Jennifer Lenardson, MHS

Phone: 207.228.8399
E-mail: jlenardson@usm.maine.edu

University of Southern Maine
PO Box 9300
Portland, ME

Completed Projects (2)

Access to Mental Health Services and Family Burden of Rural Children with Significant Mental Health Problems, Lead researcher
Research center: Maine Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Children, Mental health
The needs of rural children with SED and the burden these needs place on their families are intertwined and may place these rural children and their families at "double jeopardy" of having their mental health and other needs go unmet. Using the National Survey of Children with Special Health Care Needs (NS-CSHCN) and information on community characteristics from the Area Resource File (ARF) we will examine the factors associated with whether children and their families have their needs meet across the rural continuum.

Availability, Characteristics, and Role of Detoxification Services in Rural Areas
Research center: Maine Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topic: Substance abuse
This project will produce a comprehensive description of the distribution and characteristics of detoxification (detox) services across rural areas including a discussion of access issues, the role of detox services within local systems of care, barriers to the delivery of detox services by rural providers, and policy and regulatory incentives needed to encourage the development of rural detox services. Products will include a working paper and related journal articles addressing these topics.

Publications (11)

Access to Mental Health Services and Family Impact of Rural Children with Mental Health Problems
Author(s): Jennifer D. Lenardson, Erika C. Ziller, David Lambert, Melanie M. Race, Anush Yousefian
Research center: Maine Rural Health Research Center
Topics: Children, Mental health
Report Number: #45
Date: 10 / 2010
Mental health problems have considerable impact on children and their families and some of these impacts are higher in rural than urban areas. Rural children are slightly but significantly more likely to have a mental health problem than urban children, are more likely to have a behavioral difficulty, and are more likely to be usually or always affected by their condition. Compared to urban children, rural children are more likely to go without access to all parent-reported needed mental health services and their families spend more time coordinating their care.
Availability, Characteristics, and Role of Detoxification Services in Rural Areas
Author(s): Jennifer D. Lenardson, Melanie M. Race, John A. Gale
Research center: Maine Rural Health Research Center
Topic: Substance abuse
Report Number: 41
Date: 12 / 2009
Few detox providers (n=235) serve rural America; 82% of rural residents live in a county without a detox provider. More than half of all rural detox providers serve patients across a 100 mile radius, making travel distances a barrier to outpatient care. Referral options to substance abuse treatment are limited, especially in isolated rural areas. Analyses are based on a 2008 survey of rural detox facilities conducted by the Maine Rural Health Research Center.
Distribution of Substance Abuse Treatment Facilities Across the Rural - Urban Continuum
Author(s): Jennifer D. Lenardson, John A. Gale
Research center: Maine Rural Health Research Center
Topics: Health disparities, Health services, Rural statistics and demographics, Substance abuse
Report Number: Working Paper No. 35
Date: 10 / 2007
Considering recent growth in substance abuse among rural populations and the documented scarcity of rural health resources, this study examines the distribution of substance abuse treatment services across the continuum of rural and urban counties, identifying the type and intensity of services provided. Using the 2004 National Survey of Substance Abuse Treatment Services linked to the 2003 Rural-Urban Continuum Codes, we found few substance abuse treatment facilities operating outside of urban and rural adjacent areas and limited availability of intensive services across rural areas. This situation is particularly striking for opioid treatment programs, which are nearly absent in rural areas. The narrow range of services available in rural areas may preclude an individualized treatment approach and long-term follow-up recommended by professional organizations and other experts. The greater proportion of rural-based facilities accepting public payers and providing discounted care may reflect higher rates of uninsurance and underinsurance.
Distribution of Substance Abuse Treatment Facilities Across the Rural - Urban Continuum (Research & Policy Brief No. 35B)
Author(s): Jennifer D. Lenardson, John A. Gale
Research center: Maine Rural Health Research Center
Topics: Health disparities, Health services, Rural statistics and demographics, Substance abuse
Date: 02 / 2008
This Research & Policy Brief highlights findings from a recent study examining the distribution of substance abuse treatment facilities in rural and urban counties and identifying the type and intensity of services provided. Key findings include:
- Access to substance abuse treatment is limited in rural areas by fewer treatment beds.
- Less populated rural areas contain a small proportion of facilities offering a range of core services and varying levels of outpatient and intensive services.
- Opiod treatment programs are nearly absent in rural areas.
Few and Far Away: Detoxification Services in Rural Areas (Research & Policy Brief)
Author(s): Jennifer D. Lenardson, Melanie M. Race, John A. Gale
Research center: Maine Rural Health Research Center
Topic: Substance abuse
Date: 12 / 2009
Based on Working Paper #41: Availability, Characteristics, and Role of Detoxification Services in Rural Areas. Findings: Few rural detox providers exist; 82% of rural residents live in a county without a detox provider. More than half of all rural detox providers serve a 100 mile radius. Travel distances are a barrier to outpatient detox models. Referral options to substance abuse treatment are limited, especially in isolated rural areas.
Health Care Access and Use Among the Rural Uninsured (Policy Brief)
Author(s): Erika C. Ziller, Jennifer D. Lenardson, Andrew F. Coburn
Research center: Maine Rural Health Research Center
Topics: Health insurance and the uninsured, Health services
Date: 11 / 2011
Using data from the 2002-2007 Medical Expenditure Panel Survey (MEPS), this study examined access to care and service use among non-elderly, uninsured rural and urban residents. Key Findings include:
- Uninsured residents of both rural and urban areas face serious barriers to care compared to those with health insurance coverage.
- The rural uninsured are more likely to have a usual source of care and to have used ambulatory care in the past year than the urban uninsured.
- Insured or not, rural residents have difficulty accessing after hours care and traveling to see their usual provider
Health Insurance Profile Indicates Need to Expand Coverage in Rural Areas (Policy Brief)
Author(s): Jennifer Lenardson, Erika Ziller, Andrew Coburn, Nathaniel Anderson
Research center: Maine Rural Health Research Center
Topics: Health insurance and the uninsured, Health policy
Date: 07 / 2009
Rural residents-particularly in the most remote rural communities-are in greater need of health reform, as demonstrated by an uninsured rate higher than that of urban residents. The rural-urban disparity in coverage is driven by higher uninsured rates among rural adults, a group that should be part of any strategic effort to improve coverage. This brief provides information on the health insurance status of rural Americans, summarized from a more detailed chartbook. Analyses are based on the 2004-05 Medical Expenditure Panel Survey.
Mental Health Problems Have Considerable Impact on Rural Children and their Families (Policy Brief)
Author(s): Jennifer D. Lenardson, Erika C. Ziller, David Lambert, Melanie M. Race, Anush Yousefian
Research center: Maine Rural Health Research Center
Topics: Children, Mental health
Date: 10 / 2010
Mental health problems have considerable impact on children and their families and some of these impacts are higher in rural than urban areas. Rural children are slightly but significantly more likely to have a mental health problem than urban children, are more likely to have a behavioral difficulty, and are more likely to be usually or always affected by their condition. Compared to urban children, rural children are more likely to go without access to all parent-reported needed mental health services and their families spend more time coordinating their care. This policy brief provides information on prevalence of children's mental health needs and associated access to care and family impact across rural and urban areas. Analyses are based on the 2005-06 National Survey of Children with Special Health Care Needs.
Profile of Rural Health Insurance Coverage: A Chartbook
Author(s): Jennifer D. Lenardson, Erika C. Ziller, Andrew F. Coburn, Nathaniel J. Anderson
Research center: Maine Rural Health Research Center
Topics: Health insurance and the uninsured, Health policy
Date: 06 / 2009
As the nation considers whether and how to reform the healthcare system, it is important to consider differences in health insurance coverage for those living in rural and urban areas. Analyses of persons under age 65 from the 2004-05 Medical Expenditure Panel Survey reveal a greater proportion of rural residents than urban residents who are uninsured or covered through public sources, especially among those living in remote areas. Rural adults are at high risk of being uninsured compared to rural children. Uninsured rates are highest among adults over age 50 in the most remote rural places. Compared to urban adults, rural adults are less likely to be in employment situations where private coverage is offered.
Rural Children Don't Receive the Mental Health Care They Need (Policy Brief)
Author(s): David Lambert, Erika C. Ziller, Jennifer D. Lenardson
Research center: Maine Rural Health Research Center
Topics: Children, Mental health
Date: 01 / 2009
Just over one-third of all children with a mental health problem received a mental health visit in the past year. Controlling for other characteristics that affect access to care, rural children are 20% less likely to have a mental health visit than urban children. Having Medicaid or SCHIP increases the likelihood that a child will receive services, and this is pronounced in rural areas.
Rural-Urban Differences in Health Care Access Vary Across Measures
Author(s): Erika Ziller, Jennifer Lenardson
Research center: Maine Rural Health Research Center
Topic: Health services
Date: 06 / 2009
Higher uninsured rates and workforce shortages in rural areas suggest that rural residents face greater barriers to accessing health care than their urban counterparts. Analysis of the 2006 Medical Expenditure Panel Survey found mixed results. Rural residents were more likely than urban residents to have a usual source of health care (USC), particularly among the uninsured. Despite this, rural adults were somewhat less likely to receive certain preventive care services compared to urban adults. Additionally, rural residents were somewhat more likely to report long travel times to reach their USC and greater difficulty in reaching their provider after hours.

Topics Centers Researchers Other Resources Search		Jennifer Lenardson, MHS Maine Rural Health Research Center Phone: 207.228.8399 E-mail: jlenardson@usm.maine.edu University of Southern Maine PO Box 9300 Portland, ME Completed Projects (2) Access to Mental Health Services and Family Burden of Rural Children with Significant Mental Health Problems, Lead researcher Research center: Maine Rural Health Research Center Funder: Office of Rural Health Policy (ORHP) Topics: Children, Mental health The needs of rural children with SED and the burden these needs place on their families are intertwined and may place these rural children and their families at "double jeopardy" of having their mental health and other needs go unmet. Using the National Survey of Children with Special Health Care Needs (NS-CSHCN) and information on community characteristics from the Area Resource File (ARF) we will examine the factors associated with whether children and their families have their needs meet across the rural continuum. Availability, Characteristics, and Role of Detoxification Services in Rural Areas Research center: Maine Rural Health Research Center Funder: Office of Rural Health Policy (ORHP) Topic: Substance abuse This project will produce a comprehensive description of the distribution and characteristics of detoxification (detox) services across rural areas including a discussion of access issues, the role of detox services within local systems of care, barriers to the delivery of detox services by rural providers, and policy and regulatory incentives needed to encourage the development of rural detox services. Products will include a working paper and related journal articles addressing these topics. Publications (11) Access to Mental Health Services and Family Impact of Rural Children with Mental Health Problems Author(s): Jennifer D. Lenardson, Erika C. Ziller, David Lambert, Melanie M. Race, Anush Yousefian Research center: Maine Rural Health Research Center Topics: Children, Mental health Report Number: #45 Date: 10 / 2010 Mental health problems have considerable impact on children and their families and some of these impacts are higher in rural than urban areas. Rural children are slightly but significantly more likely to have a mental health problem than urban children, are more likely to have a behavioral difficulty, and are more likely to be usually or always affected by their condition. Compared to urban children, rural children are more likely to go without access to all parent-reported needed mental health services and their families spend more time coordinating their care. Availability, Characteristics, and Role of Detoxification Services in Rural Areas Author(s): Jennifer D. Lenardson, Melanie M. Race, John A. Gale Research center: Maine Rural Health Research Center Topic: Substance abuse Report Number: 41 Date: 12 / 2009 Few detox providers (n=235) serve rural America; 82% of rural residents live in a county without a detox provider. More than half of all rural detox providers serve patients across a 100 mile radius, making travel distances a barrier to outpatient care. Referral options to substance abuse treatment are limited, especially in isolated rural areas. Analyses are based on a 2008 survey of rural detox facilities conducted by the Maine Rural Health Research Center. Distribution of Substance Abuse Treatment Facilities Across the Rural - Urban Continuum Author(s): Jennifer D. Lenardson, John A. Gale Research center: Maine Rural Health Research Center Topics: Health disparities, Health services, Rural statistics and demographics, Substance abuse Report Number: Working Paper No. 35 Date: 10 / 2007 Considering recent growth in substance abuse among rural populations and the documented scarcity of rural health resources, this study examines the distribution of substance abuse treatment services across the continuum of rural and urban counties, identifying the type and intensity of services provided. Using the 2004 National Survey of Substance Abuse Treatment Services linked to the 2003 Rural-Urban Continuum Codes, we found few substance abuse treatment facilities operating outside of urban and rural adjacent areas and limited availability of intensive services across rural areas. This situation is particularly striking for opioid treatment programs, which are nearly absent in rural areas. The narrow range of services available in rural areas may preclude an individualized treatment approach and long-term follow-up recommended by professional organizations and other experts. The greater proportion of rural-based facilities accepting public payers and providing discounted care may reflect higher rates of uninsurance and underinsurance. Distribution of Substance Abuse Treatment Facilities Across the Rural - Urban Continuum (Research & Policy Brief No. 35B) Author(s): Jennifer D. Lenardson, John A. Gale Research center: Maine Rural Health Research Center Topics: Health disparities, Health services, Rural statistics and demographics, Substance abuse Date: 02 / 2008 This Research & Policy Brief highlights findings from a recent study examining the distribution of substance abuse treatment facilities in rural and urban counties and identifying the type and intensity of services provided. Key findings include: Access to substance abuse treatment is limited in rural areas by fewer treatment beds. Less populated rural areas contain a small proportion of facilities offering a range of core services and varying levels of outpatient and intensive services. Opiod treatment programs are nearly absent in rural areas. Few and Far Away: Detoxification Services in Rural Areas (Research & Policy Brief) Author(s): Jennifer D. Lenardson, Melanie M. Race, John A. Gale Research center: Maine Rural Health Research Center Topic: Substance abuse Date: 12 / 2009 Based on Working Paper #41: Availability, Characteristics, and Role of Detoxification Services in Rural Areas. Findings: Few rural detox providers exist; 82% of rural residents live in a county without a detox provider. More than half of all rural detox providers serve a 100 mile radius. Travel distances are a barrier to outpatient detox models. Referral options to substance abuse treatment are limited, especially in isolated rural areas. Health Care Access and Use Among the Rural Uninsured (Policy Brief) Author(s): Erika C. Ziller, Jennifer D. Lenardson, Andrew F. Coburn Research center: Maine Rural Health Research Center Topics: Health insurance and the uninsured, Health services Date: 11 / 2011 Using data from the 2002-2007 Medical Expenditure Panel Survey (MEPS), this study examined access to care and service use among non-elderly, uninsured rural and urban residents. Key Findings include: Uninsured residents of both rural and urban areas face serious barriers to care compared to those with health insurance coverage. The rural uninsured are more likely to have a usual source of care and to have used ambulatory care in the past year than the urban uninsured. Insured or not, rural residents have difficulty accessing after hours care and traveling to see their usual provider Health Insurance Profile Indicates Need to Expand Coverage in Rural Areas (Policy Brief) Author(s): Jennifer Lenardson, Erika Ziller, Andrew Coburn, Nathaniel Anderson Research center: Maine Rural Health Research Center Topics: Health insurance and the uninsured, Health policy Date: 07 / 2009 Rural residents-particularly in the most remote rural communities-are in greater need of health reform, as demonstrated by an uninsured rate higher than that of urban residents. The rural-urban disparity in coverage is driven by higher uninsured rates among rural adults, a group that should be part of any strategic effort to improve coverage. This brief provides information on the health insurance status of rural Americans, summarized from a more detailed chartbook. Analyses are based on the 2004-05 Medical Expenditure Panel Survey. Mental Health Problems Have Considerable Impact on Rural Children and their Families (Policy Brief) Author(s): Jennifer D. Lenardson, Erika C. Ziller, David Lambert, Melanie M. Race, Anush Yousefian Research center: Maine Rural Health Research Center Topics: Children, Mental health Date: 10 / 2010 Mental health problems have considerable impact on children and their families and some of these impacts are higher in rural than urban areas. Rural children are slightly but significantly more likely to have a mental health problem than urban children, are more likely to have a behavioral difficulty, and are more likely to be usually or always affected by their condition. Compared to urban children, rural children are more likely to go without access to all parent-reported needed mental health services and their families spend more time coordinating their care. This policy brief provides information on prevalence of children's mental health needs and associated access to care and family impact across rural and urban areas. Analyses are based on the 2005-06 National Survey of Children with Special Health Care Needs. Profile of Rural Health Insurance Coverage: A Chartbook Author(s): Jennifer D. Lenardson, Erika C. Ziller, Andrew F. Coburn, Nathaniel J. Anderson Research center: Maine Rural Health Research Center Topics: Health insurance and the uninsured, Health policy Date: 06 / 2009 As the nation considers whether and how to reform the healthcare system, it is important to consider differences in health insurance coverage for those living in rural and urban areas. Analyses of persons under age 65 from the 2004-05 Medical Expenditure Panel Survey reveal a greater proportion of rural residents than urban residents who are uninsured or covered through public sources, especially among those living in remote areas. Rural adults are at high risk of being uninsured compared to rural children. Uninsured rates are highest among adults over age 50 in the most remote rural places. Compared to urban adults, rural adults are less likely to be in employment situations where private coverage is offered. Rural Children Don't Receive the Mental Health Care They Need (Policy Brief) Author(s): David Lambert, Erika C. Ziller, Jennifer D. Lenardson Research center: Maine Rural Health Research Center Topics: Children, Mental health Date: 01 / 2009 Just over one-third of all children with a mental health problem received a mental health visit in the past year. Controlling for other characteristics that affect access to care, rural children are 20% less likely to have a mental health visit than urban children. Having Medicaid or SCHIP increases the likelihood that a child will receive services, and this is pronounced in rural areas. Rural-Urban Differences in Health Care Access Vary Across Measures Author(s): Erika Ziller, Jennifer Lenardson Research center: Maine Rural Health Research Center Topic: Health services Date: 06 / 2009 Higher uninsured rates and workforce shortages in rural areas suggest that rural residents face greater barriers to accessing health care than their urban counterparts. Analysis of the 2006 Medical Expenditure Panel Survey found mixed results. Rural residents were more likely than urban residents to have a usual source of health care (USC), particularly among the uninsured. Despite this, rural adults were somewhat less likely to receive certain preventive care services compared to urban adults. Additionally, rural residents were somewhat more likely to report long travel times to reach their USC and greater difficulty in reaching their provider after hours.