The relationship of health professional shortage areas to health status. Implications for health manpower policy.
OBJECTIVE
To compare the health status of adult residents of health professional shortage areas (HPSAs) with adult residents of non-HPSAs.


METHODS
A random-digit dialing telephone survey. Respondents were subsequently classified by their county of residence as residing in an HPSA or non-HPSA.


METHODS
A sample of 470 adults (18 years or older) living in Kentucky.


METHODS
Health status was measured by the Medical Outcomes Study 20-Item Short-Form Health Survey's six subscales.


RESULTS
Controlling for demographic variables in the multiple regression analysis, there were significant differences between HPSAs and non-HPSAs for the social, mental health, and pain subscales. An interaction between age and HPSAs in relation to health status was observed for the physical, social, mental health, health perception, and pain subscales. After stratification by age (18 to 44 years, 45 to 64 years, or 65 years or older), HPSA-designated areas were associated with poorer health status in all but the youngest age strata. Elders in HPSAs had the poorest health status.


CONCLUSIONS
Health professional shortage areas are associated with poorer health status in the older segments of the adult population. Future policy may need to focus on increasing access not only to primary care services but also to specific types of services that may promote better health status of elderly residents of HPSAs.
Kohrs
F P
FP
Department of Family Practice, University of Kentucky, Lexington, USA.
Mainous
A G
AG
D000328:Adult; D017677:Age Distribution; D000368:Aged; D005260:Female; D006291:Health Policy; D006304:Health Status; D006280:Health Workforce / Q000706:statistics & numerical data*; D006801:Humans; D007629:Kentucky; D008297:Male; D008507:Medically Underserved Area; D008875:Middle Aged; D012044:Regression Analysis; D011795:Surveys and Questionnaires