Abstract
Aim
Gender-related healthcare disparities persist. We sought to determine gender-related differences in rural healthcare.
Subject and methods
Quality control assurance analysis utilizing an electronic medical record was used to determine gender-related differences in rural healthcare over a 3-year period (n = 78,814).
Results
Compared to men, women tended to be older (69.4 ± 13.6 years vs 67.9 ± 12.5 years, p < 0.0001), have a higher BMI (30.8 ± 8.2 kg/m2 vs 30.5 ± 6.7 kg/m2, p < 0.0001), Caucasian (OR = 1.21; 95% CI: 1.13–1.29, p < 0.0001), reside in a rural county (OR = 1.03; 95% CI: 1.00–1.06, p = 0.03), have government pay or insurance (OR = 1.36; 95% CI: 1.32–1.41, p < 0.0001), shorter intervals between healthcare visits (158.9 ± 183.1 days vs 167.2 ± 189.7 days, p < 0.0001), more frequent number of emergency department visits (OR = 1.31; 95% CI: 1.26–1.35, p < 0.0001), and a higher number of inpatient hospital admissions (OR = 1.09; 95% CI: 1.05–1.12, p < 0.0001). With regard to cardiovascular disease, women had fewer markers as measured by a lower (Hb)A1c value (p < 0.001), tobacco use (51.3% vs 63.8%, p < 0.001), coronary artery disease diagnosis (38.2% vs 51.7%, p < 0.001), and taking a statin medication (40.4% vs 44.8%, p < 0.001).
Conclusion
Gender-related healthcare differences occur in our rural population. Compared to men, women from both rural and non-rural locations tend to utilize the healthcare system more, which is associated with fewer markers of cardiovascular disease.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Availability of data and materials
The data underlying this article will be shared on reasonable request to the corresponding author.
References
Becker SO, Fernandes A, Weichselbaumer D (2019) Discrimination in hiring based on potential and realized fertility: evidence from a large-scale field experiment. Labour Econ 59:139–152. https://doi.org/10.1016/j.labeco.2019.04.009
Bleiweis R (2020) Quick Facts About the Gender Wage Gap. Center for American Progress, Washington, DC. https://www.americanprogress.org/issues/women/reports/2020/03/24/482141/quick-facts-gender-wage-gap/. Accessed 4 May 2021
Borchelt G (n.d.) The impact poverty has on women’s health. American Bar Association, Chicago, IL. https://www.americanbar.org/groups/crsj/publications/human_rights_magazine_home/the-state-of-healthcare-in-the-united-states/poverty-on-womens-health/. Accessed 4 May 2021
Catalyst Workplaces that Work for Women (2020) Women in male-dominated industries and occupations. Catalyst, New York, NY. https://www.catalyst.org/research/women-in-male-dominated-industries-and-occupations/. Accessed 4 May 2021
Centers for Medicare & Medicaid Services (n.d.) Guide for eligible professionals practicing in multiple locations. Centers for Medicare & Medicaid Services, Baltimore, MD.https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/EP_MultipleLocationsTipsheet.pdf. Accessed 4 May 2021
International Labour Organization (2020) Advancing social justice, promoting decent work (1996–2020) International Labour Organization (ILO), Geneva. https://www.ilo.org/global/about-the-ilo/newsroom/features/WCMS_174876/lang%2D%2Den/index.htm. Accessed 4 May 2021
Martis KC, Clagg SE (2021) West Virginia. Encyclopaedia Britannica, Chicago, IL. https://www.britannica.com/place/West-Virginia. Accessed 4 May 2021
National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Health Care Services; Committee on Health Care Utilization and Adults with Disabilities (2018) Health-care utilization as a proxy in disability determination. National Academies Press, Washington, DC. https://doi.org/10.17226/24969
National Center for Health Statistics (2017) Health, United States, 2016: with chartbook on long-term trends in health. National Center for Health Statistics, Hyattsville, MD. https://www.cdc.gov/nchs/data/hus/hus16.pdf. Accessed 4 May 2021
Ngun TC, Ghahramani N, Sánchez FJ, Bocklandt S, Vilain E (2011) The genetics of sex differences in brain and behavior. Front Neuroendocrinol 32:227–246. https://doi.org/10.1016/j.yfrne.2010.10.001
Office of Disease Prevention & Health Promotion (2020) Disparities: healthy people. Office of Disease Prevention & Health Promotion, Rockville, MDhttps://www.healthypeople.gov/2020/about/foundation-health-measures/Disparities. Accessed 4 May 2021
Owens GM (2008) Gender differences in health care expenditures, resource utilization, and quality of care. J Manag Care Pharm 14:2–6. doi: https://doi.org/10.18553/jmcp.2008.14.S6-A.2
Risman B (2004) Gender as a social structure: theory wrestling with activism. Gend Soc 18:429–450 http://www.jstor.org/stable/4149444
Salganicoff A, Ranji U, Beamesderfer A, Kurani N (2014) Women and health care in the early years of the Affordable Care Act: key findings from the 2013 Kaiser Women’s Health Survey. Kaiser Family Foundation, San Francisco, CA. https://www.kff.org/womens-health-policy/report/women-and-health-care-in-the-early-years-of-the-aca-key-findings-from-the-2013-kaiser-womens-health-survey/. Accessed 4 May 2021
Vyas A, Madhavan SS, Sambamoorthi U (2017) Differences in Medicare expenditures between Appalachian and nationally representative cohorts of elderly women with breast cancer: an application of decomposition technique. J Natl Compr Cancer Netw 15:578–587. https://doi.org/10.6004/jnccn.2017.0060
West Virginians for Affordable Health Care (2008) Early deaths: West Virginians have some of the shortest life expectancies in the united states: a report by West Virginians for affordable health care. West Virginians for Affordable Health Care, Charleston, WVhttp://appvoices.org/images/uploads/2011/07/WV-early-deaths-2008.pdf. Accessed 4 May 2021
West Virginia Health Care Authority (1999) West Virginia State Health Plan: Rural Health. West Virginia Health Care Authority, Charleston, WV. https://hca.wv.gov/policyandplanning/Documents/Background%20Material/shpRurPiper.pdf Accessed 4 May 2021
West Virginia University (2020) Gender Wage Gap. West Virginia Forward. West Virginia University, Morgantown, WV. https://wvforward.wvu.edu/wv-forward-work/women-moving-forward/gender-wage-gap#:~:text=West%20Virginia%20has%20the%20third,earnings%20for%20women%20in%202017. Accessed 4 May 2021
Zewde N, Wimer C (2019) Antipoverty impact of Medicaid growing with state expansions over time. Health Aff (Millwood) 38:132–138. https://doi.org/10.1377/hlthaff.2018.05155
United Health Foundation (2019) America's Health Rankings: 2019 Senior Report: health disparities by gender. United Health Foundation, Minnetonka, MN. https://www.americashealthrankings.org/learn/reports/2019-senior-report/findings-health-disparities-by-gender. Accessed 4 May 2021
Funding
Research reported in this publication was supported by the National Institute of General Medical Sciences of the National Institutes of Health under Award Number 2U54GM104942–02. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Author information
Authors and Affiliations
Contributions
All authors had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis as well as the content of the manuscript.
Corresponding author
Ethics declarations
Ethical approval
The study obtained approval from the West Virginia University Institutional Review Board (protocol #2001835919).
Consent to participate
The study consisted of de-identified quality assurance data without direct patient care/contact. Hence, consent from patients to participate was not required.
Consent to publish
All authors give consent to publication.
Competing interests
All authors declare no competing interests.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Vallejo, M.C., Shapiro, R.E., Lilly, C.L. et al. Rural healthcare and gender-related differences. J Public Health (Berl.) 31, 869–875 (2023). https://doi.org/10.1007/s10389-021-01623-w
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10389-021-01623-w