Rural Health
Research Gateway

Health disparities and health equity

Completed Projects

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

2024

  • Assessment of the Area Deprivation Index in Rural Areas
    The Area Deprivation Index (ADI) was created by University of Wisconsin researchers to provide a score for neighborhoods based on their level of disadvantage. This study characterized differences in ADI in rural vs urban areas, summarized the existing literature on ADI, and described expert considerations for utilizing the ADI for future policy.
    Research center: Rural Health Equity Research Center
    Topics: Frontier health, Health disparities and health equity, Poverty, Rural statistics and demographics, Social determinants of 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
  • Housing as a Social Determinant of Rural Health
    The purpose of this project was to identify rural/urban and within-rural differences in housing quality and its relationship to health and disability status, especially for individuals living in poverty. We also identified rural-specific housing issues and innovative policy solutions to address housing challenges in order to improve rural health.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Disabilities, Environmental and agricultural health, Health disparities and health equity, Poverty, Public health, Rural statistics and demographics, Social determinants of health
  • Palliative Care in the Rural U.S.
    This project described the availability of palliative care services in rural hospitals and community settings using data from the American Hospital Association Annual Survey, interviews with palliative care providers, and a survey of rural hospitals without palliative care services.
    Research center: WWAMI Rural Health Research Center
    Topics: Health disparities and health equity, Health services, Healthcare access, Hospice and palliative care, Hospitals and clinics
  • 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
  • Rural Premiums, Issuer Participation, and Enrollment in Health Insurance Marketplaces: An Updated Analysis
    The project described variations in Health Insurance Marketplace plan design and availability, total and net-of-subsidy premium trends, and enrollment over time between rural and urban areas and identified associations between these factors and several key policy differences and changes, controlling for economic and demographic variation.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Health disparities and health equity, Health reform, Healthcare access, Private health insurance, Rural statistics and demographics, Uninsured and underinsured
  • 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
  • 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

2023

  • A Chartbook of Rural Population Health
    This project created a chartbook of population health for rural areas. This resource was designed to allow policymakers and practitioners to better understand rural-urban disparities across a wide variety of population health indicators.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Health disparities and health equity, Public health
  • An Innovative Approach to Targeting Rural Communities in Public Health Funding
    The Centers for Disease Control launched a new initiative to address COVID-19 related health disparities and to advance health equity among underserved and at-risk populations. This effort included state funding to address the needs of rural communities. This project was designed to better understand this initiative and its impact on rural health.
    Research center: Southwest Rural Health Research Center
    Topics: Coronavirus Disease 2019 (COVID-19), Health disparities and health equity, Healthcare financing, Public health
  • Assessing Geographic Variability in Key Indicators of Water Quality and Air Quality: A Comparison of Urban vs. Rural Communities
    The purpose of this project was to compare air and water quality indicators across U.S. Census tracts specifically focusing on rural vs. urban differences.
    Research center: Rural and Minority Health Research Center
    Topics: Environmental and agricultural health, Health disparities and health equity, Public health, Social determinants of health
  • 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
  • Diabetes Management in Urban and Rural Areas of the U.S.
    This project used the IBM MarketScan database to examine differences in type 2 diabetes prevalence and monitoring for a commercially insured sample. It also employed definitions from the Health Effectiveness Data and Information Set guidelines for comprehensive diabetes care to determine if rural residents are more or less likely to meet recommended standards for type 2 diabetes monitoring and control.
    Research center: Rural and Underserved Health Research Center
    Topics: Care management, Chronic diseases and conditions, Diabetes, Health disparities and health equity, Health promotion and disease prevention, Health services, Healthcare access, Private health insurance, Quality
  • Examining Rural-Urban Differences in Availability of Hospital Cardiac Testing Services Between 2010-2020
    This project will examine whether the availability of hospital-based cardiac testing services has changed over the past ten years in rural and urban counties and identify the characteristics of counties where service availability has changed.
    Research center: Rural and Minority Health Research Center
    Topics: Care management, Chronic diseases and conditions, Health disparities and health equity, Health services, Hospitals and clinics, Public health
  • Improving Racial Equity for Rural Mothers and Infants
    The purpose of this project was to assess differences in maternal and infant health outcomes and access to perinatal care, among urban and rural counties. We also compared health outcomes and availability of services, including evidence-based services and supports, between rural counties that are majority Black, Indigenous, and People of Color with those that are majority white.
    Research center: University of Minnesota Rural Health Research Center
    Topics: American Indians and Alaska Natives, Critical Access Hospitals (CAHs), Health disparities and health equity, Healthcare access, Hospitals and clinics, Maternal health, Minority health, Rural statistics and demographics, Social determinants of health, Women
  • Inpatient Treatment Costs Associated with Substance Use Disorders
    The purposes of this project were to examine the costs and characteristics of inpatient stays associated with substance use disorders and to examine whether there are systematic differences in these stays and costs for persons residing in rural areas compared to urban areas.
    Research center: Rural Health Equity Research Center
    Topics: Health disparities and health equity, Healthcare access, Healthcare financing, Mental and behavioral health, Substance use and treatment
  • Rural and Racial/Ethnic Disparities in COVID-19 Mortality Rates and Associations with Community Characteristics
    This project examined rural and racial/ethnic disparities in COVID-19 mortality rates during the peak of COVID-19 deaths (December 2020-January 2021). Researchers examined mortality rates across non-metropolitan and metropolitan counties overall and stratified by racial/ethnic composition and U.S. census region, and spatial regression methods were used to identify community characteristics (e.g., rurality, sociodemographic, health conditions, and health care access) associated with mortality rates at the county level.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Coronavirus Disease 2019 (COVID-19), Health disparities and health equity, Healthcare access
  • Rural Family Physicians' Ability to Address Patients' Social Determinants of Health Needs
    This project examines how practice-level and community-level characteristics are associated with a family physician's assessment of their practice's ability to address patients' social needs.
    Research center: Rural and Underserved Health Research Center
    Topics: Health disparities and health equity, Physicians, Poverty, Social determinants of health
  • Rural Health Access: Affordability and Barriers to Care
    Rural-urban comparisons of healthcare access and affordability predate many policy reform efforts aimed at increasing access and decreasing costs—ongoing concerns of rural families. This study used national health survey data to examine rural-urban differences in access to medical care, access to insurance, and affordability of care.
    Research center: Maine Rural Health Research Center
    Topics: Health disparities and health equity, Health reform, Health services, Healthcare access, Healthcare financing, Private health insurance, Public health, Social determinants of health
  • Rural Healthy People 2030: Challenges and Opportunities for the New Decade
    Building on Rural Healthy People 2010 and Rural Healthy People 2020, this project helped to launch Rural Healthy People 2030 and analyze variations in top-ranked Healthy People objectives for rural America. We identified the most important objectives for rural Americans and how Rural Healthy People priorities have changed over time.
    Research center: Southwest Rural Health Research Center
    Topics: Chronic diseases and conditions, Health disparities and health equity
  • Rural-Urban Differences in Performance of Clinicians Participating in MIPS
    This project used quantitative methods to compare MIPS performance and reported measures for clinicians working in rural and urban areas, overall, and by practice size; evaluated differences in spending per beneficiary, overall, and stratified by drugs and medical services for rural and urban clinicians participating in MIPS; and compared MIPS performance and spending for clinicians serving a large proportion of racial/ethnic minorities in rural and urban areas.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Health disparities and health equity, Healthcare financing, Physicians, Quality
  • Rural-Urban Differences in Three Domains of Access to Health Care Services
    This study proposed to leverage 2018 and 2019 Behavioral Risk Factor Surveillance System data to examine rural-urban and racial/ethnic differences within rural in three domains of access to health care services (affordability, accommodation, and acceptability) that are less frequently examined in population-based surveys.
    Research center: Rural and Minority Health Research Center
    Topics: Health disparities and health equity, Healthcare access, Minority health
  • Rural/Urban Differences in Health and Health Care Access for LGBT Adults
    The purpose of this project was to identify rural/urban differences in health and health care access for lesbian, gay, bisexual, and transgender (LGBT) adults. We also identified within-rural differences among LGBT adults by race, ethnicity, age, disability status, and socio-economic status. Finally, we identified examples of best practices supporting LGBT health and wellness in rural areas.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Aging, Cancer, Disabilities, Health disparities and health equity, Healthcare access, Lesbian, Gay, Bisexual, Transgender, Queer (LGBTQ+), Mental and behavioral health, Minority health, Poverty, Rural statistics and demographics, Social determinants of health
  • Rural/Urban Differences in Postpartum Health Insurance, Healthcare Use, and Health Outcomes
    The purpose of this project was to identify rural/urban differences in health insurance, healthcare use, and health outcomes among postpartum individuals, and to describe policy-relevant implications or strategies to improve insurance coverage, receipt of recommended healthcare, and, ultimately, health outcomes among rural residents who give birth. With a lens towards health equity, all analyses were stratified by race/ethnicity and income.
    Research center: University of Minnesota Rural Health Research Center
    Topics: American Indians and Alaska Natives, Health disparities and health equity, Healthcare access, Healthcare financing, Hispanics, Hospitals and clinics, Legislation and regulation, Maternal health, Medicaid and CHIP, Minority health, Private health insurance, Women

2022

  • Aging in Place in Rural America: What Does It Look Like and How Can It Be Supported?
    In general, people want to age in place. This project looked at the structures in place to help them do so and how those structures vary by rurality. Federal, state, and local policy implications for improving health outcomes and quality of life for rural older adults aging in place were also be identified.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Aging, Disabilities, Health disparities and health equity, Healthcare access, Home health, Long-term care, Social determinants of health
  • Evaluating the Rural HIV/AIDS Planning Grant Program
    The Rural HIV/AIDS Planning Grant program is administered by the Federal Office of Rural Health Policy to plan and develop healthcare networks designed to address HIV/AIDS prevention and treatment in states disproportionately impacted by the virus. This project identified factors that facilitate and impede success of such planning efforts.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Care management, Chronic diseases and conditions, Health disparities and health equity, Healthcare access, Minority health, Networking and collaboration
  • Living Alone: Rural-Urban Differences in Prevalence, Socio-Demographic Correlates, and Health Needs Across the Lifespan
    This project's purpose was to document rural-urban differences in the prevalence of living alone across different age groups, describe rural-urban differences in the socio-demographic correlates and health needs of individuals living alone, and identify rural-relevant policies and programs to support rural residents living alone across the lifespan.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Health disparities and health equity, Social determinants of health
  • 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
  • Rural and Urban Variation in Family Physicians' Demographics and Practices
    This project examined changes in personal demographics of family physicians comparing urban and rural areas, how these changes aligned with those of the populations they serve, and how rural physician practices have changed over time. This project used American Board of Family Medicine data.
    Research center: Rural and Underserved Health Research Center
    Topics: Health disparities and health equity, Minority health, Physicians, Rural statistics and demographics
  • Rural Hospital Closure and Effect on Local Economies
    Several research projects have analyzed the health effects of rural hospital closures. However, highly cited evidence on the economic effects of rural hospital closures is more than a decade old. The purpose of this study was to quantify the economic impact rural hospital closures have on communities.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Health disparities and health equity, Health reform, Healthcare access, Healthcare financing, Hospitals and clinics, Medicare
  • 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
  • Safe Obstetric Care Access for All Rural Residents: Minimum Standards for Clinical, Workforce, and Financial Viability of Rural Obstetric Units
    The goal of this project was to analyze data from rural hospitals to understand the criteria by which hospitals and communities assess their need and capacity for obstetric care access in rural counties and to describe effective ways to operationalize minimum standards for clinical safety and financial viability for rural obstetric units.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Critical Access Hospitals (CAHs), Health disparities and health equity, Healthcare access, Hospitals and clinics, Maternal health, Women, Workforce
  • 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
  • Unintentional Injury in Metropolitan and Nonmetropolitan Settings by Race or Ethnicity
    This study described the rates of fatal and nonfatal unintentional injury comparing metropolitan and nonmetropolitan areas, stratified by race or ethnicity. This study used Centers for Disease Control WONDER data (2014-2018) and the 2018 National Hospital Ambulatory Medical Care Survey.
    Research center: Rural and Underserved Health Research Center
    Topics: Emergency medical services (EMS) and trauma, Health disparities and health equity

2021

  • Cardiovascular & Cancer Rates for the Rural Delta Region
    This interactive tool can be used to compare county-level rates and incidence of cancer and cardiovascular related health measures for people residing in the lower Mississippi River Delta Region. Users may filter by various health measures and download images and data.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Cancer, Chronic diseases and conditions, Diabetes, Health disparities and health equity, Obesity
  • Comparison of Rural Hospital Closures and the Communities Served, 1990-2020
    This project examined rural hospital closures during three decades to profile community characteristics, health status, health care services, and resources available in communities where rural hospitals have closed.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Health disparities and health equity, Health reform, Healthcare access, Healthcare financing, Hospitals and clinics, Medicare
  • Do Rural Breast and Colorectal Cancer Patients Present at More Advanced Disease Stages than Their Urban Counterparts?
    Access to recommended cancer screening is more difficult for rural residents than their urban counterparts. This study used the Surveillance, Epidemiology and End Results Program (SEER) data to examine the extent to which rural residents present at more advanced disease stages for breast and colorectal cancer diagnosis than urban residents.
    Research center: WWAMI Rural Health Research Center
    Topics: Cancer, Health disparities and health equity, Health promotion and disease prevention, Health services
  • Lung Diseases Among Coal Miners
    Coal miners are at increased risk of lung diseases. Using secondary datasets, we will assess the distribution of lung diseases across regions, identify patterns of healthcare utilization among miners relative to HRSA-funded Black Lung Clinics, and compare healthcare utilization patterns, behaviors, and comorbidities among miners and non-miners.
    Research center: Rural and Underserved Health Research Center
    Topics: Chronic diseases and conditions, Environmental and agricultural health, Health disparities and health equity, Health services
  • Rural Variation in Access to Naloxone for Opioid Overdose Prevention
    This project examined variability in access to naloxone-based metropolitan/nonmetropolitan dispensing counts from a representative sample of outpatient pharmacies across the U.S.
    Research center: Rural and Underserved Health Research Center
    Topics: Health disparities and health equity, Healthcare access, Pharmacy and prescription drugs, Substance use and treatment
  • Rural Versus Urban Prevalence of Intimate Partner Violence
    This project determined rural-urban disparities in the prevalence of intimate partner violence-related hospitalizations using a national representative sample of hospital admissions for the period between 2009-2014 using data from the national Healthcare Cost and Utilization Project.
    Research center: Southwest Rural Health Research Center
    Topics: Health disparities and health equity, Violence and abuse, Women
  • The Association of Occupation with Mental Illnesses and Death by Suicide
    This study examined the association of occupational risk factors with mental illnesses, all-cause mortality, and suicide.
    Research center: Rural and Underserved Health Research Center
    Topics: Health disparities and health equity, Mental and behavioral health, Social determinants of health
  • Trends in Preterm Birth by Rural Status in the U.S.
    This project determined rates of preterm birth by rural versus urban residence and across census regions. The project also examined the relationship between preterm birth and maternal characteristics, including race and ethnicity as well as pregnancy complications among women in rural versus urban residence.
    Research center: Southwest Rural Health Research Center
    Topics: Health disparities and health equity, Maternal health, Women

2020

  • Disaster Planning, Preparedness, & Response for Rural Long-Term Care Providers
    This project collected and analyzed data that captures how disasters affect long-term care services and patient experiences in rural areas. We developed and pilot test long-term care provider survey, and conducted case studies of disaster-impacted, rural communities with respect to implications for long-term care services.
    Research center: Southwest Rural Health Research Center
    Topics: Emergency preparedness and response, Health disparities and health equity, Long-term care
  • Disparities in Preventive Care by Race and Ethnicity Among Rural Adults
    The purpose of this project is to identify differences in access to and use of preventive care by race and ethnicity among rural residents. Results from this project will identify racial/ethnic disparities that exist within rural communities and may guide targeted interventions to improve equity and increase access to high-quality healthcare for all rural residents.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Health disparities and health equity, Healthcare access, Hispanics, Minority health, Rural statistics and demographics
  • Emergency Obstetrics in Communities Without Hospital-Based Maternity Care
    The purpose of this project was to describe rural hospitals that do not provide obstetric services and to survey a sample of these hospitals regarding their capacity for emergency obstetrics locally in order to inform policy to support access to high-quality maternity care for all pregnant rural residents.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Health disparities and health equity, Health services, Healthcare access, Hospitals and clinics, Maternal health, Quality, Women
  • Healthcare Use and Access Among Rural & Urban Non-elderly Disabled Medicare Beneficiaries
    This project explored healthcare use and barriers to healthcare access among disabled Medicare beneficiaries under 65 in rural and urban areas. The study was based on quantitative analyses of the 2009-2013 Medicare Current Beneficiary Survey.
    Research center: Maine Rural Health Research Center
    Topics: Disabilities, Health disparities and health equity, Medicare
  • 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
  • Making It Work: Models of Success in Rural Maternity Care
    The purpose of this project was to update information on access to obstetric services in rural counties, to identify common factors across rural communities that have maintained local hospital-based obstetric services, and to describe best practices associated with successfully supporting birth locally in rural communities.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Health disparities and health equity, Health services, Healthcare access, Hospitals and clinics, Maternal health, Quality, Women
  • 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
  • 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
  • Understanding Rural-Urban Mortality Differences
    This study will address rural-urban mortality gaps in our understanding of rural mortality disparities using the 1985-2009 National Health Interview Survey (NHIS), linked to national death certificate data, to explore the individual-level characteristics and health behaviors of rural and urban adults and their association with mortality.
    Research center: Maine Rural Health Research Center
    Topic: Health disparities and health equity

2019

  • Community Health Worker Roles, Regulation and Growth in Rural America
    This study looked at the role of Community Health Workers in improving access to healthcare services in rural and urban environments. The project focused on the growing and changing roles of these influential actors and how their responsibilities vary based on setting (hospital, clinic, community, etc.), location (rural vs. urban), and regulations.
    Research center: Southwest Rural Health Research Center
    Topics: Health disparities and health equity, Healthcare access
  • Developing Rural-Relevant Strategies to Reduce Maternal Morbidity
    The purpose of this project was to distinguish and analyze predictors of maternal morbidity during childbirth hospitalization by geography and to develop recommendations to improve the safety of childbirth for rural residents. It also assessed the degree of rural focus and representation in current policy efforts to address this crisis.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Health disparities and health equity, Health services, Healthcare access, Hospitals and clinics, Legislation and regulation, Maternal health, Quality, Women
  • Do Rural Communities Have a Higher Rate of Avoidable Deaths?
    Based on some estimates, roughly half of deaths were avoidable in the sense they stem from risky behavior. What was less well known was the degree to which there was a rural-urban disparity in this rate.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Cancer, Health disparities and health equity
  • Predictors of Buprenorphine Prescribing by Family Physicians in Rural Areas Nationally
    This project examined how physician and practice-level characteristics are associated with family physicians prescribing buprenorphine for opioid use disorder across rural and urban areas. The study made use of a unique dataset collected among family physicians nationally in 2017.
    Research center: Rural and Underserved Health Research Center
    Topics: Health disparities and health equity, Health services, Mental and behavioral health, Pharmacy and prescription drugs, Physicians, Substance use and treatment
  • 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

2018

  • Barriers and Disparities Associated with Pneumococcal Immunization Among Rural Elderly Adults
    Our Center conducted analyses of national survey data and unique insurance claims data sets to identify how rurality of residence and key demographic, social, and economic characteristics serve as barriers or facilitators to vaccination against pneumococcal disease, which is relatively common although largely preventable among older Americans.
    Research center: Rural and Underserved Health Research Center
    Topics: Health disparities and health equity, Health promotion and disease prevention
  • For Amber "Waives" of Grain: The Impact of Medicaid Managed Care Waiver Programs on Care Choices in Rural America
    This project used a combination of systematic review of waiver content and structured interviews with key informants to assess the potential for rural disparities in access to care for Medicaid enrollees.
    Research center: Rural and Minority Health Research Center
    Topics: Health disparities and health equity, Medicaid and CHIP
  • Health Insurance Marketplaces, Medicaid, and Uncompensated Care: The Rural Impact
    This project provides an in-depth analysis of Health Insurance Marketplace (HIM) plan design, specifically measuring the availability and prevalence of high-deductible plans in rural as compared to urban areas.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Health disparities and health equity, Healthcare access, Medicaid and CHIP, Uninsured and underinsured
  • Implications of Rural Ambulance Service Closures
    The purpose of this project was to examine closed ambulance services and those ambulance services adjacent to the closed units. The ambulance services adjacent to those which closed were examined by service area, workload, and staffing for one year prior to and one year after the adjacent service closure.
    Research center: North Dakota and NORC Rural Health Reform Policy Research Center
    Topics: Allied health professionals, Emergency medical services (EMS) and trauma, Frontier health, Health disparities and health equity, Health services, Workforce
  • Rural/Urban Differences in Chronic Diseases and Delay of Needed Care
    This project examined rural versus urban differences in the prevalence, incidence, stage, and severity of several chronic diseases, including heart disease, stroke, and selected cancers. There was a focus on delayed access to needed care and whether rural residents present later and with more advanced disease states.
    Research center: Southwest Rural Health Research Center
    Topics: Cancer, Chronic diseases and conditions, Health disparities and health equity
  • 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
  • The Impact of Medicaid Expansion on Rural/Urban Variations in Access to Substance Use Treatment
    Research indicates that substance use treatment access is insufficient in rural areas. We made use of our rare access to restricted use NSDUH data to offer new insights about the impact of Medicaid expansion on access to substance abuse treatment among individuals with substance abuse disorders, analyzing 13 years (2004-2016).
    Research center: Rural and Underserved Health Research Center
    Topics: Health disparities and health equity, Health services, Substance use and treatment
  • Variation in Scope of Practice and Medical Services Available at Family Physician Practices within Rural Areas
    Using data collected during recertification of family physicians by the American Board of Family Medicine, we examined variation in the scope of practice of family physicians and services available in the primary practice site by degree of rurality and within rural categories by community-level deprivation, as well as variation by Patient Centered Medical Home status.
    Research center: Rural and Underserved Health Research Center
    Topics: Health disparities and health equity, Health services, Physicians

2017

  • Exploring Regional Differences in Rural and Urban Mortality Trends
    Explores the differences in U.S. mortality rates by urban and rural location, census division, and urban and rural location within each census division. The gap in nationwide urban-rural mortality is often told as a national story, but the changes are regional. This implies different regions may need different strategies for addressing the gap.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topic: Health disparities and health equity
  • Exploring the Impact of Rural Hospital Closures on Use of Emergency Medical Services
    Using a unique national database, The Enterprise Data Trust, we will explore pre- and post-closure hospital emergency department use with specific emphasis on those who used public emergency medical transportation, testing for significant changes. This study will be the first to look at the impacts of rural hospital closure at the patient level.
    Research center: Rural and Underserved Health Research Center
    Topics: Emergency medical services (EMS) and trauma, Health disparities and health equity, Health services, Transportation
  • Healthcare Access and Affordability Among Rural Children with Public Versus Private Health Insurance
    To examine differences in healthcare access and affordability among rural children with public (i.e., Medicaid or CHIP) and private health insurance coverage, the study will address the a number of research questions, using data from the 2011-12 National Survey of Children's Health.
    Research center: Maine Rural Health Research Center
    Topic: Health disparities and health equity

2015

  • Expanded Look at Rural Access to Care
    This study will use newly available national health survey data to examine rural-urban differences in access to medical care, access to insurance, and affordability of care.
    Research center: Maine Rural Health Research Center
    Topics: Health disparities and health equity, Uninsured and underinsured
  • 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 Maternal Smoking Behaviors
    In this project, we will develop a chart book documenting the prevalence of mental health/substance abuse conditions and describing the utilization of mental health services in rural and urban settings.
    Research center: Maine Rural Health Research Center
    Topics: Health disparities and health equity, Mental and behavioral health, Substance use and treatment

2014

  • Examination of Trends in Rural and Urban Health: Establishing a Baseline for Health Reform
    The purpose of this project is to update and supplement the seminal Health, United States, 2001: Urban and Rural Health Chartbook. Resulting information can not only be compared to the 2001 Chartbook but provides a baseline from which to measure future change related to the Accountable Care Act implementation. Where appropriate additional charts are included wherein rural areas are subdivided by type.
    Research center: North Dakota and NORC Rural Health Reform Policy Research Center
    Topics: Health disparities and health equity, Health services, Public health
  • Prevalence and Impact of High Deductible Health Insurance Plans in Rural Areas
    This study will use national health survey data to examine whether privately insured rural residents are more likely than their urban counterparts to have plans with high deductibles. It will also assess whether high deductible health plans create health care barriers for rural residents, and if these differ from the barriers experienced by those in urban areas.
    Research center: Maine Rural Health Research Center
    Topics: Health disparities and health equity, Private health insurance
  • 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

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

2011

  • 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

2009

  • 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

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
  • National Study of Substance Abuse Prevalence and Treatment Services in Rural Areas
    This project will research the prevalence of the abuse of legal and illegal substances across rural populations and geographic areas, including the extent to which rural individuals are receiving treatment for their substance abuse and barriers to the receipt of treatment.
    Research center: Maine Rural Health Research Center
    Topics: Health disparities and health equity, Health services, Rural statistics and demographics, Substance use and treatment
  • Rural-Urban Differences In The Use, Type, And Quality Of Depression Treatment
    As access to evidence-based treatment for affective disorders (major depressive disorder, dysthymia, and bipolar disorder) improves in urban areas, it is critical to monitor rural-urban differences in the use and quality of treatment over time to identify and address rural disparities, especially for vulnerable populations such as the elderly and ethnic minorities.
    Research center: WICHE Center for Rural Mental Health Research
    Topics: Aging, Health disparities and health equity, Mental and behavioral health, Minority health

2007

  • Breast, Cervical, Colorectal, and Prostate Cancer Screening in Rural America: Does Proximity to a Metropolitan Area Matter?
    The study compared cancer screening rates among various levels of rural versus urban Behavioral Risk Factor Surveillance System respondents and among white respondents versus those from racial/ethnic minority groups.
    Research center: WWAMI Rural Health Research Center
    Topics: Cancer, Health disparities and health equity, Health promotion and disease prevention, Minority health
  • Burden of Asthma Among Rural Residents: A National Study
    This study uses data from the Behavioral Risk Factor Surveillance System (BRFSS) to examine the prevalence of and trends in asthma among rural residents by type of geographic location and by key risk factors.
    Research center: WWAMI Rural Health Research Center
    Topics: Chronic diseases and conditions, Health disparities and health equity, Minority health, Rural statistics and demographics
  • Diabetes Burden and the Lack of Preventive Care in the Rural United States
    The project is designed to determine if there are disparities in diabetes care provided to persons with diabetes residing in rural areas as compared to those in urban areas. Additionally, the project will examine diabetes related health care resource utilization with implications for improving care and reducing the economic burden.
    Research center: FORHP-funded Individual Grantees
    Topics: Chronic diseases and conditions, Diabetes, Health disparities and health equity, Public health

2006

  • 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

2005

  • 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
  • Diabetes and Hypertension in Rural Hispanics
    The project will examine the similarities and differences between rural and urban Hispanics and Caucasian adults diagnosed with diabetes mellitus and hypertension.
    Research center: Rural and Minority Health Research Center
    Topics: Chronic diseases and conditions, Diabetes, Health disparities and health equity, Hispanics, Minority health
  • Disability Burdens Among Rural and Urban Older Americans
    This project will use the 1994-2000 Second Longitudinal Study of Aging to develop detailed estimates of healthy, disabled, and total life expectancy among rural and urban populations. We will develop and compare the estimates between women and men, by race/ethnicity, and across differing levels of education.
    Research center: Rural and Minority Health Research Center
    Topics: Aging, Disabilities, Health disparities and health equity, Long-term care, Rural statistics and demographics
  • 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
  • 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

2003

2002