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

Abstract:

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.

Planting the Seeds of Health and Resilience

Primary author: Shawna Beese
Co-author(s): Teresa Bigand; Marian Wilson
Faculty sponsor: Marian Wilson

Primary college/unit: College of Nursing
Campus: Spokane

Abstract:
PRINCIPAL TOPIC
Food bank recipients suffer a greater risk than adults who do not use food banks for insufficient access to fresh fruits and vegetables and negative health factors such as depression, obesity, and food insecurity. Creating access to gardens for this population may offer a low-cost public health approach to increase access to fresh produce and reduce risk for food insecurity. Additionally, access to gardens may offer secondary health benefits including reduced depressive symptoms and improved cardiovascular well-being.

METHOD
Through secondary survey analysis, baseline garden use of food bank recipients was assessed. The interest level of recipients to learn more about gardening, explore how gardening impacts the food security of food bank recipients, and determine potential differences between garden users and non-garden users across multiple health variables (pain interference, depressive symptoms, and sleep quality) were also analyzed.

RESULTS/IMPLICATIONS
In total, 28% (n=49) of participants identified the use of home or community gardens.

More than half of the self-identified garden users (53%, n=26) reported food insecurity; yet garden users had an 18% relative risk reduction for reporting food insecurity compared to non-garden users (p>0.05).

No statistically significant differences resulted across measured health variables between garden users and non-garden users.

Gardening may be a viable public health intervention to ease food insecurity. Future studies with larger sample sizes to investigate the relative risk between garden use and food insecurity are suggested.