Rural and Underserved Health Research Center
Current Projects
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Availability and Characteristics of Outpatient and Residential Substance Use Treatment in Rural and Urban Areas
This study will look at: 1) the availability of residential and outpatient treatment centers in rural and urban counties, including identifying counties with no facilities; and 2) characteristics of services offered (e.g., residential, outpatient), demographics of persons treated, and insurance plans accepted by rural vs urban centers.
Topics: Health disparities and health equity, Health services, Healthcare access, Mental and behavioral health, Pharmacy and prescription drugs, Social determinants of health, Substance use and treatment
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Changes in Access to Care During the Public Health Emergency: Examining Rural-Urban Disparities by Insurance Type
Using the Behavioral Risk Factor Surveillance System data, this study will compare key access to care indicators among adult beneficiaries residing in rural and urban areas before and after the Public Health Emergency by types of health insurance. Researchers will explore state-level policy variations, such as the Affordable Care Act Medicaid expansion and COVID-19-related Medicaid coverage for uninsured adults.
Topics: Health disparities and health equity, Healthcare access, Healthcare financing, Medicaid and CHIP, Uninsured and underinsured
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Disparities in Screening, Prevention, and Management of Cardiovascular Disease in Rural and Urban Primary Care
This study will use a large national primary care registry to compare cardiovascular disease (CVD) screening, prevention, and management quality measures between rural and urban primary care practices. It will also assess for disparities by patient composition (race/ethnicity, insurance) of the practice.
Topics: Care management, Chronic diseases and conditions, Health disparities and health equity, Health promotion and disease prevention, Health services, Minority health, Physicians, Quality
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Evaluating the Impact of Inflation Reduction Act Provisions on Medicare Advantage Prescription Drug Costs
Using Merative MarketScan data, this study will evaluate changes in the affordability of prescription drugs for urban and rural Medicare beneficiaries before and after the recent Inflation Reduction Act (IRA). The primary outcome will be an assessment of whether the IRA succeeded in reducing costs and identifying any remaining health disparities.
Topics: Health disparities and health equity, Healthcare financing, Medicare Advantage (MA), Pharmacy and prescription drugs
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Impact of High Deductible Health Plans on Rural Populations
Using data from Merative MarketScan insurance claims, this study will investigate utilization, spending, and care patterns of rural members enrolled in high deductible health plans (HDHP) compared to traditional plans. Trends in health outcomes before and after HDHP growth will be assessed to inform policy design tailored to rural residents.
Topics: Health disparities and health equity, Healthcare access, Healthcare financing, Private health insurance, Rural statistics and demographics
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Mental Health Treatment Among Rural and Urban Adults at Risk for Suicide
This study will look at rural/urban disparities in 1) the receipt and sources of mental health treatment among adults with suicidal thoughts and attempts using data from the National Survey on Drug Use and Health; and 2) mental health follow-up visits among adults with a hospital admission or emergency department visit for self-inflicted harm using data from a national insurance claims dataset.
Topics: Health disparities and health equity, Health services, Healthcare access, Mental and behavioral health, Post-acute care
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Review of Current Research on Rural/Urban Differences in Social Determinants of Health
Social determinants of health are social, economic, and community variables that influence health outcomes. This project will synthesize the extant literature on rural/urban differences in the social determinants of health, culminating in a comprehensive report that includes a summary of information gaps and further research needs.
Topics: Health disparities and health equity, Healthcare access, Poverty, Quality, Social determinants of health, Uninsured and underinsured
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Risky Substance Use Among Rural and Urban Adults: An Update
Very little research has examined rural vs. urban differences in substance misuse and treatment access nationally. Using public and nationally representative data from the National Survey on Drug Use and Health, this project will: 1) Estimate and compare alcohol use and binge drinking, and 2) Estimate and compare drug use (marijuana, other illicit drugs, and non-medical use of other drugs) between non-metropolitan and metropolitan adults.
Topics: Health disparities and health equity, Mental and behavioral health, Substance use and treatment
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Rural Access to Opioid Treatment Program Clinics and Certified Community Behavioral Health Clinics
This project will identify all Certified Community Behavioral Health Clinics and Opioid Treatment Program Clinics in the U.S. and then present the number of rural and urban clinics in each state as frequency tables and map visualizations.
Topics: Health services, Healthcare access, Mental and behavioral health, Substance use and treatment
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Rural/Urban Inequities in Drug and Alcohol Use Treatment
Using the National Survey on Drug Use and Health, this study will investigate rural vs. urban variations in treatment utilization for alcohol use disorder (AUD) and, separately, drug use disorder (DUD). It will yield prevalence estimates of any treatment receipt and sources of treatment among persons with past year AUD and DUD as well as the receipt of medication therapy among those treatable with medications.
Topics: Health disparities and health equity, Health services, Healthcare access, Mental and behavioral health, Substance use and treatment
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Third Party Negotiated Pricing in Rural and Urban Hospitals
We will use third party negotiated pricing information to compare prices in urban and rural hospitals, across a variety of common services. Because there has been poor compliance with the Centers for Medicare & Medicaid Services (CMS) requirement to publish third party negotiated pricing, we will also examine if the availability of this information differs for rural and urban hospitals.
Topics: Critical Access Hospitals (CAHs), Federally Qualified Health Centers (FQHCs), Healthcare financing, Hospitals and clinics, Medicare, Medicare Prospective Payment System (PPS), Private health insurance
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Work Settings, Education, and Intent to Leave Practice among Rural vs. Urban Nurses
Using data from the 2022 National Nursing Workforce Survey, this project will describe rural/urban differences in nurses' work settings, levels of education and licensure, demographic characteristics, income, and intention to retire or leave practice. Study findings could be applied to implement policies aimed at increasing nursing school output and attracting nurses to practice in rural areas.
Topics: Health disparities and health equity, Nurses and nurse practitioners, Workforce