying medical bills differed by MSA status among adults aged 18-64. Estimates are presented for adults living in a large MSA (population of 1 million or more), living in a small MSA (less than 1 million in population), and not living in an MSA. Results-In 2017, adults not living in an MSA generally had reduced access to or use of health care, and a higher financial burden associated with their care, compared with those in more populous areas. However, after controlling for selected sociodemographic and health characteristics, it was found that for the measures examined, adults not living in MSAs were more likely to have a usual place to go for care but less likely to have financial burden associated with their care compared with those in small or large MSAs. Conclusion-The unadjusted results show that adults not living in an MSA are more likely to have financial burden associated with their health care and reduced access to or use of health care services compared with those in large MSAs. However, the differences in the measures examined may be due to differential distributions of poverty levels, insurance coverage status, or other sociodemographic or health characteristics between the MSA status categories rather than MSA status itself.