Background: This study examined rural-urban differences in utilization of p
reventive healthcare services and assessed the impact of rural residence, d
emographic factors, health insurance status, and health system characterist
ics on the likelihood of obtaining each service.
Methods: National data from the 1997 Behavioral Risk Factor Surveillance Sy
stem (BRFSS) and the 1999 Area Resource File were used to evaluate the adeq
uacy of preventive services obtained by rural and urban women and men, usin
g three sets of nationally accepted preventive services guidelines from the
American Cancer Society, U.S. Preventive Services Task Force, and Healthy
People 2010. Logistic regression models were developed to control for the e
ffect of demographic factors, health insurance status, and health system ch
aracteristics.
Results: Rural residents are less likely than urban residents to obtain cer
tain preventive health services and are further behind urban residents in m
eeting Healthy People 2010 objectives.
Conclusions: Efforts to increase rural preventive services utilization need
to build on federal, state, and community-based initiatives and to recogni
ze the special challenges that rural areas present.