Treatment for Injuries among Washington State Adults: Differences by Rurality

Primary author: Janessa Graves
Co-author(s): Demetrius Abshire

Primary college/unit: College of Nursing
Campus: Spokane


Statement of Purpose: Rural residents face significant barriers in accessing trauma care, with access becoming more challenging in highly rural areas. We examined differences in injury-related medical care among Washington State residents across the rural-urban continuum.

Methods/Approach: Stratified random sampling was used to select 2575 adults from small rural, large rural, suburban, and urban areas who were invited to complete a survey on factors affecting health. Data were obtained from 616 adults (278 from small rural, 100 from large rural, 98 from suburban, and 140 from urban areas). Respondents reported past-year injury experience and barriers to access for medical care. We examined variation in access by rurality using chi-squared and modified Poisson regression models.

Results: Fewer than half (45.1%) of respondents reported any activity-restricting injury in the last year and 32.4% reported seeking care. Injuries were often treated by a primary care provider (59.7%) or walk-in clinic (21.9%) with no significant difference in care location by rurality. Overall, 20.2% of small rural residents sought medical care >30 minutes away, compared to 3.9% of urban, 8.0% of suburban, and 12.1% of large rural residents (p30 minutes away from home (adjusted IRR, p<0.01).

Conclusions: Washington residents face differential access to medical care for injuries across levels of rurality, with small rural residents reporting the most substantial access-related concerns. Health systems and policies must address inequities in access to care for residents along the rural-urban gradient.