Rural Health
Research Gateway

Children and adolescents

Completed Projects

Listed by project completion date. You can also view these projects alphabetically.

2024

  • How are Rural Health Clinics Serving Pediatric and Obstetrical Medicaid Populations?
    This project examined the roles of independent and provider-based Rural Health Clinics in serving pediatric and obstetrical patients covered by state Medicaid programs.
    Research center: Maine Rural Health Research Center
    Topics: Children and adolescents, Health services, Healthcare financing, Maternal health, Medicaid and CHIP, Rural Health Clinics (RHCs), Women

2022

  • Rural-Urban Differences in Adverse and Positive Childhood Experiences: Results from the National Survey of Children's Health
    Using the 2016-2018 National Survey of Children's Health, the prevalence of adverse childhood experiences (ACEs) and positive childhood experiences (PCEs) exposure in all 50 states and the District of Columbia were examined and whether ACE and PCE exposure differed between rural and urban residents, by type, by count, and by racial/ethnic group.
    Research center: Rural and Minority Health Research Center
    Topics: American Indians and Alaska Natives, Children and adolescents, Hispanics, Minority health, Social determinants of health
  • Rural-Urban Differences in Child and Adolescent Mental Health pre and during the COVID-19 Pandemic
    This project examined rural-urban differences in the prevalence and severity of anxiety and depression among children and adolescents before and during the COVID-19 pandemic, as well as examined rural-urban differences in access to mental health care professionals and the receipt of care from a mental health professional before and during the COVID-19 pandemic.
    Research center: Rural and Minority Health Research Center
    Topics: Children and adolescents, Health disparities and health equity, Health services, Mental and behavioral health, Minority health

2021

  • Creating County Level Estimates of Childhood Obesity in the U.S.: A Spatial Multilevel Modeling Approach
    Using the 2016 National Survey of Children's Health, spatial multilevel models were constructed to estimate county level rates of childhood obesity in the U.S. Particular emphasis was placed on rural areas, for which direct estimates are often unavailable because of small sample sizes in population-based surveys.
    Research center: Rural and Minority Health Research Center
    Topics: Children and adolescents, Obesity
  • Predictors and Barriers to Achieving Immunization in Rural and Urban Areas
    Prenatal and timely childhood immunizations offer the optimal strategy for preventing severe morbidity and mortality due to vaccine-preventable disease. This project evaluated possible gaps in immunization services for pregnant women and their infants in rural areas as compared to urban areas.
    Research center: Southwest Rural Health Research Center
    Topics: Children and adolescents, Health promotion and disease prevention, Health services, Maternal health

2020

2019

  • Identifying Obesogenic Communities in the U.S.: An Urban-Rural Comparison
    In this study, we created an obesogenic environment score for all U.S. counties and Census tracts, explored urban versus rural differences in obesogenic environment scores, and examined associations between obesogenic environments and childhood obesity overall and by level of rurality.
    Research center: Rural and Minority Health Research Center
    Topics: Children and adolescents, Obesity

2017

  • Are Rural Mothers and Infants Benefiting from Changes in National Women, Infants and Children (WIC) Policy?
    This study explored breastfeeding practices among rural participants in the Women, Infants and Children (WIC) Program before and after a federal policy change in WIC Food Packages. National Food and Nutrition Survey data was used to examine the potential impact on breastfeeding, infant feeding practices, and food/beverage consumption.
    Research center: Southwest Rural Health Research Center
    Topics: Children and adolescents, Maternal health, Poverty, Women
  • Disparities in Access to Oral Health Care Among Rural Children: Current Status and Models for Innovation
    The ACA contains key provisions on addressing oral health disparities among vulnerable populations. This project will provide baseline information on trends in rural health and describe the experiences of four states taking innovative approaches to implementation of key ACA oral health provisions.
    Research center: Rural and Minority Health Research Center
    Topics: Children and adolescents, Oral health
  • Obstetric Unit and Hospital Closures and Maternal and Infant Health in Rural Communities
    This project will examine the relationship between closure of an obstetric unit or hospital and maternity care and outcomes of childbirth in rural US counties including prenatal care, distance to delivery hospital, out-of-hospital birth, and infant health outcomes.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Children and adolescents, Health services, Hospitals and clinics, Women
  • 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

2016

  • Adverse Childhood Experiences and the Health Status of Rural Residents
    The proposed project will (1) assess the prevalence of adverse childhood experiences (ACEs) in rural populations and (2) examine associations of ACEs with health outcomes in rural versus urban settings.
    Research center: Maine Rural Health Research Center
    Topic: Children and adolescents

2015

2014

  • Health Insurance Stability Among Rural Children Following Public Coverage Expansions
    While estimates indicate that the uninsured rate among rural children has dramatically decreased since the 1997 passage of the State Children's Health Insurance Program (CHIP), it is not clear whether or not coverage has become more stable and uninsured spells shorter. The purpose of this study is to investigate changes in insurance stability among rural and urban children following CHIP, and whether this is affected by specific state eligibility and enrollment policies or clusters of policies. Using the 1996, 2001, and 2004 panels of the Survey of Income and Program Participation (SIPP), we will measure rural-urban differences in uninsured spell length and frequency, sources of coverage before and after uninsured spells, movement between sources of coverage, how these measures of stability have changed over time, and the factors that relate to greater continuity of coverage among rural children.
    Research center: Maine Rural Health Research Center
    Topics: Children and adolescents, Medicaid and CHIP, Uninsured and underinsured

2013

  • Patterns of Care for Rural and Urban Children with Mental Health Problems
    This study will assess whether use of office-based care and psychotropic medicine by children differs between rural and urban areas, as well as the role of insurance coverage and availability of mental health providers on use of these services.
    Research center: Maine Rural Health Research Center
    Topics: Children and adolescents, Health disparities and health equity, Mental and behavioral health
  • Perinatal Health in the Rural United States, 2005
    This study examines perinatal outcomes in rural areas across the United States in 2005.
    Research center: WWAMI Rural Health Research Center
    Topics: Children and adolescents, Health disparities and health equity, Women

2012

  • Analysis of State Dental Hygiene Practice Acts and Medicaid Policies for Children's Dental Care: Services Covered and Practitioners Reimbursed
    The purpose of this qualitative analysis will be to obtain a clear picture of the degree to which (1) state SCHIP and Medicaid programs are implementing waivers, or other programs, to improve access to dental care for vulnerable populations including children and pregnant women; and (2) dental hygienists impact the dental safety net for rural America.
    Research center: Rural and Minority Health Research Center
    Topics: Children and adolescents, Health disparities and health equity, Maternal health, Medicaid and CHIP, Oral health
  • Childhood Asthma and Air Quality in Rural-Urban Areas
    This study will examine the prevalence of childhood asthma across urban and rural settings. We will examine how asthma may be related to measures of ambient air quality, as well as how asthma may be related to agricultural activity of different types, to proximity to metropolitan areas, and to measures of demographics and health care insurance.
    Research center: West Virginia Rural Health Research Center
    Topics: Children and adolescents, Environmental and agricultural health
  • Dental Sealant Utilization Among Rural and Urban Children
    Dental sealants can prevent or reduce dental caries among children, but only about a third of children currently have sealants. This project will explore the dissemination of sealants among rural children, identifying characteristics of children and communities with low sealant use.
    Research center: Rural and Minority Health Research Center
    Topics: Children and adolescents, Oral health

2010

  • Access to Mental Health Services and Family Burden of Rural Children with Significant Mental Health Problems
    The needs of rural children with serious emotional disturbance and the burden these needs place on their families are intertwined and may place these rural children and their families at "double jeopardy" of having their mental health and other needs go unmet. Using the National Survey of Children with Special Health Care Needs and information on community characteristics from the Area Resource File we will examine the factors associated with whether children and their families have their needs meet across the rural continuum.
    Research center: Maine Rural Health Research Center
    Topics: Children and adolescents, Mental and behavioral health
  • Diet and Physical Activity as Risk Factors for Childhood Obesity: An Urban and Rural Comparison
    Obesity is more prevalent among rural than urban children, despite higher reported physical activity levels. This project will explore diet among rural children to explore how diet and physical activity may differ for rural children, particularly minority children.
    Research center: Rural and Minority Health Research Center
    Topics: Children and adolescents, Obesity
  • Rural Emergency Department Preparedness for Pediatric Care
    While many large cities have dedicated children's hospitals or facilities with pediatric emergency departments, many general hospitals do not have either the equipment necessary to provide optimal pediatric emergency care nor staff that is specifically trained in the care of pediatric emergencies. This project will use secondary data analysis and semi-structured interviews with emergency room directors in order to address how the availability of pediatric services, expertise and supplies in U.S. emergency departments differs between urban and rural facilities, and to determine which factors impede the availability of pediatric services, expertise, and supplies in rural emergency departments.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Children and adolescents, Health services, Hospitals and clinics
  • Rural Medicaid and CHIP Mini-Studies
    Medicaid and the Children's Health Insurance Program (CHIP) are important sources of health insurance coverage in rural communities and it is likely that the importance of Medicaid/CHIP will grow as job-based health insurance coverage continues to erode and policymakers pursue the goal of expanding coverage. This project is composed of three mini-studies that: 1) Update our State Profiles of Medicaid and CHIP in Rural and Urban Areas website, adding information on Medicaid Disproportionate Share Hospital (DSH) payments to rural hospitals; 2) Analyze trends in Medicaid/CHIP enrollment in rural and urban areas over the past two to three years; and 3) Explore the future role of CHIP given increasing levels of childhood poverty.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Children and adolescents, Medicaid and CHIP

2008

  • Changes in U.S. Rural Perinatal and Infant Health Care During the Last Decade
    This study examined changes in rates of adverse birth outcomes and prenatal care among rural Americans of different racial and ethnic groups during two time periods. The study used national data from the Linked Birth Death Data Sets to assess differences in low birth weight, neonatal death, post neonatal mortality and inadequate prenatal care.
    Research center: WWAMI Rural Health Research Center
    Topics: Children and adolescents, Health disparities and health equity, Maternal health
  • Chartbook: Oral Health and Unmet Needs for Dental Care Among Children
    This study will characterize oral health status, dental care utilization, and unmet dental care needs among U.S. children by urban/rural residence. It will provide a descriptive analysis, using cross-sectional data from the 2003 National Survey of Children's Health.
    Research center: Rural and Minority Health Research Center
    Topics: Children and adolescents, Health disparities and health equity, Oral health, Rural statistics and demographics
  • Rural-Urban Differences in Access to Children's Mental Health Services
    This study uses data from the Urban Institute's National Survey of America's Families to examine and compare the use of mental health services by rural and urban children, age 6 to 17, relative to their need for mental health care, family income, and insurance status.
    Research center: Maine Rural Health Research Center
    Topics: Children and adolescents, Health services, Mental and behavioral health

2007

  • Chartbook: Obesity in Urban and Rural Children
    By providing a descriptive analysis of the disparities of childhood obesity by residence, socioeconomic status and race/ethnicity, the study will offer important information about the needs of children and adolescents living in rural areas and from families of low socioeconomic status.
    Research center: Rural and Minority Health Research Center
    Topics: Children and adolescents, Obesity, Rural statistics and demographics
  • Hospitalizations of Rural Children for Ambulatory Care Sensitive Conditions
    This project uses state inpatient discharge data from six states, data from the Area Resource File and the AHRQ Pediatric Quality Indicators to examine Ambulatory Care Sensitive Condition admission rates for rural children.
    Research center: Upper Midwest Rural Health Research Center
    Topics: Children and adolescents, Chronic diseases and conditions

2005

  • Access to Health Care for Young Rural Medicaid Beneficiaries
    This study examined access to health care among rural children ages 0-17 who are enrolled in some type of Medicaid managed care program, and will compare this access across types of programs and, within program type, to that of urban beneficiaries.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Children and adolescents, Health services, Medicaid and CHIP, Oral health, Transportation
  • 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
  • Mental Health Risk Factors, Unmet Needs and Provider Availability for Rural Children
    The study will examine the prevalence of subclinical problems in rural children, assess risk factors associated with problems in children, and assess the influence of local provider availability on healthcare provider contact.
    Research center: Rural and Minority Health Research Center
    Topics: Children and adolescents, Health services, Mental and behavioral health
  • National Trends in the Perinatal and Infant Health Care of Rural and Urban American Indians (AIs) and Alaska Natives (ANs)
    This project examined and compared trends in prenatal care and mortality rates of rural and urban AI/AN and non-AI/AN populations in order to determine the level of disparity between these populations and their temporal changes.
    Research center: WWAMI Rural Health Research Center
    Topics: American Indians and Alaska Natives, Children and adolescents, Health disparities and health equity, Maternal health, Minority health
  • Poverty, Parental Stress, and Violent Disagreements in the Home Among Rural Families
    Using the National Survey of Children's Health, this study will address the prevalence of poverty, parental stress and violent disagreements in the home in rural and urban families. Associations among economic hardships, parent stress, violent disagreements in the home and mental health problems in children will also be investigated.
    Research center: Rural and Minority Health Research Center
    Topics: Children and adolescents, Poverty, Violence and abuse, Women

2004

  • State Child Health Insurance Program (S-CHIP) and Access to Medical Transportation Program Services
    This project created a typology of S-CHIP models and the interface between each and the existing Medical Transportation Program (MTP) available to Medicaid recipients in select states. In addition, the project compared rural and non-rural variances in patterns of utilization of MTP service in S-CHIP programs, identified the strengths and weaknesses of the various approaches utilized by the different state MTP models, and compared the performance of the various state models in assuring access to covered medical services and identified barriers to S-CHIP services.
    Research center: Southwest Rural Health Research Center
    Topics: Children and adolescents, Medicaid and CHIP, Transportation
  • Teen Violence
    This study will use national data to assess the prevalence of violence among rural youth, define risk factors for violence exposure among rural youth, and assess the current ability of rural school systems to provide appropriate mental health care and/or referrals for youth exposed to violence.
    Research center: Rural and Minority Health Research Center
    Topics: Children and adolescents, Mental and behavioral health, Violence and abuse
  • 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
  • Unmet Needs for Health Care Services: An Analysis of Children with Special Health Care Needs in Rural Areas
    This project will study whether parents of children with special healthcare needs (CSHCNs) who live in rural areas are less likely to perceive the need for routine and specialty medical care than their metropolitan counterparts, and whether CSHCNs that live in rural areas face a greater risk of having unmet needs for healthcare services than their metropolitan counterparts.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Children and adolescents, Disabilities, Health services, Oral health

2003

2002