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RUCA Data

Using RUCA Data

The RUCA codes can be used in many different ways in various types of health related research and program development and implementation. There are 33 codes. The large number of codes facilitate the aggregation of the codes to fit specific needs of those using them for health, demographic, geographic, and other purposes.

In almost all cases, the RUCA codes should be aggregated for use. For instance, it may be appropriate to aggregate them into two groups: rural and urban. In other instances it may be appropriate to create a specific group for the purposes of targeting a program (e.g., limiting a telehealth subsidy program to areas that are smaller and less functionally related to urban and large rural places: 7.0, 7.4, 8.0, 8.4, 9.0, 9.2, 10.0, 10.3, 10.5, 10.6).

There are many ways to aggregate the codes based on the policy goal. A few examples follow. Under most circumstances, suggested categorizations A, B, and C (below) will be most appropriate.

The way in which RUCAs have been used most is to aggregate the codes into four categories. This is a generally useful aggregation that is used for many health related projects. When this does not fit the bill, method B or C (see below) of collapsing the categories is usually satisfactory. This categorization approximates the metro/non metro split at the Census tract (ZIP code) level: Categorization A.

Urban focused: 1.0, 1.1, 2.0, 2.1, 3.0, 4.1, 5.1, 7.1, 8.1, and 10.1.

Large Rural City/Town (micropolitan) focused: 4.0, 4.2, 5.0, 5.2, 6.0, and 6.1

Small Rural Town focused: 7.0, 7.2, 7.3, 7.4, 8.0, 8.2, 8.3, 8.4, 9.0, 9.1, 9.2

Isolated Small Rural Town focused: 10.0, 10.2, 10.3, 10.4, 10.5, and 10.6

The percentage of the estimated 2004 US population for these groupings are: urban, 81.0%; large rural, 9.6%; small rural, 5.2%; and isolated small rural, 4.2% (55,526,530 rural residents in the US). The advantage of this definition is that it splits urban and rural in approximately the same way as does the OMB Metro definition but at the sub county-level, and it divides rural into three relevant and useful categories. In many studies and programs, it makes sense to separate the large rural cities/towns (say a place of 30,000 population with many medical providers) from those places that have 1,000 population and are isolated from urban places. It is clear that under most circumstances these two types of places differ greatly and should be considered separately.

Alternatively, the small rural and isolated small rural categories can be combined to create a single “small” rural category: Categorization B.

Urban: 1.0, 1.1, 2.0, 2.1, 3.0, 4.1, 5.1, 7.1, 8.1, and 10.1

Large Rural City/Town: 4.0, 4.2, 5.0, 5.2, 6.0, and 6.1

Small and Isolated Small Rural Town: 7.0, 7.2, 7.3, 7.4, 8.0, 8.2, 8.3, 8.4, 9.0, 9.1, 9.2, 10.0, 10.2, 10.3, 10.4, 10.5, and 10.6

The three categories can be aggregated. For instance, the three rural categories can be combined to create one “rural” category (this would approximate the standard Metro definition but at the sub county level: Categorization C.

Urban: 1.0, 1.1, 2.0, 2.1, 3.0, 4.1, 5.1, 7.1, 8.1, and 10.1

Rural: 4.0, 4.2, 5.0, 5.2, 6.0, 6.1, 7.0, 7.2, 7.3, 7.4, 8.0, 8.2, 8.3, 8.4, 9.0, 9.1, 9.2, 10.0, 10.2, 10.3, 10.4, 10.5, and 10.6

Another alternative is to define urban as all places that have 30% or more of their workers going to a Census Bureau defined Urbanized Area (this is the same as “C” but with code 3.0 being moved to the rural group): Categorization D.

Urban: 1.0, 1.1, 2.0, 2.1, 4.1, 5.1, 7.1, 8.1, and 10.1

Rural: 3.0, 4.0, 4.2, 5.0, 5.2, 6.0, 6.1, 7.0, 7.2, 7.3, 7.4, 8.0, 8.2, 8.3, 8.4, 9.0, 9.1, 9.2, 10.0, 10.2, 10.3, 10.4, 10.5, and 10.6

A more complicated approach is to assign Census tracts (ZIP codes) as in “A” but use the secondary work commuting flows to assign them to the largest place where 30% or more of their population commutes: Categorization E.

Urban: 1.0, 1.1, 2.0, 2.1, 4.1, 5.1, 7.1, 8.1, and 10.1

Large Rural City/Town: 3.0, 4.0, 4.2, 5.0, 5.2, 6.0, 6.1, 7.2, 8.2, and 10.2

Small Rural Town: 7.0, 7.3, 7.4, 8.0, 8.3, 8.4, 9.0, 9.1, 9.2, and 10.3

Isolated Small Rural Town: 10.0, 10.4, 10.5, and 10.6

And finally, another example categorization involves defining a group that is non-urban and non-large rural: Categorization F.

Rural town focused or weakly related to urban and large rural places: 3.0, 6.0, 7.0, 7.3, 7.4, 8.0, 8.3, 8.4, 9.0, 9.1, 9.2, 10.0, 10.4, 10.5, and 10.6 Not above: all other codes.

Of course, there are many variations of these aggregation schemes and other alternatives. In some demographic studies, all the codes might be used or simple combining of categories could be used (e.g., combine 10.0, 10.4, and 10.5 to create a very isolated and small rural town/area group). However, in general it is expected that categorizations A, B, and C will be used most often. For categorizations that use the Remote Tool in combination with RUCA codes, go to the Remote Tool link in the methods section.