Comparison of Coding Schemas for Rural-Urban Designations with New York State Counties and Birth Outcomes as Exemplars

Abstract

Purpose The purposes of this article are to provide background information on the agencies responsible for the development of rural coding schemas at the county level, to explain the types of codes and the definitions of terms included in the codes, and to provide a concise table that presents the assigned codes for each county in New York State. Findings Roles of U.S. Census Bureau, Office of Management and Budget, and Economic Research Service were described. At the county level, Urban Influence Codes, Rural Urban Continuum Codes, and NCHS Codes were outlined and compared. RUCA and Frontier Community Codes were discussed as non-county based rural classification schemas. Conclusions Nursing is integral to the attainment of better health outcomes through advocacy and policy recommendation at federal, state, and local levels. Accurate measures of rurality should be applied at the decision making level for the allocation of scarce resources that support projects and programs most effective for vulnerable rural populations. Maintaining policies that benefit vulnerable populations requires funding; but needs analyses using inappropriate coding schemas can result in lack of funding or the implementation of policies that are ineffective for the targeted population. This study attempted to elucidate nuances among the three rural coding schemas and demonstrated that using the appropriate rural coding schema may highlight rural/urban health disparities more clearly. Key Words Classification schemas, County, Rural Definitions, Rural-Urban Codes, New York State