Summary of Rurality Definitions and Disparities

Overview

• Study compares 8 federal definitions of rurality and their effectiveness in identifying rural areas and disparities.

• Investigates how these definitions affect socioeconomic, demographic, and healthcare access outcomes.

Objectives

• Assess agreement among different rural definitions.

• Evaluate rural-urban disparities based on these definitions.

Methods

• Analyzed data from 72,506 census tracts.

• Eight definitions used: USDA's Rural-Urban Commuting Areas (RUCAs), Rural Continuum Codes (RCCs), Urban Influence Codes (UICs), Frontier Access Codes (FAR), and definitions from HRSA, CDC, CBSAs, UA/UCs.

• Rural status determined using methods specific to each definition.

Key Findings

• Rural population estimates varied widely, from < 6.9 million (UIC) to > 75.5 million (CDC).

• Greatest rural-urban disparities identified with UIC; smallest with UA/UC.

• Population characteristics showed significant variability across definitions, notably in degree of education and poverty rates.

Disparity Insights

• Certain definitions better for certain outcomes (e.g., demographics with UIC and CBSA, healthcare access with FAR).

• Urban centers showed higher agreement in defining rural areas, with notable disambiguity around urban boundaries.

Conclusion

• Choice of rural definition significantly impacts policy-making and understanding of health disparities.

• Researchers must align their objectives with the rural definition that best captures necessary characteristics for their studies.