Rural Health
Research Gateway

Social determinants of health

Current Projects

  • Addressing Elder Abuse in Rural Areas
    Elder abuse, including financial, physical, and emotional abuse, as well as self-neglect, is widespread and impacts individual and population health outcomes. However, despite the fact that rural residents are older, in poorer health, and more financially vulnerable, little is known about rural/urban differences in the prevalence of and resources to address elder abuse; this project will address those gaps.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Aging, Disabilities, Social determinants of health, Violence and abuse
  • Alzheimer's Disease and Related Dementias (ADRD) Among Rural Residents: The State of the Field and Promising Research Directions
    This project seeks to identify what is known about rural Alzheimer's Disease and Related Dementias (ADRD) prevalence, outcomes, and health care utilization, and what public data exist to inform research rural ADRD going forward.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Aging, Care management, Healthcare access, Mental and behavioral health, Social determinants of health
  • Assessing the Clinical and Financial Impact of Community Health Workers in Rural America
    This scoping review project will assess how often the existing literature has examined community health workers (CHW) in rural America and what the literature suggests about the clinical and financial impact that CHWs have in rural communities.
    Research center: Southwest Rural Health Research Center
    Topics: Allied health professionals, Health promotion and disease prevention, Social determinants of health
  • Availability and Characteristics of Outpatient and Residential Substance Use Treatment in Rural and Urban Areas
    This study will look at: 1) the availability of residential and outpatient treatment centers in rural and urban counties, including identifying counties with no facilities; and 2) characteristics of services offered (e.g., residential, outpatient), demographics of persons treated, and insurance plans accepted by rural vs urban centers.
    Research center: Rural and Underserved Health Research Center
    Topics: Health services, Healthcare access, Mental and behavioral health, Pharmacy and prescription drugs, Social determinants of health, Substance use and treatment
  • Changes in Rural Health Insurance Coverage, 2019-2024
    This project uses secondary data sources to characterize changes in health insurance coverage during 2019-2024 for rural and urban people. The analysis will focus on changes associated with demographic, economic (particularly employment), and geographic characteristics, and will describe how exogenous changes (e.g., the economy, pandemic) as well as changes in federal policies impacted coverage.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Healthcare access, Healthcare financing, Medicaid and CHIP, Medicare, Private health insurance, Rural statistics and demographics, Social determinants of health, Uninsured and underinsured, Workforce
  • Concordance Between Social Needs Screening Provision, Programming, and Partnerships in Rural PPS Hospitals
    This study will examine how rural Prospective Payment System (PPS) hospitals differ from urban hospitals concerning social needs screening practices and alignment between social needs screening performance and corresponding programs/strategies and/or community partnerships to address social needs.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Health services, Hospitals and clinics, Medicare Prospective Payment System (PPS), Networking and collaboration, Social determinants of health
  • Considerations for the Use of Area-Level Vulnerability and Resilience Indices and Rurality in Funding Formulas
    The purpose of this study is to model potential funding formulas within states to understand how structural elements in formulas (i.e., inclusion of the Social Vulnerability Index, use of rural carve-outs or floor amounts, and other factors) affect county-level allocations compared to simple, population-based formulas.
    Research center: ETSU/NORC Rural Health Research Center
    Topics: Healthcare financing, Public health, Social determinants of health
  • Environmental Influences on Child Health: A Snapshot of Children's Health in the United States
    The environment in which a child grows up strongly influences their health in childhood, adolescence, and adulthood. Using data for 2022 and 2023 from five national data sets, this project will provide a comprehensive update on rural-urban differences in child health in the United States.
    Research center: University of South Carolina Rural Health Research Center
    Topics: Children and adolescents, Chronic diseases and conditions, Healthcare access, Obesity, Oral health, Poverty, Public health, Social determinants of health
  • Examining the Costs Associated With Dental Restorative Services in the Absence of Preventive Services Among Pediatric Medicaid Beneficiaries by Rurality
    This project will examine the costs associated with pediatric dental restorative services in the absence of preventive services. This study focuses on children with Medicaid who have historically been less likely to receive preventive dental care with subsequent impacts on pain, infections, and overall development.
    Research center: University of South Carolina Rural Health Research Center
    Topics: Children and adolescents, Health promotion and disease prevention, Medicaid and CHIP, Oral health, Poverty, Public health, Social determinants of health
  • Extent and Coverage of Rural PACE Services
    Supporting independent living and aging in place for rural residents is more important than ever. This project will provide information on the extent and coverage of rural Program of All-Inclusive Care for the Elderly (PACE) programs, along with insights into the unique challenges and opportunities faced by PACE programs operating in rural areas.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Aging, Disabilities, Healthcare access, Home health, Social determinants of health
  • Geographic and Socio-Demographic Correlates of Medical Debt Among Rural Residents
    Medical debt is widespread and impacts financial well-being and access to care. While research suggests that medical debt is higher among rural residents compared to urban residents, more work is needed to conclusively demonstrate rural/urban differences in medical debt and within-rural risk factors for greater medical debt by geography and socio-demographic characteristics.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Healthcare access, Poverty, Public health, Rural statistics and demographics, Social determinants of health
  • Identifying High-Need Counties for Resource Planning
    The primary aim of this project is to use data examining health care infrastructure, chronic disease prevalence, and the socioeconomic environment to create a metric for classifying rural counties based on needs and resources.
    Research center: University of South Carolina Rural Health Research Center
    Topics: Chronic diseases and conditions, Diabetes, Healthcare access, Maternal health, Obesity, Oral health, Physicians, Poverty, Public health, Rural statistics and demographics, Social determinants of health, Uninsured and underinsured, Workforce
  • Improving Health for "Homebound" Older Adults in Rural and Urban Areas
    This project will describe rural-urban differences in the risk of, and characteristics associated with, being classified as "homebound." We will also identify policy and programmatic interventions to reduce the risk of becoming homebound as well as to improve outcomes for those who are homebound.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Aging, Disabilities, Home health, Rural statistics and demographics, Social determinants of health
  • Mental Health Outcomes and Access to Care Among Rural Older Adults
    This project seeks to identify: 1) rates of depression, anxiety, and other common mental health conditions among rural older adults, including differences in rates of mental health conditions by age, 2) use of and access to mental health care among rural older adults, and 3) promising models to reduce barriers to mental health care among rural older adults.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Aging, Healthcare access, Mental and behavioral health, Social determinants of health, Substance use and treatment
  • Review of Current Research on Rural/Urban Differences in Social Drivers of Health
    Social drivers of health are social, economic, and community variables that influence health outcomes. This project will synthesize the extant literature on rural/urban differences in the social drivers of health, culminating in a comprehensive report that includes a summary of information gaps and further research needs.
    Research center: Rural and Underserved Health Research Center
    Topics: Healthcare access, Poverty, Quality, Social determinants of health, Uninsured and underinsured
  • Rural and Urban Sepsis Outcomes as a Measure of Health Care Quality: A Nationwide Comparative Analysis Using HCUP Data
    This study examines differences in sepsis prevalence, outcomes, costs, and treatment between rural and urban hospitals using the HCUP Nationwide Readmissions Database. It aims to inform policies related to access to timely, high-quality sepsis care and identify strategies to enhance healthcare outcomes across diverse hospital settings.
    Research center: ETSU/NORC Rural Health Research Center
    Topics: Care management, Critical Access Hospitals (CAHs), Emergency medical services (EMS) and trauma, Healthcare access, Hospitals and clinics, Medicaid and CHIP, Medicare, Medicare Advantage (MA), Private health insurance, Quality, Social determinants of health
  • Rural-Urban Differences in Access to and Quality of Care for People With Disabilities
    The purpose of this project is to identify rural-urban differences in access to and quality of health care services for people with disabilities. Results from this project will help inform policy to improve access to and quality of care for this growing population in rural areas.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Aging, Disabilities, Healthcare access, Quality, Social determinants of health
  • Rural-Urban Differences in Food-Store Access and Food Security
    This study will inform rural community members and policy makers about access to food supply and food security that can help guide the development and implementation of relevant interventions.
    Research center: University of South Carolina Rural Health Research Center
    Topics: Health promotion and disease prevention, Poverty, Public health, Social determinants of health, Transportation
  • Rural-Urban Differences in Medicare Supplemental Insurance Coverage
    This study analyzes rural-urban differences in Medicare supplemental coverage using 2015-2024 Medicare Current Beneficiary Survey data. It examines current patterns and trends in Medicare Advantage and Fee-for-Service supplemental enrollment, exploring demographic and health factors influencing coverage differences.
    Topics: Aging, Health services, Healthcare access, Healthcare financing, Medicare, Medicare Advantage (MA), Rural statistics and demographics, Social determinants of health, Uninsured and underinsured
  • Socioeconomic Profiles and Market Characteristics Associated with Ambulance Deserts
    We will address the extent to which vulnerable, aging populations live in ambulance deserts and identify ambulance desert populations facing additional barriers to healthcare access. We will also assess the impact of hospital closures on travel distances to the nearest health care facilities.
    Research center: Maine Rural Health Research Center
    Topics: Emergency medical services (EMS) and trauma, Healthcare access, Rural statistics and demographics, Social determinants of health, Transportation
  • The Impact of Chronic Pain on the Functional Wellbeing of Rural Residents
    Research indicates that rural adults experience chronic pain at higher rates than urban adults. This study uses National Health Interview Survey data to examine rural-urban differences in chronic pain impacts on functioning, quality of life, and treatment use.
    Topics: Chronic diseases and conditions, Healthcare access, Mental and behavioral health, Public health, Social determinants of health, Substance use and treatment
  • Use of Z Codes by Rural and Urban Providers to Capture Data on the Social Determinants of Health Impacting Medicare Beneficiaries
    Using a mixed methods approach, we will examine the use of Z codes by rural and urban providers to better capture information on the social determinants of health experienced by Medicare beneficiaries across the rural continuum.
    Research center: Maine Rural Health Research Center
    Topics: Health services, Medicare, Physicians, Social determinants of health