Explaining rural/non-rural disparities in physical health-related quality of life: a study of United Methodist clergy in North Carolina.
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PURPOSE: Researchers have documented lower health-related quality of life (HRQL) in rural areas. This study seeks to identify factors that can explain this disparity. METHODS: United Methodist clergy in North Carolina (N = 1,513) completed the SF-12 measure of HRQL and items on chronic disease diagnoses, health behaviors, and health care access from the Behavioral Risk Factor Surveillance Survey (BRFSS). Differences in HRQL between rural (N = 571) and non-rural clergy (N = 942) were examined using multiple regression analyses. RESULTS: Physical HRQL was significantly lower for rural clergy (-2.0; 95% CI: -2.9 to -1.1; P < 0.001). Income, body mass index, and joint disease partially accounted for the rural/non-rural difference, though a sizable disparity remained after controlling for these mediators (-1.02; 95% CI: -1.89 to -.15; P = 0.022). Mental HRQL did not differ significantly between rural and non-rural respondents (1.0, 95% CI: -0.1 to 2.1; P = 0.067). CONCLUSIONS: Rural/non-rural disparities in physical HRQL are partially explained by differences in income, obesity, and joint disease in rural areas. More research into the causes and prevention of these factors is needed. Researchers also should seek to identify variables that can explain the difference that remains after accounting for these variables.
Health Status Disparities
Health Status Indicators
Quality of Life
Published Version (Please cite this version)10.1007/s11136-010-9817-z
Publication InfoMiles, A; Proeschold-Bell, RJ; & Puffer, Eve S (2011). Explaining rural/non-rural disparities in physical health-related quality of life: a study of United Methodist clergy in North Carolina. Qual Life Res, 20(6). pp. 807-815. 10.1007/s11136-010-9817-z. Retrieved from http://hdl.handle.net/10161/6213.
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Assistant Professor of Psychology and Neuroscience
Dr. Puffer is a global mental health researcher and a licensed clinical psychologist. Her research focuses on developing and evaluating integrated community-based interventions to promote child mental health, improve family functioning, and prevent HIV risk behavior. Her work includes studies with families with young children through those with adolescents, as well as with couples. She has conducted much of this work in rural Kenya and is an investigator on multiple studies of child mental hea