Findings Disparities In Rural Health | 2018 Senior Report

Executive Summary Senior Report Spotlight IntroductionFindingsOverview State Rankings Successes Challenges Disparities in Rural HealthCore MeasuresBehaviors Community & Environment Policy Clinical Care Outcomes Supplemental MeasuresState Summaries

Alabama

United StatesAppendixCore Measures Table Supplemental Measures Table The Team

2018 Senior Report 2018 Executive Summary 2018 Senior Report – Report Data (All States)

In nearly all measures examined by urbanicity, seniors in rural areas experienced greater health challenges than those living in urban and suburban areas. We examined measures with urbanicity data from the Behavioral Risk Factor Surveillance System. Of the measures examined, excessive drinking is the only measure in which rural seniors fare better than suburban and urban seniors. The prevalence of excessive drinking among rural seniors is 5.5 percent compared with suburban (6.8 percent) and urban (6.5 percent) seniors. The disparities in rural health are evident across a wide range of behaviors, clinical care and outcomes measures.
Rural health challenges include a higher prevalence of:
Falls 
Obesity
Physical inactivity
Smoking
Teeth extractions
Rural health challenges also include a lower prevalence of:
Dedicated health care provider
Dental visit
Flu vaccine (rural vs. urban only) 
Health screenings
High health status 
Pain management
Falls 
Nationally, the prevalence of falls among seniors is 29.5 percent. Falls are significantly higher among rural (32.4 percent) seniors than suburban (28.5 percent) and urban (29.5 percent) seniors. A gap has persisted over the past four years and has widened in the past year (Figure 23).
Obesity
In the U.S., 28.0 percent of seniors have obesity. Obesity prevalence is significantly higher among rural seniors (29.2 percent) than suburban (27.2 percent) and urban (26.6 percent) seniors. This has been the trend over the past five years (Figure 24).
Physical Inactivity
Physical inactivity is defined as the percentage of adults aged 65 and older with fair or better health status who reported doing no physical activity or exercise other than their regular job in the past 30 days. It is significantly higher among rural (34.3 percent) seniors than suburban (30.4 percent) and urban (30.1 percent) seniors. This gap has persisted over the past five years (Figure 25). 
Smoking
Across the nation, 8.7 percent of adults aged 65 and older reported smoking at least 100 cigarettes in their lifetime and currently smoke every or some days. The prevalence of smoking among rural (9.9 percent) seniors is significantly higher than among suburban (7.2 percent) and urban (7.7 percent) seniors. The gap between rural and suburban/urban seniors has widened over the past year (Figure 26). 
Teeth Extractions
Nationally, 14.5 percent of seniors reported having full-mouth teeth extractions. The prevalence is significantly higher among rural (19.9 percent) seniors compared with suburban (13.7 percent) and urban (13.6 percent) seniors. This large gap has been the trend over the past four years (Figure 27).
Dedicated Health Care Provider 
Nearly all U.S. seniors (94.5 percent) reported having one or more people whom they consider as their personal doctor or health care provider. Having a dedicated health care provider, however, is significantly lower among rural (94.4 percent) seniors than suburban (95.7 percent) and urban (95.7 percent) seniors. The gap is small but has persisted over the past four years (Figure 28).
Dental Visit 
Two-thirds (66.9 percent) of U.S. seniors reported visiting a dentist or dental clinic in the past year. This percentage is significantly lower among rural (60.6 percent) seniors than suburban (69.5 percent) and urban (69.3 percent) seniors. The gap between rural and urban/suburban senior dental visits has persisted over the past four years (Figure 29).
Flu Vaccine
Nationally, flu vaccination coverage among seniors is 58.8 percent. It is significantly lower among rural (57.2 percent) seniors compared with urban (61.4 percent) seniors, but not suburban (59.1 percent) seniors. The gap between rural and urban seniors has emerged over the past year (Figure 30).
Health Screenings
Each year nearly three-quarters (73.0 percent) of seniors report receiving recommended health screenings. Health screenings is defined as the percentage of women aged 65 to 74 years who reported receiving a mammogram in the past two years and the percentage of adults aged 65 to 75 years who reported receiving colorectal cancer screening within the recommended time period. Among rural seniors, however, 66.4 percent reported receiving recommended health screenings, a significantly lower prevalence compared with suburban (74.3 percent) and urban (75.3 percent) seniors. This trend has persisted over the past four years (Figure 31).
High Health Status
Less than half (41.9 percent) of U.S. adults aged 65 and older reported their health is very good or excellent. Rural (36.8 percent) seniors, however, have a significantly lower prevalence of high health status compared with suburban (42.0 percent) and urban (41.4 percent) seniors, a consistent trend over the past five years (Figure 32). 
Pain Management 
Nationally, 53.5 percent of adults aged 65 and older with arthritis reported that arthritis or joint pain does not limit their usual activities. Pain management is significantly lower among rural (50.8 percent) seniors compared with suburban (54.4 percent) and urban (53.6 percent) seniors. There was a slight increase in pain management in all three populations between 2014 and 2016 . Suburban and urban seniors sustained progress in recent years, while pain management among seniors in rural areas declined since 2016 (Figure 33). 