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Objective. This analysis determines the importance of geography and spatial behavior as predisposing and enabling factors in rural health care utilization, controlling for demographic, social, cultural, and health status factors.

Data Sources. A survey of 1,059 adults in 12 rural Appalachian North Carolina counties.

Study Design. This cross‐sectional study used a three‐stage sampling design stratified by county and ethnicity. Preliminary analysis of health services utilization compared weighted proportions of number of health care visits in the previous 12 months for regular check‐up care, chronic care, and acute care across geographic, sociodemographic, cultural, and health variables. Multivariable logistic models identified independent correlates of health services utilization.

Data Collection Methods. Respondents answered standard survey questions. They located places in which they engaged health related …