Alva Ferdinand, DrPH, JD

Director, Southwest Rural Health Research Center

Phone: 979.436.9434
Fax: 979.436.9598
Email: aferdinand@tamu.edu

Texas A&M University
212 Adriance Lab Rd.
1266 TAMU
College Station, TX 77843-1266


Current Projects - (11)

  • "Older, Sicker, Poorer": A Scoping Review of the Literature That Contributes to This Narrative on Rural Americans
    The investigators will conduct a scoping review of peer-reviewed literature to explore the contributive evidence that rural Americans are older, sicker, and poorer. The project will provide historical and context-setting perspectives on the factors that have led to this description and the extent to which it still holds true. The project will also identify literature gaps to inform future research.
    Research center: Southwest Rural Health Research Center
    Topics: Aging, Poverty, Rural statistics and demographics
  • Assessing the Clinical and Financial Impact of Community Health Workers in Rural America
    This scoping review project will assess how often the existing literature has examined community health workers (CHW) in rural America and what the literature suggests about the clinical and financial impact that CHWs have in rural communities.
    Research center: Southwest Rural Health Research Center
    Topics: Allied health professionals, Health promotion and disease prevention, Social determinants of health
  • Evaluating the Impact and Progress of the Federal Office of Rural Health Policy's Rural Public Health Workforce Training Network Program
    HRSA established the Rural Public Health Workforce Training Network Program to expand health service capacity by supporting public health job development, training, and placement in rural and tribal communities. This project will examine how the program's 32 grantees implemented their activities and will assess the impact of their program activities.
    Research center: Southwest Rural Health Research Center
    Topics: Allied health professionals, Workforce
  • Federal Agencies' Recent Collaboration and Innovation in Rural Cancer Control: A Model for Practice
    The investigators will conduct an examination of the multi-year effort by the National Cancer Institute to focus on rural cancer issues and its collaboration with the Federal Office of Rural Health Policy. The project will explore the key pieces of evidence that served as the impetus for the emphasis on rural America in cancer control efforts.
    Research center: Southwest Rural Health Research Center
    Topics: Cancer, Health disparities and health equity
  • Identifying and Exploring the Settings That Nurse Practitioners and Physician Assistants Are Practicing in as Well as Trends in Specialization in These Groups
    Investigators will conduct a descriptive study to assess trends in specialty and population foci of nurse practitioners (NP) and physician assistants (PA). They will also explore changes in the number of clinician types billing for procedures. Trends will be assessed by census region to inform FORHP on areas for which use of NPs and PAs can be bolstered.
    Research center: Southwest Rural Health Research Center
    Topics: Health services, Nurses and nurse practitioners, Physician assistants
  • Racial and Ethnic Disparities Shouldered by Rural Americans: Evidence from the Peer-Reviewed and Grey Literature on the Five Leading Causes of Death
    A systematic review of peer-reviewed and grey literature will explore the role of racial and ethnic disparities in the five leading causes of death. The project will provide historical and context setting perspectives on the contributors to the five leading causes of death, particularly as they involve the intersection of rurality and non-majority demographic identities.
    Research center: Southwest Rural Health Research Center
    Topics: Cancer, Chronic diseases and conditions, Health disparities and health equity, Minority health
  • The Intersection of Race/Ethnicity and Rurality in Pediatric Asthma: Trends and Predictors
    Little is known about the extent to which the intersection of race/ethnicity and rurality plays a role in the disparities associated with asthma outcomes, particularly among children. Using the National Inpatient Sample from 2015 – 2019, this project identified trends in pediatric asthma-related hospitalizations and the significant predictors of them, particularly by considering interaction terms.
    Research center: Southwest Rural Health Research Center
    Topics: Children and adolescents, Chronic diseases and conditions, Health disparities and health equity
  • Trends and Predictors of Urban-Rural and Racial/Ethnic Disparities in Hospitalizations Associated with the Top Five Cancers
    This project will serve to update the Federal Office of Rural Health Policy's cancer research portfolio. Using recent nationally representative hospital discharge data, the researchers will examine trends and predictors of hospitalizations associated with the top five cancers in the U.S.: skin, lung, prostrate, breast, and colorectal.
    Research center: Southwest Rural Health Research Center
    Topics: Cancer, Health disparities and health equity
  • Trends and Predictors of Urban-Rural and Racial/Ethnic Disparities in Hospitalizations Tied to Acute Myocardial Infarction
    This project will update the Federal Office of Rural Health Policy's research portfolio on hospital-based disparities associated with acute myocardial infarctions (AMIs). Very little is known about variances in hospital-based outcomes for AMIs along the urban-rural continuum and among diverse sub-populations in the U.S.
    Research center: Southwest Rural Health Research Center
    Topic: Health disparities and health equity
  • Updating and Exploring the Burden of Potentially Avoidable Emergency Department Visits in Rural U.S. Communities
    This project will update the Federal Office of Rural Health Policy's research portfolio on potentially avoidable emergency department (ED) visits among rural residents across the U.S., particularly as they relate to ambulatory care sensitive conditions (ACSCs). Data on ACSC-related ED visits will be drawn from the State Emergency Department Databases, and findings will be stratified by census region, patient's place along the urban-rural continuum, and by race/ethnicity.
    Research center: Southwest Rural Health Research Center
    Topics: Emergency medical services (EMS) and trauma, Healthcare access, Medicaid and CHIP, Uninsured and underinsured
  • Utilization of Hospital-Based Services for Behavioral Health Conditions
    This project will update the Federal Office of Rural Health Policy's portfolio on rural residents' reliance on hospital-based care for behavioral health conditions. Data will be drawn from the State Emergency Department Databases and the National Inpatient Sample and findings will be presented in the context of patient residence along the urban-rural continuum, census region, insurance coverage, and race.
    Research center: Southwest Rural Health Research Center
    Topics: Healthcare access, Mental and behavioral health

Completed Projects - (7)

  • Evaluating the Federal Office of Rural Health Policy's Community-Based Division Funding Programs: Does the Performance Improvement and Measurement Systems (PIMS) Database Adequately Capture Impact
    This project examined three types of Federal Office of Rural Health Policy Community-Based Division programs to determine whether the Performance Improvement and Measurement Systems captures the programs' impact and goals as set forth in their respective notices of funding opportunities.
    Research center: Southwest Rural Health Research Center
    Topic: Legislation and regulation
  • Examining the Legal Landscape in Rural America: Implications for the Healthcare Workforce, Access to Care, and Population Health
    This project explores potential rural/urban differences in the prevalence of malpractice claims, clinical privilege actions, and state licensure actions among health care providers. We will also examine whether variations in nurse practitioner scope of practice laws affect rural residents differentially, especially with respect to preventive care.
    Research center: Southwest Rural Health Research Center
    Topics: Allied health professionals, Health services, Legislation and regulation, Nurses and nurse practitioners, Workforce
  • How Well are We Doing Meeting Healthy People 2020 Mortality Objectives at Midterm? Rural v. Urban Differences
    The purpose of this project was to conduct a midterm examination of urban versus rural disparities in meeting Healthy People 2020 mortality objectives for the top 10 leading causes of death in the U.S. utilizing existing secondary databases.
    Research center: Southwest Rural Health Research Center
    Topics: Chronic diseases and conditions, Health disparities and health equity
  • Malpractice Claims Among Rural and Urban Providers: Do State Telehealth Laws Make a Difference?
    This project examines trends in state telehealth laws and whether they have affected the rural and urban malpractice environments differentially. Data from the National Practitioner Data Bank are used to determine whether changes in telehealth laws are associated with increased malpractice claims and other adverse actions against providers.
    Research center: Southwest Rural Health Research Center
    Topics: Allied health professionals, Legislation and regulation, Nurses and nurse practitioners, Telehealth, Workforce
  • The Burden of Diabetes in Rural America
    The purpose of this project was to determine rural versus urban differences in type 2 diabetes prevalence, morbidity and mortality in the U.S. Diabetes complications, disparities and associated demographics were reported. A comparison of Mexican-American border versus non-border states was also included.
    Research center: Southwest Rural Health Research Center
    Topics: Chronic diseases and conditions, Diabetes, Health disparities and health equity, Minority health
  • Trends and Predictors of Human Immunodeficiency Virus (HIV) in Light of the Opioid Crisis Along the Urban-Rural Continuum
    This project explored trends in the burden of HIV and predictors of HIV-related mortality and morbidity. The study examined how the opioid crisis has changed the nature of the burden of HIV, especially considering differential disease burdens between residents of rural areas relative to their urban counterparts.
    Research center: Southwest Rural Health Research Center
    Topics: Chronic diseases and conditions, Pharmacy and prescription drugs, Substance use and treatment
  • Variations in Travel Burdens Associated with Access to Care Between Rural and Urban Residents
    This project focused on geographic access to medical and dental care, recognizing that travel time and distances can hinder individuals from obtaining necessary care. The study explored the travel time and distances to care for specific sub-populations and in specific geographic settings, particularly urban versus rural residence and region.
    Research center: Southwest Rural Health Research Center
    Topics: Health services, Healthcare access, Transportation

Publications - (23)

2023

2022

  • Meeting the Behavioral Health Needs of Farm Families in Times of Economic Distress
    Policy Brief
    RUPRI Health Panel: Rural Policy Analysis and Applications
    Date: 02/2022
    Economic fluctuations and periods of distress in farming cannot be eliminated, however, their impact on communities and individuals can be mitigated. Strategies for meeting the behavioral health needs of farm families by supporting community-based services, and expanding behavioral health services in rural contexts are highlighted in this work.
  • High-Performing Rural Health System
    Policy Brief
    RUPRI Health Panel: Rural Policy Analysis and Applications
    Date: 01/2022
    This document updates the RUPRI Health Panel's framework, for a high-performing rural health system, originally published in 2011. It offers a revised vision statement and updates the high-performing rural health system pillars (access, affordability, community health, and quality) and describes an underlying base of equity considerations.

2021

2020

2019

2018

  • Cancer Mortality in Rural America: 1999-2016
    Policy Brief
    Southwest Rural Health Research Center
    Date: 11/2018
    This policy brief details the differences in mortality from cancer at various levels of rurality in America. The primary aim of this study was to understand the scope of cancer mortality in urban and rural areas of the U.S. Common cancer types—breast, cervical, lung, prostate, and colon—were analyzed over an 18-year period from 1999-2016.
  • Diabetes-Related Hospital Mortality in Rural America: A Significant Cause for Concern
    Policy Brief
    Southwest Rural Health Research Center
    Date: 03/2018
    This brief is the third in a series prepared by the Southwest Rural Health Research Center on the topic of diabetes. The aim of this study was to examine trends and rates of diabetes-related deaths for persons hospitalized in the U.S., with emphasis on differences across the urban-rural continuum and across census regions.

2017