View Policy Brief

09/2024

The high cost of health care affects health at both the individual and population level, and rural residents experience inequities in health, access to care, and financial well-being. However, little research has examined how health care affordability differs by rural/urban residence, and how health care affordability varies along geographic and socio-demographic dimensions within rural areas. This policy brief examines rural/urban differences in rates of health care (un)affordability, as well as among rural residents by key socio-demographic characteristics.

Key Findings:

• Over 40% of rural residents and urban residents reported being worried about medical bills.
• Rural residents were more likely than their urban counterparts to have experienced problems paying medical bills (12% vs 10%) and inability to pay medical bills (8% vs 6%).
• Health care affordability and medical debt issues differed significantly among rural residents by race and ethnicity, sexual orientation, age, income, and type of health insurance.
• Rural individuals who were just above the poverty threshold were the most likely to worry about, have problems paying, or be unable to pay medical bills compared to rural residents at other income levels.
• Rural residents in the Western U.S. were more likely to be able to pay their medical bills than rural residents in the Northeast, North Central/Midwest, or Southern U.S.

University of Minnesota Rural Health Research Center

Ingrid Jacobson, Katie Rydberg, Mariana Tuttle, Alexis Swendener, Hannah MacDougall, Carrie Henning-Smith

Health disparities and health equity, Healthcare access, Poverty, Quality, Social determinants of health