J. Truong, A. Frack, M. Davis, A. Samuelson, W. M. Silvers

Whitworth University, Spokane, WA

Access to healthcare in rural areas has been shown to be a health disparity in the United States. Despite the research on rural health access, the perception of access between rural and urban populations among younger populations is poorly understood. Younger populations may provide insight on how to influence future health care in rural areas. PURPOSE: The purpose of this study was to compare perceptions of healthcare affordability, accessibility, and receptivity between rural, small, and urban areas. METHODS: Full-time undergraduate and graduate students (18-30 years old) were identified as the target population. An email was sent out to 500 students through random sampling which invited them to participate in a survey. The survey instructed participants to identify their perceptions of healthcare accessibility, affordability, and receptivity in their home community. Answers were based upon a Likert scale from one to five. Data was compared between three participant groups: those who were from rural (R; < 20,000 people), small (S; 20,000-250,000), and urban (U; >250,000) communities. An analysis of variance ANOVA (p ≤ 0.05) was used to calculate the differences between perceptions of accessibility and affordability. However, a Kruskal-Wallis test (p ≤ 0.05) was used to compare perceptions of receptivity due to non-parametric data distributions. RESULTS: There was a significant difference in perceptions of receptivity between population sizes (R: 9.4 ± 3.5, S: 12.4 ± 3.0, U: 9.9 ± 4.9, p = 0.018). There was no difference between population sizes for perceptions of accessibility (R: 11.1 ± 2.1, S: 12.9 ± 2.8, U: 11.5 ± 3.8, p = 0.140) and affordability (R: 10.1 ± 3.1, S: 10.8 ± 2.9, U: 9.8 ± 3.3, p = 0.607). CONCLUSION: Participants from rural and urban areas had lower perceptions of receptivity to healthcare than those from small areas. According to another report, 89% of physicians in the United States practiced in urban areas and 2.6% practiced in small rural areas. In both situations, more patients than providers may mean greater demand and long waits for care, shorter visit times, and less chance of building trust with a provider. Additional participants and refined lines of questioning are needed to improve the generalizability and applicability of further research on perceptions of healthcare in younger populations.

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