Table 1:
Child and County Characteristics, by County Rurality
| County rurality |
|||||
|---|---|---|---|---|---|
| Totala (N = 6,275,456) | Metro counties (N = 5,066,625) | Non-metro, adjacent to metro counties (N = 730,316) | Non-metro, not adjacent to metro counties (N = 478,516) | P valueb | |
| County characteristicsc | |||||
| Provider supply | |||||
| Children living in a full or partial primary care health HPSA, n (%) | 5,533,466 (88.2) | 4,517,366 (89.2) | 606,603 (83.1) | 409,498 (85.6) | < .001 |
| Children living in a full or partial dental HPSA, n (%) | 5,277,430 (84.1) | 4,371,791 (86.3) | 558,194 (76.4) | 347,444 (72.6) | < .001 |
| Social environment | |||||
| Percent of persons aged 0–17 years in poverty (quartiles), n (%) | < .001 | ||||
| Top quartile: 28.4% - 59.6% | 1,589,816 (25.3) | 1,032,343 (20.4) | 350,497 (48.0) | 206,976 (43.3) | |
| Third quartile: 24.9% - 28.3% | 1,550,164 (24.7) | 1,340,259 (26.5) | 146,612 (20.1) | 63,293 (13.2) | |
| Second quartile: 18.0% - 24.8% | 1,594,386 (25.4) | 1,317,358 (26.0) | 149,787 (20.5) | 127,240 (26.6) | |
| Bottom quartile: 3.3% – 17.9% | 1,541,091 (24.6) | 1,376,664 (27.2) | 83,420 (11.4) | 81,007 (16.9) | |
| Unemployment rate (quartiles), n (%) | < .001 | ||||
| Top quartile: 8.6% - 23.6% | 1,654,717 (26.4) | 1,211,529 (23.9) | 269,272 (36.9) | 173,916 (36.3) | |
| Third quartile: 7.3% - 8.5% | 1,545,456 (24.6) | 1,287,912 (25.4) | 168,229 (23.0) | 89,315 (18.7) | |
| Second quartile: 6.1% - 7.2% | 1,581,503 (25.2) | 1,373,436 (27.1) | 151,998 (20.8) | 56,068 (11.7) | |
| Bottom quartile: 0.8% - 6.0% | 1,493,781 (23.8) | 1,193,748 (23.6) | 140,816 (19.3) | 159,217 (33.3) | |
| Child characteristics | |||||
| Age in years on January 1, mean (SD) | 2.18 (1.88) | 2.19 (1.87) | 2.16 (1.90) | 2.15 (1.91) | < .001 |
| Age, n (%) | < .001 | ||||
| ≤ 0 | 1,488,075 (23.7) | 1,187,710 (23.4) | 180,682 (24.7) | 119,683 (25.0) | |
| 1 | 968,317 (15.4) | 786,655 (15.5) | 109,455 (15.0) | 72,207 (15.1) | |
| 2 | 983,392 (15.7) | 798,644 (15.8) | 112,343 (15.4) | 72,405 (15.1) | |
| 3 | 972,277 (15.5) | 790,588 (15.6) | 110,286 (15.1) | 71,403 (14.9) | |
| ≥ 4 | 1,863,396 (29.7) | 1,503,027 (29.7) | 217,551 (29.8) | 142,817 (29.8) | |
| Sex, n (%) | .261 | ||||
| Male | 3,210,992 (51.2) | 2,591,664 (51.2) | 375,109 (51.4) | 244,219 (51.0) | |
| Female | 3,064,464 (48.8) | 2,474,961 (48.8) | 355,207 (48.6) | 234,296 (49.0) | |
| Race/ethnicity, n (%) | < .001 | ||||
| White, non-Hispanic | 2,361,865 (37.6) | 1,675,416 (33.1) | 412,490 (56.5) | 273,959 (57.3) | |
| Black or African American, non-Hispanic | 1,397,214 (22.3) | 1,209,744 (23.9) | 130,770 (17.9) | 56,700 (11.8) | |
| Hispanic | 1,026,608 (16.4) | 941,472 (18.6) | 54,297 (7.4) | 30,839 (6.4) | |
| Other | 735,034 (11.7) | 593,589 (11.7) | 70,472 (9.6) | 70,973 (14.8) | |
| Unknown | 754,735 (12.0) | 646,404 (12.8) | 62,287 (8.5) | 46,045 (9.6) | |
| Months of Medicaid eligibility during year, n (%) | |||||
| 6–8 months | 633,923 (10.1) | 506,107 (10.0) | 73,863 (10.1) | 53,953 (11.3) | < .001 |
| 9–11 months | 871,203 (13.9) | 700,894 (13.8) | 98,709 (13.5) | 71,599 (15.0) | |
| 12 months | 4,770,331 (76.0) | 3,859,623 (76.2) | 557,744 (76.4) | 352,964 (73.8) | |
HPSA = health professional shortage area; SD = standard deviation
Notes:
a
The sample includes all children from 39 states who were aged < 6 years with at least 6 months of Medicaid eligibility during the 1-year study period. The sample was weighted to reflect the sampling of children in each state and calendar year.
b
P values were calculated using analysis of variance for continuous variables and the chi-squared test of independence for categorical variables.
c
County characteristics were obtained from the Area Health Resource Files based on the county of residence of each child during the study period