The effects of rural residence and other social vulnerabilities on subjective measures of unmet need

Med Care Res Rev. 2005 Oct;62(5):617-28. doi: 10.1177/1077558705279315.


To determine whether self-reports of unmet need are biased measures of access to health care, the authors examine the relationship between rural residence and perceived need for physician services. They perform logistic regression analyses to examine the likelihood of reporting a need for routine preventive care and/or specialty care using data from the National Survey of Children with Special Health Care Needs. Even after controlling for factors known to be associated with evaluated need, parents of rural children were less likely to report a need for routine or specialty services. Poor children, those whose mothers had less education, and those who were uninsured in the previous year were also less likely to perceive a need for physician services. Findings suggest that rural residence and other social vulnerabilities are associated with decreased perception of need, which may bias subjective measurements of unmet need for these populations.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Bias
  • Child
  • Child Health Services / statistics & numerical data*
  • Child Health Services / supply & distribution
  • Child, Preschool
  • Disabled Children / statistics & numerical data*
  • Female
  • Health Care Surveys
  • Humans
  • Infant
  • Logistic Models
  • Male
  • Medically Uninsured / statistics & numerical data
  • Needs Assessment / statistics & numerical data*
  • Parents / psychology*
  • Residence Characteristics
  • Rural Health
  • Self Disclosure*
  • United States
  • Vulnerable Populations / psychology
  • Vulnerable Populations / statistics & numerical data*