Health and Social Determinants Associated With Delay of Care Among Community-Dwelling Rural Older Adults.

Abstract

Delaying health care has the capacity to increase morbidity and premature mortality among individuals with chronic and acute health conditions, particularly for those living in rural areas. The objective of this study was to identify social determinants of health that are associated with delay of care (DOC) among older adults residing in rural areas across the inland northwest. We conducted descriptive, bivariate, and regression analyses using data from a needs assessment designed to identify health needs and service delivery gaps among an economically diverse 8-county region. Most respondents (aged 60+ years) were white, female, with health insurance coverage (n = 1226, mean = 71). Overall, 35% experienced DOC. We used logistic regression to determine the influence of age, sex, health conditions, distance from medical facility, income, and perceived quality of neighborhood on DOC. Individuals with younger age ( P = .017), more chronic conditions ( P < .001), lower income ( P < .001), and lower perceived quality of neighborhood ( P = .008) were more likely to experience DOC. These findings highlight risk factors associated with DOC, which can inform prevention efforts championed by community-based organizations, health care providers, and policy makers. Future research is needed to investigate compounding long-term effects of DOC, especially among individuals living in rural areas.