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Original Research

Health risk behaviors in insured and uninsured community health center patients in the rural US South

Submitted: 28 February 2012
Revised: 16 June 2012
Published: 31 October 2012

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Author(s) : Smalley K, Warren JC, Klibert J.

K. Bryant SmalleyJacob WarrenJeffrey Klibert

Citation: Smalley K, Warren JC, Klibert J.  Health risk behaviors in insured and uninsured community health center patients in the rural US South. Rural and Remote Health (Internet) 2012; 12: 2123. Available: (Accessed 20 October 2017)


Introduction:  The impact of health behaviors on the leading causes of death across the USA has been well demonstrated. However, limited focus has been placed on the leading health risk behaviors of rural Federally-Qualified Health Center (FQHC) patients, a particularly underserved group. The current study was undertaken to examine the most common risk-taking behaviors of rural FQHC patients and to examine if risk-taking behaviors vary between insured and uninsured patients.
Methods:  A convenience sample of 199 patients was recruited at an FQHC in the rural US South. Participants completed a battery of demographic and health risk behavior assessments.
Results:  The most common risk behaviors were eating fried foods, not eating five servings of vegetables per day, not eating three servings of fruit per day, drinking caloric beverages, not exercising regularly, not wearing a seatbelt, having sex without a condom and smoking. Uninsured patients were more likely to talk on their cell phones while driving (p<0.001), more likely to text while driving (p=0.007), more likely to have unprotected sex (p=0.004), more likely to drink alcohol (p=0.043) and more likely to not seek medical care when needed (p=0.005).
Conclusions:  Rural FQHC patients demonstrated high levels of behavioral and health risk-taking, including dietary-, exercise- and traffic-related risks, in a context where traditional prevention methods have failed to penetrate. Differences exist between insured and uninsured patients, indicating that the reasons behind behavioral risk-taking may be context-specific and need to be explored further to help identify intervention targets that are culturally and situationally appropriate for diverse rural groups.

Key words: health behavior, health risks, insurance status, USA.

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