Rural Health
Research Gateway

Social determinants of health

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
  • Clinical-Community Linkages in Non-Metropolitan and Metropolitan Hospitals: COVID-19 Impacts and Trends
    This study examined trends in partnerships between hospitals and public health departments and other community linkages in both non-metropolitan and metropolitan hospitals with a particular focus on the impact of the COVID-19 pandemic.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Coronavirus Disease 2019 (COVID-19), Critical Access Hospitals (CAHs), Health services, Hospitals and clinics, Networking and collaboration, Public health, Social determinants of health
  • 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
  • Medicare Advantage Plan Growth in Rural America: Opportunities for Beneficiaries?
    County Medicare Advantage enrollment data and plan characteristic data were used to create a model accounting for the availability of plans offering benefits addressing social determinants of health. Analyses compared rural and urban counties, and examined county characteristics to explore potential equitable opportunities for rural beneficiaries because of geography and other factors.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Medicare, Medicare Advantage (MA), Medicare Part D, Social determinants of health, Telehealth, Transportation
  • Rural-Urban Differences in Domestic Violence as a Contributor to Maternal Morbidity and Mortality
    Using 2016-2020 data from the CDC's Pregnancy Risk Assessment Monitoring System, this project assessed the prevalence of domestic violence among rural and urban residents who give birth. We also analyzed how screening and support services could be improved to support rural families that experience domestic violence, including during pregnancy and the postpartum period.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Maternal health, Social determinants of health, Violence and abuse, Women

2023

  • 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
  • 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
  • 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/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
  • The Direct Care Workforce in Rural Areas
    In this study, we measured the supply of long-term care services and supports (LTSS) direct care workers relative to older adult populations in rural and urban areas and measure employer and industry turnover among LTSS direct care workers. We also explored how compensation levels – including wages and employer-based health insurance – are related to and predict worker turnover in the LTSS direct care workforce in rural and urban areas.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Aging, Allied health professionals, Health services, Home health, Long-term care, Post-acute care, Poverty, Rural statistics and demographics, Social determinants of health, Workforce

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
  • 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
  • Northern Border Regional Commission State and Region Chartbooks: A Health-Focused Landscape Analysis
    The aim of this study was to compile the most recent publicly available data related to health and healthcare access at the county-level and state-level for the Norther Border Region and the individual states: ME, NH, VT, and NY. We highlighted counties with worse health outcomes, as compared to the rest of the counties in the region.
    Research center: Maine Rural Health Research Center
    Topics: Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), Rural statistics and demographics, Social determinants of health, Substance use and treatment, Telehealth, Uninsured and underinsured, Workforce
  • Rural-Urban Differences in Adverse and Positive Childhood Experiences: Results from the National Survey of Children's Health
    Using the 2016-2018 National Survey of Children's Health, the prevalence of adverse childhood experiences (ACEs) and positive childhood experiences (PCEs) exposure in all 50 states and the District of Columbia were examined and whether ACE and PCE exposure differed between rural and urban residents, by type, by count, and by racial/ethnic group.
    Research center: Rural and Minority Health Research Center
    Topics: American Indians and Alaska Natives, Children and adolescents, Hispanics, Minority health, Social determinants of health

2021

  • 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

2019

  • Social Determinants of Health Among Minority Populations in Rural America
    This project compiled information from the U.S. Census, the Area Health Resource File, and the Robert Wood Johnson Foundation County Rankings data set into a comprehensive summary of key social determinants of health among rural populations: demographic characteristics, economic characteristics, health facility availability, and selected health outcomes.
    Research center: Rural and Minority Health Research Center
    Topics: American Indians and Alaska Natives, Hispanics, Minority health, Rural statistics and demographics, Social determinants of health

2016

  • Exploring Rural and Urban Mortality Differences
    This project examines the impact of rurality on mortality and explores the regional differences in the primary and underlying causes of death. It also explores the role of the rural public health systems in addressing social determinants of health.
    Research center: North Dakota and NORC Rural Health Reform Policy Research Center
    Topics: Public health, Social determinants of health