Development of a Development of a Rural Typology GI S for Rural - - PowerPoint PPT Presentation

Development of a Development of a Rural Typology GI S for Rural Typology GI S for Policy Makers Policy Makers

Michael Shambaugh Michael Shambaugh-

• Miller, Ph.D.

Miller, Ph.D. RUPRI Center for Rural Health Policy Analysis RUPRI Center for Rural Health Policy Analysis College of Public Health College of Public Health University of Nebraska Medical Center University of Nebraska Medical Center 6 6th

th Quadrennial Conference of

Quadrennial Conference of British British – – Canadian Canadian – – American Rural Geographers American Rural Geographers July 15 July 15 – – 20, 2007 20, 2007 Spokane, WA Spokane, WA

The Current Problem The Current Problem

• There is no single, universally preferred

There is no single, universally preferred definition of rural that serves all policy definition of rural that serves all policy purposes. purposes.

– – More than 15 definitions of rural are currently used More than 15 definitions of rural are currently used by federal health programs. by federal health programs. – – There are over 50 definitions of rural for all federal There are over 50 definitions of rural for all federal programs. programs. – – 30 million Census Bureau 30 million Census Bureau-

• defined rural people live

defined rural people live in OMB in OMB-

• defined metropolitan areas.

defined metropolitan areas. – – 20 million Census Bureau 20 million Census Bureau-

• defined urban people live

defined urban people live in OMB in OMB-

• defined nonmetropolitan areas.

defined nonmetropolitan areas.

The Policy Considerations The Policy Considerations

• The choice of rural definition affects who

The choice of rural definition affects who benefits from a policy and who does not. benefits from a policy and who does not.

• Key considerations for understanding the

Key considerations for understanding the policy implications of different rural policy implications of different rural definitions include the following: definitions include the following:

The Policy Considerations The Policy Considerations

• Rural definitions can be built on different units of

Rural definitions can be built on different units of geography, each of which has distinct geography, each of which has distinct advantages and disadvantages. advantages and disadvantages.

• The two most commonly used classification

The two most commonly used classification systems, those of the Census Bureau and the systems, those of the Census Bureau and the Office of Management and Budget, result in very Office of Management and Budget, result in very different sets of places defined as rural. different sets of places defined as rural.

• Policies and programs can be targeted when

Policies and programs can be targeted when rural definitions are combined with key rural definitions are combined with key demographic, economic, or health care provider demographic, economic, or health care provider characteristics. characteristics.

The Policy Considerations The Policy Considerations

• Rural designations can change with shifts

Rural designations can change with shifts in population distribution or commuting in population distribution or commuting patterns, or as a result of changes in patterns, or as a result of changes in geographic boundaries. geographic boundaries.

• Data availability is essential to support the

Data availability is essential to support the application of the rural definition. application of the rural definition.

• There are many resources that can help

There are many resources that can help with understanding the complexities of with understanding the complexities of rural definitions. rural definitions.

What are the potential unintended consequences of What are the potential unintended consequences of relying on commonly used, easily understood relying on commonly used, easily understood definitions, such as those for nonmetropolitan definitions, such as those for nonmetropolitan counties? counties?

• Differences between definitions, such as

Differences between definitions, such as those of OMB and Census Bureau, must be those of OMB and Census Bureau, must be clearly understood to anticipate potential clearly understood to anticipate potential unintended consequences. unintended consequences.

• OMB

OMB’ ’s definition of counties as metropolitan s definition of counties as metropolitan

• r nonmetropolitan is often used as a proxy
• r nonmetropolitan is often used as a proxy

for urban and rural. for urban and rural.

Should the selected rural definition be Should the selected rural definition be narrowly targeted or widely inclusive? narrowly targeted or widely inclusive?

• While targeted, narrowly

While targeted, narrowly-

• defined definitions

defined definitions can direct resources to specific populations, can direct resources to specific populations, they also have the potential consequence of they also have the potential consequence of eliminating from policy or program eligibility eliminating from policy or program eligibility places or providers that should be covered. places or providers that should be covered. Conversely, more broadly defined definitions Conversely, more broadly defined definitions might result in the inclusion of areas with might result in the inclusion of areas with less need, with possible budgetary less need, with possible budgetary consequences. consequences.

What Can the Impact of What Can the Impact of a Definition Be? a Definition Be?

• A recent example is the use of the TRICARE definition of rural f

A recent example is the use of the TRICARE definition of rural for applying

• r applying

access standards for Medicare Part D. access standards for Medicare Part D.

• Policy makers sought a broad, inclusive rural definition in hope

Policy makers sought a broad, inclusive rural definition in hopes of ensuring s of ensuring Part D pharmacist availability across wide areas of rural Americ Part D pharmacist availability across wide areas of rural America. a.

• The TRICARE definition defined rural so broadly that only centra

The TRICARE definition defined rural so broadly that only central cities were l cities were excluded from the rural definition. excluded from the rural definition.

• Policy makers then mandated that pharmacies be available within

Policy makers then mandated that pharmacies be available within 15 miles 15 miles

• f 70% of the TRICARE
• f 70% of the TRICARE-
• defined rural population.

defined rural population.

• By including areas most people would consider suburban in the ru

By including areas most people would consider suburban in the rural ral category, the residual 30% of the TRICARE category, the residual 30% of the TRICARE-

• defined rural population not

defined rural population not protected by the access standards is a number equal to the entir protected by the access standards is a number equal to the entire rural e rural population under the most population under the most-

• used definition.

used definition.

Figure 1: Rural Areas as Defined by the TRICARE Retail Pharmacy Program

Note: Alaska and Hawaii not to scale Source: ZIP Code population classifications from #MDA906-03-R-0002, DoD, 2003. Population data from U.S. Census, 2000. ZIP code spatial files based on U.S. Census ZIP Code Tabulation Areas, 2000. Cartogrraphy: RUPRI Center for Rural Health Policy Analysis, 2004.

Classifications by Person per Square Mile (ppsm)

Rural - less than 1,000 ppsm Suburban - 1,000 to 2,999 ppsm Urban - more than 3,000 pppsm

Classifications by Person per Square Mile (ppsm)

Most Common Definitions Most Common Definitions

• The most commonly used definitions of rural are based on either

The most commonly used definitions of rural are based on either the Census Bureau Urbanized Area categorization of census blocks the Census Bureau Urbanized Area categorization of census blocks and block groups or the Office of Management and Budget (OMB) and block groups or the Office of Management and Budget (OMB) characterization of counties. characterization of counties.

• The Census Bureau intentionally creates a definition of rural by

The Census Bureau intentionally creates a definition of rural by designating census blocks and block groups as urban based on tot designating census blocks and block groups as urban based on total al population and population density, with all other areas being ru population and population density, with all other areas being rural. ral.

• The OMB classifies counties as

The OMB classifies counties as metropolitan metropolitan, when one or more , when one or more county is the county is the “ “core core” ” and other counties are included based on and other counties are included based on commuting patterns into the core. commuting patterns into the core.

• The OMB

The OMB metropolitan metropolitan classification was not designed to create a classification was not designed to create a definition of rural. However, many federal programs use the definition of rural. However, many federal programs use the metropolitan designation to declare all other counties rural. metropolitan designation to declare all other counties rural.

The Building Blocks for Defining The Building Blocks for Defining Rural Rural

• Rural definitions are aggregations of one

Rural definitions are aggregations of one

• r more of the following units of
• r more of the following units of

geography: geography:

– – Counties Counties – – ZIP code areas ZIP code areas – – Census tracts Census tracts

• Blocks and Block Groups

Blocks and Block Groups

Counties Counties

• Advantages:

Advantages: County boundaries represent County boundaries represent political jurisdictions and remain stable political jurisdictions and remain stable

• ver time.
• ver time.
• Disadvantages: County size varies

Disadvantages: County size varies substantially across the United States, and substantially across the United States, and larger counties include both urban and larger counties include both urban and rural areas. rural areas.

ZIP Codes ZIP Codes

• Advantages:

Advantages: ZIP code areas are easy to ZIP code areas are easy to implement with programs that rely on implement with programs that rely on provider or beneficiary address. provider or beneficiary address.

• Disadvantages: Because ZIP codes areas

Disadvantages: Because ZIP codes areas are designed for postal purposes, ZIP are designed for postal purposes, ZIP codes change frequently from year to codes change frequently from year to year. year.

Census Geography Census Geography

• Advantages:

Advantages: Census geography Census geography represents the smallest and most precise represents the smallest and most precise geographic unit. geographic unit.

• Disadvantages: Census tract definitions

Disadvantages: Census tract definitions can be hard to implement, because census can be hard to implement, because census geography information is not commonly geography information is not commonly used by programs and payers. used by programs and payers.

So What is Out There So What is Out There Currently Currently

Figure 2: Rural Areas as Defined using the Office of Management and Budget (OMB) Category of Nonmetropolitan, 2003

Note: Alaska and Hawaii not to scale

Source: U.S. Census Bureau, Census 2000 and OMB, 2003. Cartography: RUPRI Center for Rural Health Policy Analysis, 2004

Rural-urban classification

Urban/suburban (metropolitan counties) Rural (micropolitan and non-core based statistical area counties)

Rural-urban classifications based on OMB categories

900 1800 Miles

Core Based Statistical Areas, 2000

RUPRI Center for Rural Health Policy Analysis, 2005 Source: U.S. Bureau of the Census, 2000

CBSA

Non CBSA County CBSA County

County Typology

900 1800 Miles

Metropolitan, Micropolitan and Non-Metro Counties, 2000

RUPRI Center for Rural Health Policy Analysis, 2005 Source: U.S. Bureau of the Census, 2000

Micropolitan County

Non Micro County Micro County

Metropolitan County

Metro County

County Typology

900 1800 Miles

Non Core Based Statistical Area Rural Counties, 2000

RUPRI Center for Rural Health Policy Analysis, 2005 Source: U.S. Bureau of the Census, 2000

Non CBSA Rural County

CBSA Metro CBSA Rural

County Typology

900 1800 Miles

Rural (Including Micropolitan) Counties, 2000

RUPRI Center for Rural Health Policy Analysis, 2005 Source: U.S. Bureau of the Census, 2000

Non Metropolitan Rural County

Metro Rural

County Typology

900 1800 Miles

Rural by ORHP Outreach Grant Program Definition, 2005

RUPRI Center for Rural Health Policy Analysis, 2005 Source: U.S. Bureau of the Census, 2000 Rural areas in goldenrod color. NOTE: This map is incomplete at this time. The New England area has yet to be completed.

Source: ORHP, 2005

Recent Alternative Proposals Recent Alternative Proposals

• Isserman

Isserman’ ’s proposals s proposals

• RUCA

RUCA’ ’s s

• ESR Rural Typologies

ESR Rural Typologies

Recent work by Andrew Isserman, Recent work by Andrew Isserman, University of Illinois University of Illinois

• In the National Interest: Defining Rural and

In the National Interest: Defining Rural and Urban Correctly in Research and Public Policy Urban Correctly in Research and Public Policy

(International Regional Science Review, 28, 4:465 (International Regional Science Review, 28, 4:465-

• 499

499 (October, 2005) (October, 2005)

• Two alternative methods suggested. Most reasonable is a

Two alternative methods suggested. Most reasonable is a county level mixture of county level mixture of

– – Rural Rural – – Rural Urban Mix Rural Urban Mix – – Urban Rural Mix Urban Rural Mix – – URban URban

The Rural-Urban Density Typology

RUCA Codes RUCA Codes

http://depts.washington.edu/uwruca/ http://depts.washington.edu/uwruca/

• RUCAs

RUCAs, Rural

, Rural-

• Urban Commuting Area Codes,

Urban Commuting Area Codes, are a Census tract are a Census tract-

• based classification scheme

based classification scheme that utilizes the standard Bureau of Census that utilizes the standard Bureau of Census Urbanized Area and Urban Cluster definitions in Urbanized Area and Urban Cluster definitions in combination with work commuting information combination with work commuting information to characterize all of the nation's to characterize all of the nation's Census tracts Census tracts regarding their rural and urban status and regarding their rural and urban status and

• relationships. In addition, a ZIP Code RUCA
• relationships. In addition, a ZIP Code RUCA

approximation was developed. approximation was developed.

2004 ERS/USDA County Typology Codes 2004 ERS/USDA County Typology Codes

http://www.ers.usda.gov/briefing/rurality/Typology/ http://www.ers.usda.gov/briefing/rurality/Typology/

• An area's economic and social characteristics

An area's economic and social characteristics have significant effects on its development and have significant effects on its development and need for various types of public programs. need for various types of public programs.

• To provide policy

To provide policy-

• relevant information about

relevant information about diverse county conditions to policymakers, public diverse county conditions to policymakers, public

• fficials, and researchers, ERS has developed a
• fficials, and researchers, ERS has developed a

set of set of county county-

• level

level typology codes that captures typology codes that captures differences in economic and social differences in economic and social characteristics. characteristics.

Economic Type Economic Type Codes and definitions of the categories are Codes and definitions of the categories are as follows: as follows:

• Farming

Farming-

• dependent

dependent (440 total, 403 nonmetro) counties

(440 total, 403 nonmetro) counties— — either 15 percent or more of average annual labor and either 15 percent or more of average annual labor and proprietors' earnings derived from farming during 1998 proprietors' earnings derived from farming during 1998-

• 2000 or

2000 or 15 percent or more of employed residents worked in farm 15 percent or more of employed residents worked in farm

• ccupations in 2000. Note that a few counties have changed
• ccupations in 2000. Note that a few counties have changed

farm dependency status from the preliminary group posted in farm dependency status from the preliminary group posted in May 2004. See May 2004. See methods, data sources, and documentation methods, data sources, and documentation for for an explanation of these changes. an explanation of these changes.

• Mining

Mining-

• dependent

dependent (128 total, 113 nonmetro) counties

(128 total, 113 nonmetro) counties— —15 15 percent or more of average annual labor and proprietors' percent or more of average annual labor and proprietors' earnings derived from mining during 1998 earnings derived from mining during 1998-

• 2000.

2000.

• Manufacturing

Manufacturing-

• dependent

dependent (905 total, 585 nonmetro)

(905 total, 585 nonmetro) counties counties— —25 percent or more of average annual labor and 25 percent or more of average annual labor and proprietors' earnings derived from manufacturing during 1998 proprietors' earnings derived from manufacturing during 1998-

• 2000.

2000.

Economic Type Economic Type Codes and definitions of the categories are Codes and definitions of the categories are as follows: as follows:

• Federal/ State government

Federal/ State government-

• dependent

dependent (381 total, 222

(381 total, 222 nonmetro) counties nonmetro) counties— —15 percent or more of average 15 percent or more of average annual labor and proprietors' earnings derived from annual labor and proprietors' earnings derived from Federal and State government during 1998 Federal and State government during 1998-

• 2000.

2000.

• Services

Services-

• dependent

dependent (340 total, 114 nonmetro)

(340 total, 114 nonmetro) counties counties— —45 percent or more of average annual labor and 45 percent or more of average annual labor and proprietors' earnings derived from services (SIC categories proprietors' earnings derived from services (SIC categories

• f retail trade; finance, insurance, and real estate; and
• f retail trade; finance, insurance, and real estate; and

services) during 1998 services) during 1998-

• 2000.

2000.

• Nonspecialized

Nonspecialized (948 total, 615 nonmetro) counties

(948 total, 615 nonmetro) counties— —did did not meet the dependence threshold for any one of the not meet the dependence threshold for any one of the above industries. above industries.

Policy Types Policy Types These indicators are not mutually exclusive; These indicators are not mutually exclusive; definitions of the types are as follows: definitions of the types are as follows:

• Housing stress

Housing stress (537 total, 302 nonmetro) counties

(537 total, 302 nonmetro) counties— —30 30 percent or more of households had one or more of these percent or more of households had one or more of these housing conditions in 2000: lacked complete plumbing, lacked housing conditions in 2000: lacked complete plumbing, lacked complete kitchen, paid 30 percent or more of income for owner complete kitchen, paid 30 percent or more of income for owner costs or rent, or had more than 1 person per room. costs or rent, or had more than 1 person per room.

• Low

Low -

• education

education (622 total, 499 nonmetro) counties

(622 total, 499 nonmetro) counties— —25 25 percent or more of residents 25 percent or more of residents 25-

• 64 years old had neither a high

64 years old had neither a high school diploma nor GED in 2000. school diploma nor GED in 2000.

• Low

Low -

• employment

employment (460 total, 396 nonmetro) counties

(460 total, 396 nonmetro) counties— —less less than 65 percent of residents 21 than 65 percent of residents 21-

• 64 years old were employed in

64 years old were employed in 2000. 2000.

• Persistent poverty

Persistent poverty (386 total, 340 nonmetro) counties

(386 total, 340 nonmetro) counties— —20 20 percent or more of residents were poor as measured by each of percent or more of residents were poor as measured by each of the last 4 censuses, 1970, 1980, 1990, and 2000. the last 4 censuses, 1970, 1980, 1990, and 2000.

Policy Types Policy Types These indicators are not mutually exclusive; These indicators are not mutually exclusive; definitions of the types are as follows: definitions of the types are as follows:

• Population loss

Population loss (601 total, 532 nonmetro) counties

(601 total, 532 nonmetro) counties— —number number

• f residents declined both between the 1980 and 1990
• f residents declined both between the 1980 and 1990

censuses and between the 1990 and 2000 censuses. censuses and between the 1990 and 2000 censuses.

• Nonmetro recreation

Nonmetro recreation (334 designated nonmetro in either

(334 designated nonmetro in either 1993 or 2003, 34 were designated metro in 2003) counties 1993 or 2003, 34 were designated metro in 2003) counties— — classified using a combination of factors, including share of classified using a combination of factors, including share of employment or share of earnings in recreation employment or share of earnings in recreation-

• related

related industries in 1999, share of seasonal or occasional use housing industries in 1999, share of seasonal or occasional use housing units in 2000, and per capita receipts from motels and hotels in units in 2000, and per capita receipts from motels and hotels in

• 1997. See
• 1997. See methods

methods for more details. for more details.

• Retirement destination

Retirement destination (440 total, 277 nonmetro)

(440 total, 277 nonmetro) counties counties— —number of residents 60 and older grew by 15 percent number of residents 60 and older grew by 15 percent

• r more between 1990 and 2000 due to inmigration.
• r more between 1990 and 2000 due to inmigration.

Tools for Determining Tools for Determining Rurality Status Rurality Status

Additional Research Tools Additional Research Tools

• Web based GIS system that will allow

Web based GIS system that will allow researchers to experiment with the researchers to experiment with the potential impacts of definitions of rural potential impacts of definitions of rural upon their policy and more importantly, upon their policy and more importantly, the people it is intended to serve. the people it is intended to serve.

Contact Information Contact Information

• Michael Shambaugh

Michael Shambaugh-

• Miller, Ph.D.

Miller, Ph.D.

– – Project Director Project Director – – 402 402-

• 559

559-

• 7858

7858 – – mdmiller@unmc.edu mdmiller@unmc.edu

• Keith Mueller, Ph.D.

Keith Mueller, Ph.D.

– – Primary Investigator Primary Investigator – – 402 402-

• 559

559-

• 5260

5260 – – kmueller@unmc.edu

• RUPRI Center for

RUPRI Center for Rural Health Policy Rural Health Policy Analysis Analysis

– – 402 402-

• 559

559-

• 5260

5260 – – www.unmc.edu/rural www.unmc.edu/rural – – www.rupri.org/health www.rupri.org/healthp p

• licy
• licy

kmueller@unmc.edu

Rural Policy Research I nstitute Rural Policy Research I nstitute Health Panel Health Panel www.rupri.org/ ruralhealth www.rupri.org/ ruralhealth

• Andrew F. Coburn,

Andrew F. Coburn,

• A. Clinton MacKinney
• A. Clinton MacKinney
• Timothy D. McBride

Timothy D. McBride

• Keith J. Mueller

Keith J. Mueller

• Rebecca T. Slifkin

Rebecca T. Slifkin

• Mary K. Wakefield

Mary K. Wakefield

Organizational Information Organizational Information

RUPRI Center for Rural RUPRI Center for Rural Health Policy Analysis Health Policy Analysis

– – www.rupri.org/healthpolicy/ www.rupri.org/healthpolicy/

• Nebraska Center for Rural

Nebraska Center for Rural Health Research. Health Research.

– –

Nebraska Center for Rural Health Research

www.unmc.edu/rural www.unmc.edu/rural

• University of Nebraska

University of Nebraska Medical Center Medical Center

– – www.unmc.edu www.unmc.edu