Rural Health
Research Gateway

Rural statistics and demographics

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

  • Excess Deaths Associated With COVID-19 by Rurality and Demographic Factors in the United States
    Journal Article
    Maine Rural Health Research Center
    Date: 12/2023
    Researchers analyzed U.S. mortality data to quantify excess deaths during the COVID-19 pandemic to describe rural-urban disparities by age, sex, and race/ethnicity. There were nearly 17% more deaths than expected between March 2020 and February 2023.
  • Medicare Advantage Enrollment Update 2023
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis, Rapid Response to Requests for Rural Data Analysis
    Date: 11/2023
    This policy brief continues RUPRI Center's annual update of Medicare Advantage (MA) enrollment including the changes in enrollment in types of MA plans, and health policy changes that may have had an impact.
  • Key Informant Perspectives on Rural Housing and Health
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 10/2023
    In this policy brief, using content analysis of interview data, researchers share rural-specific housing barriers, including those that are related to health, as well as policy recommendations for addressing housing challenges to improve rural health.
  • Unmet Needs for Help With Mobility Limitations Among Older Adults Aging in Place: The Role of Rurality
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 10/2023
    This study identifies differences in unmet mobility needs among older adults by rurality. It uses data from the National Health and Aging Trends Study, limiting analyses to respondents who had not moved since baseline (average housing tenure of 27 years; n = 3343).
  • Differences in Residential Stability by Rural/Urban Location and Socio-Demographic Characteristics
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 08/2023
    This policy brief identifies rural/urban differences in residential stability and examines rural/urban differences in regional, socio-demographic, and health characteristics associated with living in the same home for more than 20 years.
  • Distributional Analysis of Variation in Medicare Advantage Participation Within and Between Metropolitan, Micropolitan, and Noncore Counties
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis, Rapid Response to Requests for Rural Data Analysis
    Date: 08/2023
    This brief identifies patterns and trends in Medicare Advantage participation (penetration rates, number of plans, and enrollment), both within and across metropolitan and nonmetropolitan counties.
  • Multi-Sector Collaboration to Support Rural Aging
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 08/2023
    In this paper, researchers examine the lessons rural areas present for supporting aging, including the role that aging and social services, public health systems, and health care have to play.
  • Rural/Urban Differences in Rates and Predictors of Intimate Partner Violence and Abuse Screening Among Pregnant and Postpartum United States Residents
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 08/2023
    This paper uses the 2016-2020 Pregnancy Risk Assessment Monitoring System (PRAMS) data to describe rates and predictors of perinatal intimate partner violence (IPV) and rates and predictors of not being screened for abuse among rural and urban IPV victims who gave birth.
  • Housing Quality by Disability, Race, Ethnicity, and Rural-Urban Location: Findings From the American Community Survey
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 07/2023
    In this policy brief, researchers examine rates of two key housing quality indicators (having incomplete plumbing and incomplete kitchen facilities) by rural-urban location, as well as at the intersections of racial/ethnic identity and disability status.
  • Ambulance Deserts: Geographic Disparities in the Provision of Ambulance Services
    Chartbook
    Maine Rural Health Research Center
    Date: 05/2023
    Access to timely ambulance service is an essential part of the emergency medical system. Yet ambulance access varies widely with significant gaps across the country. This research identifies places and people that are more than 25 minutes from an ambulance station, also called an ambulance desert.
  • Rural Healthy People 2030: Common Challenges, Rural Nuances
    Policy Brief
    Southwest Rural Health Research Center
    Date: 05/2023
    This study analyzes the most important Healthy People 2030 priorities for rural America. Data collected from a survey found mental health, substance use, health care access, and economic stability were among the most important priorities. This information could be used to accelerate health improvements in rural America.
  • Crowded Housing and Housing Cost Burden by Disability, Race, Ethnicity, and Rural-Urban Location
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 03/2023
    Housing is closely tied to health outcomes and well-being; however, little research examines housing factors by location. In this policy brief, we examine rates of crowded housing and housing cost burden by rural-urban location, as well as at the intersections of race, ethnicity, and disability status.
  • Rural and Urban Differences in Insurance Coverage at Prepregnancy, Birth, and Postpartum
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 03/2023
    In this manuscript, the research team used data from the Pregnancy Risk Assessment Monitoring System to measure insurance coverage at prepregnancy, birth, and postpartum, and insurance coverage continuity across these periods among rural and urban U.S. residents.
  • Rural Healthy People 2030: New Decade, New Challenges
    Journal Article
    Southwest Rural Health Research Center
    Date: 03/2023
    This study reports the findings of Rural Healthy People 2030, a companion piece to the Healthy People 2030 initiative with a focus on health priorities of rural populations. Data was collected from a survey given to rural stakeholders. Mental health, substance use, health care access, and economic stability were among the most important priorities.
  • Community Sociodemographics and Rural Hospital Survival Analysis
    Policy Brief
    Center for Economic Analysis of Rural Health
    Date: 01/2023
    This study examines which community sociodemographic characteristics are associated with increased risk of rural hospital closure between 2010-2019. Results show that rural hospitals at risk of financial distress are more likely to experience closure if their communities have higher unemployment and higher uninsurance for those under 65.

2022

  • Community Sociodemographics and Rural Hospital Survival
    Journal Article
    Center for Economic Analysis of Rural Health
    Date: 12/2022
    This study examines whether community sociodemographic factors are associated with the survival or closure of rural hospitals at risk of financial distress between 2010 and 2019.
  • An Insurance Profile of Rural America: Chartbook
    Chartbook
    RUPRI Center for Rural Health Policy Analysis
    Date: 11/2022
    Over the past decade, health insurance coverage has changed in major ways in rural areas with shifts towards public and publicly subsidized coverage among the nonelderly – Medicaid, Marketplace plans – and a shift towards Medicare Advantage among those eligible for Medicare. This chartbook describes these trends in detail.
  • Patterns of Health Care Use Among Rural-Urban Medicare Beneficiaries Age 85 and Older, 2010-2017
    Policy Brief
    Maine Rural Health Research Center
    Date: 11/2022
    This study examines rural-urban differences in health care use among Medicare beneficiaries age 85+.
  • Association of Health Insurance, Geography, and Race and Ethnicity With Disparities in Receipt of Recommended Postpartum Care in the U.S.
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 10/2022
    This study used data from the Pregnancy Risk Assessment Monitoring System and looked at receipt of recommended postpartum care content. The study describes variations across health insurance type, rural or urban residence, and race and ethnicity.
  • Racial/Ethnic Disparities in Postpartum Health Insurance Coverage Among Rural and Urban U.S. Residents
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 09/2022
    Using data from the 2016-2019 Pregnancy Risk Assessment Monitoring System, this study describes postpartum health insurance coverage for rural and urban U.S. residents who are Black, Indigenous, and people of color (BIPOC) compared to those who are white.
  • Review of Rural U.S. Economic and Health Care Trends
    Report
    Center for Economic Analysis of Rural Health
    Date: 09/2022
    This report reviews recent literature and publicly available data to explore important issues at the nexus of health care and local economic vibrancy. The report also explores the economic implications associated with COVID-19, however full impacts will not be known for several years.
  • Update on Rural Independently Owned Pharmacy Closures in the United States, 2003-2021
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis, Rapid Response to Requests for Rural Data Analysis
    Date: 08/2022
    Independently owned retail pharmacies in rural areas experienced a higher rate of closure than micropolitan and metropolitan areas. Closures have raised concerns about access to prescription medications as well as pharmacist-provided primary care services, which are often the sole source in rural areas for obtaining health services.
  • County-Level Availability of Obstetric Care and Economic Implications of Hospital Closures on Obstetric Care
    Policy Brief
    Center for Economic Analysis of Rural Health
    Date: 07/2022
    This policy brief draws out demographic and economic differences between counties with obstetric care facilities and those without. It provides descriptive data on the economic changes underway in counties that lost obstetric care facilities between 2012 and 2019.
  • Higher Electronic Health Record Functionality Is Associated With Lower Operating Costs in Urban—but Not Rural—Hospitals
    Journal Article
    Center for Economic Analysis of Rural Health
    Date: 07/2022
    This study examines the relationship between electronic health record use/functionality and hospital operating costs and compares the results across rural and urban facilities.
  • Social Isolation and Safety Issues Among Rural Older Adults Living Alone: Perspectives of Meals on Wheels Programs
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 05/2022
    In this article, we share results from a survey of 42 Meals on Wheels programs in rural areas across the US. Respondents highlighted challenges to meeting both social and safety needs of rural older adults living alone, as well as policy recommendations to improve the health and safety of older adults living alone in rural areas.
  • Maine: A Health-Focused Landscape Analysis
    Chartbook
    Maine Rural Health Research Center
    Date: 04/2022
    These chartbooks present a comprehensive set of state- and county-level population health and health care access measures for Maine, New Hampshire, New York, and Vermont. These data are intended to inform initiatives to support health and health care, particularly in rural counties and counties served by the Northern Border Regional Commission.
  • New Hampshire: A Health-Focused Landscape Analysis
    Chartbook
    Maine Rural Health Research Center
    Date: 04/2022
    These chartbooks present a comprehensive set of state- and county-level population health and health care access measures for Maine, New Hampshire, New York, and Vermont. These data are intended to inform initiatives to support health and health care, particularly in rural counties and counties served by the Northern Border Regional Commission.
  • New York: A Health-Focused Landscape Analysis
    Chartbook
    Maine Rural Health Research Center
    Date: 04/2022
    These chartbooks present a comprehensive set of state- and county-level population health and health care access measures for Maine, New Hampshire, New York, and Vermont. These data are intended to inform initiatives to support health and health care, particularly in rural counties and counties served by the Northern Border Regional Commission.
  • The Northern Border Region: A Health-Focused Landscape Analysis
    Chartbook
    Maine Rural Health Research Center
    Date: 04/2022
    These chartbooks present a comprehensive set of state- and county-level population health and health care access measures for Maine, New Hampshire, New York, and Vermont. These data are intended to inform initiatives to support health and health care, particularly in rural counties and counties served by the Northern Border Regional Commission.
  • Vermont: A Health-Focused Landscape Analysis
    Chartbook
    Maine Rural Health Research Center
    Date: 04/2022
    These chartbooks present a comprehensive set of state- and county-level population health and health care access measures for Maine, New Hampshire, New York, and Vermont. These data are intended to inform initiatives to support health and health care, particularly in rural counties and counties served by the Northern Border Regional Commission.

2021

2020

  • 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.
  • 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.
  • 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.
  • Considerations for Defining Rural Places in Health Policies and Programs
    Report
    RUPRI Health Panel: Rural Policy Analysis and Applications
    Date: 05/2020
    Rural definitions in statute and policy are used to direct resources to underserved people. But changes in population behavior and census processes have led to concern about historic methods of defining rural. This paper identifies key questions, reviews rural definitions, and discusses options for reconsidering rural definitions.
  • 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.

2019

  • 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.
  • Social Determinants of Health Among Rural American Indian and Alaska Native Populations
    Policy Brief
    Rural and Minority Health Research Center
    Date: 07/2019
    This policy brief is the third in a series of four policy briefs prepared by the Rural and Minority Health Research Center on the topic of social determinants of health. In this brief, we document current disparities within the rural American Indian and Alaska Native population.
  • Social Determinants of Health Among Rural Asian and Pacific Islander Populations
    Policy Brief
    Rural and Minority Health Research Center
    Date: 07/2019
    This policy brief is the fourth in a series of four policy briefs prepared by the Rural and Minority Health Research Center on the topic of social determinants of health. In this brief, we document current disparities within the rural Asian and Pacific Islander population.
  • Social Determinants of Health Among the Rural African American Population
    Policy Brief
    Rural and Minority Health Research Center
    Date: 07/2019
    This policy brief is the first in a series of four policy briefs prepared by the Rural and Minority Health Research Center on the topic of social determinants of health. It compares the distribution of social determinants among African American and White rural residents using information from the 2016 U.S. Census.
  • Social Determinants of Health Among the Rural Hispanic Population
    Policy Brief
    Rural and Minority Health Research Center
    Date: 07/2019
    This policy brief is the second in a series of four policy briefs prepared by the Rural and Minority Health Research Center on the topic of social determinants of health. In this brief, we document current disparities within the rural Hispanic population. Gaps are larger for those who were born in the U.S. compared to those born outside the U.S.
  • Measuring Access to Care in National Surveys: Implications for Rural Health
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 06/2019
    This brief presents data about how access to healthcare is measured, focusing on how this applies to rural populations.
  • 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.
  • 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

2017

  • Rural-Urban Enrollment in Part D Prescription Drug Plans: June 2017 Update
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 12/2017
    As of June 2017, the percentage of rural enrollment in Part D plans, which include stand-alone prescription drug plans (PDPs) and Medicare Advantage with Prescription Drug (MA-PD) plans, lags urban enrollment despite significant growth overall in the number of Medicare beneficiaries with prescription drug coverage through Medicare Part D plans.
  • Ambulance Services for Medicare Beneficiaries: State Differences in Usage, 2012-2014
    Policy Brief
    Rural and Underserved Health Research Center
    Date: 10/2017
    Ambulance services are at risk of scaling back or dissolving in some places. We analyzed Medicare beneficiaries' use of ambulance services across the U.S. Improved understanding of how beneficiaries, most of whom are elderly, use these services provides vital information for policymakers who set rules and regulations about access to the services.

2016

2015

2010

  • Rural Health Snapshot 2010
    Rapid Response to Requests for Rural Data Analysis
    Date: 08/2010
    The Rural Health Snapshot displays selected indicators of access to healthcare, health behavior/risk factors, and mortality rates, comparing rural to urban residents.

2009

2008

2007

  • State Updates on Medicare Advantage Enrollment
    RUPRI Center for Rural Health Policy Analysis
    Date: 12/2007
    This list contains reports for each state with the number of persons enrolled in Medicare Advantage and prepaid plans in December 2005 and September 2007 in rural and urban areas.
  • Distribution of Substance Abuse Treatment Facilities Across the Rural - Urban Continuum
    Maine Rural Health Research Center
    Date: 10/2007
    This study examines the distribution of substance abuse treatment services across the continuum of rural and urban counties, identifying the type and intensity of services provided.
  • State Profiles of Medicaid and SCHIP in Rural and Urban Areas
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 08/2007
    This final report is one component of a larger project that includes the development of web-based State Profiles of Medicaid and SCHIP in Rural and Urban Areas. The report provides national data comparing Medicaid enrollment and expenditures in rural and urban counties.

2006

2005

  • Community-Level Risk Factors for Depression Hospitalizations
    Policy Brief
    WICHE Center for Rural Mental Health Research
    Date: 09/2005
    This policy brief examines the association between depression hospitalization rates and community-level socio-demographic, economic, and healthcare system characteristics.
  • Effects of Uninsurance During the Preceding 10 Years on Health Status Among Rural Working Age Adults
    Rural and Minority Health Research Center
    Date: 09/2005
    In a population just reaching age 40, continuous health insurance coverage in the preceding 8 to 10 years was not associated with better self-perceived health than interrupted coverage. However, continuous insurance coverage was significantly related to better mental health.
  • Utilization of Home Health Services Among Rural Medicare Beneficiaries Before and After the PPS
    NORC Walsh Center for Rural Health Analysis
    Date: 08/2005
    This report describes a study conducted on the rural effects of the PPS, including whether the PPS contributed to changes in the demographic and clinical characteristics of home care users, the likelihood of using each of six home care disciplines, and the intensity of services.
  • Rural Definitions for Health Policy and Research
    Journal Article
    WWAMI Rural Health Research Center
    Date: 07/2005
    Defining "rural" for health policy and research purposes requires researchers and policy analysts to specify which aspects of rurality are most relevant to the topic at hand and then select an appropriate definition. Rural and urban taxonomies often do not discuss important demographic, cultural, and economic differences across rural places-differences that have major implications for policy and research. Factors such as geographic scale and region also must be considered. Several useful rural taxonomies are discussed and compared in this article. Careful attention to the definition of "rural" is required for effectively targeting policy and research aimed at improving the health of rural Americans.
  • Assisted Living in Rural America: Results From a National Survey
    Southwest Rural Health Research Center
    Date: 03/2005
    This article examines the assisted living industry in metropolitan and rural areas. Results indicate that assisted living was largely a private-pay form of long-term care and was more common in metropolitan than rural areas. Findings suggest that assisted living will make only a marginal contribution to meeting the needs in rural areas.
  • Rural Health Research in Progress in the Rural Health Research Centers Program, 9th Edition
    Maine Rural Health Research Center
    Date: 02/2005
    This book provides policymakers with a concise source of rural health services research underway in the Rural Health Research Centers funded by the Office of Rural Health Policy. It provides a context for legislation current that affects rural health services and populations.

2004

  • Nursing Homes in Rural And Urban Areas, 2001
    Southwest Rural Health Research Center
    Date: 06/2004
    This chartbook provides descriptive data on the entire population of longer-stay nursing home residents in the country in 2001 and categorizes them according to the rurality of the nursing homes in which they receive care in an effort to address questions related to residents' characteristics and quality of care.are.
  • Obesity Prevalence in Rural Counties: A National Study
    WWAMI Rural Health Research Center
    Date: 01/2004
    Using a telephone survey of adults ages 18 and older residing in states participating in the Behavioral Risk Factor Surveillance System in 1994-96 and 2000-01, researchers found that the prevalence of obesity was 23% for rural adults and 20.5% for urban adults.

2003

  • Classification Change, 1999 to 2003: Office of Management and Budget Metropolitan Areas and Core Based Statistical Areas (CBSAs) Map
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 07/2003
    This map shows the Office of Management and Budget's June 2003 Core Based Statistical Areas designations for counties that were nonmetropolitan in 1999.
  • Metropolitan and Micropolitan Core Based Statistical Areas (CBSAs) Map
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 07/2003
    This map illustrates the June 2003 Office of Management and Budget's metropolitan and micropolitan Core Based Statistical Areas designations by county.
  • Rural Health Research in Progress in the Rural Health Research Centers Program, 7th edition
    Maine Rural Health Research Center
    Date: 03/2003
    This book provides policy makers with a concise source of rural health services research underway in the Rural Health Research Centers funded by the Office of Rural Health Policy. It provides a context for legislation current and proposed that affects rural health services and populations.
  • Rural Minority Children
    Fact Sheet
    Rural and Minority Health Research Center
    Date: 2003
    This fact sheet provides data on rural minority children's health insurance coverage, healthcare use, poverty, and education.
  • Rural Minority Elders
    Fact Sheet
    Rural and Minority Health Research Center
    Date: 2003
    This fact sheet provides data on health status, health insurance coverage, education, and income of rural elders.
  • Rural Minority Working Age Adults
    Fact Sheet
    Rural and Minority Health Research Center
    Date: 2003
    Holding demographic considerations equal, rural residents are less likely to report having health insurance than urban residents. African Americans, Hispanics, and persons of other races are all less likely to be insured than whites. The factors placing rural minorities at risk for lacking insurance include low income and low education.

2002

2000

  • Influence of Rural Residence on the Use of Preventative Health Care Services
    University of Minnesota Rural Health Research Center
    Date: 11/2000
    This paper details a study of the utilization of specific preventive healthcare services by rural women and men to assess the impact of rural residence, the availability of healthcare providers and technology, demographic factors, and health insurance status on the likelihood of obtaining several preventive healthcare services.

1999