Rural and Minority Health Research Center: Rural Health Research Products & Journal Articles

2024

Geographic Variations in Urban-Rural Particulate Matter (PM2.5) Concentrations in the United States, 2010–2019
Journal Article
Date: 09/2024
The purpose of this project was to compare fine particulate matter 2.5 across U.S. Census tracts, specifically focusing on rural vs. urban differences between 2010 and 2019.
Rural-Urban Differences in Self-Reported Participation in Diabetes Self-Management Education
Journal Article
Date: 09/2024
Using 2019 Behavioral Risk Factor Surveillance System data, this study examined the proportion of rural versus urban adults who reported receiving Diabetes Self-Management Education.
Health Care Access Barriers Among Metropolitan and Nonmetropolitan Populations of Eight Geographically Diverse States, 2018
Journal Article
Date: 06/2024
This research focused on differences in barriers to health care access across metropolitan, micropolitan, and noncore populations. More access and cost related barriers are experienced by micropolitan respondents. These populations experience health care disparities and financial burdens that emphasize the need to mitigate these barriers.
Prevent or Treat: Availability of Diabetes Self-Management Education and Dialysis in High Need Rural Counties
Policy Brief
Date: 03/2024
In this brief, researchers assess the availability of in-county diabetes self-management education and dialysis across rural and urban counties.
Availability and Quality of Dialysis Care in Rural Versus Urban U.S. Counties
Journal Article
Date: 02/2024
An examination of rural-urban differences in quality of dialysis care offered across the United States was conducted using data from Medicare certified dialysis facilities in 2020 from the Centers for Medicaid and Medicare.

2023

Geographic Variations in Driving Time to U.S. Mental Health Care, Digital Access to Technology, & Household Crowdedness
Journal Article
Date: 12/2023
This study compared travel time to mental health facilities in rural versus urban areas and potential barriers to digital devices for telemedicine access in those same rural/urban locations. In addition, the research examined private space within the home as it relates to household crowdedness.
Assessing Key Indicators of Rural Versus Urban Water Quality
Policy Brief
Date: 08/2023
This study presents a summary of water quality monitoring data sources and models, identifies the gaps that persist, and proposes the salient categories and types of data that should be contained in a national water quality monitoring database to accurately describe rural water quality.
Availability of Dialysis Facilities in Minoritized Racial/Ethnic Group Areas
Policy Brief
Date: 08/2023
This brief is one of a series of findings briefs documenting disparities in geographic access to health services for ZIP code tabulation areas containing a high proportion of minoritized racial/ethnic residents. The brief looks at the availability of dialysis providers in minoritized racial/ethnic areas.
Availability of Primary Care Safety Net Providers in Minoritized Racial/Ethnic Group Areas
Policy Brief
Date: 08/2023
This brief is one of a series of findings briefs documenting disparities in geographic access to health services for ZIP code tabulation areas containing a high proportion of minoritized racial/ethnic residents. This report looks at the distance to the nearest primary care safety net provider.
Examining Rural-Urban Differences in the Availability of Hospital-Based Cardiac Services Between 2010-2020
Policy Brief
Date: 08/2023
This study examines the availability of hospital-based cardiac health care services (general cardiology, diagnostic catheterization, and interventional catheterization) and whether rural-urban differences in the availability of these health care services occurred between 2010 and 2020.
Accommodation and Acceptability of Health Care by Non-Metropolitan/Metropolitan and Race/Ethnicity Status
Policy Brief
Date: 07/2023
This research examined rural-urban (i.e., non-metropolitan/metropolitan) differences in accommodation and acceptability of health care by operationalizing two survey questions from the health care access optional module of the Behavioral Risk Factor Surveillance System survey.
Access to Health Services Across Rural and Urban Minoritized Racial/Ethnic Group Areas
Policy Brief
Date: 03/2023
This brief summarizes selected results from a series of reports documenting disparities in geographic access to health services for rural and urban places that have a relatively high proportion of residents from minoritized racial and ethnic groups. "Areas" were examined at the ZIP Code Tabulation Area level.
Assessing Geographic Variability in Key Indicators of Air Quality: A Rural vs. Urban Comparison of Pollution and Socio-Economic Factors
Policy Brief
Date: 03/2023
The purpose of this study was to examine rates of air pollution between rural and urban census tracts. In addition, urban-rural disparities in exposure to polluted air across Environmental Protection Agency-defined regions were examined.
The COVID-19 Pandemic Impact on Independent and Provider-Based Rural Health Clinics' Operations and Cancer Prevention and Screening Provision in the United States
Journal Article
Date: 03/2023
The provision of Rural Health Clinic (RHC) cancer prevention and screening services was examined to identify any changes pre- and peri-pandemic. The research examined overall provision of cancer prevention and screening services by RHCs and the provision of these services by independent RHCs and by provider-based RHCs .
Variations in Affordability of Health Care by Non-Metropolitan/Metropolitan and Race/Ethnicity Status Across Eight Geographically Dispersed States
Policy Brief
Date: 01/2023
This research examined rural-urban (i.e., non-metropolitan/metropolitan) differences in affordability inclusive of insurance coverage and cost barriers. The research also examined forgoing medical care/medication and medical debt using Behavioral Risk Factor Surveillance System survey data from the healthcare access optional module.

2022

The Impact of the COVID-19 Pandemic on Rural Health Clinics' Operations and Cancer Prevention and Control Efforts
Policy Brief
Date: 11/2022
This study surveyed a stratified random sample of Rural Health Clinics throughout the country to examine how the pandemic has affected their overall operations and provision of cancer prevention and control services.
Rural Health Clinic Colorectal Cancer Screening Toolkit: A Toolkit for Implementing Evidence-Based Colorectal Cancer Screening Interventions in Rural Health Clinics
Date: 11/2022
The purpose of this project is to provide evidence-based interventions and other resources to Rural Health Clinics, throughout the United States, to improve colorectal cancer screening among their patient population.
Rural Health Clinic Colorectal Cancer Screening Toolkit: A Toolkit for Implementing Evidence-Based Colorectal Cancer Screening Interventions in South Carolina Rural Health Clinics
Date: 11/2022
The purpose of this project is to provide evidence-based interventions and other resources to Rural Health Clinics, throughout South Carolina, to improve colorectal cancer screening among their patient population.
Rural-Urban Differences in Child and Adolescent Mental Health Prior to and During the COVID-19 Pandemic: Results From the National Survey of Children's Health
Policy Brief
Date: 11/2022
This policy brief analyzes data from a large national sample of children and adolescents to examine similarities and differences between rural and urban mental health outcomes prior to and during the COVID-19 pandemic and offers considerations for policy and program development.
Rural-Urban Disparities in Quality of Inpatient Psychiatric Care
Journal Article
Date: 11/2022
Using data from the Inpatient Psychiatric Facility Quality Reporting program 2015-2019, this study examined differences and changes in the quality of inpatient psychiatric care in rural and urban hospitals.
Changes in Access to Nearest Federally Qualified Health Centers and Rural Health Clinics Among Rural ZIP Codes That Did and Did Not Experience a Hospital Closure, 2006-2018
Policy Brief
Date: 10/2022
This brief explores changes in geographic accessibility within rural ZIP codes throughout the U.S. to Federally Qualified Health Centers and Rural Health Clinics, between 2016 and 2018.
The Involvement of Rural Health Clinic Practitioners in Cancer Treatment Decisions and Survivorship Care
Policy Brief
Date: 10/2022
This study examined Rural Health Clinics' practitioner involvement in cancer treatment decisions, management of side effects, surveillance, and survivorship care.
Availability of Hospital-Based Cancer Services Before and After Rural Hospital Closure, 2008-2017
Journal Article
Date: 09/2022
Using American Hospital Association survey data from 2008 to 2017, the changes in access to cancer-related screening and treatment services were examined to determine the impact of hospital closures across hospital service areas.
Availability of Hospital-Based Emergency Department and Trauma Services in Minoritized Racial/Ethnic Group Areas
Policy Brief
Date: 09/2022
This brief is one of a series of findings briefs documenting disparities in geographic access to health services for ZIP code tabulation areas (ZCTAs) containing a high proportion of minoritized racial/ethnic residents. This report looks at the availability of hospital-based emergency department and trauma services at the ZCTA level.
Availability of Nursing Homes in Minoritized Racial/Ethnic Group Areas
Policy Brief
Date: 09/2022
This brief is one of a series of findings briefs documenting disparities in geographic access to health services for ZIP code tabulation areas (ZCTAs) containing a high proportion of minoritized racial/ethnic residents. This report looks at the availability of nursing homes at the ZCTA level.
Availability of Substance Use Disorder Treatment in Minoritized Racial/Ethnic Group Areas
Policy Brief
Date: 09/2022
This brief is one of a series of findings briefs documenting disparities in geographic access to health services for ZIP code tabulation areas (ZCTAs) containing a high proportion of minoritized racial/ethnic residents. This report looks at spatial availability and travel burden for substance use disorder care at the ZCTA level.
Rural-Urban Differences in Child and Adolescent Access to and Receipt of Mental Health Services Prior to and During the COVID-19 Pandemic: Results From the National Survey of Children's Health
Policy Brief
Date: 09/2022
This policy brief analyzes data from a large, national sample of children and adolescents to examine gross inter-group similarities and differences and offer timely recommendations for alleviating the youth mental health crisis.
Availability of Home Health Services in Minoritized Racial/Ethnic Group Areas
Policy Brief
Date: 08/2022
This brief is one of a series of findings briefs documenting disparities in geographic access to health services for ZIP code tabulation areas containing a high proportion of minoritized racial/ethnic residents. This report looks at the availability of home health services in minoritized racial/ethnic areas.
Availability of Medicare-Certified Hospice Services in Minoritized Racial/Ethnic Group Areas
Policy Brief
Date: 08/2022
This is one of a series of briefs documenting disparities in geographic access to health services for ZIP code tabulation areas containing a high proportion of minoritized racial/ethnic residents. This brief explores access to hospice services.
Availability of Pharmacies in Minoritized Racial/Ethnic Areas
Policy Brief
Date: 08/2022
This brief is one of a series of findings briefs documenting disparities in geographic access to health services for ZIP code tabulation areas containing a high proportion of minoritized racial/ethnic residents. This report looks at access to pharmacies.
Examining the Association Between Rurality and Positive Childhood Experiences Among a National Sample
Journal Article
Date: 08/2022
Using the full National Survey of Children's Health with all 50 states and the District of Columbia, this study examined rural-urban differences in positive childhood experiences.
Spatial Access to Hospital-based Obstetric Units in Minoritized Racial/Ethnic Areas
Policy Brief
Date: 08/2022
This brief is one of a series of findings briefs documenting disparities in geographic access to health services for ZIP code tabulation areas containing a high proportion of minoritized racial/ethnic residents. This report looks at spatial access to hospital-based obstetric units in minoritized racial/ethnic areas.
Changes in Access to Community Health Services Among Rural Areas Affected and Unaffected by Hospital Closures Between 2006 and 2018: A Comparative Interrupted Time Series Study
Journal Article
Date: 07/2022
In this article, investigators compared access to Federally Qualified Health Centers and Rural Health Clinics by those in rural areas affected versus those in rural areas unaffected by hospital closures.
Rural Children With 4+ Adverse Childhood Experiences Often Lack Positive Experiences
Fact Sheet
Date: 07/2022
This research explored the proportion of rural children with adverse childhood experiences who lack positive childhood experience exposure.
Comparison of Cancer Treatment Services Across Hospitals
Fact Sheet
Date: 05/2022
This research compared the availability of comprehensive oncology, chemotherapy, and radiation therapy in Critical Access Hospitals and non-Critical Access Hospitals.
Racial/Ethnic Differences in Adverse and Positive Childhood Experiences Across Rural Communities: Results From the National Survey of Children's Health
Policy Brief
Date: 05/2022
This study examined whether ACE and PCE exposure varied by race/ethnicity, among rural children, finding that there were higher rates of four or more ACEs among racial/ethnic minority children.
Rates and Trends of Childhood Overweight/Obesity in the United States and South Carolina
Fact Sheet
Date: 03/2022
The goal of this project was to estimate childhood overweight/obesity rates across the United States at the region, state, and county level.
Colorectal and Cervical Cancer Prevention in Rural Health Clinics in South Carolina
Fact Sheet
Date: 02/2022
This study investigated the perceptions and practices of cervical and colorectal cancer prevention in Rural Health Clinics. An online survey was administered to all Rural Health Clinics in South Carolina. Quantitative survey findings and key takeaways were reported.
Perceptions and Practices for Colorectal and Cervical Cancer Prevention and Control in Rural Health Clinics in South Carolina
Fact Sheet
Date: 02/2022
This study investigated the perceptions and practices for colorectal and cervical cancer prevention and control in Rural Health Clinics in South Carolina. Health practitioner interviews were used to gather qualitative data.
The Problem of the Color Line: Place, Race, and Access to Health Care in America
Journal Article
Date: 02/2022
Using ZIP Code Tabulation Area boundaries and associated rural-urban commuting area codes, urban and rural places with the largest share of minoritized racial and ethnic groups were identified. A StoryMap was then created to illustrate disparities experienced based on where Indigenous populations and people of color reside spatially.
Rural-Urban Differences in Adverse and Positive Childhood Experiences: Results From the National Survey of Children's Health
Policy Brief
Date: 01/2022
This brief examines the types and counts of adverse childhood experiences (ACEs) and positive childhood experiences (PCEs) for rural and urban children. The study reports on the differences between rural and urban ACEs and PCEs across all fifty states and the District of Columbia.

2021

Changes in Socioeconomic Mix and Health Outcomes in Rural Counties With Hospital Closures, 2005-2018
Policy Brief
Date: 09/2021
This brief examines the trend of hospital closures between 2005 and 2018 across definitions of rurality. Social, economic, and health structure trends at the county level across the contiguous United States were the study's focus.
Trends in Cancer Treatment Service Availability Across Critical Access Hospitals and Prospective Payment System Hospitals
Journal Article
Date: 08/2021
This study investigated trends in cancer services availability in urban and rural Prospective Payment System (PPS) hospitals and Critical Access Hospitals (CAHs). Compared with all PPS hospitals, CAHs offered fewer cancer treatment services and experienced a decline in service capability over time.
Identification of Rural Communities With Limited Access to Safety Net Healthcare Providers
Fact Sheet
Date: 07/2021
This fact sheet identifies rural U.S. counties with suboptimal access to safety net healthcare providers.
Estimates of Childhood Overweight and Obesity at the Region, State, and County Levels: A Multilevel Small Area Estimation Approach
Journal Article
Date: 06/2021
The goal of this study is to create a map of county-level obesity rates at the regional, county, and state levels.
Trends in Spatial Access to Colonoscopy in South Carolina, 2000-2014
Journal Article
Date: 06/2021
This study looks at the availability of colonoscopy screenings in South Carolina between 2000 and 2014 with a focus on changes in spatial access for these preventive services.
Rural and Racial Disparities in Colorectal Cancer Incidence and Mortality in South Carolina, 1996 - 2016
Journal Article
Date: 05/2021
This study investigated how race and rurality impact colorectal cancer incidence and mortality in South Carolina.
Disparities in Meeting USPSTF Breast, Cervical, and Colorectal Cancer Screening Guidelines Among Women in the United States
Journal Article
Date: 04/2021
The US Preventive Services Task Force provides recommendations for breast, cervical, and colorectal cancer screening. This manuscript examines the sociodemographic characteristics associated with women meeting these recommendations.
The Intersection of Rural Residence and Minority Race/Ethnicity in Cancer Disparities in the United States
Journal Article
Date: 02/2021
This manuscript summarizes how racism and social determinants of health disproportionately affect rural racial/ethnic minorities, offers a review of the cancer disparities rural racial/ethnic minorities face, and recommends policy, research, and intervention to reduce these disparities.

2020

Spatial Access to Vaccines for Children Providers in South Carolina: Implications for HPV Vaccination
Journal Article
Date: 12/2020
In South Carolina, rural children ages 13 to 17 years old have lower rates of HPV vaccination initiation. To better understand potential drivers of this rural-urban disparity, this study's objective was to examine spatial access to Vaccines For Children-enrolled clinics across rural and urban areas of the state.
Cervical Cancer Treatment Initiation and Survival: The Role of Residential Proximity to Cancer Care
Journal Article
Date: 10/2020
This study looked at the role drive time to cancer care facilities played on cancer treatment initiation and survival for cervical cancer patients.
A National Survey of RN-to-BSN Programs: Are They Reaching Rural Students?
Journal Article
Date: 10/2020
This study used a national survey of RN-to-BSN programs to better understand their potential role in addressing disparities in BSN-prepared nurses in rural and urban areas. The results are needed to inform policymakers and stakeholders who are responsible for addressing the status and needs of nursing education.
Rural-Urban and Racial/Ethnic Trends and Disparities in Early-Onset and Average-Onset Colorectal Cancer
Journal Article
Date: 10/2020
The study's objective was to examine joint rural-urban differences in early onset colorectal cancer and average onset colorectal cancer incidence rates across racial/ethnic groups in the U.S.
Access to Colorectal Cancer Screening Programs for Underserved Populations in South Carolina
Fact Sheet
Date: 08/2020
This fact sheet identifies existing initiatives targeting colorectal cancer screening in rural South Carolina.
Cervical Cancer and HPV Vaccination Disparities in South Carolina
Fact Sheet
Date: 08/2020
This fact sheet identifies existing initiatives targeting cervical cancer prevention and control in rural South Carolina.
Rural and Racial Disparities In Colorectal Cancer Incidence and Mortality In South Carolina 1996 - 2016 (Fact Sheet)
Fact Sheet
Date: 08/2020
This fact sheet examines the burden of colorectal cancer among South Carolina residents by urban-rural status and race/ethnicity.
Development of a National Childhood Obesogenic Environment Index in the United States: Differences by Region and Rurality
Journal Article
Date: 07/2020
This study developed a novel childhood obesogenic environment index and highlighted important regional and rurality differences across U.S. counties.
Expanding Access to HPV Vaccination in South Carolina Through Community Pharmacies: A Geospatial Analysis
Journal Article
Date: 06/2020
Human papillomavirus (HPV) rates are higher in rural areas. The uptake of HPV vaccination is lower among rural populations. Pharmacies may be ideal for improving vaccination access. Does spatial access to pharmacies among adolescents and young adults in South Carolina vary by rurality and geographic access to primary care providers?
Factors Associated With Perceived Job Preparedness Among RNs: Results From a National Survey
Journal Article
Date: 05/2020
This article examines perceived job preparedness by demographic and professional characteristics among practicing registered nurses who completed a national survey. Rural and male nurses felt less prepared for nursing practice and may benefit from tailored educational experiences to improve perceptions of being prepared for the workforce.
Rural-Urban Differences in Educational Attainment Among Registered Nurses: Implications for Achieving an 80% BSN Workforce
Journal Article
Date: 05/2020
Our primary objective was to provide updated information on rural-urban differences in educational attainment. We also examined rural-urban differences in employment type, salary, and demographics among registered nurses in different practice settings.
A Bivariate Mapping Tutorial for Cancer Control Resource Allocation Decisions and Interventions
Journal Article
Date: 01/2020
This study demonstrates how geographic information systems software, specifically ArcGIS, can be used to develop bivariate choropleth maps to inform resource allocation and public health interventions.
Spatial Clustering Patterns and Regional Variations for Food and Physical Activity Environments Across the United States
Journal Article
Date: 01/2020
This study examined spatial patterns of obesogenic environments for U.S. counties. We mapped the geographic dispersion of food and physical activity (PA) environments, assessed spatial clustering, and identified differences across regions and rurality categories. This study highlights geographic clustering and disparities in food and PA access.
Travel Grant Program 2018-2019
Fact Sheet
Date: 01/2020
This project promoted attendance at cancer-related meetings by Rural Health Research Centers by facilitating the dissemination of information regarding important cancer meetings and handling the travel arrangements for Rural Health Research Center personnel.

2019

Rural-Urban Differences in Financial Burden Among Cancer Survivors: An Analysis of a Nationally Representative Survey
Journal Article
Date: 12/2019
Rural cancer survivors may disproportionately experience financial problems due to their cancer because of greater travel costs, higher uninsured/underinsured rates, and other factors. Our objective was to examine rural-urban differences in reported financial problems due to cancer using a nationally representative survey.
Financial Hardship Among Rural Cancer Survivors: An Analysis of the Medical Expenditure Panel Survey
Journal Article
Date: 11/2019
This study examined contrasts in financial hardship among 1,419 rural and urban cancer survivors using the 2011 Medical Expenditure Panel Survey supplement the Effects of Cancer and Its Treatment on Finances.
Geographic Disparities in Residential Proximity to Colorectal and Cervical Cancer Care Providers
Journal Article
Date: 11/2019
Persistent rural‐urban disparities for colorectal and cervical cancers raise concerns regarding access to treatment providers. To the authors knowledge, little is known regarding rural‐urban differences in residential proximity to cancer specialists.
RN-to-BSN Programs: Challenges for Rural Nurse Education
Policy Brief
Date: 10/2019
To ascertain the status of rural-focused nursing education, we surveyed registered nurse to bachelor of science in nursing (RN-to-BSN) programs. Using an American Association of Colleges of Nursing mailing list, surveys were mailed to all schools with RN-to-BSN programs. This report summarizes responses from the 237 that completed surveys.
Rural Registered Nurses: Educational Preparation, Workplace, and Salary
Policy Brief
Date: 10/2019
Using national data from census data from the 2011-2015 American Community Survey Public Use Microdata Sample, this brief looks at the reported education levels and worksites of rural and urban registered nurses.
Multilevel Analysis in Rural Cancer Control: A Conceptual Framework and Methodological Implications
Journal Article
Date: 09/2019
Our objective was two-fold: 1) to develop a multilevel conceptual framework describing how rural residence and relevant micro, macro, and supra-macro factors can be considered in evaluating disparities across the cancer control continuum and 2) to outline the unique considerations of multilevel statistical modeling in rural cancer research.
Challenges of Using Nationally Representative, Population-Based Surveys to Assess Rural Cancer Disparities
Journal Article
Date: 08/2019
Population-based surveys provide important information about cancer-related health behaviors across the cancer care continuum. However, due to small rural sample sizes, varying sampling methods, and/or other study design or analytical concerns, there are challenges in using population-based surveys for rural cancer control research and practice.
Development of a Childhood Obesogenic Environment Index
Policy Brief
Date: 08/2019
The purposes of this study were to describe the development of a childhood obesogenic environment index and examine differences in obesogenic environment index values by rurality and region across the U.S.
Perceived Facilitators and Barriers to Rural Nursing Practice
Policy Brief
Date: 08/2019
A web-based survey was disseminated to a geographically diverse sample of nurses throughout the U.S. to assess perceived barriers and facilitators to nursing practice; job satisfaction; and self-identified challenges in nursing work environments and patient care. Of particular interest were nurses in ambulatory care practices.
Social Determinants of Health Among Rural American Indian and Alaska Native Populations
Policy Brief
Date: 07/2019
This policy brief is the third in a series of four policy briefs prepared by the Rural and Minority Health Research Center on the topic of social determinants of health. In this brief, we document current disparities within the rural American Indian and Alaska Native population.
Social Determinants of Health Among Rural Asian and Pacific Islander Populations
Policy Brief
Date: 07/2019
This policy brief is the fourth in a series of four policy briefs prepared by the Rural and Minority Health Research Center on the topic of social determinants of health. In this brief, we document current disparities within the rural Asian and Pacific Islander population.
Social Determinants of Health Among the Rural African American Population
Policy Brief
Date: 07/2019
This policy brief is the first in a series of four policy briefs prepared by the Rural and Minority Health Research Center on the topic of social determinants of health. It compares the distribution of social determinants among African American and White rural residents using information from the 2016 U.S. Census.
Social Determinants of Health Among the Rural Hispanic Population
Policy Brief
Date: 07/2019
This policy brief is the second in a series of four policy briefs prepared by the Rural and Minority Health Research Center on the topic of social determinants of health. In this brief, we document current disparities within the rural Hispanic population. Gaps are larger for those who were born in the U.S. compared to those born outside the U.S.
Identification of High-Need Rural Counties to Assist in Resource Location Planning
Policy Brief
Date: 05/2019
To identify high-need, low-resource locations, we began by identifying counties that lacked safety-net providers. For the purposes of this analysis, we identified Medicare-certified Rural Health Clinics (RHCs), Federally Qualified Health Centers (FQHCs) and Critical Access Hospitals (CAHs).
Identification of High-Need Rural Counties to Assist in Resource Location Planning for Primary Care
Policy Brief
Date: 05/2019
We examined simultaneously areas with poor health outcomes and limited access to primary care safety net settings. The combination of facility availability with health status indicators may help with identifying those areas in rural America that are in the greatest need of additional primary care resources.

2018

Rural-Urban Differences in Hospital Payer Mix in 2017
Fact Sheet
Date: 11/2018
This work revealed that rural hospitals heavily rely on Medicare.
Differences in Medicare Utilization and Expenditures in the Last Six Months of Life Among Patients With and Without Alzheimer's Disease and Related Disorders
Journal Article
Date: 10/2018
The purpose of this study was to examine differences in utilization of inpatient services and Medicare expenditures (overall and by category) in the last six months of life for patients with, versus those without, a diagnosis of Alzheimer's disease and related disorders.
The Importance of Rural Hospitals: Transfers and 30-day Readmissions Among Rural Residents and Patients Presenting at Rural Hospitals
Journal Article
Date: 07/2018
This study looked at reasons why transfers and readmissions occurred among Medicare patients who first came to rural hospitals.
Medicaid Managed Care and the Rural Exception: A Review of Issues and Perspectives From the Field
Policy Brief
Date: 05/2018
To examine the intersection of state Medicaid procedures with rural populations, we conducted a review of Medicaid waivers current as of September 2017. This was supplemented with calls to State Offices of Rural Health (SORHs), state Medicaid offices, and other relevant stakeholders in an attempt to understand the process of waiver development.
Characteristics of Rural Medicaid Recipients, 2012, 35 States
Policy Brief
Date: 04/2018
The purpose of this brief is to examine the characteristics of Medicaid enrollees prior to Medicaid expansion in 2014, using enrollment and claims data from the Medicaid Analytic Extract Files. This sample allowed for a detailed examination of Medicaid populations in the pre-Medicaid expansion period.
Health Care Utilization Patterns of Rural Medicaid Recipients, 2012, 35 States
Policy Brief
Date: 04/2018
The purpose of this brief is to examine inpatient and other institutional encounters among individuals enrolled in Medicaid prior to expansion in 2014, using enrollment and claims data from the Medicaid Analytic eXtract Files. All Medicaid-covered individuals, institutionalized and living in the community, are included.
Rural-Urban Differences in Costs of End-of-Life Care for the Last 6 Months of Life Among Patients With Breast, Lung, or Colorectal Cancer
Journal Article
Date: 04/2018
Our findings indicate that Medicare expenditures are lower for rural beneficiaries with each type of cancer than urban beneficiaries, even after adjusting for age, gender, race, dual eligibility, region, chronic conditions, and type of service utilization.

2017

ESRD Facility Characteristics by Rurality and Risk of Closure
Report
Date: 11/2017
This study's purpose was to profile rural end stage renal disease (ESRD) facilities, focusing on those at greatest risk for closure. We examined the characteristics of these facilities, the quality of care provided, and the distance patients in rural areas would have to travel if the facilities closed.
Gender and Geographic Differences in Medicare Service Utilization During the Last Six Months of Life
Journal Article
Date: 11/2017
End-of-life issues are important for senior women, particularly rural women, who are more likely than their urban counterparts to live alone. The role of residence has yet to be investigated. The purpose of this study is to examine whether service utilization in the last six months of life differs across gender and rurality.
Supply-Side Differences Only Modestly Associated With Inpatient Hospitalizations Among Medicare Beneficiaries in the Last Six Months of Life
Journal Article
Date: 11/2017
This study examined rural and urban Medicare beneficiaries and inpatient hospitalizations during their last six months of life. The study concluded that care at the end of life is much the same for rural and urban Medicare decedents.
Who Performs Colonoscopy? Workforce Trends Over Space and Time
Journal Article
Date: 11/2017
Using data from South Carolina from 2001-2010, this study looked at changes in the types of facilities doing colonoscopies as well as the any changes in who is performing them.
Chartbook: Trends in Rural Children's Oral Health and Access to Care
Chartbook
Date: 08/2017
Assessing progress at improving children's oral health requires examining trends to see whether rural disparities, if present, are being reduced. Our report uses data from the National Survey of Children's Health (2003, 2007, and 2011- 2012) to assess progress in access to oral health care, and perceived status of teeth among rural children.
Differences in Medicare Service Use in the Last Six Months of Life Among Rural and Urban Dual – Eligible Beneficiaries
Report
Date: 08/2017
In this brief, we compare rural and urban dual-eligible beneficiaries to Medicare-only beneficiaries in their service utilization in the last six months of life. Within rural beneficiaries, we further explore differences associated with race/ethnicity.
Improving Rural Oral Health: Six States' Response to the United States Department of Health and Human Services Oral Health Strategic Framework
Policy Brief
Date: 08/2017
The U.S. Public Health Service Oral Health Coordinating Committee published the Oral Health Strategic Framework 2014-2017. The framework includes 5 goals for advancing oral health in America. We explore how 6 states have responded to the Strategic Framework; specifically, how they address oral health inter-professional practice, and access to care.
Rural-Urban Differences in Medicare Service Use in the Last Six Months of Life
Report
Date: 08/2017
This brief focuses on the current status of healthcare use during the last six months of life among Medicare beneficiaries. We used data from a sample of Medicare beneficiary claims to assess whether service utilization differed between rural and urban decedents and across decedents of different race/ethnicity categories.
Transitions in Care Among Rural Residents With Congestive Heart Failure, Acute Myocardial Infarction, and Pneumonia
Report
Date: 08/2017
Rural and urban hospitals vary with regard to the levels of care they are able to provide, requiring that a subset of patients be transferred from the first point of encounter to a second facility. The degree to which inter-hospital transfers occur, and the outcomes for transfer patients, have not been studied across rural and urban institutions.
Trends in Rural Children's Health and Access to Care
Chartbook
Date: 01/2017
The past ten years have seen positive trends in the availability of health insurance coverage for children. This project examines data from three iterations of the National Survey of Children's Health to see if rural children have benefited equally from any improvements in health insurance, healthcare use, and health status.

2016

Health-Related Quality of Life Among Adults 65 Years and Older in the United States, 2011-2012: A Multilevel Small Area Estimation Approach
Journal Article
Date: 10/2016
This study compiled estimates, at the county level, of poor health-related quality of life among those ages 65 and older. The study examined physical and mental health and found significant differences in health across the United States.
Current State of Child Health in Rural America: How Context Shapes Children's Health
Journal Article
Date: 09/2016
Provides an essay on the status of children in rural America that focuses on the rural environment that may affect health.
Colonoscopy Access and Utilization – Rural Disparities in the Carolinas, 2001-2010
Policy Brief
Date: 07/2016
This study aims to use data on where patients travel for their colonoscopies to determine the extent to which access is changing over space and time, and to better understand utilization patterns among rural residents of North and South Carolina between 2001 and 2010.
Looking Ahead: Rural-Urban Differences in Anticipated Need for Aging-Related Assistance
Policy Brief
Date: 07/2016
Rural older adults with a disability can anticipate a longer lifespan than urban adults. Rural areas tend to be served by fewer providers of home health services. This brief describes the degree to which rural and urban pre-retirement age adults, persons ages 40-64, anticipate the need for assistance later in life and where they obtain such help.
Vulnerable Rural Counties: The Changing Landscape, 2000-2010
Policy Brief
Date: 07/2016
This brief illustrates the distribution of rural vulnerable populations and the challenges they face. Understanding the demography of rural America is vital to understanding what programs, interventions and policy initiatives are needed to improve healthcare access, delivery and outcomes.
Ambulatory Care-Sensitive Condition Hospitalizations Among Medicare Beneficiaries
Journal Article
Date: 06/2016
Examines the relationship between the distribution of primary care physicians and Medicare beneficiaries' ambulatory care-sensitive condition hospitalizations using statistical and spatial analyses.
Geographic Disparities in Mortality Among the End Stage Renal Disease Patients: An Analysis of the United States Renal Data System, 2007-08.
Journal Article
Date: 06/2016
Explores the association between morality, rurality, and distance from the treatment facility of patients with end-stage renal disease (ESRD). Rural patients were found to have a mortality advantage.
Disparities in Home Health Service Providers Among Medicare Beneficiaries with Stroke
Journal Article
Date: 01/2016
Examines the intensity of home health services, by the number of visits and service delivery by rehabilitation specialists, among Medicare beneficiates with stroke. There were no significant rural-urban differences in the number of home health visits, but rural residents were less likely to receive services from rehabilitation specialists.

2015

Obesity and Obesity-Related Behaviors Among Rural and Urban Adults in the United States
Journal Article
Date: 10/2015
Examines the differences in obesity-related behaviors across rural and urban adult populations in the United States. Data from the 1999 - 2006 National health and Nutrition Examination Survey was used.
Rural Area Deprivation and Hospitalizations Among Children for Ambulatory Care Sensitive Conditions
Journal Article
Date: 10/2015
Evaluates inpatient hospitalizations among children in nine states to determine the effect of rurality and social/economic advantage on health outcomes and health disparities.
Free Clinics in the Rural Safety Net, 2014
Policy Brief
Date: 09/2015
This brief explores two issues. First, it examines where free clinics are located and describes their availability in rural counties across all 50 states. Second, through telephone interviews with leadership at 14 of the 21 state free clinic associations, it explores the issues they face.
Post-Discharge Rehabilitation Care Delivery for Rural Medicare Beneficiaries With Stroke
Policy Brief
Date: 09/2015
Provision/type of post-discharge rehab care (PDRC) received by stroke survivors by rurality and race/ethnicity are examined as are the distances between their homes and the discharge hospitals related to the type of PDRC recommended. The brief also looks at whether factors such as initial hospital admission relate to the PDRC provision/type.
Area Deprivation Is Higher Among Rural Counties - But Not All Rural Counties Are Deprived
Policy Brief
Date: 08/2015
This brief is one of two on the role of residence/community deprivation on potentially avoidable hospitalizations (PAH) of children. It details development of an area deprivation index, examines area deprivation across all U.S. counties, and describes findings when applied to rates of PAH among a nine-state sample of children.
The Intersection of Residence and Area Deprivation: The Case of Hospitalizations From Ambulatory Care Sensitive Conditions Among Children
Policy Brief
Date: 08/2015
This brief is the second in a series providing information on the role of residence and community deprivation on potentially avoidable hospitalizations among children. This brief describes the findings from a nine-state sample of children's hospitalizations and discusses the potential implications for rural health research and policy.
Thirty-Day Readmission Rates Among Dual-Eligible Beneficiaries
Journal Article
Date: 08/2015
Examines readmission rates and factors affecting readmission of patients eligible for both Medicare and Medicaid (dual-eligibility).
Poorer Quality Outcomes of Medicare-Certified Home Health Care in Areas With High Levels of Native American/Alaska Native Residents
Journal Article
Date: 04/2015
Examines CMS quality indicators in home healthcare to determine disparities in rural areas with high population of Native American or Alaska Natives.

2014

Characteristics, Utilization Patterns, and Expenditures of Rural Dual Eligible Medicare Beneficiaries
Policy Brief
Date: 11/2014
This study analyzes the rural-urban differences regarding dual eligible beneficiaries and their races, regions of residence, patterns of utilizing health services, and Medicare expenditures.
Intensity of Service Provision for Medicare Beneficiaries Utilizing Home Health Services: A Closer Look at Cerebrovascular Disease, Diabetes, and Joint Replacement
Report
Date: 11/2014
This report details the impact of home health services provided to the rural elderly receiving Medicare by the number of visits, the use of rehabilitation specialists, and the median payment per each claim.
Differences in Case-Mix Between Rural and Urban Recipients of Home Health Care
Report
Date: 10/2014
This report provides a description of the health status and service needs of rural and urban Medicare home health patients based on professional assessments of their conditions at the start of care.
Rural Border Health Chartbook II
Chartbook
Date: 10/2014
This chartbook presents an analysis of border counties, urban and rural, by comparing them to other counties within the four border states and to rural and urban counties in the rest of the county. It details county-level rates and statistics for socio-demographic factors, the physical environment, access to care, and health outcomes.
Home Health Care Agency Availability in Rural Counties
Report
Date: 06/2014
This report looks at home healthcare, including availability and service quality, in the United States and in rural counties. Findings include that counties at risk for limited service availability were almost all rural. Of the 34 counties lacking home health agencies, 30 were rural. Of the 120 counties served by single agencies, 118 were rural.

2013

Diffusion of Preventive Innovation: Racial and Rural Differences in Cervical Cancer Prevention and Control Practices
Date: 05/2013
This report examines differences associated with residence and race/ethnicity in receipt of cervical cancer screening and HPV vaccination.
Dental Sealant Utilization Among Rural and Urban Children
Date: 03/2013
This report examines the proportion of rural children who have received dental sealants applied to the surface of their teeth to prevent or delay the development of dental decay.
Dialysis Availability in Rural America
Date: 01/2013
This study explores the availability of dialysis services in rural America, including the prevalence of dialysis use across urban and rural counties, travel distance for services, and dialysis quality outcomes.
HIV/AIDS in Rural America (Key Facts)
Date: 01/2013
This report describes the proportion of the population affected by HIV/AIDS.
HIV/AIDS in Rural America: Prevalence and Service Availability
Date: 01/2013
This report examines the prevalence of HIV/AIDS in rural counties across 28 states in 2008 and the rural-versus-urban distribution of Ryan White providers.
Rural Border Health Chartbook
Date: 01/2013
The chartbook examines potential geographic and ethnic disparities among U.S. border residents and describes select indicators related to access to care, women's preventive services, oral health, infectious and communicable diseases, and mental health that have been identified as disparities.
Rural Border Health Chartbook (Key Facts)
Date: 01/2013
This report examines potential geographic and ethnic disparities among U.S. border residents and describes select indicators related to access to care, women's preventive services, oral health, infectious and communicable diseases, and mental health that have been identified as disparities.
Rural Population Estimates: An Analysis of a Large Secondary Data Set
Journal Article
Date: 2013
Examines in the underrepresentation of rural counties in large secondary data sources, specifically the Behavioral Risk Factor Surveillance System (BRFSS).

2012

State Policy Levers for Addressing Preventive Dental Care Disparities for Rural Children: Medicaid Reimbursement to Non-Dental Clinicians for Fluoride Varnish and Dental Hygiene Supervision in Primary Care Safety Net Settings (Full Report)
Date: 03/2012
This report addresses preventive dental care disparities for rural children by studying access to fluoride varnish applications and the extent that dental hygienists can provide select preventive dental services in primary care safety net settings.
State Policy Levers for Addressing Preventive Dental Care Disparities for Rural Children: Medicaid Reimbursement to Non-Dental Clinicians for Fluoride Varnish and Dental Hygiene Supervision in Primary Care Safety Net Settings (Key Facts)
Date: 03/2012
This report provides keys facts regarding preventive dental care disparities for rural children.
Lower Rehospitalization Rates Among Rural Medicare Beneficiaries With Diabetes
Journal Article
Date: 2012
Evaluates 30-day readmission rates of Medicare beneficiaries with diabetes in rural areas.
Missing the Handoff: Post-Hospitalization Follow-up Care Among Rural Medicare Beneficiaries With Diabetes
Journal Article
Date: 2012
Analyzes urban and rural differences in post-discharge physician follow-up care using data from 2005 Medicare claims files.

2011

Handling the Handoff: Rural and Race-Based Disparities in Post-Hospitalization Follow-Up Care Among Medicare Beneficiaries With Diabetes
Fact Sheet
Date: 10/2011
This fact sheet uses information regarding Medicare beneficiaries with diabetes to examine the provision of care in rural America.
Higher Risk of Death in Rural Blacks and Whites Than Urbanites Is Related to Lower Incomes, Education, and Health Coverage
Journal Article
Date: 10/2011
Explores the degree to which lack of health insurance may contribute to high mortality rates among rural minority men and women aged 45-64.
Handling the Handoff: Rural and Race-Based Disparities in Post Hospitalization Follow-Up Care Among Medicare Beneficiaries With Diabetes
Date: 09/2011
This report uses information regarding Medicare beneficiaries with diabetes to examine the provision of care in rural America.

2010

Diet, Physical Activity, and Sedentary Behaviors as Risk Factors for Childhood Obesity: An Urban and Rural Comparison (Final Report)
Date: 11/2010
Nearly 20% of the U.S. population resides in non-metropolitan areas, yet our knowledge about the prevalence of obesity in rural America is limited. Previous research found that rural children, paradoxically, were more likely to be overweight or obese and more likely to be physically active than urban children.
Is Your Hospital's Board Prepared to Govern? Rural Acute Care Hospital Boards Of Directors: Education and Development Needed
Date: 06/2010
This report examines the structural, leadership, and educational needs of rural hospital boards as viewed by rural hospital board chairs and CEOs.
Diet, Physical Activity, and Sedentary Behaviors as Risk Factors for Childhood Obesity: An Urban and Rural Comparison (Fact Sheet)
Date: 2010
This fact sheet reports that the prevalence of those who are overweight and obese is higher among rural children than their urban counterparts.
Rural Acute Care Hospital Boards Of Directors: CAHs Lag in Oversight (Fact Sheet)
Date: 2010
As small and rural hospitals face changes in finance, reimbursement, quality of care, and workforce shortages, strong governance is essential. Our study explored the structural, leadership, and educational needs of rural hospital boards through a survey of board chairs and CEOs at critical access and prospective payment system hospitals.

2009

Community Health Center and Rural Health Clinic Presence Associated With Lower County-Level Hospitalization Rates for Ambulatory Care Sensitive Conditions (Fact Sheet)
Date: 08/2009
This study examines the contribution that community health centers and rural health clinics make to access to healthcare, as measured by rates of ambulatory care sensitive hospitalizations.
Community Health Center and Rural Health Clinic Presence Associated With Lower County-Level Hospitalization Rates for Ambulatory Care Sensitive Conditions (Full Report)
Date: 08/2009
Using data from eight states, this report examines the effect of the presence of a federally qualified community health center or rural health clinic within a county on population rates of hospitalization for ambulatory care sensitive conditions.
Rural Residents Lag in Preventive Services Use; Lag Increases With Service Complexity
Date: 06/2009
This research brief describes the receipt of preventive services among rural adults and explores the factors that are related to disparities in utilization.

2008

Health Disparities: A Rural-Urban Chartbook (Fact Sheet)
Date: 12/2008
This fact sheet expands the work of the National Healthcare Disparities Reports, issued annually by the Agency for Healthcare Research and Quality, by examining potential disparities among rural populations in health, health behaviors, preventive services, and diabetes care.
Health Disparities: A Rural-Urban Chartbook (Full Report)
Date: 06/2008
This chartbook expands the work of the National Healthcare Disparities Reports, issued annually by the Agency for Healthcare Research and Quality, by examining potential disparities among rural populations in health, health behaviors, preventive services, and diabetes care.
Chartbook: Dental Health and Access to Care Among Rural Children: A National and State Portrait (Full Report)
Date: 03/2008
This chartbook examines dental health status, use of preventive services, and dental insurance among rural and urban children. It provides information specific to rural children, and in particular rural minority children, not available in similar detail from other sources.

2007

Use of Preventive Services Among Hispanic Sub-Groups: Does One Size Fit All?
Date: 07/2007
This executive summary includes results from the exploration of the use of preventive health services among Mexicans, Puerto-Ricans, Cubans, and other Latinos and examined how the use of preventive services was influenced by nation of origin and by rural versus urban residence.
Overweight and Physical Inactivity Among Rural Children Aged 10-17: A National and State Portrait
Date: 05/2007
This report examines the issues of obesity and being overweight among children in rural and urban settings using the data from the 2003 National Survey of Children's Health.
Mode of Travel and Actual Distance Traveled For Medical or Dental Care By Rural and Urban Residents (Fact Sheet)
Fact Sheet
Date: 2007
This fact sheet addresses the cost and difficulty associated with travel for medical or dental care.
Overweight and Physical Inactivity Among Rural Children Aged 10-17: A National and State Portrait (Fact Sheet)
Fact Sheet
Date: 2007
This fact sheet offers a brief overview on the issues of obesity and being overweight, physical activity, and weight-related behaviors among rural and urban children.
Use of Preventive Services Among Hispanic Sub-Groups: Does One Size Fit All? (Fact Sheet)
Fact Sheet
Date: 2007
This fact sheet provides key facts on preventive health services provided to rural Hispanics.

2006

Rural-Urban Differences in Depression Prevalence: Implications for Family Medicine
Journal Article
Date: 10/2006
Examined the prevalence of depression in rural vs. urban areas. An estimated 2.6 million rural adults suffer from depression. The unadjusted prevalence of depression was significantly higher among rural than urban populations. After adjusting for rural/urban population characteristics, the odds of depression did not differ by residence.
Mode of Travel and Actual Distance Traveled For Medical or Dental Care By Rural and Urban Residents
Date: 05/2006
This report discusses the cost and difficulty associated with travel for medical or dental care, which may serve as a barrier for rural populations.
Expected Annual Emergency Miles per Ambulance: An Indicator for Measuring Availability of Emergency Medical Services Resources
Journal Article
Date: 04/2006
Proposes a county-level indicator of emergency medical services (EMS) resource availability that takes into consideration existing EMS resources, population health and demographics, and geographic factors. The indicator, the expected annual emergency miles per ambulance, provides a basis for comparing ambulance availability across counties.
Racial and Ethnic Disparities in Potentially Avoidable Delivery Complications Among Pregnant Medicaid Beneficiaries in South Carolina
Journal Article
Date: 2006
Within groups defined by race or ethnicity, unadjusted rates for potentially avoidable maternity complications did not differ significantly by hospital location. Potentially avoidable maternity complications in rural hospitals, African Americans had higher risk for complications than did non-Hispanic whites.
Rural Residence and Hispanic Ethnicity: Doubly Disadvantaged for Diabetes?
Journal Article
Date: 2006
Determines whether living in a rural area and being Hispanic confers special risks for diagnosis and control of diabetes.

2005

Barriers Associated With the Delivery of Medicare Reimbursed Diabetes Self-Management Education
Journal Article
Date: 11/2005
Explores the barriers that practitioners face in providing diabetes self-management education to Medicare beneficiaries. Barriers identified for rural providers include costs, the shortage of designated specialists, fewer resources, amount of Medicare reimbursement, transportation and more.
Early Alcohol Use, Rural Residence, and Adulthood Employment
Date: 10/2005
Findings indicate that drinking during youth and early adulthood was common in the early 1980s. Nearly half of respondents reported drinking before age 18, and 55.3% reported binge drinking. Drinking behaviors did not differ significantly between rural and urban residents.
Rural Hospitals and Spanish Speaking Patients With Limited English Proficiency
Date: 10/2005
This report details that 40 million Latinos in the United States, 14.2% of the population, have limited English proficiency, which can lead to poor health outcomes in the absence of effective medical interpretation or translation services.
Trends in Uninsurance Among Rural Minority Children
Date: 10/2005
Using 21 years of data from the National Health Interview Survey to explore trends in health insurance and health services utilization for children between 1980 and 2001, the authors found that rural children have been consistently less likely to have insurance than urban children, and minority status adds to the disparity.
Disability Burdens Among Older Americans Associated With Gender and Race/Ethnicity in Rural and Urban Areas
Date: 09/2005
No prior research has investigated differences in disability-free and disabled life expectancy associated with rural or urban residence. This report addresses this gap and identifies differences in healthy life expectancy that may signal important policy needs.
Effects of Uninsurance During the Preceding 10 Years on Health Status Among Rural Working Age Adults
Date: 09/2005
In a population just reaching age 40, continuous health insurance coverage in the preceding 8 to 10 years was not associated with better self-perceived health than interrupted coverage. However, continuous insurance coverage was significantly related to better mental health.
Mental Health Risk Factors, Unmet Needs, and Provider Availability for Rural Children
Date: 09/2005
This study used the 2001 National Health Interview Survey to assess the prevalence of sub-clinical mental health problems among children, the degree to which children with potential problems use mental health and general providers for these problems, and the degree of unmet need.
Poverty, Stress, and Violent Disagreements in the Home Among Rural Families
Date: 08/2005
This study used information from a large, nationally representative telephone survey of households with children, carried out by the National Center for Health Statistics, to explore the prevalence of violent disagreements in the home.
Depression in Rural Populations: Prevalence, Effects on Life Quality, and Treatment-Seeking Behavior
Date: 05/2005
The authors found the prevalence of major depression was higher among rural than among urban populations. Nearly all individuals scoring positive for depression reported their symptoms interfered with their life/activities. Persons without health insurance were less likely to have talked with a physician than were the privately/publicly insured.
Violence and Rural Teens: Teen Violence, Drug Use, and School-Based Prevention Services in Rural America
Date: 03/2005
This report describes a study to explore the prevalence of violence-related exposures and drug use among rural teens, to investigate the effects of race and gender on the risk of exposure to violence and drug use, and to compare the policies and mental healthcare services of rural and urban schools.
Delivery Complications Associated With Prenatal Care Access for Medicaid-Insured Mothers in Rural and Urban Hospitals
Journal Article
Date: 2005
Examined access to healthcare during pregnancy for mothers insured by Medicaid as well as the risks of potentially avoidable maternity complications among rural and urban hospital deliveries for groups of mothers defined by race or ethnicity.
Depression in Rural Populations: Prevalence, Effects on Life Quality, and Treatment-Seeking Behavior (Fact Sheet)
Fact Sheet
Date: 2005
To explore the prevalence of selected mental health diagnoses across rural populations, including rural minority residents, they studied information obtained by the 1999 National Health Interview Survey, a nationally representative survey of more than 30,000 adults.
Disability Burdens Among Older Americans in Rural and Urban Area
Fact Sheet
Date: 2005
This fact sheet examines differences in disability-free and disabled life expectancy among rural or urban residents, using an indicator called "health expectancy."
Effects of Uninsurance During the Preceding 10 Years on Health Status Among Rural Working Age Adults (Fact Sheet)
Fact Sheet
Date: 2005
The National Longitudinal Survey of Youth was used to examine the effects of gaps in health insurance coverage on how individuals rate their physical and mental health.
Mental Health Risk Factors, Unmet Needs, and Provider Availability for Rural Children (Fact Sheet)
Fact Sheet
Date: 2005
Children in rural areas have fewer mental health resources available. To assess the need for services among rural children, they studied information from the 2001 National Health Interview Survey. Possible mental health problems were identified based on the Strengths and Difficulties Questionnaire.
More May Be Better: Evidence of a Negative Relationship Between Physician Supply and Hospitalization for Ambulatory Care Sensitive Conditions
Journal Article
Date: 2005
The authors conducted an empirical test of the relationship between physician supply and hospitalization for ambulatory care sensitive conditions.
Recruitment and Retention of EMTs: A Qualitative Study
Journal Article
Date: 2005
Emergency medical technicians (EMTs) are critical to out-of-hospital care, but maintaining staff can be difficult. The study objective was to identify factors that contribute to recruitment and retention of EMTs and paramedics.
Rural Hospitals and Spanish Speaking Patients With Limited English Proficiency (Fact Sheet)
Fact Sheet
Date: 2005
This fact sheet offers a brief overview of findings from a study of how rural hospitals are meeting the needs of patients with limited English proficiency.
Trends in Uninsurance Among Rural Minority Children (Fact Sheet)
Fact Sheet
Date: 2005
This fact sheet describes childhood disparities found in health insurance, healthcare utilization, and factors related to acquiring health insurance.
Update: Health Insurance and Utilization of Care Among Rural Adolescents
Journal Article
Date: 2005
Using data from the 1999-2000 National Health Interview Survey, it was found that across races, rural adolescents were as likely to have insurance but less likely to report a preventive visit than urban children; residence did not affect the likelihood of a visit or a usual source of care.
Violence and Rural Teens: Teen Violence, Drug Use, and School-Based Prevention Services in Rural America (Fact Sheet)
Fact Sheet
Date: 2005
This fact sheet covers the key findings from a study of violence and drug use among rural teens.

2004

Impact of Medicaid Managed Care, Race/Ethnicity, and Rural/Urban Residence on Potentially Avoidable Maternity Complications: A Five-State Multi-Level Analysis
Date: 12/2004
This study examines pregnancy-related complications using Potentially Avoidable Maternity Complications as an indicator of access.
Assessment of Barriers to the Delivery of Medicare Reimbursed Diabetes Self-Management Education in Rural Areas
Date: 09/2004
This report explores the barriers that rural practitioners face in providing diabetes education services to Medicare beneficiaries.
Investigating Rural EMS Infrastructure: A Developmental Methodology for Measuring the Availability of EMS Resources
Date: 08/2004
This report explores a potential indicator of emergency medical services availability, the Expected Annual Emergency Miles per Ambulance (EXAMB). The EXAMB measure calculates expected annual emergency miles per ambulance beginning with the number of ambulances, the land area of a county as a proxy for distance, and county population.
Development of a Methodology for Assessing the Effect of a Lay Home Visitation Program for Rural High-Risk Women and Infants
Date: 02/2004
This pilot study successfully demonstrated that a retrospective, population-based, comparative design is a feasible method for evaluating the effectiveness of a community health worker program for women at risk for poor pregnancy and birth outcomes.
Assessing the Effect of a Lay Home Visitation Program for Rural High-Risk Women and Infants
Date: 2004
This study tested a retrospective data set approach for evaluating the effectiveness of a community health worker program to improve pregnancy and birth outcomes. The program uses lay health workers to provide health education, referral, and social support to rural, low income, Medicaid-insured pregnant African-American women and their infants.
Barriers to the Delivery of Medicare Reimbursed Diabetes Self-Management Education in Rural Areas
Fact Sheet
Date: 2004
Diabetes Self-Management Education programs help newly diagnosed and chronic patients with diabetes learn to manage their care. This project explored the barriers that rural practitioners face in providing diabetes education to Medicare beneficiaries.
Diabetes & Hypertension Among Rural Hispanics
Fact Sheet
Date: 2004
This fact sheet describes rates of diabetes and hypertension among rural Hispanics.
Diabetes & Hypertension Among Rural Hispanics: Disparities in Diagnostics and Disease Management
Date: 2004
Modest health disparities were found among rural Hispanics when examining diabetes. Undiagnosed hypertension was higher for rural residents than for urban residents. A large proportion of persons diagnosed with either disease had poor control of their condition, as indicated by elevated glucose levels or high blood pressure.
Effects of Medicaid Managed Care and Medicaid Managed Care Penetration on Potentially Avoidable Maternity Complications
Fact Sheet
Date: 2004
The effects of Medicaid Managed Care on pregnancy-related complications affecting mothers during their delivery hospitalizations were examined using the Potentially Avoidable Maternity Complications indicator.
Emergency Department Use by Medically Indigent Rural Residents (Fact Sheet)
Fact Sheet
Date: 2004
An estimated 211 million emergency department visits were made across the United States during 1999-2000, 37 visits per 100 persons per year. Just under a quarter of these, 43 million visits, were made to rural emergency departments.
Rural Emergency Medical Service (EMS) Infrastructure
Fact Sheet
Date: 2004
Prehospital care has become an important element in the spectrum of health services. Approaches for comparing the availability of emergency medical services across communities are a first step in developing policies that ensure equitable access for rural and frontier communities.
Rural Minority Children's Access to and Timeliness of Immunizations
Fact Sheet
Date: 2004
This fact sheet examined whether rural children ages 3-71 months are keeping up with urban children in the receipt of needed vaccinations.

2003

Rural Minority Children's Access to and Timeliness of Immunizations: 1993-2001
Date: 11/2003
The purpose of this study is to assess the quality of pediatric healthcare provided to rural minorities using timeliness of immunization receipt as a marker for quality.
Prevalence of Health Related Behavioral Risk Factors Among Non-Metro Minority Adults
Date: 08/2003
Data is shared on tobacco use, seat belt use, and alcohol consumption among rural minority adults. It includes recommendations and detailed data tables.
Emergency Department Use by Medically Indigent Rural Residents
Date: 07/2003
This report examined emergency department (ED) use, combining national data and South Carolina state data to estimate the uncompensated charges in rural EDs nationally and the ameliorating effects of rural community health centers on ED use by rural residents.
Hospitalization for Ambulatory Care Sensitive Conditions: Asthma, Diabetes, and Congestive Heart Failure in South Carolina
Date: 05/2003
Hospitalization rates for ambulatory care sensitive conditions, diseases for which primary care in the preceding six months could have reduced or eliminated the need for hospitalization, are a commonly used indicator of disparities in access to care.
Diabetes and Cardiovascular Disease Among Rural African Americans
Date: 02/2003
This report investigates the association of race and rural residence on rates of diagnosis of diabetes and cardiovascular disease and indicators of good medical control among people with diabetes, hypertension, and cardiovascular disease.
Access to Care Among Rural Minorities: Working Age Adults
Date: 01/2003
This report examines the prevalence of health insurance and the use of physician services in rural areas.
Access to Care Among Rural Minorities: Working Age Adults (Appendix - Methods, Data, and Detailed Tables)
Date: 01/2003
This is an appendix of a report on health status and health services use among poor and minority working-age adults in non-metro areas.
Behavioral Risk Factors Among Rural African Americans
Fact Sheet
Date: 2003
This fact sheet discusses seat belt use, tobacco use, and alcohol use among rural African Americans.
Behavioral Risk Factors Among Rural Hispanics
Fact Sheet
Date: 2003
This fact sheet discusses seat belt use, tobacco use, and alcohol use among rural Hispanics.
Demand for Medical Services Among Previously Uninsured Children: The Roles of Race and Rurality
Fact Sheet
Date: 2003
This fact sheet examines the use of medical services over nearly two years among newly insured and continuously insured children, ages 6 through 12, in the CHIP and Medicaid programs in South Carolina and West Virginia.
Diabetes and Cardiovascular Disease in Rural African Americans
Fact Sheet
Date: 2003
Previous research has indicated that persons living in rural areas are more vulnerable to poor health than those living in urban areas. Minorities in particular are more vulnerable to poor health than non-minorities.
Diagnostic Risk Factors & Improvement Activities Among Rural African Americans
Fact Sheet
Date: 2003
This fact sheet discusses disease management among rural African Americans.
Diagnostic Risk Factors & Improvement Activities Among Rural Hispanics
Fact Sheet
Date: 2003
This fact sheet discusses disease management among rural Hispanics.
Hospitalization for Ambulatory Care Sensitive Conditions: Congestive Heart Failure, Diabetes and Asthma in South Carolina
Fact Sheet
Date: 2003
This fact sheet gives a brief overview of findings from a study of hospitalizations in South Carolina for ambulatory care sensitive conditions.
Rural Minority Children
Fact Sheet
Date: 2003
This fact sheet provides data on rural minority children's health insurance coverage, healthcare use, poverty, and education.
Rural Minority Elders
Fact Sheet
Date: 2003
This fact sheet provides data on health status, health insurance coverage, education, and income of rural elders.
Rural Minority Working Age Adults
Fact Sheet
Date: 2003
Holding demographic considerations equal, rural residents are less likely to report having health insurance than urban residents. African Americans, Hispanics, and persons of other races are all less likely to be insured than whites. The factors placing rural minorities at risk for lacking insurance include low income and low education.

2002

Hypertension, Diabetes, Cholesterol, Weight, and Weight Control Activities Among Non-Metro Minority Adults
Date: 12/2002
This report uses data from the 1998 National Health Interview Survey to examine the prevalence of selected problems among rural populations, with an emphasis on rural minorities.
Access to Care Among Rural Minorities: Children
Date: 11/2002
This report profiles the characteristics of non-metro children, their health insurance coverage, and their healthcare visits.
Access to Care Among Rural Minorities: Children (Appendix - Methods, Data Sources, and Detailed Tables)
Date: 11/2002
This is the appendix of a report on rural minority children and the factors affecting their health insurance coverage and health services use.
Access to Care Among Rural Minorities: Older Adults
Date: 10/2002
This report profiles the health status of, and use of physicians by, non-metro older adults.
Access to Care Among Rural Minorities: Older Adults (Appendix - Methods, Data, and Detailed Tables)
Date: 10/2002
This is the appendix of a report on health status and health services use among poor and minority older adults in non-metro areas.
Demand for Medical Services Among Previously Uninsured Children: The Roles of Race and Rurality (Report)
Date: 10/2002
This report examined the use of medical services over nearly two years among newly insured and continuously insured children, ages 6 through 12, in the CHIP and Medicaid programs in West Virginia and South Carolina.
Minorities in Rural America: An Overview of Population Characteristics
Date: 01/2002
This report presents an overview of demographic and economic statistics pertaining to rural minority populations.
Minorities in Rural America: Appendix A Description of Method and Supporting Tables Tables Ordered by Chapter
Date: 2002
This is the appendix of a report that gives an overview of demographic and economic statistics pertaining to rural minority populations.
Minorities in Rural America: Appendix B Map Supplement
Date: 2002
This appendix to a report on an overview of demographic and economic statistics pertaining to rural minority populations includes maps.
Minorities in Rural America: Appendix C Economic Patterns in Non-Metro America
Date: 2002
This appendix to a report on an overview of demographic and economic statistics pertaining to rural minority populations focuses on economic status and health services infrastructure.

2001

Development of a Research Agenda on the Issues of Access to Care and Reduction of Health Status Disparities of Rural African Americans in South Carolina
Date: 01/2001
This report explores disparities in health among rural African Americans and rural white South Carolina residents.