How Much DoWe Know about Rural-Urban Health Disparities: Lessons from Four Major Diseases in Virginia

Health disparities are abundantly recorded in literature, but is much less understood within a rural-urban context. In this paper, four major diseases in Virginia are studied: cancer, stroke, cardiovascular disease (heart disease) and chronic obstructive pulmonary disease (COPD). Separate count data regressions are estimated at regional level to provide a primary understanding of those factors. A simultaneous equations model with rural-urban specification are then estimated via seemingly unrelated regression (SUR) techniques to take account of possible causalities among these diseases as well as error correlations, which is followed by Blinder-Oaxaca decomposition of the disparity proportions explained by observed characteristics and unobserved mechanisms. The results suggest that regional-level factors are significantly correlated with health disparities between rural and urban areas. The unknown mechanisms behind these linkages are different between rural and urban areas, and explain an even larger proportion of these disparities