Concordance of Rural‐Urban Self‐identity and ZIP Code‐Derived Rural‐Urban Commuting Area (RUCA) Designation. Issue 2 (26th March 2019) - Onega, Tracy
Abstract: Purpose: This study examined the concordance between individuals' self‐reported rural‐urban category of their community and ZIP Code‐derived Rural‐Urban Commuting Area (RUCA) category. Methods: An Internet‐based survey, administered from August 2017 through November 2017, was used to collect participants' sociodemographic characteristics, self‐reported ZIP Code of residence, and perception of which RUCA category best describes the community in which they live. We calculated weighted kappa ( ĸ ) coefficients (95% confidence interval [CI]) to test for concordance between participants' ZIP Code‐derived RUCA category and their selection of RUCA descriptor. Descriptive frequency distributions of participants' demographics are presented. Findings: A total of 622 survey participants, residents of New Hampshire (63%) and Vermont (37%), responded to the survey's self‐reported rural‐urban category. The overall ĸ was 0.33 (95% CI: 0.27‐0.38). The highest concordance was found among those living in a small rural area (N = 81, 13%): 62% of this group identified their communities as small rural. Sixty‐five percent (300/459) of participants residing in urban or large rural areas reported their community as more rural (small rural or isolated). Sixty‐eight percent (111/163) of participants living in small rural or isolated areas identified their community as more urban (large rural or urban). Conclusions: Discordance was found between self‐report of rural‐urban category and ZIP Code‐derived RUCA designation. Caution is warranted when attributing rural‐urban designation to individuals based on geographic unit, since perceived rurality/urbanicity of their community that relates to health behaviors may not be reflected.