Urban Versus Rural Differences in Insurance Coverage and Impact on Employment Among Families Caring for a Child With Cerebral Palsy

Braydon Schaible, Georgia Southern University
Gavin Colquitt, Georgia Southern University
Li Li, Georgia Southern University
Manuela Caciula, Georgia Southern University
Noelle G. Moreau, Louisiana State University Health Sciences Center New Orleans

© 2017 Schiable, B., Colquitt, G., Li, L., Caciula, M., & Moreau, N. G. This open access article is distributed under a Creative Commons Attribution (CC-BY) 4.0 license. The publisher’s version can be found in Cogent Magazine.


Background: The purpose of this study was to examine urban vs. rural differences on the relationship between family contextual variables and adequacy of insurance coverage and impact on employment for among families with a child with Cerebral Palsy from a nationally representative sample.

Methods: A retrospective, observational study was carried out using data from the National Survey of Children with Special Healthcare Needs.

Results: A total of 744 participants reported as having a child with a diagnosis of Cerebral Palsy and were included in the sample. Logistic regression analyses, adjusting for urban and rural setting revealed different predictors of adequacy of insurance coverage and impact on employment. Among urban respondents, three variables with odds ratios ranging from 1.33 to 1.58 served as protective factors, increasing the likelihood of adequate insurance coverage. Four variables with odds ratios ranging from 1.41 to 1.79 decreased the likelihood of negatively impacting employment. Among rural families, there was only one significant protective factor for adequacy of insurance coverage (odds ratio 1.80) and one for decreasing the chances of impact on employment (odds ratio 2.53).

Conclusion: Families in rural areas caring for a child with CP have few protective factors for adequate insurance coverage and impact on familial employment.