Charity G. Moore, PhD


Completed Projects - (3)

  • Mental Health Risk Factors, Unmet Needs and Provider Availability for Rural Children
    The study will examine the prevalence of subclinical problems in rural children, assess risk factors associated with problems in children, and assess the influence of local provider availability on healthcare provider contact.
    Research center: South Carolina Rural Health Research Center
    Topics: Children, Health services, Mental health
  • Poverty, Parental Stress, and Violent Disagreements in the Home among Rural Families
    Using the National Survey of Children's Health, this study will address the prevalence of poverty, parental stress and violent disagreements in the home in rural and urban families. Associations among economic hardships, parent stress, violent disagreements in the home and mental health problems in children will also be investigated.
    Research center: South Carolina Rural Health Research Center
    Topics: Children, Physical abuse and domestic violence, Poverty, Women
  • Teen Violence
    This study will use national data to assess the prevalence of violence among rural youth, define risk factors for violence exposure among rural youth, and assess the current ability of rural school systems to provide appropriate mental health care and/or referrals for youth exposed to violence.
    Research center: South Carolina Rural Health Research Center
    Topics: Children, Mental health, Physical abuse and domestic violence

Publications - (25)

  • Access to Care among Rural Minorities: Children
    South Carolina Rural Health Research Center
    Date: 11/2002
    Profiles the characteristics of non-metro children, their health insurance coverage, and their health care visits. Recommends a multi-faceted approach to ensure that non-metro children obtain appropriate levels of health care. Facets including retaining and expanding provision of care to indigent and low-income families, expanding insurance coverage, and addressing rural poverty.
  • Access to Care Among Rural Minorities: Children (Appendix - Methods, Data Sources, and Detailed Tables)
    South Carolina Rural Health Research Center
    Date: 11/2002
    Appendix of report on rural minority children and the factors affecting their health insurance coverage and health services use.
  • Access to Care Among Rural Minorities: Older Adults
    South Carolina Rural Health Research Center
    Date: 10/2002
    Profiles health status of, and use of physicians by, non-metro older adults. Programmatic recommendations based on the findings: maintain programs that encourage providers to practice in non-metro areas, pay particular attention to the problems of the near-poor African-American elderly, and foster coalitions linking providers with voluntary community-based organizations to increase support services to elderly non-metro populations.
  • Access to Care Among Rural Minorities: Older Adults (Appendix - Methods, Data, and Detailed Tables)
    South Carolina Rural Health Research Center
    Date: 10/2002
    Appendix of report on health status and health services use among poor and minority older adults in non-metro areas.
  • Access to Care among Rural Minorities: Working Age Adults
    South Carolina Rural Health Research Center
    Date: 01/2003
    Examines the prevalence of health insurance and the use of physician services in rural areas. Findings include that rural minorities are handicapped by poverty and lack of education; low income and low education levels in non-metro areas translate into jobs that do not offer health insurance; and although non-metro adults were less likely to have insurance than metropolitan residents, they were not less likely to see a physician, with some exceptions.
  • Becoming an Emergency Medical Technician: Urban-Rural Differences in Motivation and Job Satisfaction
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 03/2007
    This study uses cross-sectional data from the 2003 national Longitudinal Emergency Medical Technician Attributes and Demographic Study (LEADS) Project to explore urban-rural differences in why EMTs enter the field, what is important in their jobs, and whether they are satisfied with their profession.
  • Depression in Rural Populations: Prevalence, Effects on Life Quality, And Treatment-Seeking Behavior
    South Carolina Rural Health Research Center
    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.
  • Development of a Methodology for Assessing the Effect of a Lay Home Visitation Program for Rural High-Risk Women and Infants
    South Carolina Rural Health Research Center
    Date: 02/2004
    This pilot study successfully demonstrated that a retrospective, population-based, comparative design is a feasible method for evaluating the effectiveness of a community health worker program for women at risk for poor pregnancy and birth outcomes.
  • Early Alcohol Use, Rural Residence, and Adulthood Employment
    South Carolina Rural Health Research Center
    Date: 10/2005
    Findings indicate that drinking during youth and early adulthood was common in the early 1980's. Nearly half (47.6%) of respondents reported drinking before age 18, and 55.3% reported binge drinking. Drinking behaviors did not differ significantly between rural and urban residents, and rural youth surveyed in 1979-1983 were as likely as their urban counterparts to start drinking before the age of 18, binge drink before 18, and report that work or school was impacted by drinking.
  • Effects of Race and Poverty on Perceived Stress Among Rural Women
    South Carolina Rural Health Research Center
    Date: 2005
  • Effects of Uninsurance during the Preceding 10 Years on Health Status among Rural Working Age Adults
    South Carolina Rural Health Research Center
    Date: 09/2005
    In a population just reaching age 40, continuous health insurance coverage across the preceding 8 to 10 years was not associated with better self-perceived health than interrupted coverage. However, continuous insurance coverage was significantly related to better mental health, with the effect persisting in multivariable analysis controlling for residence, race, and demographic characteristics. Rural residents reaching age 40 in 1998 or 2000 were less likely to have been continuously insured between 1989-2000 than were their urban peers.
  • Emergency Department Use By Medically Indigent Rural Residents
    South Carolina Rural Health Research Center
    Date: 07/2003
    Examined emergency department (ED) use, combining national data and South Carolina state data to estimate the uncompensated charges in rural EDs nationally and the ameliorating effects of rural community health centers on ED use by rural residents.
  • Expected Annual Emergency Miles per Ambulance: An Indicator for Measuring Availability of Emergency Medical Services Resources
    South Carolina Rural Health Research Center
    Date: 04/2006
    Proposes a county-level indicator of emergency medical services (EMS) resource availability that takes into consideration existing EMS resources, population health and demographics, and geographic factors. The indicator, the expected annual emergency miles per ambulance, provides a basis for comparing ambulance availability across counties.
  • Hospitalization for Ambulatory Care Sensitive Conditions: Asthma, Diabetes, and Congestive Heart Failure in South Carolina
    South Carolina Rural Health Research Center
    Date: 05/2003
    Hospitalization rates for ambulatory care sensitive conditions, diseases for which primary care in the preceding six months could have reduced or eliminated the need for hospitalization, are a commonly used indicator of disparities in access to care.
  • Hypertension, Diabetes, Cholesterol, Weight, and Weight Control Activities Among Non Metro Minority Adults
    South Carolina Rural Health Research Center
    Date: 12/2002
    The 1998 National Health Interview Survey (NHIS) included a detailed examination of preventive health problems and behaviors. This report uses data from the 1998 NHIS to examine the prevalence of selected problems among rural populations, with an emphasis on rural minorities. ?Rural? was defined, following NHIS guidelines, as living in a non-MSA county.
  • The Impact of Medicaid Cuts on Rural Communities
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 08/2005
    Medicaid is a critical program in both urban and rural areas, but it is particularly important in rural areas because of high levels of poverty and less access to employer-sponsored insurance. This study assesses the perception of state Medicaid staff and individuals from State Offices of Rural Health (SORH) and Rural Health Associations (RHA) regarding the impact on rural areas of state Medicaid policy changes that occurred between 2002 and 2004. Despite the importance of this program to rural communities, our study suggests that few people are specifically concerned with the unique challenges Medicaid changes may pose to rural communities. This study presents insight to the potential rural impact of Medicaid policy changes, especially those that could adversely affect the ability of rural residents to access services or that might potentially affect the overall rural health infrastructure.
  • Investigating Rural EMS Infrastructure: A Developmental Methodology For Measuring The Availability Of EMS Resources
    South Carolina Rural Health Research Center
    Date: 08/2004
    Explores a potential indicator of EMS availability, the Expected Annual Emergency Miles per Ambulance (EXAMB). The ambulance is used as the core unit of availability due to its importance for safe transport and the initiation of medical services. The EXAMB measure calculates expected annual emergency miles per ambulance beginning with the number of ambulances, the land area of a county as a proxy for distance, and county population. Findings showed that in three of the five states studied, EXAMB values varied in parallel with other measures of resource availability, and in all states, the EXAMB was positively related to the proportion of the county population in poverty.
  • Mental Health Risk Factors, Unmet Needs, and Provider Availability for Rural Children
    South Carolina Rural Health Research Center
    Date: 09/2005
    The study used the 2001 National Health Interview Survey to assess the prevalence of sub-clinical mental health problems among children, the degree to which children with potential problems use mental health and general providers for these problems, and the degree of unmet need. Key findings include: 1) Nearly 1 of every 4 rural children has a potential mental health problem as derived from the Strengths and Difficulties Questionnaire (SDQ).; 2) Age, sex, family income, parental education, living situation, health insurance status, and previously diagnosed developmental disorder were all associated with sub-clinical mental health problems in children.; 3) Less than 1 out of 5 parents of rural or urban children with sub-clinical mental health problems had seen or talked to a mental health professional about the child in the past 12 months.; and 4) Characteristics associated with mental health care utilization were race/ethnicity, insurance status, level of education in the child's family, living situation, and previous diagnosis of a developmental disorder. Among roughly 2.9 million rural children with a potential mental health problem as defined by the SDQ score, two thirds (68.1%) are living in a HPSA-mental health designated area. This translates to over 1.9 million children with mental health problems but living in areas where very minimal to no resources are available for their care.
  • Poverty, Stress, and Violent Disagreements in the Home Among Rural Families
    South Carolina Rural Health Research Center
    Date: 08/2005
    This study used information from a large, nationally representative telephone survey of households with children, carried out by the National Center for Health Statistics, to explore the prevalence of violent disagreements in the home. "Violent" disagreements are those that involve hitting or throwing, as opposed to heated argument or calm discussion. Poverty and parenting stress also were examined as they are hypothesized to be associated with violent disagreement. Findings from the study showed that rural children, all things held equal, were less likely than urban children to live in households where disagreements are expressed violently. Similarly, rural children were less likely to live in households with high parenting stress or low reported neighborhood trust. Nonetheless, rural practitioners must still be sensitive to the possibility of exposure to violence. Key factors associated with parenting stress, and thus with violent disagreements, are more prevalent in rural areas. Poverty and low-income were more common among rural than urban children, and affected well over half of rural minority children, in particular.
  • Premium Assistance Programs for Low Income Families: How Well Does it Work in Rural Areas?
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 01/2006
    Reports results of a study on the viability in rural areas of premium assistance programs use Medicaid or State Children's Health Insurance (SCHIP) funding to subsidize the premium costs of employer-sponsored insurance or private non-group policies for eligible individuals. Because of the characteristics of rural residents and their employment markets, many stand to benefit from premium assistance programs, but there are also reasons to believe that these programs may be less successful in rural communities. Findings form the telephone survey of Medicaid or SCHIP officials in 14 of the 16 states with at least one premium assistance program indicate that premium assistance programs have not lived up to their potential. Enrollment in most of the states' programs has been small, and while positive in concept, these programs have inherent limitations that may preclude more widespread enrollment. Of particular concern is that rural residents are more likely to work for small employers who do not offer health insurance or have higher premiums or less comprehensive benefits. However, with creative program design, premium assistance programs may be a useful tool for states to expand health insurance coverage to the rural uninsured.
  • Prevalence of Health Related Behavioral Risk Factors Among Non-Metro Minority Adults
    South Carolina Rural Health Research Center
    Date: 08/2003
    Data on tobacco use, seat belt use, and alcohol consumption among rural minority adults. Includes recommendations and detailed data tables.
  • Rural-Urban Differences in Depression Prevalence: Implications for Family Medicine
    South Carolina Rural Health Research Center
    Date: 10/2006
    Examined the prevalence of depression in rural vs. 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. After adjusting for rural/urban population characteristics, the odds of depression did not differ by residence.
  • Trends in Uninsurance among Rural Minority Children
    South Carolina Rural Health Research Center
    Date: 10/2005
    Disparities in health insurance coverage for both minority and rural children persist, with children who are simultaneously minority race/ethnicity and living in rural areas being particularly disadvantaged. Using twenty-one years of data from the National Health Interview Survey to explore trends in health insurance and health services utilization for children between 1980 and 2001, and focusing on non-Hispanic white, non-Hispanic African American, and Hispanic children, the authors found that rural children have been consistently less likely to have insurance than urban children, and minority status adds to the disparity. Several factors consistently influenced the odds that a child would lack health insurance, measured in 1980, 1986, 1994 and 2001. Compared to urban white children, rural white children and Hispanic children, both urban and rural, were more likely to lack insurance. Factors consistently associated with lack of health insurance, such as poverty, low education, and non-parental households, have been more prevalent among minority children since 1979, and remained so in 2001. Rural disadvantages for minority children are marked.
  • Update: Health Insurance and Utilization of Care Among Rural Adolescents
    South Carolina Rural Health Research Center
    Date: 2005
    Using data from the 1999-2000 National Health Interview Survey, it was found that across races, rural adolescents were as likely to have insurance but less likely to report a preventive visit than urban children; residence did not affect the likelihood of a visit or a usual source of care.
  • Violence And Rural Teens: Teen Violence, Drug Use, And School-Based Prevention Services In Rural America
    South Carolina Rural Health Research Center
    Date: 03/2005
    Describes a study which had three main purposes: (1) to explore the prevalence of violence-related exposures and drug use among rural teens, (2) to investigate the effects of race and gender on the risk of exposure to violence and drug use, and (3) to compare the policies and mental health care services of rural and urban schools. This study found no evidence to support the common assumption that rural youth are protected from exposure to violence. Rural teens are equally or more likely than suburban and urban teens to be exposed to violent activities, including weapons carrying, fighting, fear of violence, and suicide behaviors. Rural teens are at significantly greater risk of using cigarettes, chewing tobacco, crack/cocaine, and steroids than both suburban and urban teens. Of important note is the high prevalence of "crystal-meth" use among rural teens.