James Laditka, PhD

South Carolina Rural Health Research Center

Phone: 803.251.6852
E-mail: jladitka@gwm.sc.edu

University of South Carolina

Current Projects

Effect of Safety Net Providers on Ambulatory Care Sensitive Hospitalization Rates in Rural Counties
Research center: South Carolina Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Chronic diseases and conditions, Federally Qualified Health Centers (FQHCs), Health services, Poverty, Rural Health Clinics (RHCs)
This project will determine if the presence of a community health center or rural health clinic in a county reduces ambulatory care sensitive hospitalizations for children, working age adults, and older adults.

Completed Projects

Disability Burdens among Rural and Urban Older Americans, Lead researcher
Research center: South Carolina Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Aging, Disabilities, Health disparities, Long term care, Rural statistics and demographics
This project will use the 1994-2000 Second Longitudinal Study of Aging to develop detailed estimates of healthy, disabled, and total life expectancy among rural and urban populations. We will develop and compare the estimates between women and men, by race/ethnicity, and across differing levels of education.

Publications

• 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.
• 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.
• 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.