The effect of rurality and distance from care on health outcomes, environmental barriers, and healthcare utilization patterns in persons with traumatic spinal cord injury

Spinal Cord, 2023 · DOI: https://doi.org/10.1038/s41393-023-00898-y · Published: April 3, 2023

Spinal Cord Injury Healthcare Public Health

Simple Explanation

This study examines if living in a rural area affects the health and well-being of people with spinal cord injuries compared to those in urban areas. Researchers looked at factors like access to healthcare, environmental challenges, and overall quality of life for individuals in Atlantic Canada who had experienced traumatic spinal cord injuries. The study found that while urban residents perceived more barriers, health outcomes and healthcare use were similar regardless of whether participants lived in rural or urban settings.

Study Duration

2012 to 2018

Participants

104 participants with traumatic spinal cord injury (tSCI)

Evidence Level

Cohort study

Key Findings

1
Individuals from urban area codes reported a greater magnitude of perceived barriers on the policies and work/school subscales of the CHIEF-SF.
2
No differences in function, quality of life, and healthcare utilization patterns according to the measures of rurality were observed.
3
Individuals living >100 km from the nearest RHSCIR facility reported greater rates of sexual dysfunction.

Research Summary

This study evaluated the association between residential living location and various outcomes after traumatic spinal cord injury (tSCI) in Atlantic Canada. The study found similar health outcomes between individuals from rural and urban postal codes and between those who lived >100 km or ≤100 km from the nearest RHSCIR facility. Urban residents reported greater environmental barriers in policies and work/school, while those living further from facilities reported more sexual dysfunction.

Practical Implications

Healthcare Planning

Healthcare providers should consider tailored interventions that address the specific environmental barriers faced by urban residents with tSCI.

Resource Allocation

Resources may need to be directed towards addressing sexual dysfunction in individuals living further from specialized care centers.

Community Support

Maintaining and strengthening community support networks can help to mitigate the impact of living location on health outcomes after tSCI.

Study Limitations

1
Recall bias and incompleteness of information due to reliance on participant recall.
2
Missing postal codes contributed to a high number of patients from the RHSCIR data set that were not eligible for the study, which could have contributed to non-response bias.
3
The results may not be generalizable to other populations due to the regional data set.

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