The development of a rural-focused tool is needed to help policy makers identify specific under-resourced communities or those in high need of specific public health intervention. This project's purpose is to develop a resource to identify urban and rural high-need counties in the areas of:

• Health care infrastructure/workforce
• Burden of chronic disease
• Socioeconomic environment

Previous work from the Rural and Minority Health Research Center (RMHRC) titled “Identification of High-Need Rural Counties to Assist in Resource Location Planning” has served as a tool for policy makers to identify rural areas with a high need for safety net providers. This project will update the previous work by the RMHRC. The previous analysis will be updated with current data and will include a newly created metric that will allow for the inclusion of each of the nations' approximately 1,975 rural counties rather than the 174 counties that were the focus of the previous report.

Using county-level urban influence codes (UIC), we will limit our analysis to only those counties classified as rural (UIC = 3-12). All datasets will be linked together using county Federal Information Processing System (FIPS) codes to create one large datafile. Counties will be examined in three core areas:

• Health care workforce (number of providers in primary care, obstetrics, cardiology, and dentistry)
• Chronic disease prevalence and mortality (diabetes, obesity, high blood pressure, high cholesterol, chronic kidney disease)
• Socioeconomic environment (unemployment, uninsured, no college education, median household income)

This will allow researchers to examine the variation across all counties. Choropleth maps in ArcGIS will also be made to visualize where counties with the most needs are located and potentially if there are specific geographic clusters across the country.