Rural Health
Research Gateway

Health disparities and health equity

Research Products & Journal Articles

Browse the full list of research publications on this topic completed by the Rural Health Research Centers.

Products – Freely accessible products include policy briefs, fact sheets, full reports, chartbooks, and interactive data websites.

Journal Articles – Articles in peer-reviewed journals may require a subscription or affiliation with a subscribing library. For these publications, Gateway lists the article citation, a brief summary, a link to additional information and access to the full-text of the article, if available.

2024

2023

2022

2021

2020

  • The Declining Scope of Practice of Family Physicians Is Limited to Urban Areas
    Journal Article
    Rural and Underserved Health Research Center
    Date: 11/2020
    The scope of practice for family medicine physicians has decreased in recent years. Using survey data, researchers compared family medicine physicians' scope of practice scores based on rural-urban status and other variables. Researchers found statistically significant decreases in scope of practice scores in urban settings.
  • 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.
  • Long-Term Care Planning, Preparedness, and Response Among Rural Long-Term Care Providers
    Journal Article
    Southwest Rural Health Research Center
    Date: 09/2020
    This manuscript explores how rural long-term care providers plan, prepare, and respond to slowly or rapidly unfolding disasters (i.e., hurricanes, wildfires, and environmental spills) in three U.S. geographic areas. Data includes secondary sources and semi-constructed interviews with long-term care facilities and disaster management organizations.
  • Racial and Ethnic Differences in Self-Rated Health Among Rural Residents
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 09/2020
    This study looks at racial and ethnic differences in self-rated health among rural residents as well as whether these differences can be explained by socio-demographic characteristics. Researchers used data from the 2011–2017 National Health Interview Survey to study differences in rural residents' self-rated health by race and ethnicity.
  • Characteristics of U.S. Rural Hospitals by Obstetric Service Availability, 2017
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 08/2020
    This study described characteristics of rural U.S. hospitals by whether they provide labor and delivery care for pregnant patients. Researchers used the 2017 American Hospital Association Annual Survey to identify rural hospitals and detail their characteristics based on whether they provide obstetric services.
  • Rural Versus Urban Prevalence of Intimate Partner Violence-Related Emergency Department Visits, 2009-2014
    Policy Brief
    Southwest Rural Health Research Center
    Date: 08/2020
    This project examines rural-urban disparities in the prevalence of intimate partner violence-related emergency department visits using a nationally representative sample of emergency room visits for the years 2009-2014.
  • Rural-Urban Differences Among Older Adults
    Chartbook
    University of Minnesota Rural Health Research Center
    Date: 08/2020
    This chartbook presents the characteristics of older adults in rural counties, as well as rural-urban differences among older adults, across four domains: demographics, socioeconomic characteristics, healthcare access and use, and health characteristics.
  • Changes in Hospital-Based Obstetric Services in Rural U.S. Counties, 2014-2018
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 07/2020
    In 2014, 54% of rural U.S. counties had no hospital-based obstetric services, following a steady decrease during the previous decade. Loss of rural maternity care is tied to adverse maternal and infant health outcomes. This study shares hospital-based obstetric service losses in rural U.S. counties from 2014 to 2018.
  • Mortality Among Workers Employed in the Mining Industry in the United States: A 29‐Year Analysis of the National Health Interview Survey—Linked Mortality File, 1986‐2014
    Journal Article
    Rural and Underserved Health Research Center
    Date: 07/2020
    Working in the mining industry increases the risk of chronic diseases and mortality. We investigated overall and cause‐specific mortality rates among workers employed in the mining sector in the U.S.
  • Post-Acute Skilled Nursing Care Availability in Rural United States
    Policy Brief
    Southwest Rural Health Research Center
    Date: 07/2020
    This policy brief explores factors related to variations in the availability of post-acute skilled nursing care in rural areas in the U.S. The focus of this analysis is on swing bed program hospitals and skilled nursing facility post-acute skilled nursing care.
  • 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.
  • Supporting the Health and Wellbeing of Middle-Aged Adults Living Alone in Rural Counties
    University of Minnesota Rural Health Research Center
    Date: 06/2020
    This report shares insights from healthcare providers in 14 rural counties with the highest rates of middle-aged adults living alone in order to inform policy and practice in how best to support the health and well-being of this demographic.
  • The Unique Impact of COVID-19 on Older Adults in Rural Areas
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 06/2020
    Older adults in rural areas of the U.S. face unique risks related to COVID-19, which puts them at risk of not only the virus, but of not being able to meet their healthcare, social, and basic needs. Rural/urban inequities, combined with within-rural inequities in health, healthcare, and financial resources cause particular challenges.
  • Characteristics of Counties With the Highest Proportion of the Oldest Old
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 05/2020
    The "oldest old," or individuals age 85 and older, are one of the fastest-growing segments of the U.S. population, yet little is known about where those individuals tend to live and what their communities are like. This information is important for planning how to best respond to and support this growing population.
  • Differences by Rurality in Satisfaction With Care Among Medicare Beneficiaries
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 05/2020
    There are stark differences between rural and urban areas in demographic characteristics, health status, and healthcare. Yet less is known about rural‐urban differences in Medicare beneficiaries' satisfaction with care. We seek to understand rural‐urban differences in satisfaction with care for Medicare beneficiaries.
  • Factors Affecting the Likelihood of a Hospitalization Following a Diabetes-Related Emergency Department Visit: A Regional and Urban-Rural Analysis
    Journal Article
    Southwest Rural Health Research Center
    Date: 05/2020
    This study examines place-based and individual-level predictors of diabetes-related hospitalizations using 2009-2014 data from the National Inpatient Sample. Our findings indicate a higher incidence of these hospitalizations in residents of noncore areas in the South and Midwest, racial and ethnic minorities, and the uninsured population.
  • Rural-Urban Residence and Mortality Among Three Cohorts of U.S. Adults
    Policy Brief
    Maine Rural Health Research Center
    Date: 05/2020
    Rural residents have a shorter life expectancy than urban residents. We analyzed national linked survey and death certificate data and found risk of death was 10% higher for rural than urban residents and has increased over time. Findings suggest the overall mortality penalty in rural areas may be partly driven by social determinants of health.
  • Rates of Living Alone by Rurality and Age
    University of Minnesota Rural Health Research Center
    Date: 04/2020
    In this infographic, we identify rates of living alone for all adults and within specific age groups using two classifications of rurality.
  • Estimating the Prevalence and Spatial Clusters of Coal Workers' Pneumoconiosis Cases Using Medicare Claims Data, 2011‐2014
    Journal Article
    Rural and Underserved Health Research Center
    Date: 03/2020
    Workers in the coal mining sector are at increased risk of respiratory diseases, including coal workers' pneumoconiosis (CWP). We investigated the prevalence of CWP and its association with sociodemographic factors among Medicare beneficiaries. We found evidence of significant spatial clustering of CWP in the states and population analyzed.
  • Healthy People 2020 Progress for Leading Causes of Death in Rural and Urban America: A Chartbook
    Chartbook
    Southwest Rural Health Research Center
    Date: 03/2020
    The purpose of this project is 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.
  • Early-Career and Graduating Physicians More Likely to Prescribe Buprenorphine
    Journal Article
    Rural and Underserved Health Research Center
    Date: 01/2020
    Only a small percentage of people who need treatment for opioid use disorder receive it, including buprenorphine. This paper shows differences in rates of prescribing buprenorphine and intentions to prescribe buprenorphine between early- and mid-to-late career family physicians, based on a survey of physicians taking a certification examination.
  • Health Care Use and Access Among Rural and Urban Nonelderly Adult Medicare Beneficiaries
    Policy Brief
    Maine Rural Health Research Center
    Date: 01/2020
    Little is known about the characteristics and healthcare use of rural residents with disabilities. This study compares access to and use of health services among rural and urban nonelderly Medicare beneficiaries with a disability and the factors associated with rural access issues.
  • Practice Predictors of Buprenorphine Prescribing by Family Physicians
    Journal Article
    Rural and Underserved Health Research Center
    Date: 01/2020
    Physicians may prescribe buprenorphine if they obtain a waiver, but relatively few family physicians do so. This paper examines the association between practice characteristics and the likelihood that a family physician will prescribe buprenorphine, based on a survey of physicians seeking board certification in family medicine.

2019

  • Congestive Heart Failure-Related Hospital Deaths Across the Urban-Rural Continuum in the United States
    Journal Article
    Southwest Rural Health Research Center
    Date: 12/2019
    This study examines congestive heart failure (CHF)-related, in-hospital mortality across six levels of rurality and four census regions. Results indicated CHF-related hospital admissions in small metropolitan, micropolitan, and noncore areas, compared to large central metropolitan areas, were more likely to result in death.
  • Healthy People 2020: Rural Areas Lag in Achieving Targets for Major Causes of Death
    Journal Article
    Southwest Rural Health Research Center
    Date: 12/2019
    For the period 2007-2017 rural death rates were higher than urban rates for the seven major causes of death analyzed, and disparities widened for five of the seven. In 2017 urban areas had met national targets for three of the seven causes, while rural areas had met none of the targets.
  • 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.
  • The Prevalence of Chronic Diseases Among Current and Ex-Miners in the United States
    Journal Article
    Rural and Underserved Health Research Center
    Date: 12/2019
    This paper compares the prevalence and odds of chronic diseases among ex-miners and current miners, adjusting for certain variables that might influence health outcomes. The analysis found that the prevalence of chronic disease is significantly higher among ex-miners.
  • Rural Counties With Majority Black or Indigenous Populations Suffer the Highest Rates of Premature Death in the U.S.
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 12/2019
    Despite well-documented health disparities by rurality and race/ethnicity, research investigating racial/ethnic health differences among U.S. rural residents is limited. We used county-level data to measure and compare premature death rates in rural counties by each county's majority racial/ethnic group.
  • Rural-Urban Differences in Severe Maternal Morbidity and Mortality in the U.S., 2007-15
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 12/2019
    In the U.S., severe maternal morbidity and mortality (SMMM) is climbing—a reality that is especially challenging for rural communities, which face declining access to obstetric services. Using data for 2007-15 from the National Inpatient Sample, we analyzed SMMM during childbirth hospitalizations among rural and urban residents.
  • Differences in Preventive Care Among Rural Residents by Race and Ethnicity
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 11/2019
    Disparities in preventive care by rural and urban location and by race and ethnicity are well documented in the literature, but less is known about whether there are differences in healthcare use among rural residents by race and ethnicity. We address this gap by examining differences in preventive care among rural residents by race and ethnicity.
  • Hospital Closures and Short-Run Change in Ambulance Call Times
    Journal Article
    Rural and Underserved Health Research Center
    Date: 11/2019
    Hospital closures affect the availability of emergency department services. This paper examines changes in ambulance ride times in areas with hospital closures compared to those in similar areas without hospital closures and separately analyzes changes in ambulance ride times between urban and rural areas and among Medicare-eligible patients.
  • Prevalence and Mortality of Heart Disease and Related Conditions: Disparities Affecting the South, Rural Areas, and American Indian and Alaska Natives
    Policy Brief
    Southwest Rural Health Research Center
    Date: 11/2019
    This policy brief identifies trends in the prevalence of stroke, heart disease, and heart attack while also assessing trends in mortality for heart disease and related conditions across the nation. The study examined whether disease-related mortality and prevalence varied across place and time.
  • Severe Maternal Morbidity and Hospital Transfer Among Rural Residents
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 11/2019
    In this brief, we compare hospital transfer rates for rural and urban residents who gave birth. We also provide descriptive information about the relationship between transfer status and severe maternal morbidity and mortality for rural residents nationally who gave birth 2008-2014.
  • Risk Factors and Potentially Preventable Deaths in Rural Communities
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 10/2019
    In this study, we use variation in three risk factors – smoking, obesity, and excessive alcohol use – to identify their relative contribution to common causes of mortality.
  • Investigating the Impact of Geographic Location on Colorectal Cancer Stage at Diagnosis: A National Study of the SEER Cancer Registry
    Journal Article
    WWAMI Rural Health Research Center
    Date: 08/2019
    Access to recommended cancer screening is more difficult for rural than urban residents. As a result, rural patients may present at later stages than urban patients due to delays in detection. This study compared the adjusted rates of and late colorectal cancer staging at diagnosis between patients residing in urban and rural counties.
  • Declining Endoscopic Care by Family Physicians in Both Rural and Urban Areas
    Journal Article
    Rural and Underserved Health Research Center
    Date: 07/2019
    This paper explores the decline in the percentage of family physicians providing endoscopic services overall and in urban and rural areas. This has implications on the availability of colonoscopies, endoscopies, and flexible sigmoidoscopies in areas that lack specialists who perform such services.
  • 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).
  • Comparing Rural and Urban Medicare Advantage Beneficiary Characteristics
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 03/2019
    This brief reports few rural and urban differences in observed demographic characteristics among enrollees in the Medicare Advantage program. Issuers often exclude rural counties from their service areas, but we find no evidence that this is due to such demographics, suggesting that other reasons relating to population size may be more likely.
  • Dying Too Soon: County-Level Disparities in Premature Death by Rurality, Race, and Ethnicity
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 03/2019
    In this brief, we examined county-level differences in premature death (years of potential life lost before age 75 per 100,000 people) by county-level racial and ethnic composition, across rural and urban counties. We also calculated whether there were rural-urban disparities in mortality within counties with similar racial and ethnic compositions.
  • The Changing Landscape of Diabetes Mortality in the United States Across Region and Rurality, 1999-2016
    Journal Article
    Southwest Rural Health Research Center
    Date: 02/2019
    This brief report examines place-based differences in diabetes mortality to understand whether disparities in diabetes mortality have changed across U.S. Census regions and levels of rurality over time. Reductions in diabetes mortality are lagging in rural areas, and the rural South in particular, relative to other areas of the country.
  • Diabetes-Related Hospital Mortality in the U.S.: A Pooled Cross-Sectional Study of the National Inpatient Sample
    Journal Article
    Southwest Rural Health Research Center
    Date: 02/2019
    This study examined place-based and individual-level variations in diabetes-related hospital deaths using the 2009-2015 National Inpatient Sample. Results show that place-based disparities exist. Targeted focus should be placed on the control of diabetic complications in the South, West, and Midwest census regions and among rural residents.
  • Do Hospital Closures Affect Patient Time in an Ambulance?
    Policy Brief
    Rural and Underserved Health Research Center
    Date: 02/2019
    Our study explores how a local hospital closure changes patient time in an ambulance for 9-1-1 calls. Access to emergency department services in communities, especially rural communities, persists as a priority for the Medicare program. We found when hospitals close, rural patients requiring ambulance services are disproportionately affected.

2018

  • Cancer Mortality in Rural America: 1999-2016
    Policy Brief
    Southwest Rural Health Research Center
    Date: 11/2018
    This policy brief details the differences in mortality from cancer at various levels of rurality in America. The primary aim of this study was to understand the scope of cancer mortality in urban and rural areas of the U.S. Common cancer types—breast, cervical, lung, prostate, and colon—were analyzed over an 18-year period from 1999-2016.
  • Rural-Urban Differences in Hospital Payer Mix in 2017
    Fact Sheet
    Rural and Minority Health Research Center
    Date: 11/2018
    This work revealed that rural hospitals heavily rely on Medicare.
  • Update: Rural/Urban Disparities in Pneumococcal Vaccine Service Delivery Among the Fee-for-Service Medicare Population, 2012-2015
    Policy Brief
    Rural and Underserved Health Research Center
    Date: 11/2018
    Delivery of pneumococcal vaccines to fee-for-service Medicare beneficiaries increased 380% from 2014-2015 as a result of uptake of pneumococcal conjugate vaccine (PCV13). However, a significant rural-urban disparity remains. Pharmacy providers delivered a significantly greater proportion of vaccines in rural versus urban counties.
  • Rural-Urban Differences in Risk Factors for Motor Vehicle Fatalities
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 09/2018
    This study uses 2017 County Health Rankings data to run stratified regression models to estimate county-level correlates of motor vehicle fatalities (MVFs) by rural and urban location. We found that rural counties have higher rates of MVFs than urban counties (22 vs. 14 per 100,000, p<0.001).
  • A National Examination of Caregiver Use of and Preferences for Support Services: Does Rurality Matter?
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 07/2018
    The objective of this study was to assess rural-urban differences in caregiver use of and preferences for support services.
  • Geographic Variation in the Supply of Selected Behavioral Health Providers
    Journal Article
    WWAMI Rural Health Research Center
    Date: 06/2018
    This study examined the supply of select behavioral health providers by metropolitan, micropolitan, and non-core county and Census Division. Psychiatrists, psychologists, and psychiatric nurse practitioners are unequally distributed throughout the U.S., with disparities between Census Divisions and rural vs. urban areas.
  • Rural-Urban Difference in Workplace Supports and Impacts for Employed Caregivers
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 06/2018
    This study finds that employed rural caregivers had significantly fewer workplace benefits available to them compared with urban caregivers. In particular, employed rural caregivers were less likely to have access to telecommuting, employee assistance programs, and paid leave.
  • Individual- and County-Level Predictors of Cervical Cancer Screening: A Multi-Level Analysis
    Journal Article
    Southwest Rural Health Research Center
    Date: 05/2018
    Despite gains in cervical cancer screening, persistent socio-economic, geographical, racial, and ethnic disparities remain. The objective of this study was to examine the combined effect of individual- and county-level characteristics on the use of cervical cancer screening tests such as Papanicolaou (Pap) tests in Texas.
  • Medicaid Managed Care and the Rural Exception: A Review of Issues and Perspectives From the Field
    Policy Brief
    Rural and Minority Health Research Center
    Date: 05/2018
    To examine the intersection of state Medicaid procedures with rural populations, we conducted a review of Medicaid waivers current as of September 2017. This was supplemented with calls to State Offices of Rural Health (SORHs), state Medicaid offices, and other relevant stakeholders in an attempt to understand the process of waiver development.
  • Diabetes-Related Hospital Mortality in Rural America: A Significant Cause for Concern
    Policy Brief
    Southwest Rural Health Research Center
    Date: 03/2018
    This brief is the third in a series prepared by the Southwest Rural Health Research Center on the topic of diabetes. The aim of this study was to examine trends and rates of diabetes-related deaths for persons hospitalized in the U.S., with emphasis on differences across the urban-rural continuum and across census regions.
  • Rural Family Physicians Have a Broader Scope of Practice Than Urban Family Physicians
    Policy Brief
    Rural and Underserved Health Research Center
    Date: 02/2018
    While the scope of practice of family physicians has been shrinking, they still practice broadly, often due to fewer health care resources in rural areas. Using data from family physicians seeking continued board certification in 2014 and 2015, we found that a high percentage of rural family physicians provide nearly every clinical service queried.
  • Rural Family Physicians in Patient Centered Medical Homes Have a Broader Scope of Practice
    Policy Brief
    Rural and Underserved Health Research Center
    Date: 02/2018
    The Patient Centered Medical Home (PCMH) is supposed to provide accessible and comprehensive care. Using data from family physicians seeking to continue their American Board of Family Medicine certification in 2014 and 2015, we found that rural family physicians in PCMH practices generally provide more services than those in non-PCMH practices.
  • Rural/Urban Disparities in Pneumococcal Vaccine Service Delivery Among the Fee-for-Service Medicare Population
    Policy Brief
    Rural and Underserved Health Research Center
    Date: 02/2018
    Using 2014 Medicare data, we found a significant disparity in pneumococcal vaccine service delivery to fee-for-service Medicare beneficiaries. Although primary care providers delivered the majority of pneumococcal vaccines to this population, pharmacy providers delivered a significantly greater proportion of vaccines in rural versus urban counties.
  • 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.

2017

2016

  • Community Factors and Outcomes of Home Health Care for High-Risk Rural Medicare Beneficiaries
    Policy Brief
    WWAMI Rural Health Research Center
    Date: 10/2016
    Outcomes of care vary by region of the country for rural Medicare beneficiaries receiving home health services for high-risk conditions such as heart failure. Those in the East South Central and West South Central Census Divisions had lower rates of community discharge and higher rates of hospital readmission and emergency department use.
  • Health-Related Quality of Life Among Adults 65 Years and Older in the United States, 2011-2012: A Multilevel Small Area Estimation Approach
    Journal Article
    Rural and Minority Health Research Center
    Date: 10/2016
    This study compiled estimates, at the county level, of poor health-related quality of life among those ages 65 and older. The study examined physical and mental health and found significant differences in health across the United States.
  • Health Insurance Marketplaces: Premium Trends in Rural Areas
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 06/2016
    Total Health Insurance Marketplace premiums have grown disproportionately in rural places in 2016. Urban counties have an average of 4.2 firms, while rural counties average 3.2 firms offering coverage through the HIMs. This causes concern since, at the county level, we find that as the number of firms increases, premiums increase at a slower rate.
  • Exploring Rural and Urban Mortality Differences
    North Dakota and NORC Rural Health Reform Policy Research Center
    Date: 03/2016
    Contains visual aids which display indicators of mortality rates by cause of death, age group, rural-urban status, region, and sex for populations 15 years of age and older cross-referenced to tables and statistical results.
  • Rural Opioid Abuse: Prevalence and User Characteristics
    Policy Brief
    Maine Rural Health Research Center
    Date: 02/2016
    Opioid abuse is the fastest growing substance abuse problem in the nation and the primary cause of unintentional drug overdose deaths. This study examined the rural-urban prevalence of non-medical use of pain relievers and heroin in the past year and the socioeconomic characteristics associated with their use and other risky behavior.

2015

2014

  • The 2014 Update of the Rural-Urban Chartbook
    Chartbook
    North Dakota and NORC Rural Health Reform Policy Research Center
    Date: 10/2014
    This chartbook includes trends and disparities in urban/rural health. Reports on population characteristics include age, race and ethnicity, and poverty; risk factors such as smoking, alcohol use, and obesity; mortality data; health status measures such as adolescent births and total tooth loss; healthcare access/use; and mental health measures.
  • Rural-Urban Disparities in Heart Disease
    Policy Brief
    North Dakota and NORC Rural Health Reform Policy Research Center
    Date: 10/2014
    The Department of Health and Human Services' report Health, United States, 2001: With Urban and Rural Health Chartbook illustrated trends and highlighted priorities in urban/rural health. The Rural Health Reform Policy Research Center replicated the analyses using the most recent data available. This brief highlights key heart disease findings.

2013

  • Demographic and Economic Characteristics Associated With Sole County Pharmacy Closures, 2006-2010
    RUPRI Center for Rural Health Policy Analysis
    Date: 11/2013
    This policy brief describes demographic and economic characteristics associated with counties experiencing closure of their sole pharmacy.
  • Inadequate Prenatal Care Among Racial and Ethnic Groups in the Rural United States, 2005
    WWAMI Rural Health Research Center
    Date: 10/2013
    This brief reports that in most states, rural minority racial/ethnic groups had levels of inadequate prenatal care (less than 50% of expected visits) in the "worst" or "worse than mid-range" categories.
  • Inadequate Prenatal Care in the Rural United States, 2005
    WWAMI Rural Health Research Center
    Date: 10/2013
    This policy brief finds that the states with levels of rural inadequate prenatal care (less than 50% of expected visits) in the "worst" or "worse than mid-range" categories were largely in southern and southwestern areas of the United States.
  • Low Birth Weight Rates Among Racial and Ethnic Groups in the Rural United States, 2005
    WWAMI Rural Health Research Center
    Date: 10/2013
    Reports that non-hispanic blacks generally had the highest rural low birth weight rates of all races/ethnicities, regardless of geographic location.
  • Low Birth Weight Rates in the Rural United States, 2005
    WWAMI Rural Health Research Center
    Date: 10/2013
    This brief shares that the rural U.S. low birth weight rate in 2005 was significantly higher than the urban U.S. low birth weight rate.
  • 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.
  • 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.
  • Rural Border Health Chartbook (Key Facts)
    Rural and Minority Health Research Center
    Date: 01/2013
    This report 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.

2011

2008

2007

2006

2005

2004

2003

2002

2001

2000