title: Explaining rural/non-rural disparities in physical health-related quality of life: a study of United Methodist clergy in North Carolina.
abstract: OBJECTIVE
  Researchers have documented lower health-related quality of life (HRQL) in rural areas. This study seeks to identify factors that can explain this disparity.
  
  
  METHODS
  United Methodist clergy in North Carolina (N = 1,513) completed the SF-12 measure of HRQL and items on chronic disease diagnoses, health behaviors, and health care access from the Behavioral Risk Factor Surveillance Survey (BRFSS). Differences in HRQL between rural (N = 571) and non-rural clergy (N = 942) were examined using multiple regression analyses.
  
  
  RESULTS
  Physical HRQL was significantly lower for rural clergy (-2.0; 95% CI: -2.9 to -1.1; P < 0.001). Income, body mass index, and joint disease partially accounted for the rural/non-rural difference, though a sizable disparity remained after controlling for these mediators (-1.02; 95% CI: -1.89 to -.15; P = 0.022). Mental HRQL did not differ significantly between rural and non-rural respondents (1.0, 95% CI: -0.1 to 2.1; P = 0.067).
  
  
  CONCLUSIONS
  Rural/non-rural disparities in physical HRQL are partially explained by differences in income, obesity, and joint disease in rural areas. More research into the causes and prevention of these factors is needed. Researchers also should seek to identify variables that can explain the difference that remains after accounting for these variables.
authors.affiliation: Department of Sociology, Duke University, Durham, NC, USA. andrew.miles@duke.edu
authors.forename: Andrew
authors.initials: A
authors.lastname: Miles
authors.forename: Rae Jean
authors.initials: RJ
authors.lastname: Proescholdbell
authors.forename: Eve
authors.initials: E
authors.lastname: Puffer
mesh_terms: D000328:Adult; D000368:Aged; D002977:Clergy / Q000706:statistics & numerical data*; D005260:Female; D015438:Health Behavior; D054624:Health Status Disparities; D006305:Health Status Indicators; D006801:Humans; D007592:Joint Diseases / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology; D011788:Quality of Life; D012424:Rural Population / Q000706:statistics & numerical data*