Rural and urban differences in perceptions, behaviors, and health care disruptions during the COVID-19 pandemic

Breanna B Greteman; Crystal J Garcia-Auguste; Brian M Gryzlak; Amanda R Kahl; Susan K Lutgendorf; Elizabeth A Chrischilles; Mary E Charlton

doi:10.1111/jrh.12667

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Rural and urban differences in perceptions, behaviors, and health care disruptions during the COVID-19 pandemic

Journal article

Peer reviewed

Rural and urban differences in perceptions, behaviors, and health care disruptions during the COVID-19 pandemic

Breanna B Greteman, Crystal J Garcia-Auguste, Brian M Gryzlak, Amanda R Kahl, Susan K Lutgendorf, Elizabeth A Chrischilles and Mary E Charlton

The journal of rural health, Vol.38(4), pp.932-944

Autumn 2022

DOI: 10.1111/jrh.12667

PMCID: PMC9115219

PMID: 35466479

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Abstract

The objective of this study was to assess perceptions, health behaviors, and disruptions related to the COVID-19 pandemic in a largely rural, Midwestern state, and to examine differences between rural and urban respondents. A questionnaire was mailed August 2020 to a sample of 10,009 registered voters in Iowa ages 18-100 years, with oversampling from 6 select rural counties. Previously validated and tested items assessed COVID-19 precautions, health care disruptions, emotional reactions, health behavior changes, telehealth and experiences with the internet, and demographic characteristics. There were 4,048 respondents (40% response rate); 65% were rural and 35% were urban residents. The average age of respondents was 58.3 years and 45% of respondents identified as female. Rural respondents reported less concern about COVID-19 in their community (29% vs 40%, P<.001) and lower perceived importance of social distancing (51% vs 64%, P<.001). Urban respondents more often reported experiencing disruption to daily living, stronger negative emotional reactions, and displayed more pronounced behavior change compared to their rural counterparts. For example, urban respondents reported more pandemic-related job losses (6% vs 4%, P = .05), disruptions to daily activities (48% vs 35%, P<.001), and use of telehealth services during the pandemic (24% vs 16%, P<.001). The majority of respondents reported disruptions to normal activities, medical appointment cancellations, and emotional distress during the first 6 months of the pandemic. The impact of the pandemic on urban residents appeared to be greater than for rural respondents. Timing of pandemic spread and varying beliefs are potential explanations.

COVID-19

urban

experiences

behaviors

rural

Details

Title: Subtitle: Rural and urban differences in perceptions, behaviors, and health care disruptions during the COVID-19 pandemic
Creators: Breanna B Greteman - Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, USA
Crystal J Garcia-Auguste - Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, USA
Brian M Gryzlak - Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, USA
Amanda R Kahl - University of Iowa
Susan K Lutgendorf - University of Iowa
Elizabeth A Chrischilles - University of Iowa
Mary E Charlton - Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, USA
Resource Type: Journal article
Publication Details: The journal of rural health, Vol.38(4), pp.932-944
DOI: 10.1111/jrh.12667
PMID: 35466479
PMCID: PMC9115219
NLM abbreviation: J Rural Health
ISSN: 0890-765X
eISSN: 1748-0361
Language: English
Electronic publication date: 04/24/2022
Date published season: Autumn 2022
Date published: 2022
Academic Unit: Pharmacy; Epidemiology; Psychological and Brain Sciences; Iowa Neuroscience Institute; Obstetrics and Gynecology; Urology
Record Identifier: 9984251445802771

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