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Analysis of Geospatial Variations in Healthcare Across Rural Communities in the US Using Machine Learning.

Radion Svynarenko1, Hyun Kim2, Tracey Stansberry1

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Summary
This summary is machine-generated.

Social drivers of health (SDOH) significantly impact rural public health. This study used spatial-statistical methods to analyze geospatial variations in rural healthcare access and identified key factors influencing these disparities.

Keywords:
healthcare accessmachine learningmultiscale geographically weighted regressionrural healthsocial drivers of health (SDOH)

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Area of Science:

  • Public Health
  • Rural Health Disparities
  • Spatial Statistics

Background:

  • Social drivers of health (SDOH) critically affect rural public health, presenting challenges like aging populations, limited employment, lower incomes, higher mortality, and poor healthcare access.
  • Existing research on rurality and SDOH often uses narrow definitions, neglecting the crucial spatial dimension of healthcare access.

Purpose of the Study:

  • To investigate geospatial variations in healthcare across different levels of rurality using county-level data.
  • To identify key social drivers of health and healthcare characteristics influencing rural healthcare access.

Main Methods:

  • Utilized county-level data from the 2020 Agency of Healthcare Research and Quality SDOH database.
  • Employed advanced spatial-statistical methods including gradient boosting machines (GBM), Shapley additive explanations (SHAP), and multiscale geographically weighted regression (MGWR).

Main Results:

  • Identified 20 key variables influencing rural healthcare from an analysis of 262 variables across 1976 counties.
  • Key variables grouped into health insurance status, access to care, and Medicare payment volume.
  • Multiscale geographically weighted regression revealed significant global and local effects of healthcare characteristics, strongly linked to socio-geographical factors.

Conclusions:

  • Policymakers must develop equitable, innovative care models to address SDOH and access-to-care issues in vulnerable rural communities, especially in states without Medicaid expansion.
  • Urgent action is needed to mitigate the impact of potential public health program cuts on rural populations.