Cohen Steven A, Ahmed Neelam, Brown Monique J, Meucci Marissa R, Greaney Mary L
Department of Health Studies, College of Health Sciences, University of Rhode Island, Kingston, Rhode Island, USA.
Department of Biological Sciences, College of Environmental and Life Sciences, University of Rhode Island, Kingston, Rhode Island, USA.
J Rural Health. 2022 Mar;38(2):442-456. doi: 10.1111/jrh.12581. Epub 2021 May 6.
Rural-urban health disparities are pervasive among older adults. Rural US locations have a disproportionately high population of older adults, have reduced access to services, and are therefore more reliant on family and friends for care. However, little is known about rural-urban disparities among the 40+ million informal caregivers nationwide. There is a critical need to understand how rural-urban disparities impact caregiving experiences and health-related quality of life (HRQoL). The objectives of this study were to assess rural-urban differences in informal caregiving status, caregiving intensity (caregiving hours/week and types of care provided), and caregiver HRQoL.
Data were abstracted from the 2018 Behavioral Risk Factor Surveillance System. The primary measure of rural-urban status was "metropolitan status." Associations between rural-urban status and caregiving and rural-urban differences in caregiving intensity and HRQoL were examined using generalized linear models, controlling for confounding and accounting for complex sampling.
Rural respondents were more likely to be caregivers than urban respondents (OR = 1.17, 95% CI: 1.02-1.34). After adjustment for confounders, rural caregivers were more likely than urban caregivers to provide 20 or more hours of caregiving per week (OR 1.38, 95% CI: 1.07-1.77), although the findings for health and HRQoL were somewhat mixed.
Results indicate that rural older adults offer more care than urban counterparts, which may have implications for caregiver health, well-being, and quality of life. These results can inform policies designed to improve caregiver health, and facilitate the translation and adaptation of existing policies, programs, and interventions to address rural caregivers' needs.
城乡健康差异在老年人中普遍存在。美国农村地区的老年人口比例过高，获得服务的机会减少，因此在护理方面更依赖家人和朋友。然而，对于全国4000多万名非正式护理人员中的城乡差异知之甚少。迫切需要了解城乡差异如何影响护理体验和健康相关生活质量（HRQoL）。本研究的目的是评估城乡在非正式护理状况、护理强度（每周护理小时数和提供的护理类型）以及护理人员健康相关生活质量方面的差异。
数据摘自2018年行为危险因素监测系统。城乡状况的主要衡量标准是“大都市状况”。使用广义线性模型研究城乡状况与护理之间的关联以及护理强度和健康相关生活质量方面的城乡差异，同时控制混杂因素并考虑复杂抽样。
农村受访者比城市受访者更有可能成为护理人员（OR = 1.17，95% CI：1.02 - 1.34）。在对混杂因素进行调整后，农村护理人员比城市护理人员更有可能每周提供20小时或更多的护理（OR 1.38，95% CI：1.07 - 1.77），尽管在健康和健康相关生活质量方面的研究结果有些复杂。
结果表明，农村老年人提供的护理比城市老年人更多，这可能对护理人员的健康、幸福感和生活质量产生影响。这些结果可为旨在改善护理人员健康的政策提供参考，并促进现有政策、项目和干预措施的转化和调整，以满足农村护理人员的需求。
