Rural-Urban Health Care Cost Differences Among Latinx Adults With and Without Dementia in the United States

J Aging Health. 2023 Oct 29:8982643231207517. doi: 10.1177/08982643231207517. Online ahead of print.

Abstract

Objectives: To compare rural-urban health care costs among Latinx adults ages 51+ and examine variations by dementia status.

Methods: Data are from the Health and Retirement Study (2006-2018 waves; n = 15,567). We inflation-adjusted all health care costs using the 2021 consumer price index. Geographic context and dementia status were the main exposure variables. We applied multivariate two-part generalized linear models and adjusted for sociodemographic and health characteristics.

Results: Rural residents had higher total health care costs, regardless of dementia status. Total health care costs were $850 higher in rural ($2,640) compared to urban ($1,789) areas (p < .001). Out-of-pocket costs were $870 higher in rural ($2,677) compared to urban ($1,806) areas (p < .001). Dementia status was not an effect modifier.

Discussion: Health care costs are disproportionately higher among Latinx rural, relative to urban, residents. Addressing health care costs among Latinx rural residents is a public health priority.

Keywords: dementia; health services; hispanic health; rural aging.