Rural-urban differences in health care unaffordability

Abstract

Purpose: To compare health care unaffordability in rural versus urban contexts while also examining the impact of sociodemographic/socioeconomic variables on this relationship. Methods: We examined survey responses from the 2019-2021 National Health Interview Survey (n = 90,761). We conducted chi-squared tests comparing urban and rural subsamples and multivariable logistic regression analyses examining the associations between rurality and 3 measures of health care unaffordability while also including interactions between rurality and individual characteristics of respondents. Findings: In bivariate analyses, compared to their urban counterparts, rural residents were more likely to report problems paying medical bills (15.0% vs 11.5%, P