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Rural blacks risk poor health, study says

Older black people living in rural areas are at unusually high risk of poor health, University of Florida researchers reported Tuesday after an in-depth study of the issue.

"Rural blacks appear to be in worse health than their counterparts who are white and live in the same rural communities or who are black and live in more urban and suburban settings," said Raymond Coward, professor of health policy and epidemiology.

He said rural blacks suffer a kind of "triple jeopardy" from the combination of their age, race, and place of residence.

The study, funded by the National Institute on Aging, tracked 1,200 North Florida residents, aged 65 and older, over a three-year period.

Half the respondents were black, half were white, with half living in rural areas and half living in a large metropolitan area. Researchers interviewed in person and by telephone, and held focus groups with senior citizens from the study sites.

The findings indicated that rural blacks were almost twice as likely as other elderly groups to describe their health as poor and were less likely to perceive their health as excellent or very good.

Rural blacks were more likely to report that their health had gotten worse over the past year. Rural blacks reported the highest rates of arthritis, while older blacks in general were more likely than whites to report high blood pressure and diabetes.

Rural blacks cope with these health problems with fewer personal resources. More than 78 percent of older rural blacks in the sample lived in households with incomes below the poverty threshold. They also were less likely to be enrolled in Medicare and were three times less likely than white urban elders to have private health insurance.

This survey is especially important in the South, where more than 90 percent of all older rural blacks live. In some rural Southern counties, blacks are the majority of older residents.

"Rural areas often have a smaller number and narrower range of health and social services available to their residents," Coward said. "We must closely monitor the health of these residents to be sure that we are targeting services to the people and the locations that are most in need."