Urban-rural differences in work disability after an occupational injury.
OBJECTIVE
In comparison with their urban counterparts, people living in rural areas have been found to experience higher rates of morbidity and mortality and have inferior health outcomes after illnesses and injuries. The current study sought to determine if this trend extends to work-disability outcomes after work-related injuries.


METHODS
This study was a retrospective cohort study using data on workers' compensation claims. Rurality was defined at the postal-code level on the basis of United States 2000 census data. Work disability was measured using the number of full days a person was off work in the 2 years following an injury. Regression analyses were used to test the association between rurality and the duration of work disability after a work-related bone fracture.


RESULTS
The claimants with higher rurality experienced less work disability than those with lower rurality. This relationship remained after control for the impact of age, gender, part of body injured, occupation, and industry.


CONCLUSIONS
Rurality was found to be related to work disability. However, rather than being associated with more time off after an injury, as could be expected on the basis of past findings, increased rurality was found to be associated with less time off work. The findings suggest that features of rural environments, cultures, and behavioral patterns may facilitate return to work.
Young
Amanda E
AE
Center for Disability Research, Liberty Mutual Research Institute for Safety, 71 Frankland Road, Hopkinton, MA 07148, USA. AmandaE.Young@LibertyMutual.com
Wasiak
Radoslaw
R
Webster
Barbara S
BS
Shayne
Rebecca Gf
RG
D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009784:Occupational Diseases / Q000453:epidemiology*; D012044:Regression Analysis; D012111:Residence Characteristics; D012189:Retrospective Studies; D012424:Rural Population / Q000706:statistics & numerical data; D018582:Sick Leave / Q000706:statistics & numerical data*; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data; D014942:Workers' Compensation / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000453:epidemiology*