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Distance and health care utilization among the rural elderly


  • 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.

Suggested Citation

  • Nemet, Gregory F. & Bailey, Adrian J., 2000. "Distance and health care utilization among the rural elderly," Social Science & Medicine, Elsevier, vol. 50(9), pages 1197-1208, May.
  • Handle: RePEc:eee:socmed:v:50:y:2000:i:9:p:1197-1208

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    Cited by:

    1. Chris Herbst & Erdal Tekin, 2012. "Child Care Subsidies, Maternal Well-Being, and Child-Parent Interactions: Evidence from Three Nationally Representative Datasets," Working Papers 1372, Princeton University, Woodrow Wilson School of Public and International Affairs, Center for Research on Child Wellbeing..
    2. repec:eee:socmed:v:194:y:2017:i:c:p:96-104 is not listed on IDEAS
    3. 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.
    4. repec:pri:crcwel:wp12-01-ff is not listed on IDEAS
    5. Herbst, Chris M. & Tekin, Erdal, 2012. "The geographic accessibility of child care subsidies and evidence on the impact of subsidy receipt on childhood obesity," Journal of Urban Economics, Elsevier, vol. 71(1), pages 37-52.
    6. Astell-Burt, Thomas & Flowerdew, Robin & Boyle, Paul J. & Dillon, John F., 2011. "Does geographic access to primary healthcare influence the detection of hepatitis C?," Social Science & Medicine, Elsevier, vol. 72(9), pages 1472-1481, May.
    7. repec:eee:chieco:v:44:y:2017:i:c:p:282-295 is not listed on IDEAS
    8. Yamashita, Takashi & Kunkel, Suzanne R., 2010. "The association between heart disease mortality and geographic access to hospitals: County level comparisons in Ohio, USA," Social Science & Medicine, Elsevier, vol. 70(8), pages 1211-1218, April.
    9. 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.
    10. 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.
    11. repec:pri:crcwel:wp11-20-ff is not listed on IDEAS
    12. Panelli, Ruth & Gallagher, Lou & Kearns, Robin, 2006. "Access to rural health services: Research as community action and policy critique," Social Science & Medicine, Elsevier, vol. 62(5), pages 1103-1114, March.
    13. Jehu-Appiah, Caroline & Aryeetey, Genevieve & Spaan, Ernst & de Hoop, Thomas & Agyepong, Irene & Baltussen, Rob, 2011. "Equity aspects of the National Health Insurance Scheme in Ghana: Who is enrolling, who is not and why?," Social Science & Medicine, Elsevier, vol. 72(2), pages 157-165, January.
    14. Majumder, Amlan, 2014. "Economics of health care utilisation: a study of self-reported morbidity and health seeking patterns in the districts of Cooch Behar and Jalpaiguri, West Bengal, India," EconStor Books, ZBW - German National Library of Economics, number 110899.
    15. 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.
    16. 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," NBER Working Papers 16250, National Bureau of Economic Research, Inc.
    17. repec:eee:soceps:v:60:y:2017:i:c:p:1-14 is not listed on IDEAS
    18. Inagami, Sanae & Cohen, Deborah A. & Finch, Brian K., 2007. "Non-residential neighborhood exposures suppress neighborhood effects on self-rated health," Social Science & Medicine, Elsevier, vol. 65(8), pages 1779-1791, October.
    19. 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.
    20. Vilhjalmsson, Runar, 2005. "Failure to seek needed medical care: Results from a national health survey of Icelanders," Social Science & Medicine, Elsevier, vol. 61(6), pages 1320-1330, September.


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