Urban-Rural Disparities in Vaccination Service Use Among Low-Income Adolescents

Details

• Alternative Title:
  J Adolesc Health
• Personal Author:
  Tsai, Yuping ; Lindley, Megan C. ; Zhou, Fangjun ; Stokley, Shannon
• Description:
  Objective:
  
  To access urban-rural disparities in vaccination service use among Medicaid-enrolled adolescents and examine its association with residence county characteristics.
  
  Study design:
  
  We used the 2016 Medicaid T-MSIS Analytic File to estimate adolescents’ use of vaccination services, defined as the proportion of adolescents aged 11–18 years with ≥ 1 vaccination visit in a county. We used linear regression and the Oaxaca-Blinder decomposition method to examine the association between county characteristics and urban-rural disparities in vaccination service use.
  
  Results:
  
  The analysis included 2,473 counties located in 38 states. The mean proportion of adolescents making ≥ 1 vaccination visit at the county level was low (36.09%) and was lower in rural than in urban counties (31.99% vs. 36.85%, p < .01). The number of primary care physicians (PCPs) was positively associated with vaccination service use in rural counties; in urban counties, % of households without a vehicle was negatively associated with vaccination service use. The decomposition results showed that 66.78% (3.24 percentage points) of the urban-rural disparities in vaccination service use could be attributed to urban-rural differences in the county characteristics included in the study. Characteristics measuring access to care (number of PCPs), social and economic factors (% adults with at least a bachelor’s degree and % children in poverty), quality of care (influenza vaccination rates and preventable hospital stays), and demographics (% non-Hispanic black, % Hispanic, and % females) played a role in urban-rural disparities.
  
  Conclusions:
  
  Differences in county characteristics could partly explain the observed urban-rural disparities in vaccination service use among low-income adolescents.
  
  
• Subjects:
  Adolescent Adult Black Or African American Child Female Humans Male Poverty Residence Characteristics Rural Population Urban Population Vaccination

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• Keywords:
  Adolescents Health Care Disparities Medicaid Rural Health
• Source:
  J Adolesc Health. 69(1):114-120
• Pubmed ID:
  33288460
• Pubmed Central ID:
  PMC8175462
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Place as Subject:
  United States
• Volume:
  69
• Issue:
  1
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:ecd002bb463d4c44f38b379e06f178639f78ab5080d5bce8ec843a63c9495fed
• Download URL:
  https://stacks.cdc.gov/view/cdc/107980/cdc_107980_DS1.pdf
• File Type:
  [PDF - 241.75 KB ]