Honors Study

Diabetes Management in the Rural, Uninsured Population

Devon J. Trolley

Devon J. Trolley
HPA Schreyer Scholar


Diabetes represents one of the many chronic diseases that have increased in prevalence and challenged the U.S. health care system to find effective ways of disease management. Diabetes treatments recommend regular physician visits and continuous monitoring for health complications. This presents problems specifically to the rural and uninsured populations that typically have less access to health care. The following paper examines the environmental influences on the rural and uninsured population and studies the impact of specific factors on patient behavior. A patient’s health belief model, health literacy, depression, and disease knowledge have been shown in past literature to impact patient behaviors that help successfully manage diabetes.

Findings were drawn from comparisons between rural and non-rural residents of Pennyslvania, from comparisons between diabetics and non-diabetics in the study population of Centre County, and from data collected through questionnaires administered to rural, uninsured diabetic patients at a free health clinic. The findings support much of the literature on rural and uninsured populations, although Centre County is found to be unique in several aspects.

Our results showed that health literacy was high, diabetes knowledge was low, and depression affected about half of the participants. Regarding beliefs about diabetes, participants seemed to have confidence in medicine to help treat their disease, but they did not perceive their disease as severe. The conclusions present information for the free health clinic and for providers treating similar populations to create diabetes management classes looking to encourage patients have take a more active role in the management of their disease.