Previously submitted to: JMIR Mental Health (no longer under consideration since Sep 30, 2023)
Date Submitted: Apr 28, 2023
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Geographic Variations in Driving Distance to Mental Health Facilities, Digital Access to Telecommunication Technology, and Household Crowdedness in the United States
ABSTRACT
Background:
Rural residents face significant barriers in accessing mental health services. As the need for these services increases and greater emphasis is put on telemedicine, examining geographic availability of mental health facilities and facilitators of telemedicine utilization is critical.
Objective:
To examine geographic variations in driving time to mental health facilities, digital access to telehealth services, and household crowdedness.
Methods:
This cross-sectional study used ZIP Code Tabulation Area (ZCTA)-level data from the 2015-2019 American Community Survey and 2021 SAMHSA Behavioral Health Treatment Services Locator to examine rural-urban differences in driving times to specialty mental health facilities, digital technology, and ZCTA-level household crowdedness.
Results:
Driving to outpatient facilities took longer in rural areas, with 8,545 (86.5%) of small rural ZCTAs and 3,535 (74.6%) of large rural ZCTAs being > 30 minutes from outpatient care, versus 7,655 (43.7%) of urban ZCTAs. Within those > 30 minutes, 522,154 (16.5%) rural households versus 237,800 (11.9%) urban households had no digital devices. Multivariable results show greater driving times to any mental health facility for small/isolated rural areas (8.6 minutes; 95% confidence interval CI, 8.2-9.1) than for urban areas.
Conclusions:
Rural communities are farther from mental health facilities and have lower digital access than urban communities.
Citation
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Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.