South Carolina Rural Health Research Center

Publications

Alphabetical list. You can also view by publication date.

• Access to Care among Rural Minorities: Children
  Author(s): Janice C. Probst, Charity Moore, Karin Willert Roof, Elizabeth G. Baxley, Michael E. Samuels
  Date: 11 / 2002
  Topics: Children, Minority health, Poverty
  Profiles the characteristics of non-metro children, their health insurance coverage, and their health care visits. Recommends a multi-faceted approach to ensure that non-metro children obtain appropriate levels of health care. Facets including retaining and expanding provision of care to indigent and low-income families, expanding insurance coverage, and addressing rural poverty.
• Access to Care Among Rural Minorities: Children (Appendix - Methods, Data Sources, and Detailed Tables)
  Author(s): Janice C. Probst, Charity Moore, Karin Willert Roof, Elizabeth G. Baxley, Michael E. Samuels
  Date: 11 / 2002
  Topics: Children, Health disparities, Minority health
  Appendix of report on rural minority children and the factors affecting their health insurance coverage and health services use.
• Access to Care Among Rural Minorities: Older Adults
  Author(s): Janice C. Probst, Michael E. Samuels, Charity G. Moore, Joette Gdovin
  Date: 10 / 2002
  Topics: Aging, Health disparities, Minority health, Poverty
  Profiles health status of, and use of physicians by, non-metro older adults. Programmatic recommendations based on the findings: maintain programs that encourage providers to practice in non-metro areas, pay particular attention to the problems of the near-poor African-American elderly, and foster coalitions linking providers with voluntary community-based organizations to increase support services to elderly non-metro populations.
• Access to Care Among Rural Minorities: Older Adults (Appendix - Methods, Data, and Detailed Tables)
  Author(s): Janice C. Probst, Michael E. Samuels, Charity G. Moore, Joette Gdovin
  Date: 10 / 2002
  Topics: Aging, Health disparities, Minority health, Poverty
  Appendix of report on health status and health services use among poor and minority older adults in non-metro areas.
• Access to Care among Rural Minorities: Working Age Adults
  Author(s): Janice C. Probst, Michael E. Samuels, Charity G. Moore
  Date: 01 / 2003
  Topics: Health services, Minority health, Poverty
  Examines the prevalence of health insurance and the use of physician services in rural areas. Findings include that rural minorities are handicapped by poverty and lack of education; low income and low education levels in non-metro areas translate into jobs that do not offer health insurance; and although non-metro adults were less likely to have insurance than metropolitan residents, they were not less likely to see a physician, with some exceptions.
• Assessing the Effect of a Lay Home Visitation Program for Rural High-Risk Women and Infants
  Date: 2004
  Topics: African Americans, Children, Maternal and child health, Poverty, Women
  This pilot study tested a retrospective data set approach for evaluating the effectiveness of a community health worker program at improving pregnancy and birth outcomes. The home visitation program uses lay health workers to provide health education, referral, and social support to rural, low income, Medicaid-insured pregnant African American women and their infants.
• Assessment Of Barriers To The Delivery Of Medicare Reimbursed Diabetes Self-Management Education In Rural Areas
  Author(s): M. Paige Powell, Saundra H. Glover, Janice C. Probst, Sarah B. Laditka
  Date: 09 / 2004
  Topics: Chronic diseases and conditions, Medicare
  Explores the barriers that rural practitioners face in providing diabetes education services to Medicare beneficiaries. Survey results from a random sample of ADA-recognized diabetes education facilities indicated that insufficient Medicare reimbursement, staffing, institutional support as well as the ADA recognition process all constituted barriers to diabetes self-management education in rural areas. Executive summary available online.
• Barriers Associated With the Delivery of Medicare Reimbursed Diabetes Self-Management Education
  Author(s): M. Paige Powell, Saundra H. Glover, Janice C. Probst, Sarah B. Laditka
  Citation: Diabetes Educator, 31(6), 890-9
  Date: 2005
  Topics: Chronic diseases and conditions, Medicare
  Describes the results of a study to explore the barriers that practitioners face in providing diabetes self-management education (DSME) to Medicare beneficiaries, with a special focus on barriers faced by rural providers. Barriers identified for rural providers include costs, reporting requirements, the shortage of designated specialists, fewer resources, high application fees for ADA recognition, staffing/institutional support, amount of Medicare reimbursement, lack of hours covered, and transportation.
• Barriers to the Delivery of Medicare Reimbursed Diabetes Self-Management Education in Rural Areas
  Date: 2004
  Topic: Chronic diseases and conditions
  Diabetes is one of the most prevalent chronic conditions among older adults in the United States, disproportionately affecting women and minorities. Diabetes Self-Management Education (DSME) programs help newly diagnosed and chronic patients with diabetes learn to manage their care. This project explored the barriers that rural practitioners face in providing diabetes education to Medicare beneficiaries.
• Behavioral Risk Factors Among Rural African Americans
  Date: 2003
  Topics: African Americans, Health promotion and disease prevention, Substance abuse
  Discusses seat belt use, tobacco use, and alcohol use among rural African Americans.
• Behavioral Risk Factors Among Rural Hispanics
  Date: 2003
  Topics: Health promotion and disease prevention, Hispanics, Substance abuse
  Discusses seat belt use, tobacco use, and alcohol use among rural Hispanics.
• Chartbook: Dental Health and Access to Care among Rural Children: A National and State Portrait (Executive Summary)
  Author(s): Amy Brock Martin, Eric Wang, Janice Probst, Nathan Hale, and Andrew Johnson
  Date: 03 / 2008
  Topics: Children, Dental health, Health disparities, Rural statistics and demographics
  Although children's dental health in the U.S. has improved over recent decades, a subset of children continues to suffer dental disease severe enough to constitute a public health problem. This Chartbook examines dental health status, use of preventive services, and dental insurance among rural and urban children. The Chartbook provides information specific to rural children, and in particular rural minority children, not available in similar detail from other sources. This information can be used at the state level for program planning and assessment.

  A copy of the full report is available through the South Carolina Rural Health Research Center's Online Report Request System at http://rhr.sph.sc.edu/request.htm. You may elect to receive a paper or an electronic copy of the full report. Generally, the requested report will be sent to you via postal mail (paper copy) or email (electronic copy) within one working day.

• Delivery Complications Associated With Prenatal Care Access for Medicaid-Insured Mothers in Rural and Urban Hospitals
  Author(s): Sarah B. Laditka, James N. Laditka, Kevin J. Bennett, Janice C. Probst
  Citation: Journal of Rural Health, 21(2), 158-66
  Date: 2005
  Topics: African Americans, Health services, Maternal and child health, Medicaid and S-CHIP, Women
  Examined access to health care during pregnancy for mothers insured by Medicaid as well as the risks of potentially avoidable maternity complications among rural and urban hospital deliveries for groups of mothers defined by race or ethnicity. Within groups defined by race or ethnicity, unadjusted rates for potentially avoidable maternity complications did not differ significantly by hospital location. Holding other factors constant, potentially avoidable maternity complications were less common in rural hospitals than in urban hospitals. In rural hospitals, African Americans had notably higher risk for potentially avoidable maternity complications than did non-Hispanic whites. The authors conclude that providers and policymakers should work to reduce the risks of potentially avoidable maternity complications for African American women in rural areas who are insured by Medicaid.
• Demand for Medical Services Among Previously Uninsured Children: The Roles of Race and Rurality
  Date: 10 / 2002
  Topics: Children, Health insurance and the uninsured
  Examined the use of medical services over nearly two years among newly insured and continuously insured children, ages six through twelve, in the CHIP and Medicaid programs in West Virginia and South Carolina. The study focused on the patterns of medical care utilization in the children, and found that there was not a significant change in utilization patterns among newly insured children in general. There were findings that newly insured children illustrated delayed demand and actually used fewer health services initially than their continually insured peers. Executive summary available online.
• Demand For Medical Services Among Previously Uninsured Children: The Roles of Race and Rurality
  Date: 2003
  Topics: Children, Health insurance and the uninsured, Medicaid and S-CHIP, Minority health
  Fact sheet examining the use of medical services over nearly two years among newly insured and continuously insured children, ages six through twelve, in the CHIP and Medicaid programs in South Carolina and West Virginia.
• Depression in Rural Populations: Prevalence, Effects on Life Quality, And Treatment-Seeking Behavior
  Author(s): Janice C. Probst, Sarah Laditka, Charity G. Moore, Nusrat Harun, M. Paige Powell
  Date: 05 / 2005
  Topics: Health disparities, Mental health
  Using the National Health Interview Survey and the NHIS-administered depression scale from the Comprehensive International Diagnostic Interview to explore depression among rural versus urban residents, the authors found that the prevalence of major depression was significantly higher among rural (6.11%) than among urban (5.16%) populations. However, nearly all individuals scoring positive for depression reported that their symptoms interfered with their life or activities (46.67% rural, 44.25% urban). Persons without any health insurance were less likely to have communicated with a physician than were the privately or publicly insured. Additionally, the likelihood that an individual with depression would have communicated with a practitioner rose as the person's self reported health declined. Executive summary available online.
• Depression in Rural Populations: Prevalence, Effects on Life Quality, and Treatment-Seeking Behavior (Fact Sheet)
  Date: 2005
  Topics: Health disparities, Mental health
  To explore the prevalence of selected mental health diagnoses across rural populations, including rural minority residents, they studied information obtained by the 1999 National Health Interview Survey (NHIS), a nationally representative survey of more than 30,000 U.S. adults.
• Development of a Methodology for Assessing the Effect of a Lay Home Visitation Program for Rural High-Risk Women and Infants
  Author(s): Elizabeth A. Erkel, Charity G. Moore, Yvonne Michel
  Date: 02 / 2004
  Topics: Health promotion and disease prevention, Maternal and child health, Women
  This pilot study successfully demonstrated that a retrospective, population-based, comparative design is a feasible method for evaluating the effectiveness of a community health worker program for women at risk for poor pregnancy and birth outcomes. Executive summary available online.
• Development of a Research Agenda on the Issues of Access to Care and Reduction of Health Status Disparities of Rural African Americans in South Carolina
  Author(s): Michael E. Samuels, Janice C. Probst, Karen Willert, Walter (Pete) Bailey, Elizabeth Corley
  Date: 01 / 2001
  Topics: African Americans, Health disparities
  Explores disparities in health among rural African Americans and rural white South Carolina residents. Introductory, descriptive study. Key findings include: Mortality, use of hospital and emergency department services, and outpatient visits among Medicaid recipients.
• Diabetes & Hypertension among Rural Hispanics
  Date: 2004
  Topics: Chronic diseases and conditions, Health disparities, Hispanics
  Fact sheet describing rates of diabetes and hypertension among rural Hispanics.
• Diabetes & Hypertension among Rural Hispanics: Disparities in Diagnostics and Disease Management (Executive Summary)
  Date: 2004
  Topics: Chronic diseases and conditions, Health disparities, Hispanics
  Modest disparities in health were found among rural Hispanics when examining diabetes. Undiagnosed hypertension was higher for rural residents, both Hispanic and White, than for urban residents. A large proportion of persons diagnosed with either disease had poor control of their condition, as indicated by elevated glucose levels or high blood pressure.
• Diabetes and Cardiovascular Disease among Rural African Americans
  Date: 02 / 2003
  Topics: African Americans, Chronic diseases and conditions, Minority health
  Investigates the association of race and rural residence on rates of diagnosis of diabetes and cardiovascular disease and indicators of good medical control among people with diabetes, hypertension, and cardiovascular disease. Finds that rural African Americans with diagnosed diabetes have significantly higher rates of problems associated with diabetes than do urban whites; that rural and urban African Americans are more likely than rural and urban whites to have undiagnosed diabetes; that rural African Americans with diagnosed hypertension are more likely than urban whites to still have elevated diastolic blood pressure; and that rural African Americans have the highest prevalence of undiagnosed diastolic hypertension. The study documents the need to improve access to health care services in rural areas. Executive summary available online.
• Diabetes and Cardiovascular Disease in Rural African Americans
  Date: 2003
  Topics: African Americans, Chronic diseases and conditions, Health disparities
  Previous research has indicated that persons living in rural areas are more vulnerable to poor health than those living in urban areas. Minorities in particular are more vulnerable to poor health than non-minorities.
• Diagnostic Risk Factors & Improvement Activities Among Rural African Americans
  Date: 2003
  Topics: African Americans, Chronic diseases and conditions
  Discusses disease management among rural African Americans.
• Diagnostic Risk Factors & Improvement Activities Among Rural Hispanics
  Date: 2003
  Topics: Chronic diseases and conditions, Hispanics
  Discusses disease management among rural Hispanics.
• Disability Burdens among Older Americans Associated with Gender and Race/Ethnicity in Rural and Urban Areas
  Author(s): James N. Laditka, Sarah B. Laditka, Bankole Olatosi, Keith T. Elder
  Date: 09 / 2005
  Topics: Disabilities, Minority health, Women
  No prior research has investigated differences in disability-free and disabled life expectancy associated with rural or urban residence. This report addresses this gap, and identifies differences in healthy life expectancy that may signal important policy needs. The authors examined total life expectancy, disability-free life expectancy, and disabled life expectancy, comparing people in rural and urban areas. These expectancy measures for subgroups of rural and urban areas were compared, distinguished by sex, race (white and African American) and educational attainment. The authors found that among a cohort of Americans aged 65 to 69 in 1982, in seven of the eight subgroups, individuals in rural areas lived longer lives than those in urban areas. Rural as compared to urban people lived (a) more disability-free years, (b) more disabled years, and (c) a notably greater percentage of their lives with a disability. There were striking differences among the high and low education groups, with individuals with more education living substantially longer, less disabled lives. Women lived longer, more disabled lives than men. For most subgroups, African Americans lived shorter, more disabled lives than whites. Executive summary available online.
• Disability Burdens among Older Americans in Rural and Urban Area
  Date: 2005
  Topics: Aging, Disabilities
  Examines differences in disability-free and disabled life expectancy among rural or urban residents, using an indicator called "health expectancy."
• Early Alcohol Use, Rural Residence, and Adulthood Employment
  Author(s): Michael Mink, Jong-Yi Wang, Kevin J. Bennett, Charity G. Moore, M. Paige Powell, Janice C. Probst
  Date: 10 / 2005
  Topics: Children, Substance abuse
  Findings indicate that drinking during youth and early adulthood was common in the early 1980's. Nearly half (47.6%) of respondents reported drinking before age 18, and 55.3% reported binge drinking. Drinking behaviors did not differ significantly between rural and urban residents, and rural youth surveyed in 1979-1983 were as likely as their urban counterparts to start drinking before the age of 18, binge drink before 18, and report that work or school was impacted by drinking. Executive summary available online.
• Effects of Medicaid Managed Care and Medicaid Managed Care Penetration On Potentially Avoidable Maternity Complications
  Date: 2004
  Topics: Maternal and child health, Medicaid and S-CHIP
  The effects of Medicaid Managed Care on pregnancy-related complications affecting mothers during their delivery hospitalizations were examined using the Potentially Avoidable Maternity Complications (PAMCs) indicator.
• Effects of Race and Poverty on Perceived Stress Among Rural Women
  Author(s): Janice C. Probst, Charity G. Moore, Elizabeth G. Baxley
  Citation: Coward RT, Davis LA et al, Eds., Rural women's health: Mental, behavioral and physical issues. p. 197-215. New York, NY: Springer Publishing Company
  Date: 2005
  Topics: Mental health, Minority health, Poverty, Women
  
• Effects of Uninsurance during the Preceding 10 Years on Health Status among Rural Working Age Adults
  Author(s): Janice C. Probst, Charity G. Moore, M. Paige Powell, William Pearson, Amy Brock Martin
  Date: 09 / 2005
  Topics: Health insurance and the uninsured, Rural statistics and demographics
  In a population just reaching age 40, continuous health insurance coverage across 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, with the effect persisting in multivariable analysis controlling for residence, race, and demographic characteristics. Rural residents reaching age 40 in 1998 or 2000 were less likely to have been continuously insured between 1989-2000 than were their urban peers. Executive summary available online.
• Effects of Uninsurance during the Preceding 10 Years On Health Status among Rural Working Age Adults (Fact Sheet)
  Date: 2005
  Topic: Health insurance and the uninsured
  Used a long-running panel survey, the National Longitudinal Survey of Youth that began in 1979, to examine the effects of gaps in health insurance coverage on how individuals rate their physical and mental health.
• Emergency Department Use By Medically Indigent Rural Residents
  Author(s): Kevin Bennett, Janice C. Probst, Charity G. Moore, Judith A. Shinogle
  Date: 07 / 2003
  Topics: Emergency medical services (EMS), Federally Qualified Health Centers (FQHCs), Health services, Hospitals and clinics
  Examined emergency department (ED) use, combining national data and South Carolina state data to estimate the uncompensated charges in rural EDs nationally and the ameliorating effects of rural community health centers on ED use by rural residents. Executive summary available online.
• Emergency Department Use by Medically Indigent Rural Residents (Fact Sheet)
  Date: 2004
  Topics: Emergency medical services (EMS), Hospitals and clinics, Minority health
  An estimated 211 million emergency department visits were made across the United States during 1999 - 2000, 37 visits per 100 persons per year. Just under a quarter of these, 43 million visits, were made to rural emergency departments.
• Expected Annual Emergency Miles per Ambulance: An Indicator for Measuring Availability of Emergency Medical Services Resources
  Author(s): P.Daniel Patterson, Janice C. Probst, Charity G. Moore
  Citation: Journal of Rural Health, 22(2), 102-111
  Date: 2006
  Topic: Emergency medical services (EMS)
  Proposes a county-level indicator of emergency medical services (EMS) resource availability that takes into consideration existing EMS resources (ambulances), population health and demographics, and geographic factors. The indicator, the EXpected annual emergency miles per AMBulance (EXAMB), provides a basis for comparing ambulance availability across counties within states. A method for calculating the EXAMB indicator is demonstrated using data from 5 states.
• Hospitalization for Ambulatory Care Sensitive Conditions: Asthma, Diabetes, and Congestive Heart Failure in South Carolina (Executive Summary)
  Author(s): Janice C. Probst, Charity Moore, Elizabeth G. Baxley, John L. Lammie
  Date: 05 / 2003
  Topics: Chronic diseases and conditions, Health disparities
  Hospitalization rates for ambulatory care sensitive conditions, diseases for which primary care in the preceding six months could have reduced or eliminated the need for hospitalization, are a commonly used indicator of disparities in access to care.
• Hospitalization for Ambulatory Care Sensitive Conditions: Congestive Heart Failure, Diabetes and Asthma in South Carolina (Fact Sheet)
  Date: 2003
  Topics: Chronic diseases and conditions, Health disparities
  Brief overview of findings from a study of hospitalizations in South Carolina for ambulatory care sensitive conditions. A full report is also available.
• Hypertension, Diabetes, Cholesterol, Weight, and Weight Control Activities Among Non Metro Minority Adults
  Author(s): P. Daniel Patterson, Charity G. Moore, Janice C. Probst, Michael E. Samuels
  Date: 12 / 2002
  Topics: Chronic diseases and conditions, Health disparities, Minority health, Obesity
  The 1998 National Health Interview Survey (NHIS) included a detailed examination of preventive health problems and behaviors. This report uses data from the 1998 NHIS to examine the prevalence of selected problems among rural populations, with an emphasis on rural minorities. ?Rural? was defined, following NHIS guidelines, as living in a non-MSA county.
• Impact Of Medicaid Managed Care, Race/Ethnicity, and Rural/Urban Residence On Potentially Avoidable Maternity Complications: A Five-State Multi-Level Analysis
  Author(s): Sarah B. Laditka, James N. Laditka, Kevin J. Bennett, Janice C. Probst
  Date: 12 / 2004
  Topics: African Americans, Hispanics, Maternal and child health, Medicaid and S-CHIP, Women
  Complications of pregnancy affect the lives of many women and infants. This study examines pregnancy-related complications using Potentially Avoidable Maternity Complications (PAMCs) as an indicator of access. Findings include: 1) Mothers delivering in rural hospitals had lower PAMC risks than those with urban deliveries.; 2) In rural hospitals, African American women had greater PAMC risks than white women.; and 3) In urban hospitals, adjusted PAMC risks were substantially lower for Hispanics and Asians than for whites. Executive summary available online.
• Investigating Rural EMS Infrastructure: A Developmental Methodology For Measuring The Availability Of EMS Resources
  Author(s): P. Daniel Patterson, Janice C. Probst, Charity G. Moore
  Date: 08 / 2004
  Topic: Emergency medical services (EMS)
  Explores a potential indicator of EMS availability, the Expected Annual Emergency Miles per Ambulance (EXAMB). The ambulance is used as the core unit of availability due to its importance for safe transport and the initiation of medical services. The EXAMB measure calculates expected annual emergency miles per ambulance beginning with the number of ambulances, the land area of a county as a proxy for distance, and county population. Findings showed that in three of the five states studied, EXAMB values varied in parallel with other measures of resource availability, and in all states, the EXAMB was positively related to the proportion of the county population in poverty.
• Mental Health Risk Factors, Unmet Needs, and Provider Availability for Rural Children
  Author(s): Charity G. Moore, Michael Mink, Janice C. Probst, Mark Tompkins, Andy Johnson, Shereca Hughley
  Date: 09 / 2005
  Topics: Children, Mental health
  The study used the 2001 National Health Interview Survey to assess the prevalence of sub-clinical mental health problems among children, the degree to which children with potential problems use mental health and general providers for these problems, and the degree of unmet need. Key findings include: 1) Nearly 1 of every 4 rural children has a potential mental health problem as derived from the Strengths and Difficulties Questionnaire (SDQ).; 2) Age, sex, family income, parental education, living situation, health insurance status, and previously diagnosed developmental disorder were all associated with sub-clinical mental health problems in children.; 3) Less than 1 out of 5 parents of rural or urban children with sub-clinical mental health problems had seen or talked to a mental health professional about the child in the past 12 months.; and 4) Characteristics associated with mental health care utilization were race/ethnicity, insurance status, level of education in the child's family, living situation, and previous diagnosis of a developmental disorder. Among roughly 2.9 million rural children with a potential mental health problem as defined by the SDQ score, two thirds (68.1%) are living in a HPSA-mental health designated area. This translates to over 1.9 million children with mental health problems but living in areas where very minimal to no resources are available for their care. Executive summary available online.
• Mental Health Risk Factors, Unmet Needs, and Provider Availability for Rural Children (Fact Sheet)
  Date: 2005
  Topics: Children, Mental health
  Children in rural areas have fewer mental health resources available. To assess the need for services among rural children, they studied information from the 2001 National Health Interview Survey, a nationally representative survey of the U.S. population. Possible mental health problems were identified based on the Strengths and Difficulties Questionnaire (SDQ).
• Minorities in Rural America: An Overview of Population Characteristics
  Author(s): Janice C. Probst, Michael E. Samuels, Kristen P. Jespersen, Karin Willert, R. Suzanne Swann, Joshua A. McDuffie
  Date: 01 / 2002
  Topics: Minority health, Rural statistics and demographics
  Presents an overview of demographic and economic statistics pertaining to rural minority populations and addresses the following questions: Where do rural minorities live? How is the rural minority population distributed across ages and sexes? What is the economic structure of rural, minority communities? What health resources are available in rural, minority communities? Findings pertaining to each minority group are presented in separate chapters. Based on the findings, the authors make several recommendations regarding issues ranging from program participation to infrastructure to research.
• Minorities in Rural America: Appendix A Description of Method and Supporting Tables Tables Ordered by Chapter
  Author(s): Janice C. Probst, Michael E. Samuels, Kristen P. Jespersen, Karin Willert, R. Suzanne Swann, Joshua A. McDuffie
  Date: 2002
  Topics: Minority health, Rural statistics and demographics
  Appendix of a report that gives an overview of demographic and economic statistics pertaining to rural minority populations.
• Minorities in Rural America: Appendix B Map Supplement
  Author(s): Janice C. Probst, Michael E. Samuels, Kristen P. Jespersen, Karin Willert, R. Suzanne Swann, Joshua A. McDuffie
  Date: 2002
  Topics: Minority health, Rural statistics and demographics
  Appendix to report on overview of demographic and economic statistics pertaining to rural minority populations. Maps.
• Minorities in Rural America: Appendix C Economic Patterns in Non-Metro America
  Author(s): Janice C. Probst, Michael E. Samuels, Kristen P. Jespersen, Karin Willert, R. Suzanne Swann, Joshua A. McDuffie
  Date: 2002
  Topics: Minority health, Rural statistics and demographics
  Appendix to report on an overview of demographic and economic statistics pertaining to rural minority populations. Focuses on economic status and health services infrastructure.
• Mode of Travel and Actual Distance Traveled For Medical or Dental Care By Rural and Urban Residents
  Author(s): Janice C. Probst, Sarah B. Laditka, Jong-Yi Wang, Andy Johnson
  Date: 05 / 2006
  Topic: Health disparities
  Discusses the cost and difficulty associated with travel for medical or dental care, which may serve as a barrier for rural populations. Executive summary available online. The full report is available by contacting Janie Godbold at godboldj@gwm.sc.edu.
• Mode of Travel and Actual Distance Traveled For Medical or Dental Care By Rural and Urban Residents (Fact Sheet)
  Date: 2007
  Topic: Health disparities
  Fact sheet addressing the cost and difficulty associated with travel for medical or dental care. A full report is also available.
• More May Be Better: Evidence of a Negative Relationship Between Physician Supply and Hospitalization for Ambulatory Care Sensitive Conditions
  Author(s): James N. Laditka, Sarah B. Laditka, Janice C. Probst
  Citation: Health Services Research, 40(4), 1148-1166
  Date: 2005
  Topics: Chronic diseases and conditions, Health services, Physicians
  The authors conducted an empirical test of the relationship between physician supply and hospitalization for ambulatory care sensitive conditions (ACSH). Principal findings showed that in the urban models for ages 0-17 physician supply has the largest negative adjusted relationship with ACSH. For ages 18-39 and 40-64, physician supply has the second largest negative adjusted relationship with ACSH. Physician supply was not associated with ACSH in rural areas. The authors conclude that physician supply is positively associated with the overall performance of the primary health care system in a large sample of urban counties of the United States.
• Overweight and Physical Inactivity among Rural Children Aged 10-17: A National and State Portrait
  Author(s): Jihong Liu, Kevin J. Bennett, Nusrat Harun, Xia Zheng, Janice C. Probst, Russell R. Pate
  Date: 05 / 2007
  Topics: Children, Obesity
  Recent studies have found that the tide of child obesity is rising faster in rural communities in several states, including Pennsylvania, New Mexico, Michigan, West Virginia, and North Carolina. This report examines the presence of overweight and obesity among children in both rural and urban settings using the data from a recent national survey, the 2003 National Survey of Children’s Health (NSCH). In 2003, 30.6% of children aged 10-17 years old were overweight, 14.8% of which were obese. Rural children (16.5%) were more likely to be obese than urban children (14.4%). Executive summary available online.
• Overweight and Physical Inactivity among Rural Children Aged 10-17: A National and State Portrait (Fact Sheet)
  Date: 2007
  Topics: Children, Obesity
  Brief overview obesity and overweight, physical activity, and weight-related behaviors among rural and urban children.
• Poverty, Stress, and Violent Disagreements in the Home Among Rural Families
  Author(s): Charity G. Moore, Janice C. Probst, Mark Tompkins, Steven Cuffe, Amy B. Martin
  Date: 08 / 2005
  Topics: Children, Physical abuse and domestic violence, Poverty
  This study used information from a large, nationally representative telephone survey of households with children, carried out by the National Center for Health Statistics, to explore the prevalence of violent disagreements in the home. "Violent" disagreements are those that involve hitting or throwing, as opposed to heated argument or calm discussion. Poverty and parenting stress also were examined as they are hypothesized to be associated with violent disagreement. Findings from the study showed that rural children, all things held equal, were less likely than urban children to live in households where disagreements are expressed violently. Similarly, rural children were less likely to live in households with high parenting stress or low reported neighborhood trust. Nonetheless, rural practitioners must still be sensitive to the possibility of exposure to violence. Key factors associated with parenting stress, and thus with violent disagreements, are more prevalent in rural areas. Poverty and low-income were more common among rural than urban children, and affected well over half of rural minority children, in particular. Executive summary available online.
• Prevalence of Health Related Behavioral Risk Factors Among Non-Metro Minority Adults
  Author(s): P. Daniel Patterson, Charity G. Moore, Janice C. Probst, Michael E. Samuels
  Date: 08 / 2003
  Topics: Health promotion and disease prevention, Minority health, Substance abuse
  Data on tobacco use, seat belt use, and alcohol consumption among rural minority adults. Includes recommendations and detailed data tables.
• Racial and Ethnic Disparities in Potentially Avoidable Delivery Complications Among Pregnant Medicaid Beneficiaries in South Carolina
  Author(s): Sarah Laditka, James Laditka, Janice C. Probst
  Citation: Maternal and Child Health Journal, 10(4), 339-50
  Date: 2006
  Topics: African Americans, Health disparities, Maternal and child health, Medicaid and S-CHIP, Minority health, Women
  Examined access to health care during pregnancy for mothers insured by Medicaid as well as the risks of potentially avoidable maternity complications among rural and urban hospital deliveries for groups of mothers defined by race or ethnicity. Within groups defined by race or ethnicity, unadjusted rates for potentially avoidable maternity complications did not differ significantly by hospital location. Holding other factors constant, potentially avoidable maternity complications were less common in rural hospitals than in urban hospitals. In rural hospitals, African Americans had notably higher risk for potentially avoidable maternity complications than did non-Hispanic whites. The authors conclude that providers and policymakers should work to reduce the risks of potentially avoidable maternity complications for African American women in rural areas who are insured by Medicaid.
• Recruitment and Retention of EMTs: A Qualitative Study
  Author(s): P. Daniel Patterson, Janice C. Probst, Katherine H. Leith, Sara J. Corwin, M. Paige Powell
  Citation: Journal of Allied Health, 34(3), 153-62
  Date: 2005
  Topics: Emergency medical services (EMS), Workforce
  Emergency medical technicians (EMTs) are critical to out-of-hospital care, but maintaining staff can be difficult. The study objective was to identify factors that contribute to recruitment and retention of EMTs and paramedics. Analysis of focus group responses showed that for a majority of respondents, emergency medical services was not a primary career path. Most respondents entered the industry as an alternate or replacement for a nursing career or as a second career following military medic service. The majority of respondents believed the job was stressful yet rewarding, and although it negatively affected their personal lives, the occupation gave them a sense of accomplishment and belonging. Respondents expressed a preference for EMT education resulting in college credit or licensure versus professional certification. Job-related stress produced by numerous factors appears to be a likely contributor to low employee retention.
• Rural Emergency Medical Service (EMS) Infrastructure
  Date: 2004
  Topics: Emergency medical services (EMS), Frontier health
  Prehospital care has become an important element in the spectrum of health services. Approaches for comparing the availability of Emergency Medical Service (EMS) across communities are a first step in developing policies that ensure equitable access for rural and frontier communities.
• Rural Hospitals and Spanish Speaking Patients with Limited English Proficiency
  Author(s): Myriam E. Torres, Deborah Parra-Medina, Amy Brock Martin, Andrew O. Johnson, Jessica D. Bellinger, Janice C. Probst
  Date: 10 / 2005
  Topics: Cultural competency, Hispanics
  This is the executive summary. Reports that 40 million Latinos in the United States, 14.2% of the population, have limited English proficiency (LEP), which can lead to poor health outcomes in the absence of effective medical interpretation or translation services. Executive summary available online.
• Rural Hospitals and Spanish Speaking Patients with Limited English Proficiency (Fact Sheet)
  Date: 2005
  Topics: Cultural competency, Hispanics
  Brief overview of findings from a study of how rural hospitals are meeting the needs of patients with Limited English Proficiency (LEP).
• Rural Minority Children
  Date: 2003
  Topics: Children, Health insurance and the uninsured, Minority health, Rural statistics and demographics
  Fact sheet providing data on rural minority children's health insurance coverage, health care use, poverty and education.
• Rural Minority Children's Access to and Timeliness of Immunizations (Fact Sheet)
  Date: 2004
  Topics: Children, Health promotion and disease prevention
  Examined whether rural children aged 3-71 months are keeping up with urban children in the receipt of needed vaccinations.
• Rural Minority Children's Access To And Timeliness Of Immunizations: 1993-2001
  Author(s): Arch G. Mainous III, Terrence E. Steyer, Mark E. Geesey
  Date: 11 / 2003
  Topics: Children, Health promotion and disease prevention, Minority health
  The purpose of this study is to assess the quality of pediatric health care provided to rural minorities using timeliness of immunization receipt as a marker for quality. Findings include: 1) Children living in rural areas are less likely to receive newly recommended vaccines within the first two years after introduction of the recommendation.; 2) There are no significant differences in the percentages of children up-to-date with their immunizations between Whites, Blacks, and Hispanics living in urban and rural areas.; 3) By 2001 lack of health insurance was the strongest predictor for children not receiving their immunizations in a timely manner.; 4) When using national surveys, there is significant year-to-year variation in the percentage of children who are up-to-date with their immunizations. Executive summary available online.
• Rural Minority Elders
  Date: 2003
  Topics: Aging, Health insurance and the uninsured, Minority health, Rural statistics and demographics
  Fact sheet providing data on health status, health insurance coverage, education and income of rural elders.
• Rural Minority Working Age Adults
  Date: 2003
  Topics: African Americans, Health insurance and the uninsured, Hispanics, Minority health, Rural statistics and demographics
  Holding demographic considerations equal, rural residents are less likely to report having health insurance than urban residents. African Americans, Hispanics and persons of other race 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.
• Rural Residence and Hispanic Ethnicity: Doubly Disadvantaged for Diabetes?
  Author(s): Richelle J. Koopman, Arch G. Mainous III, Mark E. Geesey
  Citation: Journal of Rural Health, 22(1), 63-8
  Date: 2006
  Topics: Chronic diseases and conditions, Hispanics, Minority health
  Reports the results of a study to determine whether living in a rural area and being Hispanic confers special risks for diagnosis and control of diabetes.
• Rural-Urban Differences in Depression Prevalence: Implications for Family Medicine
  Author(s): Janice C. Probst, Sarah B. Laditka, Charity G. Moore, Nusrat Harun, M. Paige Powell, Elizabeth G. Baxley
  Citation: Family Medicine, 38(9), 653-60
  Date: 10 / 2006
  Topic: Mental health
  Reports results of a study that examined the prevalence of depression in rural versus urban areas. An estimated 2.6 million rural adults suffer from depression. The unadjusted prevalence of depression was significantly higher among rural than urban populations (6.1% versus 5.2% ). After adjusting for rural/urban population characteristics, however, the odds of depression did not differ by residence. Depression risk was higher among persons likely to be encountered in a primary care setting: those with fair or poor self-reported health, hypertension, with limitations in daily activities, or whose health status changed during the previous year.
• Trends in Uninsurance among Rural Minority Children
  Author(s): Amy Martin, Janice C. Probst, Charity G. Moore, Daniel Patterson, Keith Elder
  Date: 10 / 2005
  Topics: African Americans, Children, Health insurance and the uninsured, Hispanics, Minority health, Poverty
  Disparities in health insurance coverage for both minority and rural children persist, with children who are simultaneously minority race/ethnicity and living in rural areas being particularly disadvantaged. Using twenty-one years of data from the National Health Interview Survey to explore trends in health insurance and health services utilization for children between 1980 and 2001, and focusing on non-Hispanic white, non-Hispanic African American, and Hispanic children, the authors found that rural children have been consistently less likely to have insurance than urban children, and minority status adds to the disparity. Several factors consistently influenced the odds that a child would lack health insurance, measured in 1980, 1986, 1994 and 2001. Compared to urban white children, rural white children and Hispanic children, both urban and rural, were more likely to lack insurance. Factors consistently associated with lack of health insurance, such as poverty, low education, and non-parental households, have been more prevalent among minority children since 1979, and remained so in 2001. Rural disadvantages for minority children are marked. Executive summary available online.
• Trends in Uninsurance Among Rural Minority Children (Fact Sheet)
  Date: 2005
  Topics: Children, Health insurance and the uninsured, Minority health
  Describes childhood disparities found in health insurance, health care utilization, and factors related to acquiring health insurance.
• Update: Health Insurance and Utilization of Care Among Rural Adolescents
  Author(s): Janice C. Probst, Charity G. Moore, Elizabeth G. Baxley
  Citation: Journal of Rural Health, 21(4), 279-287
  Date: 2005
  Topics: Children, Health insurance and the uninsured
  Using data from the 1999-2000 National Health Interview Survey, the authors found that across races, rural adolescents were as likely to have insurance but less likely to report a preventive visit than urban children; residence did not affect the likelihood of a visit or a usual source of care. Minority rural adolescents were less likely than whites to be insured, report a visit, or have a usual source of care. The authors conclude that most barriers to care among rural and minority youth are attributable to factors originating outside the health care system, such as language, living situation, caretaker education, and income. A combination of outreach activities and programs to enhance rural schools and economic opportunities will be needed to improve coverage and utilization among adolescents.
• Use of Preventive Services Among Hispanic Sub-Groups: Does One Size Fit All?
  Author(s): Myriam E. Torres, Jessica D. Bellinger, Janice C. Probst, Nusrat Harun, and Andrew O. Johnson
  Date: 07 / 2007
  Topics: Cultural competency, Health promotion and disease prevention, Hispanics, Minority health
  The Hispanic population, the largest and fastest growing minority group in the nation, is generally under-served with regard to health services. This executive summary includes results from the exploration of the use of preventive health services among Mexicans, Puerto-Ricans, Cubans, and “other” Latinos (persons from all other Spanish-speaking countries such as Spain, Central and South America) and examined how the use of preventive services was influenced by nation of origin and by rural versus urban residence.
• Use of Preventive Services Among Hispanic Sub-Groups: Does One Size Fit All? (Fact Sheet)
  Author(s): Myriam E. Torres, Jessica D. Bellinger, Janice C. Probst, Nusrat Harun, and Andrew O. Johnson
  Date: 2007
  Topics: Cultural competency, Health promotion and disease prevention, Hispanics, Minority health
  This Fact Sheet provides key facts on preventive health services provided to rural Hispanics.
• Violence And Rural Teens: Teen Violence, Drug Use, And School-Based Prevention Services In Rural America
  Author(s): Michael D. Mink, Charity G. Moore, Andy Johnson, Janice C. Probst, Amy Martin
  Date: 03 / 2005
  Topics: Children, Physical abuse and domestic violence, Substance abuse
  Describes a study which had three main purposes: (1) to explore the prevalence of violence-related exposures and drug use among rural teens, (2) to investigate the effects of race and gender on the risk of exposure to violence and drug use, and (3) to compare the policies and mental health care services of rural and urban schools. This study found no evidence to support the common assumption that rural youth are protected from exposure to violence. Rural teens are equally or more likely than suburban and urban teens to be exposed to violent activities, including weapons carrying, fighting, fear of violence, and suicide behaviors. Rural teens are at significantly greater risk of using cigarettes, chewing tobacco, crack/cocaine, and steroids than both suburban and urban teens. Of important note is the high prevalence of "crystal-meth" use among rural teens. Executive summary available online.
• Violence and Rural Teens: Teen Violence, Drug Use, and School-Based Prevention Services in Rural America (Fact Sheet)
  Date: 2005
  Topics: Children, Physical abuse and domestic violence, Substance abuse
  Fact sheet covering the key findings from a study of violence and drug use among rural teens. A full report is also available.