The role of federally funded health centers in serving the rural population.
BACKGROUND
Federally funded health centers attempt to improve rural health by reducing and eliminating access barriers to primary care services.


OBJECTIVE
This study compares rural health center patients with people in the general rural population for indicators of access to preventive services and health outcomes.


METHODS
Data from the annual reporting system for federally funded health centers, the 1999 Uniform Data System, and published national census data were used to provide sociodemographic comparisons. Selected health status indicators, preventive services utilization, and health outcomes were obtained from a survey of health center patients, and the results were compared with the National Health Interview Survey and National Vital Statistics.


RESULTS
Unlike the nation's rural population, the majority of rural health center patients are of minority race/ethnicity, live at or below poverty, and are either uninsured or on Medicaid. Despite having higher prevalence of traditional access barriers than the general rural population, rural health center patients are significantly more likely to receive certain preventive services and also to experience lower rates of low birthweight, particularly for African American infants. However, rural health center patients are not more likely to have received influenza vaccination or up-to-date mammogram screening.


CONCLUSIONS
Health centers provide access to essential preventive care for many of the most vulnerable rural residents. A national strategy to expand the rural health center network will likely help to ensure improved health for the considerable proportion of rural residents who still lack access to appropriate services.
Regan
Jerrilynn
J
Bureau of Primary Health Care, Health Resources and Services Administration, Bethesda, MD 20814, USA. jregan@hrsa.gov
Schempf
Ashley H
AH
Yoon
Jean
J
Politzer
Robert M
RM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D003151:Community Health Centers / Q000191:economics* / Q000706:statistics & numerical data; D003710:Demography; D035082:Federal Government; D005260:Female; D005380:Financing, Government; D006297:Health Services Accessibility / Q000191:economics*; D006302:Health Services Research; D006305:Health Status Indicators; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology / Q000517:prevention & control; D011314:Preventive Health Services / Q000191:economics / Q000706:statistics & numerical data; D012307:Risk Factors; D019035:Rural Health Services / Q000191:economics* / Q000706:statistics & numerical data; D012907:Smoking / Q000453:epidemiology; D000074606:Smoking Prevention; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology