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Routine Healthcare Utilization Among Reproductive-Age Women Residing in a Rural Maternity Care Desert

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Abstract

It is important that women of reproductive age have access to and use routine health services to improve birth outcomes. While it is estimated that more than 5 million women in over 1000 counties across the United States live in maternity care deserts, to date there have been no published studies characterizing access and barriers to routine healthcare utilization in these areas. Therefore, a cross-sectional study was conducted in a rural county in northwest Ohio with 315 women ages 18–45 years. Health insurance coverage, usual source of care, length of time since routine check-up, and barriers to receipt of health services were assessed via a self-reported, anonymous survey. Over one-tenth (11.3%) of participants reported having no health insurance coverage. A total of 14.4% reported having no usual source of care and 22.8% reported not having a routine check-up in the past year. Just over one-half (53.0%) of participants reported having at least one barrier to accessing health care. In a logistic regression analysis, having a routine check-up in the past year was inversely associated with number of barriers (OR 0.73, 95% CI 0.56–0.95; p = 0.019); women who reported more barriers were less likely to report receipt of preventive care in the past year. The results of this study reveal that many reproductive-age women living in a maternity care desert face challenges in accessing health services. Policies and programs need to be developed and implemented to close these gaps and maximize opportunities for optimal health.

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Acknowledgements

The authors acknowledge and thank Patrick T.S. Lai, MPH, PhD (Candidate), Graduate Student and Assistant, Indiana University, Polis Center, for his assistance in creating Fig. 1.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Author notes

  1. Natalie A. DiPietro Mager

    Present address: Department of Pharmacy Practice, Ohio Northern University Rudolph H. Raabe College of Pharmacy, 525 S. Main St, Ada, OH, 45810, USA

Authors and Affiliations

  1. Department of Epidemiology, Indiana University Richard M. Fairbanks School of Public Health, 1050 Wishard Blvd., Indianapolis, IN, 46202, USA

    Natalie A. DiPietro Mager, Terrell W. Zollinger, Jianjun Zhang & Brian E. Dixon

  2. Department of Social and Behavioral Sciences, Indiana University Richard M. Fairbanks School of Public Health, 1050 Wishard Blvd., Indianapolis, IN, 46202, USA

    Jack E. Turman Jr

  3. Indiana University Melvin and Bren Simon Comprehensive Cancer Center, 535 Barnhill Dr, Indianapolis, IN, 46202, USA

    Jianjun Zhang

  4. Center for Biomedical Informatics, Regenstrief Institute, Inc., 1101 West Tenth Street, Indianapolis, IN, 46202, USA

    Brian E. Dixon

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  1. Natalie A. DiPietro Mager
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Natalie DiPietro Mager with input and direction provided by Brian Dixon, Jack Turman, Jianjun Zhang, and Terrell Zollinger. The first draft of the manuscript was written by Natalie DiPietro Mager and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Natalie A. DiPietro Mager.

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DiPietro Mager, N.A., Zollinger, T.W., Turman, J.E. et al. Routine Healthcare Utilization Among Reproductive-Age Women Residing in a Rural Maternity Care Desert. J Community Health 46, 108–116 (2021). https://doi.org/10.1007/s10900-020-00852-6

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  • DOI: https://doi.org/10.1007/s10900-020-00852-6

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