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High School Census Tract Information Predicts Practice in Rural and Minority Communities
Author(s) -
Hughes Susan,
Zweifler John,
Schafer Sean,
Smith Mark A.,
Athwal Sukhdeep,
Blossom H. John
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.tb00087.x
Subject(s) - census , graduation (instrument) , population , ethnic group , medicine , census tract , american community survey , rural area , health equity , gerontology , demography , family medicine , geography , public health , sociology , nursing , environmental health , geometry , mathematics , pathology , anthropology
Purpose: Identify census‐derived characteristics of residency graduates' high school communities that predict practice in rural, medically underserved, and high minority‐population settings. Methods: Cohort study of 214 graduates of the University of California, San Francisco‐Fresno Family Practice Residency Program (UCSF‐Fresno) from its establishment in 1970 through 2000. Rural‐urban commuting area code; education, racial, and ethnic distribution; median income; population; and federal designation as a medically underserved area were collected for census tracts of each graduate's (1) high school address and (2) practice location. Findings: Twenty‐one percent of graduates practice in rural areas, 28% practice in areas with high proportions of minority population (high minority areas), and 35% practice in federally designated medically underserved areas. Graduation from high school in a rural census tract was associated with rural practice (P <.01). Of those practicing in a rural site, 32% graduated from a rural high school, as compared with 11% of nonrural practitioners. Graduation from high school in a census tract with a higher proportion of minorities was associated with practice in a proportionally high minority community (P =.01). For those practicing in a high‐minority setting, the median minority percentage of the high school census tract was 31%, compared with 16% for people not practicing in a high minority area. No characteristics of the high school census tract were predictive of practice in a medically underserved area. Conclusion: Census data from the residency graduate's high school predicted rural practice and practice in a proportionally high minority community, but not in a federally designated medically underserved area.