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This chapter assesses the effects of two rural community residential advantages – economic growth and availability of health services – upon residents’ health and emotional well-being.

A de facto experimental design divided communities into four analytical types based on their economic growth and health services. Household survey data were gathered via a drop-off/pickup procedure and 400 randomly selected households were surveyed in each location. Physical health was measured with a subset of items from the Medical Outcomes Study’s 36-item short form. A 10-item emotional well-being index was used. Beyond sociodemographic items, questions concerned household assets, medical problems, social supports, and community ties. Nested regression analyses were used to assess the effects of residential advantage upon health, net of potentially confounding factors.

Contrary to expectations, both residential advantages were necessary for improved health. The most important negative net effect on health was aging. Beyond household assets and community economic expansion, miles commuted to work was the next most important factor enhancing physical health. In all types of communities, residents’ emotional well-being scores were independent of age, but positively related to household income and religious involvement.

Obviously the study is limited by geography and by the small number of communities in each residential type. While we could measure the effects of household members not being able to address all health needs, we could not assess the effects of such problems on anyone else in the households beyond the respondents. Our survey approach is also unable to address the effects of rural residents being unable to meet their health needs over time.

Ours is the first study that we know of applying a de facto natural experimental design to assess community residential effects. The interrelated effects of residential community resources for residents’ health suggests that more studies like this one should be done.

Information gathered from a sample of residents in four rural Pennsylvania communities is used to test the net effects of household resources (financial assets, supports, and community ties) upon respondents’ physical health and emotional well-being. Size and composition of households, types, and extent of insurance coverage, age, and aspects of household liquidity had major net effects upon physical health. Some measures of liquidity, a range of supports, and community ties had net impacts upon emotional well-being. The importance of considering the collective health needs of rural households in relation to their affordability and sustainability is stressed. The public policy implications of our results are discussed.

This chapter provides an introduction to volume 27, Research in the Sociology of Health Care, Social Sources of Disparities in Health and Health Care and Linkages to Policy, Population Concerns and Providers of Care. It introduces the topic of social sources of disparities in health and health care and discusses the approach to this issue in the United States based on federal government efforts as well as based on research by medical sociologists, political scientists, epidemiologists and researchers in health care more generally, such as those in public health. This chapter serves as an introduction to the volume also. As such, the chapter explains the organization of the volume and briefly comments on each of the chapters included in the volume.