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Table 3 Multivariate Regression Assessing Determinants of Percent Utilization Rate Among MPW Eligible Women (Dependent variable) Calculated from Pooled Sample During Years 2014–2016, in North Carolina Counties, by Metro vs. Non-metro classification

From: County‐level correlates of dental service utilization for low income pregnant women. Ecologic study of the North Carolina Medicaid for Pregnant Women (MPW) program

  Non-metro Counties Metro Counties Full Sample
Variable Coeff 95% Confidence Interval Coeff 95% Confidence Interval Coeff 95% Confidence Interval
Intercept -18.26 -37.49, 0.97 -12.97 -29.16, 3.23 -16.26 -28.40, -4.12
Group 1 Predisposing Factors
Farming/Recreation 1.53 -1.37, 4.44 -0.002 -2.33, 2.32 1.61** 0.03, 3.20
Persistent Poverty -4.29** -7.38, -1.22 -0.81 -6.22, 4.59 -3.11** -5.46, -0.76
High School Grad Rate 0.20* -0.02, 0.43 0.18* -0.009, 0.37 0.19** 0.04, 0.33
Group 2 County Well-being (need)
Abuse reporting past year 0.003 -0.05, 0.05 0.03 -0.02, 0.08 0.01 -0.02, 0.05
Change in Abuse reporting 0.16*** 0.08, 0.25 -0.03 -0.19, 0.13 0.13*** 0.07, 0.20
Infant Mortality 0.24** 0.07, 0.42 -0.09 -0.39, 0.22 0.18** 0.04, 0.32
Length of Life County Rank 0.05** 0.01, 0.09 0.03 -0.01, 0.07 0.04** 0.01, 0.07
Poor Mental Health Days 1.26** 0.15, 2.38 1.03* -0.17, 2.23 1.35*** 0.59, 2.11
Group 3 Dental Health Services
Dentists per 100,000 pop 0.05 -0.02, 0.12 0.02 -0.008, 0.05 0.03** 0.004, 0.06
FQHC Dental in County 1.28 -0.86, 3.42 1.31 -0.47, 3.09 1.28* -0.09, 2.65
R 2 0.63 0.43 0.51
Adj R2 0.54 0.25 0.45
N 50 43 93
  1. Note: * P < .10; ** P < .05; *** P < .001.
  2. Notes on Variables:
  3. County Codes from US Department of Agriculture (USDA)
  4. RUCC is the Rural Urban Continuum Code system.8 Codes range from 1 to 9. This is a classification scheme developed by the USDA. It attempts to arrange counties on a continuum from most metro to least metro based on population density and proximity of non-metro counties to urban areas
  5. County Typology Codes9 for Persistent Poverty, Farming, Recreation
  6. Persistent Poverty is a county-level designation that identifies counties where at least 20 percent of the population is at or below the Federal Poverty Level in each of the census years of 1980, 1990, 2000 and the American Community Survey of 2013. In North Carolina, 10 counties are designated as areas of Persistent Poverty. Persistent Poverty is often a marker that alerts providers of direct and indirect services to the increased vulnerability of the population especially low educational attainment and poor health outcomes
  7. Farming/Recreation is derived to represent counties that were designated as either Farming or Recreation. Farming is the Farm-dependent county indicator, where 0 = no 1 = yes. Farming accounted for at 25% or more of the county’s earnings or 16% or more of the employment averaged over 2010–2012
  8. Recreation defines counties (0 = no 1 = yes) based on computation from three data sources: (1) Percentage of wage and salary employment in entertainment and recreation, accommodations, eating and drinking places, and real estate as a percentage of all employment reported by the Bureau of Economic Analysis; (2) Percentage of total personal income reported for these same categories by the Bureau of Economic Analysis; and (3) Percentage of vacant housing units intended for seasonal or occasional use reported in the 2010 Census. The three variables measuring employment, earnings, and seasonal housing were converted to z-scores and combined into a weighted index (weights of 0.3 were assigned to income and employment and 0.4 to seasonal housing) to reflect recreational activity. Counties with index scores of 0.67 or higher were regarded as recreation counties. Seasonal housing was given a higher weight because in some areas employment and income may not reflect recreational activity because of the seasonality. The comparison group was all other counties and these were designated as either Manufacturing, Government, or Non-specialized
  9. Variables from NC Child ( http://www.ncchild.org/ )
  10. Abuse and Neglect claims in 2015 and 2016. The rate per 1000 of children under age 18 who were assessed for abuse or neglect
  11. Infant Mortality in 2015. This represents the number of infant deaths per 1000 babies born alive
  12. North Carolina County Health Rankings 2015 variables (http://www.countyhealthrankings.org/rankings/data/NC)
  13. Length of Life – County rank among counties in North Carolina (from 1 to 100, with 100 being worst) for age-adjusted Years of Potential Life Lost before age 75, calculated from 2010–2012 Mortality files National Center for Health Statistics
  14. Quality of Life - from BRFSS 2006–2012, measured as county-level average number of mentally unhealthy days (poor mental health days) in the past 30 days (age-adjusted). Poor mental health days ranged from 2.0 to 6.2 days per month, median of 3.6
  15. High School Graduation Rate = (percent) number students that graduated divided by the number of students expected to graduate from high school in 2015
  16. Dentist rate = number of dentists per 100,000 population in 2015
  17. North Carolina Department of Health and Human Services variable
  18. (https://publichealth.nc.gov/oralhealth/services/safetynetclinics.htm)
  19. FQHC with Dental in County = indicator variable for presence of a Federally Qualified Health Center (FQHC) that provides dental services located in the county