Rural Health Research Gateway

Sarah Laditka, PhD

South Carolina Rural Health Research Center

Phone: 803.777.3332
E-mail: sladitka@gwm.sc.edu

Rural Health Research Center
University of South Carolina
220 Stoneridge Drive
Suite 204
Columbia, SC 29210

Completed Projects

Impact of Medicaid Managed Care, Race/Ethnicity, and Rural/Urban Residence on Avoidable Maternity Complications: A Five-State Multi-level Analysis, Lead researcher
Research center: South Carolina Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Maternal and child health, Medicaid and S-CHIP, Minority health, Women
This project will examine differences in access to care for pregnant women enrolled in Medicaid Managed Care (MMC) and Medicaid fee-for-service, and examine differences in the impact of MMC on access among rural and minority persons.

Mode of Travel and Actual Distance Traveled for Medical or Dental Care by Rural Residents, Lead researcher
Research center: South Carolina Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Dental health, Health disparities, Health services, Minority health
This project examined the influence of race and rural isolation on distance traveled to receive medical or dental care, and how the potential interaction of these factors might exacerbate disparities in access to care.

Publications

  • Assessment Of Barriers To The Delivery Of Medicare Reimbursed Diabetes Self-Management Education In Rural Areas
    Author(s): M. Paige Powell, Saundra H. Glover, Janice C. Probst, Sarah B. Laditka
    Research center: South Carolina Rural Health Research Center
    Topics: Chronic diseases and conditions, Medicare
    Date: 09 / 2004
    Explores the barriers that rural practitioners face in providing diabetes education services to Medicare beneficiaries. Survey results from a random sample of ADA-recognized diabetes education facilities indicated that insufficient Medicare reimbursement, staffing, institutional support as well as the ADA recognition process all constituted barriers to diabetes self-management education in rural areas. Executive summary available online.
  • Barriers Associated With the Delivery of Medicare Reimbursed Diabetes Self-Management Education
    Author(s): M. Paige Powell, Saundra H. Glover, Janice C. Probst, Sarah B. Laditka
    Research center: South Carolina Rural Health Research Center
    Topics: Chronic diseases and conditions, Medicare
    Citation: Diabetes Educator, 31(6), 890-9
    Date: 2005
    Describes the results of a study to explore the barriers that practitioners face in providing diabetes self-management education (DSME) to Medicare beneficiaries, with a special focus on barriers faced by rural providers. Barriers identified for rural providers include costs, reporting requirements, the shortage of designated specialists, fewer resources, high application fees for ADA recognition, staffing/institutional support, amount of Medicare reimbursement, lack of hours covered, and transportation.
  • Delivery Complications Associated With Prenatal Care Access for Medicaid-Insured Mothers in Rural and Urban Hospitals
    Author(s): Sarah B. Laditka, James N. Laditka, Kevin J. Bennett, Janice C. Probst
    Research center: South Carolina Rural Health Research Center
    Topics: African Americans, Health services, Maternal and child health, Medicaid and S-CHIP, Women
    Citation: Journal of Rural Health, 21(2), 158-66
    Date: 2005
    Examined access to health care during pregnancy for mothers insured by Medicaid as well as the risks of potentially avoidable maternity complications among rural and urban hospital deliveries for groups of mothers defined by race or ethnicity. Within groups defined by race or ethnicity, unadjusted rates for potentially avoidable maternity complications did not differ significantly by hospital location. Holding other factors constant, potentially avoidable maternity complications were less common in rural hospitals than in urban hospitals. In rural hospitals, African Americans had notably higher risk for potentially avoidable maternity complications than did non-Hispanic whites. The authors conclude that providers and policymakers should work to reduce the risks of potentially avoidable maternity complications for African American women in rural areas who are insured by Medicaid.
  • Depression in Rural Populations: Prevalence, Effects on Life Quality, And Treatment-Seeking Behavior
    Author(s): Janice C. Probst, Sarah Laditka, Charity G. Moore, Nusrat Harun, M. Paige Powell
    Research center: South Carolina Rural Health Research Center
    Topics: Health disparities, Mental health
    Date: 05 / 2005
    Using the National Health Interview Survey and the NHIS-administered depression scale from the Comprehensive International Diagnostic Interview to explore depression among rural versus urban residents, the authors found that the prevalence of major depression was significantly higher among rural (6.11%) than among urban (5.16%) populations. However, nearly all individuals scoring positive for depression reported that their symptoms interfered with their life or activities (46.67% rural, 44.25% urban). Persons without any health insurance were less likely to have communicated with a physician than were the privately or publicly insured. Additionally, the likelihood that an individual with depression would have communicated with a practitioner rose as the person's self reported health declined. Executive summary available online.
  • Disability Burdens among Older Americans Associated with Gender and Race/Ethnicity in Rural and Urban Areas
    Author(s): James N. Laditka, Sarah B. Laditka, Bankole Olatosi, Keith T. Elder
    Research center: South Carolina Rural Health Research Center
    Topics: Disabilities, Minority health, Women
    Date: 09 / 2005
    No prior research has investigated differences in disability-free and disabled life expectancy associated with rural or urban residence. This report addresses this gap, and identifies differences in healthy life expectancy that may signal important policy needs. The authors examined total life expectancy, disability-free life expectancy, and disabled life expectancy, comparing people in rural and urban areas. These expectancy measures for subgroups of rural and urban areas were compared, distinguished by sex, race (white and African American) and educational attainment. The authors found that among a cohort of Americans aged 65 to 69 in 1982, in seven of the eight subgroups, individuals in rural areas lived longer lives than those in urban areas. Rural as compared to urban people lived (a) more disability-free years, (b) more disabled years, and (c) a notably greater percentage of their lives with a disability. There were striking differences among the high and low education groups, with individuals with more education living substantially longer, less disabled lives. Women lived longer, more disabled lives than men. For most subgroups, African Americans lived shorter, more disabled lives than whites. Executive summary available online.
  • Impact Of Medicaid Managed Care, Race/Ethnicity, and Rural/Urban Residence On Potentially Avoidable Maternity Complications: A Five-State Multi-Level Analysis
    Author(s): Sarah B. Laditka, James N. Laditka, Kevin J. Bennett, Janice C. Probst
    Research center: South Carolina Rural Health Research Center
    Topics: African Americans, Hispanics, Maternal and child health, Medicaid and S-CHIP, Women
    Date: 12 / 2004
    Complications of pregnancy affect the lives of many women and infants. This study examines pregnancy-related complications using Potentially Avoidable Maternity Complications (PAMCs) as an indicator of access. Findings include: 1) Mothers delivering in rural hospitals had lower PAMC risks than those with urban deliveries.; 2) In rural hospitals, African American women had greater PAMC risks than white women.; and 3) In urban hospitals, adjusted PAMC risks were substantially lower for Hispanics and Asians than for whites. Executive summary available online.
  • Mode of Travel and Actual Distance Traveled For Medical or Dental Care By Rural and Urban Residents
    Author(s): Janice C. Probst, Sarah B. Laditka, Jong-Yi Wang, Andy Johnson
    Research center: South Carolina Rural Health Research Center
    Topic: Health disparities
    Date: 05 / 2006
    Discusses the cost and difficulty associated with travel for medical or dental care, which may serve as a barrier for rural populations. Executive summary available online. The full report is available by contacting Janie Godbold at godboldj@gwm.sc.edu.
  • More May Be Better: Evidence of a Negative Relationship Between Physician Supply and Hospitalization for Ambulatory Care Sensitive Conditions
    Author(s): James N. Laditka, Sarah B. Laditka, Janice C. Probst
    Research center: South Carolina Rural Health Research Center
    Topics: Chronic diseases and conditions, Health services, Physicians
    Citation: Health Services Research, 40(4), 1148-1166
    Date: 2005
    The authors conducted an empirical test of the relationship between physician supply and hospitalization for ambulatory care sensitive conditions (ACSH). Principal findings showed that in the urban models for ages 0-17 physician supply has the largest negative adjusted relationship with ACSH. For ages 18-39 and 40-64, physician supply has the second largest negative adjusted relationship with ACSH. Physician supply was not associated with ACSH in rural areas. The authors conclude that physician supply is positively associated with the overall performance of the primary health care system in a large sample of urban counties of the United States.
  • Racial and Ethnic Disparities in Potentially Avoidable Delivery Complications Among Pregnant Medicaid Beneficiaries in South Carolina
    Author(s): Sarah Laditka, James Laditka, Janice C. Probst
    Research center: South Carolina Rural Health Research Center
    Topics: African Americans, Health disparities, Maternal and child health, Medicaid and S-CHIP, Minority health, Women
    Citation: Maternal and Child Health Journal, 10(4), 339-50
    Date: 2006
    Examined access to health care during pregnancy for mothers insured by Medicaid as well as the risks of potentially avoidable maternity complications among rural and urban hospital deliveries for groups of mothers defined by race or ethnicity. Within groups defined by race or ethnicity, unadjusted rates for potentially avoidable maternity complications did not differ significantly by hospital location. Holding other factors constant, potentially avoidable maternity complications were less common in rural hospitals than in urban hospitals. In rural hospitals, African Americans had notably higher risk for potentially avoidable maternity complications than did non-Hispanic whites. The authors conclude that providers and policymakers should work to reduce the risks of potentially avoidable maternity complications for African American women in rural areas who are insured by Medicaid.
  • Rural-Urban Differences in Depression Prevalence: Implications for Family Medicine
    Author(s): Janice C. Probst, Sarah B. Laditka, Charity G. Moore, Nusrat Harun, M. Paige Powell, Elizabeth G. Baxley
    Research center: South Carolina Rural Health Research Center
    Topic: Mental health
    Citation: Family Medicine, 38(9), 653-60
    Date: 10 / 2006
    Reports results of a study that examined the prevalence of depression in rural versus urban areas. An estimated 2.6 million rural adults suffer from depression. The unadjusted prevalence of depression was significantly higher among rural than urban populations (6.1% versus 5.2% ). After adjusting for rural/urban population characteristics, however, the odds of depression did not differ by residence. Depression risk was higher among persons likely to be encountered in a primary care setting: those with fair or poor self-reported health, hypertension, with limitations in daily activities, or whose health status changed during the previous year.

This web site includes content provided by and adapted from the Maine Rural Health Research Center, University of Southern Maine under a Cooperative Agreement with the University of North Dakota.