The purpose of this study was to identify whether and to what extent there are rural-urban differences in underinsured rates among the privately insured, and, where differences exist, to understand what characteristics of rural residents are related to their likelihood of being underinsured. Using the 2001 and 2001 Medical Expenditure Panel Survey (MEPS), the authors examined the annual out-of-pocket health care expenditures for U.S. residents under age 65 that were continuously insured by a private plan in either 2001 or 2002.
Findings showed that, despite having private health insurance coverage, those who use medical services continue to pay for a substantial portion of their own health care costs, particularly those living in rural areas. The average rural non-adjacent individual paid for 39% of their care in 2001 or 2002, compared to 35% for rural adjacent and 32% for urban individuals. Additional findings showed that one out of eight non-adjacent residents is underinsured (12.4%), compared to 10% of rural adjacent and 7% of urban residents.
Just over one-third of all children with a mental health problem received a mental health visit in the past year;
Controlling for other characteristics that affect access to care, rural children are 20% less likely to have a mental health visit than urban children;
Having Medicaid or SCHIP increases the likelihood that a child will receive services, and this is pronounced in rural areas.
Access to substance abuse treatment is limited in rural areas by fewer treatment beds.
Less populated rural areas contain a small proportion of facilities offering a range of core services and varying levels of outpatient and intensive services.
Opiod treatment programs are nearly absent in rural areas.
One of four issue briefs related to the full length report entitled "Shaping Youth Behavior: Impact of School Environments on Physical Activity and Food Choices" designed to reinforce the points presented in this report in a concise and accessible format. These issue briefs contain best practices, relevant action steps, and a resource list that points the reader to supporting information. They are ideal for printing and distributing to stakeholders, policymakers, and other interested parties.
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