Research Alert: October 27, 2022

New Recaps on Aging, Maternal Health, Mental Health, and Travel Burdens

Gateway has developed Rural Health Research Recaps to identify the key findings from all of the Rural Health Research Centers on specific rural health topics. The following Recaps have recently been published on Gateway.

Aging in Place

This Recap examines aging in place as it relates to social engagement, living alone, long-term care preferences, and nursing home availability.

• From 2013 to 2017, rural counties had higher shares of population age 65 and older than urban counties (18.1% vs 14.3%).
• In 2019, a lower percentage of noncore counties had nursing homes than micropolitan or metropolitan counties (87% vs 95% vs 96%).
• When examining preferences for long-term care arrangements, in 2018, the majority of rural and urban residents indicated they would prefer to remain in their own home, either with the help of friends/family or paid help.

Maternal Health Disparities: An Intersection of Race and Rurality

This Recap examines the loss of hospital-based obstetric services and racial/ethnic disparities surrounding maternal and infant health.

• From 2014 to 2018, 53 rural counties (2.7% of all rural counties) lost hospital-based obstetric services.
• In 2019, 30.8% of rural counties had no obstetric clinicians of any type.
• From 2012 to 2018, non-Hispanic Black mothers had the highest rate of preterm birth (12.5% rural vs 11.3% urban).

Rural Mental Health

This Recap examines mental health conditions and treatment across rural and urban areas, including: serious mental illness (SMI), major depression, adverse childhood experiences (ACEs), and suicidal thoughts, plans, and attempts.

• In 2019, past year SMI was significantly higher among adults residing in nonmetropolitan than metropolitan counties (5.9% vs 5.2%).
• Approximately 32.4% of nonmetropolitan and 35.7% of metropolitan adults with SMI received no mental health treatment in 2018.
• From 2016 to 2018, rural children were more likely than urban children to experience four or more ACEs (10.7% vs 6.8%).

This Recap explores travel burdens to receive care, including time spent in travel, distance traveled, financial burden of travel, public transportation use, and motor vehicle fatalities.

• In 2017, the average rural resident traveled 120% more miles per one-way trip to receive medical or dental care than the average urban resident.
• Rural Hispanic residents were nearly three times more likely to travel more than 30 miles for care, compared to rural White residents.
• Households earning less than $25,000 annually traveled the most time while households earning more than $100,000 traveled the least time.