Contextualizing Rural/Non-Rural Differences in Pediatric Primary Care Patterns in South Carolina: A Mixed-Methods...

Area of Science:

• Pediatric primary care utilization
• Childhood obesity prevention
• Rural health disparities

Background:

• Overweight and obesity affect 30.7% of US children (10-17 years), increasing health risks.
• Clinical guidelines recommend frequent primary care visits for preventative weight management.
• Limited research exists on rural primary care patterns and family perspectives in South Carolina.

Purpose of the Study:

• To examine rural versus non-rural differences in pediatric primary care patterns for Medicaid-insured children.
• To understand families' perspectives on pediatric primary care access in rural areas.

Main Methods:

• Analysis of South Carolina Medicaid claims (2018-2022) for 22,084 children with weight-related diagnoses and primary care visits.
• Logistic regression to assess associations between patient characteristics and seeking primary care.
• In-depth interviews with 12 families to explore perspectives on rural primary care access.

Main Results:

• 40.54% of children were diagnosed as overweight/obese.
• Children in rural areas, younger children, non-Hispanic white children, and those with healthy weight were more likely to travel for primary care.
• Rurality affected the interplay between travel for care, race/ethnicity, and weight status. Families cited limited trust and perceived poor local healthcare quality as reasons for traveling.

Conclusions:

• Findings highlight the need for tailored public health strategies to improve child and family health outcomes in rural South Carolina.
• Addressing rural healthcare quality perceptions is crucial for effective preventative care and weight management.