Rural-urban disparities in health outcomes, clinical care, health behaviors, and social determinants of health and an action-oriented, dynamic tool for visualizing them.

Autor:	Weeks WB; AI for Good Lab, Microsoft Corporation, Redmond, Washington, United States of America., Chang JE; School of Global Public Health, New York University, New York, New York, United States of America., Pagán JA; School of Global Public Health, New York University, New York, New York, United States of America., Lumpkin J; AI for Good Lab, Microsoft Corporation, Redmond, Washington, United States of America., Michael D; AI for Good Lab, Microsoft Corporation, Redmond, Washington, United States of America., Salcido S; AI for Good Lab, Microsoft Corporation, Redmond, Washington, United States of America., Kim A; AI for Good Lab, Microsoft Corporation, Redmond, Washington, United States of America., Speyer P; Novartis Foundation, Basel, Switzerland., Aerts A; Novartis Foundation, Basel, Switzerland., Weinstein JN; Microsoft Research, Microsoft Corporation, Redmond, Washington, United States of America.; The Dartmouth Institute and Tuck School of Business, Dartmouth College, Hanover, New Hampshire, United States of America.; Kellogg School of Business, Northwestern University, Evanston, Illinois, United States of America., Lavista JM; AI for Good Lab, Microsoft Corporation, Redmond, Washington, United States of America.
Jazyk:	angličtina
Zdroj:	PLOS global public health [PLOS Glob Public Health] 2023 Oct 03; Vol. 3 (10), pp. e0002420. Date of Electronic Publication: 2023 Oct 03 (Print Publication: 2023).
DOI:	10.1371/journal.pgph.0002420
Abstrakt:	While rural-urban disparities in health and health outcomes have been demonstrated, because of their impact on (and intervenability to improve) health and health outcomes, we sought to examine cross-sectional and longitudinal inequities in health, clinical care, health behaviors, and social determinants of health (SDOH) between rural and non-rural counties in the pre-pandemic era (2015 to 2019), and to present a Health Equity Dashboard that can be used by policymakers and researchers to facilitate examining such disparities. Therefore, using data obtained from 2015-2022 County Health Rankings datasets, we used analysis of variance to examine differences in 33 county level attributes between rural and non-rural counties, calculated the change in values for each measure between 2015 and 2019, determined whether rural-urban disparities had widened, and used those data to create a Health Equity Dashboard that displays county-level individual measures or compilations of them. We followed STROBE guidelines in writing the manuscript. We found that rural counties overwhelmingly had worse measures of SDOH at the county level. With few exceptions, the measures we examined were getting worse between 2015 and 2019 in all counties, relatively more so in rural counties, resulting in the widening of rural-urban disparities in these measures. When rural-urban gaps narrowed, it tended to be in measures wherein rural counties were outperforming urban ones in the earlier period. In conclusion, our findings highlight the need for policymakers to prioritize rural settings for interventions designed to improve health outcomes, likely through improving health behaviors, clinical care, social and environmental factors, and physical environment attributes. Visualization tools can help guide policymakers and researchers with grounded information, communicate necessary data to engage relevant stakeholders, and track SDOH changes and health outcomes over time. Competing Interests: The authors declared that no competing interests exist. (Copyright: © 2023 Weeks et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze:	MEDLINE
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