Evidence map›Paper›PMID 40339142›Full record

ArticleThe Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association2025

The relationship between low social/emotional support and health care affordability among rural and urban residents.

Ingrid Jacobson, Katie Rydberg, Alexis Swendener, Hannah MacDougall, Carrie Henning-Smith

Abstract read
In one paragraph

Article in The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. The relationship between low social/emotional support and health care affordability among rural and urban residents.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Ingrid JacobsonDivision of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA.ORCID https://orcid.org/0000-0003-0199-9082
Katie RydbergDivision of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA.ORCID https://orcid.org/0009-0002-3615-4792
Alexis SwendenerDivision of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA.ORCID https://orcid.org/0000-0002-5964-3970
Hannah MacDougallUniversity of Minnesota School of Social Work, St. Paul, Minnesota, USA.ORCID https://orcid.org/0000-0001-7124-3913
Carrie Henning-SmithDivision of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA.ORCID https://orcid.org/0000-0002-0273-0387

Funding

University of Minnesota Clinical and Translational Science Institute (UMN CTSI)UL1TR002494 · NCATS · UNIVERSITY OF MINNESOTA · PI BLAZAR, BRUCE R, WEISDORF, DANIEL J · 2018 to 2022
$34.9M
University of Minnesota Clinical and Translational Science Institute (UMN CTSI)UM1TR004405 · NCATS · UNIVERSITY OF MINNESOTA · PI Bruce R Blazar, Damien A Fair · 2023 to 2026
$30.8M
NCATS NIH HHS UL1 TR002494NCATS NIH HHS UM1 TR004405NIH National Center for Advancing Translational Sciences UL1TR002494University of Minnesota (UMN) McKnight Presidential Fellowship
6 · The paper itself

Abstract

purposeSocial/emotional support can help to buffer the health and financial impacts of health care costs. However, little research examines differences in social/emotional support as it relates to health care affordability, and even less examines these issues by rurality despite rural/urban differences in health and health care access. This study addresses these gaps by examining differences in social/emotional support and health care affordability issues among rural and urban adults.

methodsUsing weighted data from the 2020 and 2021 National Health Interview Survey (n = 44,987), we examined differences in three health care affordability issues: worry about medical bills, problems paying medical bills, and inability to pay medical bills. We conducted bivariate and multivariate logistic regression analyses comparing these issues by rurality, social/emotional support, and other sociodemographic and health characteristics, generating adjusted odds ratios and predicted probabilities of these issues.

findingsRural residents were more likely to report problems paying and inability to pay medical bills (13.0% vs. 10.2%, p < 0.001; 8.2% vs 6.2%, p < 0.001). Sociodemographic and health covariates were differentially associated with adjusted odds of health care affordability issues, while low social/emotional support was associated with higher adjusted odds and adjusted predicted probabilities of all three health care affordability issues in both rural and urban areas.

conclusionsLow social/emotional support is associated with higher odds and predicted probabilities of all health care affordability issues regardless of rurality. Future policy aimed at reducing medical debt in rural areas should consider the beneficial impacts of social/emotional support.

Indexed as

Health Services AccessibilityRural PopulationSocial SupportUrban PopulationAdolescentAdultAgedFemaleHumansLogistic ModelsMaleMiddle AgedSurveys and Questionnaireshealth care affordabilitysocial determinants of healthsocial support

Identifiers

PMID40339142
PMCPMC12059202

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.