Ty Borders, PhD
Director, Rural and Underserved Health Research Center
Phone: 859.218.0108
Email: ty.borders@uky.edu
College of Nursing
University of Kentucky
Healthy Kentucky Research Building
760 Press Avenue, Suite 360
Lexington, KY 40536
- Current Projects - (5)
- Completed Projects - (10)
- Publications - (16)
Current Projects - (5)
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Availability and Characteristics of Outpatient and Residential Substance Use Treatment in Rural and Urban Areas
This study will look at: 1) the availability of residential and outpatient treatment centers in rural and urban counties, including identifying counties with no facilities; and 2) characteristics of services offered (e.g., residential, outpatient), demographics of persons treated, and insurance plans accepted by rural vs urban centers.
Research center: Rural and Underserved Health Research Center
Topics: Health disparities and health equity, Health services, Healthcare access, Mental and behavioral health, Pharmacy and prescription drugs, Social determinants of health, Substance use and treatment
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Mental Health Treatment Among Rural and Urban Adults at Risk for Suicide
This study will look at rural/urban disparities in 1) the receipt and sources of mental health treatment among adults with suicidal thoughts and attempts using data from the National Survey on Drug Use and Health; and 2) mental health follow-up visits among adults with a hospital admission or emergency department visit for self-inflicted harm using data from a national insurance claims dataset.
Research center: Rural and Underserved Health Research Center
Topics: Health disparities and health equity, Health services, Healthcare access, Mental and behavioral health, Post-acute care
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Risky Substance Use Among Rural and Urban Adults: An Update
Very little research has examined rural vs. urban differences in substance misuse and treatment access nationally. Using public and nationally representative data from the National Survey on Drug Use and Health, this project will: 1) Estimate and compare alcohol use and binge drinking, and 2) Estimate and compare drug use (marijuana, other illicit drugs, and non-medical use of other drugs) between non-metropolitan and metropolitan adults.
Research center: Rural and Underserved Health Research Center
Topics: Health disparities and health equity, Mental and behavioral health, Substance use and treatment
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Rural/Urban Inequities in Drug and Alcohol Use Treatment
Using the National Survey on Drug Use and Health, this study will investigate rural vs. urban variations in treatment utilization for alcohol use disorder (AUD) and, separately, drug use disorder (DUD). It will yield prevalence estimates of any treatment receipt and sources of treatment among persons with past year AUD and DUD as well as the receipt of medication therapy among those treatable with medications.
Research center: Rural and Underserved Health Research Center
Topics: Health disparities and health equity, Health services, Healthcare access, Mental and behavioral health, Substance use and treatment
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Work Settings, Education, and Intent to Leave Practice among Rural vs. Urban Nurses
Using data from the 2022 National Nursing Workforce Survey, this project will describe rural/urban differences in nurses' work settings, levels of education and licensure, demographic characteristics, income, and intention to retire or leave practice. Study findings could be applied to implement policies aimed at increasing nursing school output and attracting nurses to practice in rural areas.
Research center: Rural and Underserved Health Research Center
Topics: Health disparities and health equity, Nurses and nurse practitioners, Workforce
Completed Projects - (10)
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Longitudinal Trends in Community Mental Health Center and Federally Qualified Health Center Supply in Nonmetropolitan and Metropolitan Counties
This study described how the supply of community mental health centers and Federally Qualified Health Centers has changed over time in nonmetropolitan and metropolitan counties nationally.
Research center: Rural and Underserved Health Research Center
Topics: Health disparities and health equity, Health promotion and disease prevention, Hospitals and clinics, Mental and behavioral health, Rural Health Clinics (RHCs), Substance use and treatment
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Mental Health Treatment Access: How Do Mental Health Treatment Use and Unmet Treatment Need Vary Among Rural and Urban Adults Nationally?
This project will estimate the prevalence and policy-modifiable correlates of unmet mental health treatment need and utilization among metropolitan, micropolitan, and other non-metropolitan adults nationally who have a mental health condition. Additionally, the study will investigate the same issues among Native Americans/American Indians.
Research center: Rural and Underserved Health Research Center
Topics: American Indians and Alaska Natives, Health disparities and health equity, Health services, Mental and behavioral health
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Risky Substance Use Among Adolescents and Adults in Nonmetropolitan and Metropolitan Counties
Little research has examined the prevalence of risky substance use (alcohol and drugs) among nonmetropolitan adolescents and adults relative to their metropolitan counterparts. Using nationally representative data, this project shed new light on the prevalence and correlates of risky substance use that could inform prevention strategies.
Research center: Rural and Underserved Health Research Center
Topics: American Indians and Alaska Natives, Health disparities and health equity, Health promotion and disease prevention, Mental and behavioral health, Minority health, Substance use and treatment
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Rural and Urban Cancer Survivors' Follow-Up Care Experiences
This project examined rural vs. urban differences in cancer survivors' follow-up care experiences using the 2017 Medical Expenditure Panel Survey.
Research center: Rural and Underserved Health Research Center
Topics: Cancer, Care management, Health disparities and health equity, Health services, Healthcare access, Physicians, Post-acute care, Quality
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Rural and Urban Differences in Access to Psychiatric Partial Hospitalization Programs
The project informed policymakers about the accessibility of psychiatric partial hospitalization programs, which provide moderately intensive and structured psychiatric services in outpatient settings, particularly hospital-based outpatient clinics.
Research center: Rural and Underserved Health Research Center
Topics: Health services, Healthcare access, Hospitals and clinics, Mental and behavioral health
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Rural and Urban Primary Care Physicians' Colorectal Screening Performance
The objectives of this project were to profile, compare, and further understand rural versus urban differences in colorectal screening performance among primary care physicians nationally.
Research center: Rural and Underserved Health Research Center
Topics: Cancer, Chronic diseases and conditions, Health promotion and disease prevention, Healthcare access, Physicians
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Rural/Urban and Racial/Ethnic Inequities in Patient-Reported Health Care Access and Quality among Medicare Beneficiaries with Lung or Colorectal Cancer
Incidence and mortality for colorectal and lung cancer are higher among rural versus urban residents, but many rural cancer patients lack accessible, high-quality care. This study 1) Identified rural/urban inequities in Medicare cancer patient-reported health care access and quality and 2) Determined if rural racial/ethnic minority patients have worse health care access and quality than rural White patients.
Research center: Rural and Underserved Health Research Center
Topics: Cancer, Health disparities and health equity, Healthcare access, Maternal health, Medicare, Minority health, Quality
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Rural/Urban Variations in Cancer Screening During the COVID-19 Pandemic
Using the National Cancer Institute Health Information National Trends Survey, we examined how the COVID-19 pandemic disrupted the receipt of recommended screenings for common cancers. Findings informed policymakers about potential widening of rural/urban disparities in the receipt of cancer preventive services and the potential need to target these services toward rural residents.
Research center: Rural and Underserved Health Research Center
Topics: Cancer, Coronavirus Disease 2019 (COVID-19), Health disparities and health equity, Health promotion and disease prevention, Health services, Healthcare access
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Serious Mental Illness and Access to Care Among Rural and Urban Adults
Very little research has examined the prevalence of serious mental illness and access to mental health treatment among rural relative to urban adults in the U.S. Using nationally representative data, this project shed new light on the prevalence and correlates of serious mental illness and related access to mental health services.
Research center: Rural and Underserved Health Research Center
Topics: Health disparities and health equity, Healthcare access, Hospitals and clinics, Mental and behavioral health, Substance use and treatment
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Substance Use, Depression, and Suicide: What Are the Individual and Policy-Modifiable Correlates Amongst Metropolitan and Non-metropolitan Adults?
We estimated the prevalence of depression and suicidal ideation and attempts amongst metropolitan and non-metropolitan adults nationally. We also investigated how demographic, social, economic, and health (including alcohol and drug abuse) as well as healthcare access factors explain depression and suicide indicators amongst residents.
Research center: Rural and Underserved Health Research Center
Topics: Health disparities and health equity, Health services, Mental and behavioral health, Substance use and treatment
Publications - (16)
2024
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Cervical Cancer Screening Rates Among Rural and Urban Females, From 2019 to 2022
Journal Article
Rural and Underserved Health Research Center
Date: 06/2024
This study examines the receipt of a Papanicolaou test in the past year among U.S. females overall and females residing in rural and urban areas in 2019, 2020, and 2022, using the Health Information National Trends Survey. -
Discussions of Cancer Survivorship Care Needs: Are There Rural Versus Urban Inequities?
Journal Article
Rural and Underserved Health Research Center
Date: 05/2024
This study used 2017 Medical Expenditure Panel Survey data to test for rural versus urban inequities and identify other correlates of discussions about cancer survivorship care with health care professionals. -
Satisfaction With Care Among Cancer Survivors With Medicare Coverage: Are There Rural vs. Urban Inequities?
Journal Article
Rural and Underserved Health Research Center
Date: 03/2024
This article examines satisfaction with health care among rural vs urban Medicare cancer survivors. Researchers looked at nine dimensions of health care and tested for rural/urban differences, adjusting for demographic factors, health insurance, and self-rated health.
2023
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Colorectal Cancer Screening in Rural and Urban Primary Care Practices Amid Implementation of the Medicare Access and CHIP Reauthorization Act
Journal Article
Rural and Underserved Health Research Center
Date: 06/2023
This study examined whether colorectal cancer screening rates improved among rural and urban primary care practices amid implementation of the Medicare Access and CHIP Reauthorization Act. Researchers tested for rural/urban differences and changes in screening rates between 2016 and 2020.
2022
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Increased Rates of Death From Unintentional Injury Among Non-Hispanic White, American Indian/Alaska Native, and Nonmetropolitan Communities
Policy Brief
Rural and Underserved Health Research Center
Date: 07/2022
This brief examines the rate of fatal and nonfatal unintentional injuries in nonmetropolitan and metropolitan areas, with a focus on the effects of race/ethnicity. -
Non-Metropolitan and Metropolitan Trends in Mental Health Treatment Availability in Community Health and Community Mental Health Centers
Policy Brief
Rural and Underserved Health Research Center
Date: 06/2022
This study shows how the supply of community mental health centers (CMHCs) and community health centers (CHCs) delivering mental health services changed from 2000 to 2019. While the supply of CHCs offering mental health services increased, the supply of CMHCs decreased. -
Serious Mental Illness and Mental Health Treatment Utilization Among Adults Residing in Non-Metropolitan and Metropolitan Counties
Policy Brief
Rural and Underserved Health Research Center
Date: 02/2022
This report estimates and compares the prevalence of mental health treatment utilization and reasons for not seeking mental health treatment among adults with serious mental illness residing in non-metropolitan and metropolitan counties nationally.
2021
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Suicide Mortality Rates in Farm-Related Occupations and the Agriculture Industry in the United States
Journal Article
Rural and Underserved Health Research Center
Date: 09/2021
This article examines suicide mortality among agricultural workers comparing rural and urban residents using pooled data from the Mortality‐Linked National Health Interview Survey, 1986–2014. -
Spatial Analysis of Healthcare Utilization Among Medicare Beneficiaries With Coal Workers' Pneumoconiosis and Other Related Pneumoconiosis
Policy Brief
Rural and Underserved Health Research Center
Date: 04/2021
Miners risk developing coal workers' pneumoconiosis (black lung disease) and other pneumoconiosis. This study determines, maps, and analyzes the spatial patterns of healthcare utilization among Medicare beneficiaries with black lung disease and other related pneumoconiosis using the Medicare beneficiaries Limited Data Set from 2011-2014.
2020
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Risky Substance Use Behaviors Among Adolescents Residing in Nonmetropolitan and Metropolitan Counties in the United States, 2017-2018
Policy Brief
Rural and Underserved Health Research Center
Date: 11/2020
This brief uses nationally representative survey data to compare past-30 day and past-year risky substance use among adolescents 12 to 17 years of age residing in metropolitan and nonmetropolitan counties. Specifically, we compared consumption of alcohol, tobacco, and other illicit substances. -
Risky Substance Use Behaviors Among Adults Residing in Nonmetropolitan and Metropolitan Counties in the United States, 2017-2018
Policy Brief
Rural and Underserved Health Research Center
Date: 11/2020
This brief uses nationally representative survey data to identify differences in past-30 day and past-year risky substance use among adults, including alcohol, tobacco, and illicit drugs. This data indicates some significant differences in substance use consumption. -
Major Depression, Treatment Receipt, and Treatment Sources Among Non-Metropolitan and Metropolitan Adults
Policy Brief
Rural and Underserved Health Research Center
Date: 06/2020
This study estimates and compares the prevalence of past year depression, receipt of treatment for depression, and sources of treatment for depression between non-metropolitan and metropolitan adults.
2019
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Partial Psychiatric Hospitalization Program Availability in Nonmetropolitan and Metropolitan Hospitals Nationally
Policy Brief
Rural and Underserved Health Research Center
Date: 12/2019
Partial psychiatric hospitalization programs (PPHPs) are intended to reduce or avoid inpatient stays by providing intensive psychiatric services in outpatient settings. We provide national estimates of PPHP availability among nonmetropolitan and metropolitan hospitals and describe the hospital characteristics associated with the provision of PPHPs. -
Suicidal Thoughts, Plans, and Attempts by Non-Metropolitan and Metropolitan Residence
Policy Brief
Rural and Underserved Health Research Center
Date: 05/2019
Suicide is among the leading causes of death in the US, and rates in non-metropolitan (rural) counties have historically exceeded those in metropolitan (urban) counties. This study examined the prevalence of suicidal thoughts, plans, and attempts by year (2010-2016) and county type (non-metropolitan, small metropolitan, and large metropolitan).
2018
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Illicit Drug and Opioid Use Disorders Among Non-Metropolitan Residents
Policy Brief
Rural and Underserved Health Research Center
Date: 01/2018
We provide estimates of the prevalence of illicit drug and opioid use disorders among non-metropolitan adults ages 18-64. Prevalence rates did not decline from 2011-2013 to 2014-2015 despite the implementation of major substance use treatment policies. Of particular concern, heroin use disorder prevalence increased in recent years. -
Perceived Treatment Need and Utilization for Illicit Drug and Opioid Use Disorders in Non-Metropolitan Areas
Policy Brief
Rural and Underserved Health Research Center
Date: 01/2018
The vast majority of non-metropolitan adults 18-64 who satisfy criteria for an illicit drug use or opioid use disorder do not perceive a need for treatment or receive formal substance use treatment. Despite policies to increase treatment access during the 2008-2015 study period, we found few changes in perceived treatment need and utilization.