Rural Health
Research Gateway

Janice C. Probst, PhD

Email: probst.rural@gmail.com
X: @JanProbst

Current Projects - (1)

  • Rural-Urban Disparities in Mental Health Access and Quality in the United States
    The purpose of this project is to document the recent trends of mental health care access and quality in urban and rural communities and to assess the intersectionality of residence rurality and race/ethnicity on disparities in mental health care access and quality.
    Research center: Rural and Minority Health Research Center
    Topics: Health disparities and health equity, Healthcare access, Mental and behavioral health

Completed Projects - (34)

  • Adequacy of Ambulatory Care Among Rural African Americans with Congestive Heart Failure, Diabetes or Asthma
    Research center: Rural and Minority Health Research Center
    Topics: Chronic diseases and conditions, Diabetes, Minority health
  • Adequacy of Home Health Care Availability in Rural Counties
    This project will describe current distribution of HHC agencies, by ZIP Code and county of facility location and of service provision, across levels of rurality. Second, the project will estimate whether rural populations at risk for inadequate access to HHC, based on projected population need population / provider ratios.
    Research center: Rural and Minority Health Research Center
    Topics: Aging, Home health
  • Availability and Quality of Dialysis in Rural Counties with a High Diabetes Burden
    This project examined the degree to which counties with a high population risk for end stage renal disease, defined by high diabetes prevalence, are served by dialysis providers. It assessed the accessibility and quality of services for end stage renal disease looking for disparities associated with rural residence and racial/ethnic population composition.
    Research center: Rural and Minority Health Research Center
    Topics: Diabetes, Health disparities and health equity, Health services, Public health, Quality
  • Availability of Diabetes Self-Management Education in High Need Rural Counties
    This project examined the degree to which counties with a high need for diabetes education, defined by high diabetes prevalence, have such education available. Findings were linked to a related study that examined the availability of dialysis for end stage renal disease, a severe outcome of poorly addressed diabetes.
    Research center: Rural and Minority Health Research Center
    Topics: Diabetes, Health services
  • Availability of Healthcare Infrastructure in Minoritized Racial/Ethnic Groups
    This analysis compared the likelihood that selected healthcare infrastructure elements are available within rural and urban ZIP Code Tabulation Areas that contain versus do not contain a high proportion of historically disadvantaged minority residents.
    Research center: Rural and Minority Health Research Center
    Topics: American Indians and Alaska Natives, Health disparities and health equity, Healthcare access, Hispanics, Home health, Long-term care, Minority health
  • Characteristics and Educational Needs of Rural Acute Care Hospital Boards of Directors
    Rural hospital boards face challenges in an environment of increasing legal and financial complexity. This study will characterize rural hospital Board of Directors' backgrounds, perceptions of board function, and perceived need of training and development.
    Research center: Rural and Minority Health Research Center
    Topic: Hospitals and clinics
  • Characteristics and Utilization Patterns of Rural Dual-eligible Medicare Beneficiaries
    Persons who are eligible for both Medicare and Medicaid insurance coverage (dual eligible) represent 21% of total Medicare enrollment, but account for more than 36% of Medicare expenditures. The purpose of this study is to ascertain whether dual-eligible beneficiaries living in rural areas differ from their urban counterparts in demographic characteristics and Medicare expenditures.
    Research center: Rural and Minority Health Research Center
    Topics: Cancer, Diabetes, Medicaid and CHIP, Medicare
  • Chartbook: Racial and Ethnic Disparities in the Health of Rural Populations
    This study will provide a cross-sectional, descriptive study that uses large, nationally representative data sets to illustrate health and health care among rural populations. The data sets to be used include the 2005 Behavioral Risk Factor Surveillance Survey, the 2005 National Health Interview Survey, and the Area Resource File.
    Research center: Rural and Minority Health Research Center
    Topics: Health disparities and health equity, Minority health, Rural statistics and demographics
  • Colorectal Cancer Screening Bypass Behavior and Outcomes
    Studies have shown that increased distance to the closest endoscopy provider is associated with lower screening utilization among Medicare enrollees. The purpose of this study is to expand beyond the Medicare population to examine the travel behaviors of the entire population, comparing urban vs. rural residents in obtaining endoscopies for colorectal cancer screening.
    Research center: Rural and Minority Health Research Center
    Topics: Cancer, Health promotion and disease prevention, Medicare
  • Depression and Generalized Anxiety Disorder across Rural Populations
    Research center: Rural and Minority Health Research Center
    Topics: Health disparities and health equity, Mental and behavioral health, Minority health
  • Effect of Safety Net Providers on Ambulatory Care Sensitive Hospitalization Rates in Rural Counties
    This project will determine if the presence of a community health center or rural health clinic in a county reduces ambulatory care sensitive hospitalizations for children, working age adults, and older adults.
    Research center: Rural and Minority Health Research Center
    Topics: Chronic diseases and conditions, Federally Qualified Health Centers (FQHCs), Health services, Poverty, Rural Health Clinics (RHCs)
  • Effects of Alcohol Use on Educational Attainment and Employment in Rural Youth
    This study will examine the effects of alcohol use during the teen years on subsequent educational attainment and employment in a panel of rural residents.
    Research center: Rural and Minority Health Research Center
    Topics: Children and adolescents, Substance use and treatment
  • Effects of Uninsurance during the Preceding 10 Years on Health Status Among Rural Working Age Adults
    Utilizing data from the 1979 National Longitudinal Survey of Youth, the effects of long-term, continuous uninsurance on health status will be analyzed through a comparison of rural and urban populations who were between the ages of 14-22 in 1979.
    Research center: Rural and Minority Health Research Center
    Topics: Diabetes, Uninsured and underinsured
  • Emergency Department Use by Medically Indigent Rural Residents
    Research center: Rural and Minority Health Research Center
    Topics: Emergency medical services (EMS) and trauma, Hospitals and clinics, Uninsured and underinsured
  • Identification of High-Need Rural Counties Lacking an FQHC Presence
    Federally Qualified Health Centers (FQHCs) have been key safety net providers since the program was initiated. However, many rural communities lack this resource. Expanding on the index of relative rural deprivation developed by the SCRHRC, we identified high-need rural counties that currently are not served by an FQHC or similar provider.
    Research center: Rural and Minority Health Research Center
    Topics: Critical Access Hospitals (CAHs), Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs)
  • Intensity of Service Provision for Medicare Beneficiaries Utilizing Home Health Services
    This study will assess whether Medicare beneficiaries in rural areas receive a lower intensity of home health (HH) services compared to their urban counterparts. Specifically, the study will examine (1) the distribution of levels of HH services for four conditions: joint (hip and knee) replacement, stroke, end-stage renal disease (ESRD), and diabetes; (2) the distribution of type of provider for each condition across the levels of rurality; and (3) the median charge and payment per beneficiary for these services across the levels of rurality.
    Research center: Rural and Minority Health Research Center
    Topics: Chronic diseases and conditions, Diabetes, Home health, Medicare
  • Mode of Travel and Actual Distance Traveled for Medical or Dental Care by Rural Residents
    This project examined the influence of race and rural isolation on distance traveled to receive medical or dental care, and how the potential interaction of these factors might exacerbate disparities in access to care.
    Research center: Rural and Minority Health Research Center
    Topics: Health disparities and health equity, Health services, Minority health, Oral health, Transportation
  • Post-Hospital Transitions in Care Among Dually-Eligible Medicare Beneficiaries
    This project will examine the hospitalization rates, post-discharge physician follow-up, and subsequent readmission rates among Medicare beneficiaries who are also enrolled in Medicaid. We will examine these dual-eligible beneficiaries by level of rurality to determine if residence is a significant factor in these rates. We will also control for co-morbidities, county characteristics, and other factors related to readmission rates.
    Research center: Rural and Minority Health Research Center
    Topics: Diabetes, Hospitals and clinics, Medicare
  • Premature Mortality: Potential Role of Health Insurance in Moderating Race/Ethnicity and Rural/Urban Disparities
    This project will explore the degree to which lack of health insurance may contribute to high mortality rates among rural minority men and women aged 45-64.
    Research center: Rural and Minority Health Research Center
    Topics: Minority health, Uninsured and underinsured
  • Profiling Health and Health Resource Availability in U.S. – Mexico Border Counties
    This project will augment a previous SCRHRC chartbook on Border health with additional information on health resources and health outcomes in US counties adjacent to Mexico.
    Research center: Rural and Minority Health Research Center
    Topic: Minority health
  • Racial and Rural Differences in Cervical Cancer Screening Practices
    The purpose of this study is to describe and compare racial and rural differences in cervical cancer screening practices using data from the National Ambulatory Medical Care Survey. The findings will inform policies to increase appropriate access to quality cancer-preventive services.
    Research center: Rural and Minority Health Research Center
    Topics: Cancer, Health promotion and disease prevention, Minority health, Women
  • Rapid Research Response on Health Care Reform Issues
    The focus of the SC Rural Health Research Center is on investigating persistent inequities in health status within the population of the rural US, with an emphasis on inequities stemming from socioeconomic status, race and ethnicity, and access to healthcare services. Building on existing expertise, the SC Rural Health Research Center will create an internal process that allows for rapid turnaround of analysis on race/ethnicity and rural-based health disparity inquiries from policymakers.
    Research center: Rural and Minority Health Research Center
    Topic: Healthcare financing
  • Rural and Urban Differences in Case-Mix Among Recipients of Home Health Care
    We will examine current patient case-mix for the Medicare population receiving skilled health care from a home health agency to determine if there are rural or race/ethnicity-based disparities with regards to receipt of services and clinical acuity indicators.
    Research center: Rural and Minority Health Research Center
    Topics: Health disparities and health equity, Home health, Medicare
  • Rural Area Deprivation and Hospitalizations Among Children for Ambulatory Sensitive Conditions
    Rural areas with reduced social and economic resources may be particularly vulnerable to inadequate primary care for children.
    Research center: Rural and Minority Health Research Center
    Topics: Children and adolescents, Health disparities and health equity, Hospitals and clinics
  • Rural Border Chartbook
    This chartbook is the first study to examine the health status of residents living in U.S. counties that border Mexico as a single region rather than as four distinct state areas. We examined select health status indicators among residents of the four border states, Arizona, California, New Mexico, and Texas, comparing indicators by ethnicity (Hispanic vs. non-Hispanic), rurality (rural vs. urban), and proximity to border (border vs. non-border).
    Research center: Rural and Minority Health Research Center
    Topics: Hispanics, Minority health
  • Rural EMS Infrastructure
    Research center: Rural and Minority Health Research Center
    Topics: Emergency medical services (EMS) and trauma, Frontier health
  • Rural Health Center Expansion and Recruitment Survey
    This collaborative project between WWAMI and the South Carolina Rural Health Research Centers examined and described the current staffing needs of rural health centers (RHCs), ascertained the staffing, recruitment, and retention issues that RHC CEOs regard as most critical; distinguished how issues differ between CEOs contemplating development of expansion sites versus those who are not; and described how these findings correlate with the literature and current national supply projections for the categories of health professions needed by the RHCs.
    Research centers: Rural and Minority Health Research Center, WWAMI Rural Health Research Center
    Topics: Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), Workforce
  • Rural Minority Health: A Comprehensive Assessment
    This study will profile demographics of rural African Americans by region of the U.S.; describe clinical problems prevalent in rural African American populations; explore available health care facilities and practitioners in rural areas; investigate outpatient treatment provided to rural African American populations by type of practitioner; explore expenditures for health care among rural African Americans by region of the U.S.; and determine barriers to care such as insurance, provider availability, and health beliefs and behaviors.
    Research center: Rural and Minority Health Research Center
    Topics: Health disparities and health equity, Minority health, Rural statistics and demographics
  • Rural Minority Health: A Comprehensive Assessment of Health Status, Health Care Utilization and Barriers to Care Among Rural Minorities
    Research center: Rural and Minority Health Research Center
    Topics: Health disparities and health equity, Minority health, Rural statistics and demographics
  • Rural Nursing Workforce: Current Educational Characteristics and Options for Improvement
    This project examined the current distribution of nurses, subset by educational attainment, across the rural U.S. using data from Census Public-Use Microdata files. Then surveyed approximately 750 registered nurse to bachelor of science in nursing (RN-to-BSN) educational programs across the U.S. identifying the proportion of programs offering rural content or facilitating rural placement.
    Research center: Rural and Minority Health Research Center
    Topics: Nurses and nurse practitioners, Workforce
  • Social Determinants of Health Among Minority Populations in Rural America
    This project compiled information from the U.S. Census, the Area Health Resource File, and the Robert Wood Johnson Foundation County Rankings data set into a comprehensive summary of key social determinants of health among rural populations: demographic characteristics, economic characteristics, health facility availability, and selected health outcomes.
    Research center: Rural and Minority Health Research Center
    Topics: American Indians and Alaska Natives, Hispanics, Minority health, Rural statistics and demographics, Social determinants of health
  • Transitions in Care for Rural Medicare Beneficiaries with Diabetes
    Hospital readmission rates among persons with diabetes, as well as absolute admission rates, may be used to study health disparities among rural and minority populations. This project will use data from the Medicare Chronic Conditions Data Warehouse to explore residence- and race-based disparities in diabetes admission rates, effective transitions to outpatient care, and re-admission rates, to help guide rural policy-makers and healthcare providers.
    Research center: Rural and Minority Health Research Center
    Topics: Chronic diseases and conditions, Diabetes, Health disparities and health equity, Medicare, Minority health
  • Trends in Rural Children's Health and Access to Care
    The past ten years have seen positive trends in the availability of health insurance coverage for children, coupled with worsening trends for poverty. This project will examine data from three iterations of the National Survey of Children' Health (2003, 2007, 2012) to see whether rural children have benefited equally from any improvements in health insurance, healthcare use, and health status.
    Research center: Rural and Minority Health Research Center
    Topics: Children and adolescents, Private health insurance
  • Trends in Uninsurance Among Rural Minority Children
    This project analyzed trends in health insurance coverage and health services utilization among rural children, in order to ascertain whether the S-CHIP program has positively affected rural children, and whether all rural children, including minority children, have benefited equally.
    Research center: Rural and Minority Health Research Center
    Topics: Children and adolescents, Uninsured and underinsured

Publications - (128)

2024

2023

  • Geographic Variations in Driving Time to U.S. Mental Health Care, Digital Access to Technology, & Household Crowdedness
    Journal Article
    Rural and Minority Health Research Center
    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.
  • Availability of Dialysis Facilities in Minoritized Racial/Ethnic Group Areas
    Policy Brief
    Rural and Minority Health Research Center
    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
    Rural and Minority Health Research Center
    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.
  • Access to Health Services Across Rural and Urban Minoritized Racial/Ethnic Group Areas
    Policy Brief
    Rural and Minority Health Research Center
    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.

2022

2021

2020

2019

  • RN-to-BSN Programs: Challenges for Rural Nurse Education
    Policy Brief
    Rural and Minority Health Research Center
    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
    Rural and Minority Health Research Center
    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.
  • Perceived Facilitators and Barriers to Rural Nursing Practice
    Policy Brief
    Rural and Minority Health Research Center
    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
    Rural and Minority Health Research Center
    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
    Rural and Minority Health Research Center
    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
    Rural and Minority Health Research Center
    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
    Rural and Minority Health Research Center
    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
    Rural and Minority Health Research Center
    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
    Rural and Minority Health Research Center
    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

2017

2016

2015

2014

2013

  • Diffusion of Preventive Innovation: Racial and Rural Differences in Cervical Cancer Prevention and Control Practices
    Rural and Minority Health Research Center
    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
    Rural and Minority Health Research Center
    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
    Rural and Minority Health Research Center
    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: Prevalence and Service Availability
    Rural and Minority Health Research Center
    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
    Rural and Minority Health Research Center
    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.

2012

2011

2010

2009

2008

  • Health Disparities: A Rural-Urban Chartbook (Full Report)
    Rural and Minority Health Research Center
    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)
    Rural and Minority Health Research Center
    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

2006

2005

2004

2003

2002

2001