Rural Health Research Gateway

Eric Larson, PhD

Phone: 206.685.0401
Fax: 206.616.4768
E-mail: ehlarson@u.washington.edu

WWAMI Rural Health Research Center
University of Washington
Department of Family Medicine
Box 354696
Seattle, WA 98195-4696

Completed Projects

Are Rural Perinatal Care Systems Deregionalizing?, Lead researcher
Research center: WWAMI Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Children, Health services, Maternal and child health

Changes in U.S. Rural Perinatal and Infant Health Care During the Last Decade, Lead researcher
Research center: WWAMI Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Children, Health disparities, Maternal and child health
This study examined changes in rates of adverse birth outcomes and prenatal care among rural Americans of different racial and ethnic groups during two time periods. The study used national data from the Linked Birth Death Data Sets to assess differences in low birth weight, neonatal death, post neonatal mortality and inadequate prenatal care.

Rural Dentistry: Availability, Practice, and Access, Lead researcher
Research center: WWAMI Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Dental health, Workforce

Publications

  • Access to Maternity Care in Rural Washington: Its Effect on Neonatal Outcomes and Resource Use
    Author(s): Thomas S. Nesbitt, Eric H. Larson Roger A. Rosenblatt, L Gary Hart
    Research center: WWAMI Rural Health Research Center
    Topics: Children, Health services, Maternal and child health
    Citation: American Journal of Public Health, 87(1), 85-90
    Date: 01 / 1997
    Compares birth outcomes for areas with poor health care access to those with adequate health care access in rural Washington state.
  • Access to Specialty Health Care for Rural American Indians in Two States
    Author(s): Baldwin LM, Hollow WB, Casey S, Hart LG, Larson EH, Moore K, Lewis E, Andrilla CHA, Grossman DC
    Research center: WWAMI Rural Health Research Center
    Topics: American Indians and Alaska Natives, Health services, Minority health
    Citation: Journal of Rural Health 24(3), 269-278
    Date: 2008
    The Indian Health Service (IHS), whose per capita expenditure for American Indian and Alaska Native (AI/AN) health services is about half that of the US civilian population, is the only source of health care funding for many rural AI/ANs. Specialty services, largely funded through contracts with outside practitioners, may be limited by low IHS funding levels. This study outlines the examination of specialty service access among rural Indian populations in two states. Results indicate that limitations in specialty care access for rural Indian clinic patients appear to be influenced by financial constraints. Health care systems factors may play a role in perceived differences in specialty access between rural Indian and non-Indian clinic patients.
  • Access to Specialty Health Care for Rural American Indians: Provider Perceptions in Two States
    Author(s): Laura-Mae Baldwin, Waler B. Hollow, Susan Casey, L. Gary Hart, Eric H. Larson, Kelly Moore, Ervin Lewis, David C. Grossman
    Research center: WWAMI Rural Health Research Center
    Topics: American Indians and Alaska Natives, Health services, Minority health, Physicians
    Report Number: Working Paper No. 78
    Date: 10 / 2004
    Examines access to specialty services among rural Indian populations in Montana and New Mexico, based on a survey sent to primary care providers addressing access to specialty physicians, perceived barriers to access, and access to nonphysician clinical services. Report available upon request by contacting rhrc@fammed.washington.edu.
  • Characterizing the General Surgery Workforce in Rural America
    Author(s): Matthew J. Thompson, Dana Christian Lynge, Eric H. Larson, Pantipa Tachawachira, L. Gary Hart
    Research center: WWAMI Rural Health Research Center
    Topics: Physicians, Workforce
    Citation: Archives of Surgery, 140(1), 74-79
    Date: 01 / 2005
    Describes the rural general surgical workforce. Discusses the potential impact of its demographic characteristics on rural access to surgical services in the future.
  • Contribution of Nurse Practitioners and Physician Assistants to Generalist Care in Underserved Areas of Washington State
    Author(s): Eric H Larson, Lorella Palazzo, Bobbi Berkowitz, Michael J Pirani, L Gary Hart
    Research center: WWAMI Rural Health Research Center
    Topics: Mid-level practitioners, Nurses, Workforce
    Citation: Health Services Research, 38(4), 1033-1050
    Date: 08 / 2003
    Uses productivity data from the non-physician clinician (NPC) and physician populations in Washington State to assess the contribution to generalist care made by NPCs, giving special attention to the role of NPCs in rural and underserved areas and the role of women NPCs in the female provider population. Overall, generalist NPCs make up 23.4 percent of the generalist provider population and perform about 21 percent of the generalist outpatient visits in Washington State. NPC contribution is higher in rural areas of the state and a bit lower in urban areas. In rural areas, female physicians provided only 49.3 percent of the visits by female providers; female NPCs provided the remaining 50.3 percent. In urban areas, female physicians provided about 63.5 percent; female NPCs provided 46.5 percent. NPCs made similar contributions to total care in rural HPSAs compared to rural non-shortage areas, though physician assistants appear to contribute somewhat more care in HPSAs with severe shortages of providers. The results suggest that accurate and meaningful estimates of available generalist care must take into account the contribution of NPCs.
  • Geographic and Demographic Dimensions of the Adoption of a Health Workforce Innovation: Physician Assistants in the United States, 1967-2000
    Author(s): Eric H. Larson, L. Gary Hart
    Research center: WWAMI Rural Health Research Center
    Topics: Mid-level practitioners, Workforce
    Report Number: Working Paper No. 105
    Date: 12 / 2005
    Describes changes in the demography and distribution of the physician assistant (PA) population between 1967 and 2000, as well as the spread of PA training programs.
  • Modeling the Mental Health Workforce in Washington State: Using State Licensing Data to Examine Provider Supply in Rural and Urban Areas
    Author(s): Laura-Mae Baldwin, Miriam M. Patanian, Eric H. Larson, Denise M. Lishner, Larry B. Mauksch, Wayne J. Katon, Edward Walker, L. Gary Hart
    Research center: WWAMI Rural Health Research Center
    Topics: Mental health, Workforce
    Citation: Journal of Rural Health, 22(1), 50-8
    Date: 2006
    The authors sought to identify mental health shortage areas using existing licensing and survey data, and found that notable shortages of mental health providers existed throughout the state, especially in rural areas. Urban areas had 3 times the psychiatrist FTEs per 100,000 and more than 1.5 times the nonpsychiatrist mental health provider FTEs per 100,000 as rural areas. More than 80% of rural health service areas had at least 10% fewer psychiatrist FTEs and nonpsychiatrist mental health provider FTEs than the state ratio. They concluded that states gathering a minimum database at licensure renewal can identify area-specific mental health care shortages for use in program planning.
  • Pathways to Rural Practice: A Chartbook of Family Medicine Residency Training Locations and Characteristics
    Author(s): L. Gary Hart, Denise M. Lishner, Eric H. Larson, Frederick M. Chen, C. Holly A. Andrilla, Thomas E. Norris, Ronald Schneeweiss, Tim M. Henderson, Roger A. Rosenblatt
    Research center: WWAMI Rural Health Research Center
    Topics: Physicians, Workforce
    Citation: Seattle, WA: WWAMI Rural Health Research Center, University of Washington.
    Date: 08 / 2005
    Discusses characteristics and geographic locations of family medicine residency programs' rural locations, types of rural family medicine training by location, and rural mission of family medicine residencies.
  • Poor Birth Outcome in the Rural United States: 1985-1987 to 1995-1997 (Project Summary)
    Author(s): Larson EH, Murowchick E, Hart LG
    Research center: WWAMI Rural Health Research Center
    Topics: Children, Health disparities, Maternal and child health
    Report Number: Final Report 119
    Date: 02 / 2008
    Rates of low birthweight, poor outcomes, and inadequate prenatal care among urban and rural areas were evaluated and compared from 1985-1997 using data from the Linked Birth-Death Data Set. The study found that while progress was made in closing rural/urban gaps, rural residence and residence in a persistent poverty county remained independent risk factors for inadequate care and some adverse birth outcomes, especially postneonatal mortality.
  • Rural Definitions for Health Policy and Research
    Author(s): L. Gary Hart, Eric H. Larson, Denise M. Lishner
    Research center: WWAMI Rural Health Research Center
    Topics: Defining rural, Health policy
    Citation: American Journal of Public Health, 95(7), 1149-1155
    Date: 07 / 2005
    Defining "rural" for health policy and research purposes requires researchers and policy analysts to specify which aspects of rurality are most relevant to the topic at hand and then select an appropriate definition. Rural and urban taxonomies often do not discuss important demographic, cultural, and economic differences across rural places-differences that have major implications for policy and research. Factors such as geographic scale and region also must be considered. Several useful rural taxonomies are discussed and compared in this article. Careful attention to the definition of "rural" is required for effectively targeting policy and research aimed at improving the health of rural Americans.
  • State of the Health Workforce in Rural America: Profiles and Comparisons
    Author(s): Eric H. Larson, Karin E. Johnson, Thomas E. Norris, Denis M. Lishner, Roger A. Rosenblatt, L. Gary Hart
    Research center: WWAMI Rural Health Research Center
    Topic: Workforce
    Date: 08 / 2003
    Overview of rural health care workforce issues. National and state-by-state data on the health care workforce, with rural-urban comparisons and interstate comparisons. Also includes data on rural health care facilities. To request a copy, call (206) 685-0402 or email: rowe@u.washington.edu

This web site includes content provided by and adapted from the Maine Rural Health Research Center, University of Southern Maine under a Cooperative Agreement with the University of North Dakota.