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Health Insurance Coverage and Rural-Urban Differences in Maternal Health Care Among Postpartum Women-National Health

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Rural postpartum women face more health and care access challenges, especially if uninsured or publicly insured. These disparities highlight the impact of insurance status on maternal health outcomes.

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National Health Interview Surveyhealth insurancematernal healthpostpartumrural health

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Area of Science:

  • Public Health
  • Health Services Research
  • Rural Health

Background:

  • Rural-urban disparities in healthcare access and quality impact maternal health outcomes.
  • Health insurance coverage is a key factor in accessing care, with rural populations experiencing higher rates of uninsurance and public insurance.
  • Understanding these differences is crucial for improving maternal and infant care.

Purpose of the Study:

  • To examine rural-urban differences in maternal health and care utilization among postpartum women.
  • To assess how these differences vary based on health insurance coverage status.

Main Methods:

  • Utilized cross-sectional data from the 2013-2018 National Health Interview Surveys (NHIS).
  • Included 2664 non-pregnant female respondents aged 18-49 with an infant under one year old.
  • Assessed rurality using the National Center for Health Statistics Urban-Rural Classification Scheme and analyzed outcomes like sleep problems, acute care use, and care delays by insurance type.

Main Results:

  • Postpartum rural residents were more likely to have public insurance or be uninsured compared to urban residents.
  • Sleep problems were more prevalent in rural (one-third) versus urban (one-fourth) postpartum women, particularly among the publicly insured.
  • Delayed or forgone care was significantly higher for uninsured and publicly insured women in both rural and urban settings compared to privately insured women.

Conclusions:

  • Maternal health challenges, including sleep problems and delayed care, differ between rural and urban postpartum women.
  • Publicly insured or uninsured postpartum women experienced more health and care access challenges than privately insured women.
  • Findings underscore the critical role of insurance status in mitigating rural-urban disparities in maternal healthcare.