Emergency Department Utilization and Mortality Rates Among Hispanic Residents in Rural vs Suburban vs Urban Settings: A Comparison of Colquitt County, Gwinnett County, Fulton County, and Georgia Overall (2020–2024)

Moultrie, GA

Background:

Geographic disparities in healthcare access and outcomes may exist within Hispanic populations in Georgia, particularly across rural, suburban, and urban settings. Rural communities often face provider shortages, higher poverty rates, and limited access to preventive services, which may influence emergency department (ED) utilization and mortality outcomes.

Objective:

To describe differences in emergency department utilization and age-adjusted mortality among Hispanic residents across selected rural, suburban, and urban counties in Georgia from 2020–2024.

Methods:

A retrospective ecological analysis was conducted using Georgia Department of Public Health OASIS data (2020–2024). Hispanic ER visit rates and age-adjusted death rates were compared across Colquitt County (rural), Gwinnett County (suburban), Fulton County (urban), and Georgia overall. Selected years totals were analyzed, and percentage differences were calculated to assess disparities. Findings were contextualized using the 2025 Colquitt Regional Health System Community Health Needs Assessment.

Results:

A stepwise rural–suburban–urban gradient was observed. Hispanic ER visit rates were highest in rural Colquitt County (30,517 per 100,000), compared with Georgia overall (17,827.8 per 100,000[TL1.1][TL1.2]) and urban Fulton County (14,993 per 100,000). Hispanic age-adjusted mortality was also highest in Colquitt County (509.8 per 100,000), exceeding Georgia overall (454.5 per 100,000) and Fulton County (358.2 per 100,000). Mortality decreased from 2020–2024 across all regions but remained highest in the rural setting.

Conclusion:

Hispanic residents in rural Colquitt County experience substantially higher ED utilization and mortality compared with suburban and urban counties. These highlight potential geographic disparities in healthcare utilization and outcomes and underscore the need for further investigation of structural and healthcare access factors affecting rural Hispanic communities in Georgia.