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Distance and health care utilization among the rural elderly


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  • Nemet, Gregory F.
  • Bailey, Adrian J.


This paper explores the relationship between distance and the utilization of health care by a group of elderly residents in rural Vermont. By drawing on recent work on the geography of health we frame the decision to visit a primary care physician in the context of the experience of place. The paper devises a test of this broader reading of the role of distance for utilization, and operationalizes this test using a custom designed survey. Using a randomized mail survey of elderly residents of Vermont's North East Kingdom we explore how grocery shopping, travel to work, home location relative to local services, access to private transportation, and living arrangements are associated with the number of doctor visits made to primary health care providers. Although the results confirm the idea that increased distance from provider does reduce utilization, they strongly suggest that distance to provider is a surrogate for location in a richer web of relations between residents and their local communities. We conclude by calling for further research that establishes links between place and the use of health facilities.

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Bibliographic Info

Article provided by Elsevier in its journal Social Science & Medicine.

Volume (Year): 50 (2000)
Issue (Month): 9 (May)
Pages: 1197-1208

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Handle: RePEc:eee:socmed:v:50:y:2000:i:9:p:1197-1208

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Keywords: Elder health care Rural Utilization Vermont;


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Cited by:
  1. Chris M. Herbst & Erdal Tekin, 2010. "The Impact of Child Care Subsidies on Child Well-Being: Evidence from Geographic Variation in the Distance to Social Service Agencies," Working Papers id:2739, eSocialSciences.
  2. Chris M. Herbst & Erdal Tekin, 2011. "The Geographic Accessibility of Child Care Subsidies and Evidence on the Impact of Subsidy Receipt on Childhood Obesity," NBER Working Papers 17471, National Bureau of Economic Research, Inc.
  3. Chris M. Herbst & Erdal Tekin, 2012. "Child Care Subsidies, Maternal Well-Being, and Child-Parent Interactions: Evidence from Three Nationally Representative Datasets," NBER Working Papers 17774, National Bureau of Economic Research, Inc.
  4. Mellow, Jeff & Schlager, Melinda D. & Caplan, Joel M., 2008. "Using GIS to evaluate post-release prisoner services in Newark, New Jersey," Journal of Criminal Justice, Elsevier, vol. 36(5), pages 416-425, September.
  5. Kajal Lahiri & Guibo Xing, 2002. "An Empirical Analysis of Medicare-eligible Veterans' Demand for Outpatient Health Care Services," Discussion Papers 02-01, University at Albany, SUNY, Department of Economics.
  6. Ryvicker, Miriam & Gallo, William T. & Fahs, Marianne C., 2012. "Environmental factors associated with primary care access among urban older adults," Social Science & Medicine, Elsevier, vol. 75(5), pages 914-921.
  7. Vallée, Julie & Cadot, Emmanuelle & Roustit, Christelle & Parizot, Isabelle & Chauvin, Pierre, 2011. "The role of daily mobility in mental health inequalities: The interactive influence of activity space and neighbourhood of residence on depression," Social Science & Medicine, Elsevier, vol. 73(8), pages 1133-1144.
  8. Yao, Jing & Murray, Alan T. & Agadjanian, Victor, 2013. "A geographical perspective on access to sexual and reproductive health care for women in rural Africa," Social Science & Medicine, Elsevier, vol. 96(C), pages 60-68.


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