University of South Carolina Rural Health Research Center
Research Products & Journal Articles
Browse the full list of research publications from this Rural Health Research Center.
Products – Freely accessible products include policy briefs, fact sheets, full reports, chartbooks, and interactive data websites.
Journal Articles – Articles in peer-reviewed journals may require a subscription or affiliation with a subscribing library. For these publications, Gateway lists the article citation, a brief summary, a link to additional information and access to the full-text of the article, if available.
2024
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Geographic Disparities in Availability of Hospital-Based Cardiac Services Across the United States
Journal Article
Date: 12/2024
This project examined geographic disparities in the availability of essential cardiac care in counties across the United States. -
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
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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. -
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 .
2022
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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. -
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. -
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. -
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.
2021
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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. -
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. -
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.
2020
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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. -
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.
2019
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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. -
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.
2018
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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.
2017
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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.
2016
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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. -
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
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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. -
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).
2013
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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
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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.
2006
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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. -
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.
2005
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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. -
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.