Methodological Issues in Rural Health Research and Care

  • Sana Loue
  • Hal Morgenstern


Numerous calls have been made to increase the quantity and the quality of research on rural health and rural health care (Cohen, Braden, & Ward, 1993). A cogent response to this plea necessarily mandates greater attention to various methodological issues and objectives. We examine three general issues. The first is the estimation of disease parameters, such as disease frequency or exposure effects in rural populations—that is, focusing attention on people who live in rural areas and on the important health problems of these populations.


Census Bureau Rural Health Urban Fringe Regular Source Rural Sociology 
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  1. Beale, C. L. (1984). Poughkeepsie’s complaint or defining metropolitan areas. American Demographics, January, 29–48.Google Scholar
  2. Beltrami, J. F., Vermund, S. H., Fawal, H. J., Moon, T. D., Von Bargen, J. C., & Holmberg, S. D. (1999). HIV/AIDS in nonurban Alabama: Risk activities and access to services among HIV-infected persons. Southern Medical Journal, 92, 677–683.Google Scholar
  3. Bureau of Health Planning and Resources Development. (1976). Methodological approaches for determin- ing health manpower supply and requirements. Vol. II. (DHEW Publication No. HRA 76–14512 ). Washington, DC: United States Government Printing Office.Google Scholar
  4. Burke, M. (1990). Policymakers struggle to define essential access. Hospitals, 64, 38, 40, 42.Google Scholar
  5. Centers for Disease Control. (1990). Guidelines for investigating clusters of health events. Morbidity and Mortality Weekly Report, 39, 1–23.Google Scholar
  6. Chavez, E., Beauvais, F., & Oetting, E. R. (1986). Drug use by small town Mexican American youth: A pilot study. Hispanic Journal of Behavioral Science, 8, 243–258.CrossRefGoogle Scholar
  7. Checkoway, H. Pearce, N. E., & Crawford-Brown, D. J. (1989). Research methods in occupational epidemiology. Oxford: Oxford University Press.Google Scholar
  8. Cohen, S. B., Braden, J. J., & Ward, E. P. (1993). Enhancing the representation of rural areas in the National Medical Expenditure Survey. Journal of Rural Health, 9, 188–203.Google Scholar
  9. Cordes, S. M., & Lloyd, R. C. (1979). Recent social science research on rural health services: A critique and directions for the future. American Journal of Rural Health: Rural Health Communications, 5, 1-19.Google Scholar
  10. Coward, R. T., McLaughlin, D. K., Duncan, R. P., & Bull, C. N. (1994). An overview of health and aging in rural America. In R. T. Coward, C. N. Bull, G. Kukulka, & J. M. Galliher (Eds.), Health Services for Rural Elders (pp. 1–32). New York: Springer.Google Scholar
  11. Crosby, F. S., Ogden, A. B., Kerr, S. L., & Heady, J. (1996). Focus groups describe rural nursing in New York State. Journal of the New York State Nurses Association, 27, 4–8.Google Scholar
  12. Eberts, D. (1994). Socieconomic trends in New York State: 1950–1990. Albany, NY: Report to New York State Legislative Committee.Google Scholar
  13. Frenzen, P. D. (1991). The increasing supply of physicians in U.S. urban and rural areas, 1975 to 1988. American Journal of Public Health, 81, 1141–1147.PubMedCrossRefGoogle Scholar
  14. Gilbert, G. H., Duncan, R. P., Heft, M. W., Dolan, T. A., Vogel, W. B. (1997). Oral disadvantage among dentate adults. Community Dentistry and Oral Epidemiology, 25, 301–313.Google Scholar
  15. Hays, R. B., Craig, M. L., Wise, A. L., Nichols, A., Mahoney, M. D., Adkins, P. B., Sheehan, M., & Siskind, V. (1994). A sampling framework for rural and remote doctors. Australian Journal of Public Health, 18, 273–276.Google Scholar
  16. Hayward, R. A., Beynard, A. M., Freeman, H. E., & Corey, C. R. (1991). Regular sources of ambulatory care and access to health services. American Journal of Public Health, 81, 434–438.PubMedCrossRefGoogle Scholar
  17. Hewitt, M. (1989). Defining rural areas: Impact on health care policy and research. Washington, DC: United States Government Printing Office.Google Scholar
  18. Kindig, D. A. & Ricketts, T. C. (1991). Determining adequacy of physicians and nurses for rural populations: Background and strategy. Journal of Rural Health, 7, 313–326.PubMedGoogle Scholar
  19. Kleinman, A., Eisenberg, L., & Good, B. (1978). Clinical lessons from anthropologic and cross-cultural research. Annals of Internal Medicine, 88, 251–258.PubMedGoogle Scholar
  20. Kleinman, J. C. & Makuc, D. M. (1983). Travel for ambu- latory medical care. Medical Care, 21, 543–557.Google Scholar
  21. Makuc, D. M., Haglund, B., Ingram, D. D., Kleinman, J. C., & Feldman, J. J. (1991). The use of health service areas for measuring provider availability. Journal of Rural Health, 7, 347–356.Google Scholar
  22. Mata, D. G., & Castillo, V. (1986). Rural female adolescent dissatisfaction, support, and helpseeking. Free Inquiry Creative Sociology, 14, 135–138.Google Scholar
  23. Matthew, G. K. (1992). Health and the environment: The significance of chemicals and radiation. In P. Elliott, J. Cuzick, D. English, & R. Stern (Eds.), Geographic and Environmental Epidemiology: Methods for Small Area Studies (pp. 22–33 ). New York: Oxford University Press.Google Scholar
  24. McCoy, C. B., Metsch, L. R., McCoy, H. V., and Weatherby, N. L. (1999). HIV seroprevalence across the rural/urban continuum. Substance Use and Misuse, 34, 595–615.Google Scholar
  25. Mines, R. Gabbard, S., & Boccalandro, B. (1991). Find-ings from the National Agricultural Workers’ Survey (NAWS). 1990: A demographic and employment profile of perishable crop farm workers (U.S. Department of Labor, Office of Program Economics Research Report No. 1). Washington, DC: United States Government Printing Office.Google Scholar
  26. Mobed, K., Gold, E., & Schenker, M. (1992). Occupational health problems among migrant and seasonal farm workers. Western Journal of Medicine, 157, 367–373.PubMedGoogle Scholar
  27. Napolitano, M., & Goldberg, B. W. (1998). Migrant health. In S. Loue (Ed.), Handbook of Immigrant Health (pp. 261–276 ). New York: Plenum.Google Scholar
  28. Pathman, D. E. (1991). Estimating rural health professional requirements: An assessment of current methodologies. Journal of Rural Health, 7, 327–346.PubMedGoogle Scholar
  29. Patton, L. (1989). Setting the rural health services agenda: The congressional perspective. Health Services Research, 23, 1005–1051.PubMedGoogle Scholar
  30. Pearlman, B., & Hartman, E. A. (1983). The community health care administrator project: Characteristics and problems of rural administrators. Journal of Mental Health Administration, 10,15–18.Google Scholar
  31. Rothenberg, R. B. & Thacker, S. B. (1992). Guidelines for the investigation of clusters of adverse health events. In P. Elliott, J. Cuzick, D. English, & R. Stern, (Eds.), Geographic and environmental epidemiology: Methods for small area studies (pp. 264–277). New York: Oxford University Press.Google Scholar
  32. Rust, G. S. (1990). Health status of migrant farmworkers: A literature review and commentary. American Journal of Public Health, 80, 1213–1217.PubMedCrossRefGoogle Scholar
  33. Stokes, C. S. & Miller, M. K. (1985). A methodological review of fifty years of research in rural sociology. Rural Sociology, 50, 539–560.Google Scholar
  34. Talley, R. C. (1990). Graduate medical education and rural health care. Academic Medicine, 65, S22 - S25.PubMedCrossRefGoogle Scholar
  35. U.S. Census Bureau. (1985). Census and geography concepts and products. Factfinder (CCF No. 8 ). Washington, DC: United States Government Printing Office.Google Scholar
  36. U.S. Census Bureau. (1995, October). Urban and rural definitions; cens usdata/urdef. txt.Google Scholar
  37. U.S. Department of Commerce. (1981). Census of Population, 1980: Volume 1, Characteristics of the Population: General Social and Economic Characteris-tics. Washington, DC: U.S. Government Printing Office.Google Scholar
  38. U.S. Department of Commerce. (1990). Residents of Farms and Rural Areas: 1989. Current Population Reports (Series p-20, No. 446 ). Washington, DC: U.S. Government Printing Office.Google Scholar
  39. U.S. Department of Health, Education, and Welfare. (1980). Evaluation of health manpower shortage area criteria (DHEW Publication No. HRA 80–20 ). Washington, DC: Health Resources and Services Administration.Google Scholar
  40. U.S. Department of Health and Human Services. (1980). Migrant health program target population estimates. Rockville, MD: Author.Google Scholar
  41. U.S. Department of Labor. (1989). Occupational injury & illnesses, 1989. Washington, DC: National Bureau of Labor Statistics.Google Scholar
  42. U.S. House of Representatives, Select Committee on Aging. (1983). Status of the rural elderly. (Vols. I, I I ). Washington, DC: United States Government Printing Office.Google Scholar
  43. Wilk, V. A. (1986). Occupational health of migrant and seasonal farmworkers in the United States (2nd ed.). Washington, DC: Farmworker Justice Fund.Google Scholar

Copyright information

© Springer Science+Business Media New York 2001

Authors and Affiliations

  • Sana Loue
    • 1
  • Hal Morgenstern
    • 2
  1. 1.Department of Epidemiology and Biostatistics, School of MedicineCase Western Reserve UniversityClevelandUSA
  2. 2.Department of Epidemiology, School of Public HealthUniversity of California at Los AngelesLos AngelesUSA

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