Rural Health

Children in rural areas must travel far distances to receive pediatric specialty care

Adults generally need care for chronic conditions more often than children. However, children who need care from pediatricians specializing in areas such as cardiology, rheumatology, or endocrinology may not have ready access to these doctors if they are from low-income families and live in the Mountain or West North Central regions of the United States, a new study finds.

Michelle L. Mayer, Ph.D., M.P.H., of the University of North Carolina at Chapel Hill, used zip code locations to determine the distance to 16 pediatric subspecialties. Children from low-income families and from the Mountain and West North Central regions had to travel the farthest for pediatric specialty care. These geographic barriers may limit these children's access to care and lead to poor outcomes, the author suggests. Families that are forced to travel long distances for care are burdened not only by travel costs, but adults also miss time from work and children are absent from school.

Regions where families faced the longest travel times to specialty care typically did not have adequate patient populations to sustain a physician's practice. For example, when the population of children doubled in a region, this resulted in a 4- to 13-mile reduction in the distance a family needed to travel for specialty care. The author recommends novel approaches, such as telemedicine, be considered in these areas so that children have access to quality care without long drives. This study was funded in part by the Agency for Healthcare Research and Quality (HS13309).

See "Disparities in geographic access to pediatric subspecialty care," by Dr. Mayer in the September 2008 Maternal and Child Health Journal 12(5), pp. 624-632.

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