Rural Health Information Survey
Studies have shown that rural populations tend to experience worse health when compared to their urban or suburban counterparts. Little is known, however about why these disparities exist. There are many complex factors that can impact health for people who live in rural areas. To further explore health and healthcare in rural northern California, CCRP developed a four page survey containing questions about general health, mental health, preventive health, access and utilization of healthcare, transportation, food security, sources of health information and access to phones, electricity, and internet. Results of the surveys will help identify health disparities in underserved populations within the four-county region and inform planners and policy makers.
Methods
Study Design and Sample
Using this Rural Health Information Survey Instrument a cross-sectional survey of a random sample of adults residing in the four counties of Humboldt, Del Norte, Trinity and Mendocino was conducted. A four-page self-administered survey was developed by project administrators at CCRP. The survey contained questions about general health, mental health, preventive health and access and utilization of health care. Many of the questions were based on existing surveys (Behavioral Risk Factor Surveillance Survey, California Health Interview Survey, Canadian Community Health Survey and Mendocino Community Health Survey) and new questions were developed as needed to inquire about areas of rural health not previously explored, such as access to transportation, electricity, phones, computers and Internet as well as skills for responding to emergency medical situations and sources of health information.
The survey contained a combination of quantitative and qualitative responses. The quantitative responses were either categorical or continuous numerical answers. A 15% response rate was anticipated and it was desired to compare answers by county. Sample sizes were examined that would be necessary to satisfy a 10% level of precision (i.e., a bound on relative sampling error E of 10%), at a 95% confidence level. To satisfy this criteria, the desired sample size for each county ranged from n = 23 to n = 385 depending on the question. The number of surveys mailed took these estimates into account.
Surveys were mailed to a random sample of residents within the four county study site. The sampling strategy employed the use of a Geographic Information System (GIS) to map the population density for Zip Code Tabulation Areas (ZCTA) with an overlay of the locations of post offices. All of the post offices in low population density areas (<11 people per square mile) were selected (total post offices = 24; total post office boxes = 8165). Post offices located in higher population density areas (≥11 people per square mile) were randomly selected (total post offices = 19; total post office boxes = 15,441). Forty three different communities were sampled
Surveys were addressed to the box holder and the cover letter instructed someone in the household over the age of 18 to complete the survey and return it in the self-addressed stamped envelope. The survey was mailed to a total of 23,606 box holders.Surveys and follow-up reminder cards were sent during August and September, 2006.
Analysis
Quantitative data was entered and analyzed using SPSS (14.0). To compare proportions and means Chi Square and ANOVA were used respectively for tests of statistical significance with a P value of <0.05 considered statistically significant. Differences found by Chi Square were explored using post hoc testing with Bonferroni adjustment to account for alpha inflation.
Qualitative data was entered and analyzed using ATLAS ti. Codes were developed for the answers to capture common themes.
Health Maps
- Health Issues Affecting the Latino Community
- Places Frequented for Medical Care by the Latino Community
- Places Frequented for Dental Care by the Latino Community
Rural Health Information Survey, 2006
- Percent of Respondents without Adequate Health Care Access
- Percent of Respondents with Transportation Impacting Health Needs without Health Insurance
- Percent of Respondents with Very Low Food Security, by Poverty Status
- Percent of Respondents without CPR Training
- Percent of Respondents without Health Insurance
- Respondents' Average Time to Health Care
- Respondents' Average Distance to the Grocery Store
- Percent of Respondents without In-Home Internet Access
- Percent of Respondents without Health Insurance, by Poverty Status
- Percent of Respondents with Very Low Food Security
- Percent of Respondents without First Aid Training
- Socio-Spatial Sampling Scheme by Zip Code Tabulation Area (ZCTA)
Rural Health Information Survey Presentations
Briefs & Reports
- Rural Health Information Survey, 2006 Selected Findings for Klamath May 2011
- Disparities in Screening for Breast Cancer in the Redwood Coast Region June 2010
- Emergency Preparedness Skills: Human & Social Capital in the Redwood Coast Region March 2010
- Oral Health Care Disparities in the Redwood Coast Region January 2010
- Transportation Disparities Impacting Health Needs in the Redwood Coast Region July
- Rural Poverty & Its Health Impacts: A look at Poverty in the Redwood Coast Region October 2008
- Atlas of Health Indicators in the Redwood Coast Region September 2008
- County-Level Reports: Access to Health Care & Food Security
- Del Norte County Access to Health Care & Food Security
- Trinity County Access to Health Care & Food Security
- Mendocino County Access to Health Care & Food Security
- Humboldt County Access to Health Care & Food Security
- Health Insurance Disparities in the Redwood Coast Region
- Investigating Very Low Food Security in the Redwood Coast Region
- Disparities in Connectivity & Access to Health Care in the Redwood Coast Region