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Rural‐Urban Differences in Employment‐Related Health Insurance
Author(s) -
Larson Sharon L.,
Hill Steven C.
Publication year - 2005
Publication title -
the journal of rural health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.439
H-Index - 57
eISSN - 1748-0361
pISSN - 0890-765X
DOI - 10.1111/j.1748-0361.2005.tb00058.x
Subject(s) - metropolitan area , medical expenditure panel survey , residence , health insurance , rural area , demographic economics , sample (material) , business , geography , socioeconomics , health care , medicine , economics , economic growth , chemistry , archaeology , pathology , chromatography
Context: Rural residents are disproportionately represented among the uninsured in the United States. Purpose: We compared nonelderly adult residents in 3 types of nonmetropolitan areas with metropolitan workers to evaluate which characteristics contribute to lack of employment‐related insurance. Research Design and Analysis: Data were obtained from the Medical Expenditure Panel Survey, pooled across 3 panels (1996–1998) to enhance the rural sample size. Econometric decomposition was used to quantify the contribution of employment structure to differences in the probability of being offered employment‐related health insurance. Findings: The most rural workers are 10.4 percentage points less likely to be offered insurance compared with urban workers; the difference is smaller for residents of other rural areas. In rural counties not adjacent to urban areas, lower wages and smaller employers each account for about one‐third of the total difference. Conclusions: Health insurance disparities associated with rural residence are related to the structure of employment. Major factors include smaller employers, lower wages, greater prevalence of self‐employment, and sociodemographic characteristics.