Geographic Differences in MS Populations in Washington State.

TitleGeographic Differences in MS Populations in Washington State.
Publication TypeJournal Article
AuthorsKuehn CM, Johnson KL, Vollan T, Amtmann D
JournalInternational Journal of MS Care

We had hypothesized that there would be significant differences in access to health care based on the region in which people with MS lived in the state of Washington. Washington has concentrations of population and medical services around metropolitan Seattle on the west side of the Cascade Range, and Spokane on the east side of the state. Much of the remaining population is distributed among relatively rural areas. We analyzed survey data collected from 1,287 eligible respondents from Western (N = 739) and Eastern (N = 548) Washington including demographic characteristics, disease history, symptoms, health care and health status. Addresses were mapped using geographic information software and U.S. Census 2000 and Washington State Department of Health data were also mapped and linked to the MS dataset to determine urban/rural status. We found that 87% of the sample lived in urban areas and only 13% lived in rural areas. Individuals with MS living in eastern Washington were more likely to be married, unemployed, lower income; less education; more likely to have Medicaid or Medicare, less advanced disease, poorer overall health; more depression, pain, and fatigue than those from Western Washington. Despite these regional differences, comparisons of urban vs. rural individuals revealed no statistically significant differences related to disease or access to medical care although rural individuals were more likely to have less education, be married, and live in Eastern Washington. In summary, though the Eastern and Western samples differed in demographic and disease characteristics of MS, these differences are unrelated to living in a rural vs. urban area, and are therefore due to, as yet, undetermined factors. To gain a better understanding of variables that may contribute, we would like to obtain better representation of individuals living with MS in rural areas.

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