Health Disparities
Rural Medication Disparities for Diabetes, Hypertension and Hyperlipidemia Chia-Lin Chang* CHIA-LIN CHANG University of North Dakota SMHS
Introduction Health disparities remain a major concern in rural America, where limited healthcare access and socioeconomic challenges lead to higher chronic disease burdens. Prior research on rural medication disparities has focused primarily on opioid prescribing and substance misuse. However, few studies have examined disparities in prescribing practices for chronic diseases, despite their direct implications for treatment optimization, cost-effectiveness, and long-term health outcomes. This study examines rural-urban disparities in chronic medication use to determine whether these disparities reflect actual disease prevalence or inequities in treatment decision-making.Methods We analyzed data from the Behavioral Risk Factor Surveillance Survey (BRFSS) 2021–2023 for North Dakota. We compared self-reported prevalence of chronic conditions (diabetes, hypertension, and high cholesterol) and associated medication usage between rural and urban residents. Statistical significance of differences in prevalence and medication adherence between populations was assessed using chi-square tests.Results Analysis revealed distinct rural-urban patterns. Insulin use for diabetes was similar between groups. However, rural residents reported significantly higher use of blood pressure medications (81.3% vs. 76.5%, p=0.056) and cholesterol medications (29.4% vs. 24.1%, p<0.001) compared with urban residents. While higher rates of hypertension explain the increased use of blood pressure medication (36.3% vs. 30.2%, p<0.001), the prevalence of hypercholesterolemia was nearly identical between groups (35.6% vs. 33.9%, p=0.169).Conclusion The finding that rural cholesterol medication use exceeds urban use despite similar disease prevalence suggests that rural-urban differences may reflect variations in prescribing behaviors, treatment thresholds, or access to non-pharmacological preventive care rather than disease burden alone. These patterns raise concerns about possible overprescription or missed opportunities for lifestyle interventions in rural settings. While limited by the self-reported nature of BRFSS data, these preliminary findings highlight a critical gap in rural health management. This study helps future patient-centered care and precision care.