Evaluating Rural-Urban Typologies for Use in Health Care Research

Emily Shrider , University of Wisconsin-Madison
David Mallinson, University of Wisconsin-Madison

Recent studies on variations in health outcomes across the rural-urban gradient raise questions about the way health scholars classify rurality and urbanicity. Concerns about our existing rural-urban typologies—namely, that they suffer from over- and under-bounding, are inconsistent with one another, and vary by region—make it difficult to draw consistent conclusions about the role of place in health outcomes. This study seeks to provide some clarity by systematically assessing the degree of over- and under-bounding and the inter-typology consistency of popular rural-urban typologies. It then examines the effect of regional variation in the “goodness of fit” of these typologies by testing how well they explain variation in three healthcare outcomes: infant mortality, access to obstetrical care, and access to general practitioners. Understanding how accurate these classifications are and how well they “fit” different outcomes should allow us to better understand the role of place in healthcare outcomes.

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 Presented in Session 3. Population, Development, & the Environment; Data & Methods; Applied Demography