Rural Health
Research Gateway

Social determinants of health

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

  • State Priorities and Needs: The Role of Block Grants
    Journal Article
    Rural Health Equity Research Center
    Date: 11/2023
    This study looks at state-level funding allocations for 5 federal block grant programs from 2015-2019, and associations with state-level measures of need that align with the purposes of each block grant program.
  • Addressing Social Determinants of Health in Family Medicine Practices
    Journal Article
    Rural and Underserved Health Research Center
    Date: 10/2023
    This study evaluated physician, practice, and community characteristics as health care system elements to determine the ability of a primary care practice to address social determinants of health.
  • 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.
  • Rural/Urban Differences in Receipt of Governmental Rental Assistance: Relationship to Health and Disability
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 10/2023
    Housing is a vital component of health, and governmental rental assistance is one avenue of increasing access to affordability. In this paper, researchers examined rural/urban and within-rural differences in receipt of governmental rental assistance, with a focus on differences by health and disability.
  • 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).
  • Access to Health Care for Transgender and Gender-Diverse Adults in Urban and Rural Areas in the United States
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 08/2023
    This study examines access to care based on gender identity in urban and rural areas, focusing on transgender and gender diverse (TGD) populations. Data came from the 2019 to 2020 Behavioral Risk Factor Surveillance System. Researchers found greater barriers to care for TGD adults, with the most frequent barriers found among rural TGD adults.
  • Assessing Key Indicators of Rural Versus Urban Water Quality
    Policy Brief
    Rural and Minority Health Research Center
    Date: 08/2023
    This study presents a summary of water quality monitoring data sources and models, identifies the gaps that persist, and proposes the salient categories and types of data that should be contained in a national water quality monitoring database to accurately describe rural water quality.
  • 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.
  • Eight Postpartum Support Programs in Rural Communities Across the United States
    University of Minnesota Rural Health Research Center
    Date: 08/2023
    This case study series highlights locally focused organizations working to improve postpartum health for rural residents across the United States. Interviews were conducted with eight unique organizations working in their local rural communities to support postpartum health.
  • 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.
  • 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.
  • Two National-Level Organizations Supporting Rural Postpartum Health Across the United States
    University of Minnesota Rural Health Research Center
    Date: 07/2023
    The purpose of this case study series is to highlight national-level organizations working in innovative ways to improve postpartum health for rural residents across the United States. These may serve as examples to others considering this work.
  • Maniilaq Health Center: Providing High-Quality Obstetric Care to American Indian/Alaska Native People in Rural Kotzebue, Alaska
    University of Minnesota Rural Health Research Center
    Date: 06/2023
    This case study highlights a hospital providing care to rural American Indian and Alaska Native patients within the state of Alaska. The study examines the maternity care context with attention to the intersection of race and geography with social determinants of health.
  • 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.
  • Assessing Geographic Variability in Key Indicators of Air Quality: A Rural vs. Urban Comparison of Pollution and Socio-Economic Factors
    Policy Brief
    Rural and Minority Health Research Center
    Date: 03/2023
    The purpose of this study was to examine rates of air pollution between rural and urban census tracts. In addition, urban-rural disparities in exposure to polluted air across Environmental Protection Agency-defined regions were examined.
  • 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.
  • Indicators of Familial Social Support by Rurality and Gender Identity
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 03/2023
    Social and emotional support from family significantly contributes to positive health outcomes. Understanding how familial social support differs for those with overlapping marginalized identities is critical to advance population health and health equity. This brief examines differences in familial social support by rurality and gender identity.
  • 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.
  • Rural Working-Age Adults Report More Cost Barriers to Health Care
    Policy Brief
    Maine Rural Health Research Center
    Date: 03/2023
    Using the 2019-2020 National Health Insurance Survey, this study examined rural-urban differences in affordability of care and cost-saving strategies among working-age adults.
  • Advancing the Age-Friendly Movement in Rural Communities
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 02/2023
    The research team looked at the role of Aging Life Care Managers® to help support the age-friendly movement in rural areas. The team explored ways in which Aging Life Care Managers® could advocate for the needs and interests of their clients, help them access care and support, and involve rural communities in the age-friendly movement.
  • Rural School- and Community-Based Programs Supporting LGBTQ+ Youth
    University of Minnesota Rural Health Research Center
    Date: 02/2023
    The purpose of this case series is to highlight youth-focused and school- and community-based organizations that affirm and support LGBTQ+ individuals in their rural communities. These may serve as examples to others considering this work.
  • Rural-Urban Differences in Workers' Access to Paid Sick Leave
    Journal Article
    Maine Rural Health Research Center
    Date: 02/2023
    The authors analyzed the prevalence of paid sick leave (PSL) among rural versus urban workers and found that rural workers had lower access to PSL than urban workers, even after adjusting for worker and employment characteristics, especially those who were Hispanic, lacked employer-sponsored insurance, and reported poorer health status.
  • 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

2021

2020

  • Substance Use Among Rural and Urban Youth and Young Adults
    Policy Brief
    Maine Rural Health Research Center
    Date: 11/2020
    This study uses national data to examine rural-urban differences in the rates of substance use among youth and young adults. Findings can help inform rural-specific prevention strategies and research targeting rural communities.
  • 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.
  • 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.
  • 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

  • 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.
  • 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.
  • Community Health Worker Roles and Responsibilities in Rural and Urban America
    Policy Brief
    Southwest Rural Health Research Center
    Date: 11/2019
    The primary aim of this study was to understand the evolving profession of community health workers (CHWs) in the U.S. Through focus groups in rural and urban regions of four states, we explored CHW roles and responsibilities, the growing professionalization of the field, and evolving interactions between CHWs and other care providers.
  • 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.
  • Preventive Health Service Use Among Rural Women
    Policy Brief
    Maine Rural Health Research Center
    Date: 04/2019
    This study used the National Health Interview Survey to examine differences in receipt of preventive health services among rural and urban women. It found that rural women are less likely to receive HPV vaccines and mammograms, even controlling for rural-urban sociodemographic and resource differences.

2018

  • 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.
  • Key Informant Perspectives on Rural Social Isolation and Loneliness
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 10/2018
    This policy brief uses data from interviews with 22 key informants in 12 states, all of whom were experts on the issue of social isolation and/or rural health, to describe key challenges and opportunities related to rural social isolation.
  • Practical Implications: Opioid-Affected Births to Rural Residents
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 09/2018
    This publication provides two physicians' reactions to research findings on rates of diagnosis of maternal opioid use disorder and infant neonatal abstinence syndrome at the time of childbirth for rural residents based on the type of hospital where the birth occurred.
  • 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).
  • Gender Differences in Social Isolation and Social Support Among Rural Residents
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 08/2018
    This policy brief uses identifies gender differences in social isolation and social support among older rural residents and provides ways to reduce social isolation in rural communities.
  • Non-Medical Opioid Use Among Rural and Urban Pregnant Women, 2007-2014
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 08/2018
    This policy brief presents data on rural-urban differences in non-medical opioid use among pregnant women to inform policy, programmatic, and clinical efforts to address this crisis.
  • Addressing Commuting as a Public Health Issue: Strategies Should Differ by Rurality
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 07/2018
    This policy brief estimates the rate of solo and long (greater than 30 minutes) solo car commutes by rurality and urban adjacency and identifies differences in factors that relate to commuting behavior.

2017

2015

  • Care Coordination in Rural Communities Supporting the High Performance Rural Health System
    Report
    RUPRI Health Panel: Rural Policy Analysis and Applications
    Date: 06/2015
    This paper examines care coordination programs and processes that affect rural areas to discover what is happening in rural communities, how various programs and approaches are working, who benefits, and to make policy recommendations that will facilitate care coordination efforts in support of high performance rural health system development.

2005

  • The Effects of Rural Residence and Other Social Vulnerabilities on Subjective Measures of Unmet Need
    Journal Article
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 2005
    Are self-reports of unmet need a biased measure of access to healthcare? We examined the relationship between rural residence and perceived need for physician services and the likelihood of reporting a need for routine preventive care and/or specialty care using data from the National Survey of Children with Special Health Care Needs.