Rural Health Research Gateway

Mark Doescher, MD, MSPH

Director, WWAMI Rural Health Research Center

Phone: 206.616.9207
Fax: 206.616.4768
E-mail: mdoesche@u.washington.edu

Department of Family Medicine
University of Washington
Box 354982
Seattle, WA 98195-4982

Current Projects

Dentist Supply, Access to Dental Care, and Oral Health among Rural and Urban Residents: A National Study
Research center: WWAMI Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Dental health, Workforce
This study will determine whether shortages of dentists in rural areas of the U.S. are associated with impaired access to dental care and a higher prevalence of dental disease.

General and Specialist Surgeon Supply and Inpatient Procedural Content: A National Rural-Urban Study
Research center: WWAMI Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topic: Workforce
This study will examine the degree to which access to inpatient surgical care in rural areas is affected by the diminishing workforce of general surgeons. Using inpatient surgical procedure data, we will examine the availability and content of general surgical procedures in rural and urban hospitals nationally as a function of surgeon supply.

Trends in Access to Health Care among Rural Residents: A National Study
Research center: WWAMI Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Health disparities, Health services, Rural statistics and demographics
This study used national data from the Behavioral Risk Factor Surveillance System (BRFSS) to ascertain the extent to which individual rural residents lack access to health care providers.

Completed Projects

Breast, Cervical, Colorectal, and Prostate Cancer Screening in Rural America: Does Proximity to a Metropolitan Area Matter?, Lead researcher
Research center: WWAMI Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Health disparities, Health promotion and disease prevention, Minority health
The study compared cancer screening rates among various levels of rural versus urban Behavioral Risk Factor Surveillance System respondents and among white respondents versus those from racial/ethnic minority groups.

Burden of Asthma Among Rural Residents: A National Study, Lead researcher
Research center: WWAMI Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Chronic diseases and conditions, Health disparities, Minority health, Rural statistics and demographics
This study uses data from the Behavioral Risk Factor Surveillance System (BRFSS) to examine the prevalence of and trends in asthma—among rural residents by type of geographic location and by key risk factors.

The Rural/Urban Practice Location Patterns of Women Medical School Graduates, Lead researcher
Research center: WWAMI Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Physicians, Women, Workforce
While women are becoming an increasingly large percentage of the graduates of medical schools, they are much less likely to locate their practices in rural towns. This study involved a survey including questions about where the residents preferred to locate and how much they thought they would be practicing in the future.

Unhealthy Lifestyle Behaviors Among Minority Group Members: A National Rural and Urban Study, Lead researcher
Research center: South Carolina Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: Health disparities, Health promotion and disease prevention, Minority health

Publications

  • 2005 Physician Supply and Distribution in Rural Areas of the United States (Full Report)
    Author(s): Meredith A. Fordyce, Frederick M. Chen, Mark P. Doescher, L. Gary Hart
    Research center: WWAMI Rural Health Research Center
    Topics: International Medical Graduates (IMGs), Physicians, Workforce
    Date: 11 / 2007
    This study describes the 2005 supply and distribution of physicians (including osteopathic physicians and international medical graduates) with particular emphasis on generalists in rural areas. Results indicate variability in the rural-urban distribution of physicians, with generalist physicians playing prominent roles in rural areas.
  • 2005 Physician Supply and Distribution in Rural Areas of the United States (Project Summary)
    Author(s): Meredith A. Fordyce, Frederick M. Chen, Mark P. Doescher, L. Gary Hart
    Research center: WWAMI Rural Health Research Center
    Topics: International Medical Graduates (IMGs), Physicians, Workforce
    Date: 11 / 2007
    This study describes the 2005 supply and distribution of physicians (including osteopathic physicians and international medical graduates) with particular emphasis on generalists in rural areas. Results indicate variability in the rural-urban distribution of physicians, with generalist physicians playing prominent roles in rural areas.
  • Heavy And Binge Drinking In Rural America: A Comparison Of Rural And Urban Counties From 1995/1997 Through 1999/2001
    Author(s): J. Elizabeth Jackson, Mark P. Doescher, L. Gary Hart
    Research center: WWAMI Rural Health Research Center
    Topics: Health promotion and disease prevention, Substance abuse
    Report Number: Working Paper No. 95
    Date: 02 / 2005
    Assesses the prevalence of, and recent trends in, alcohol use among adults 18 years and older in rural areas of the United States. It uses a random digit telephone survey method to gather information on alcohol use among adults in 49 states and the District of Columbia that participated in the Behavioral Risk Factor Surveillance System. The paper finds that heavy drinking was highest and increasing in urban areas, but that binge drinking was greater in rural areas. It recommends tailoring interventions specifically to meet the needs of rural residents. Report available upon request by contacting rhrc@fammed.washington.edu.
  • National Study of Lifetime Asthma Prevalence and Trends in Metro and Non-Metro Counties, 2000-2003 (Full Report)
    Author(s): J. Elizabeth Jackson, Mark P. Doescher, L. Gary Hart
    Research center: WWAMI Rural Health Research Center
    Topic: Chronic diseases and conditions
    Report Number: Working Paper No. 108
    Date: 01 / 2007
    Reports the findings of a study of the prevalence of and recent trends in asthma among adults residing in metropolitan and non-metropolitan counties in the United States. In 2003, the adjusted prevalence of lifetime asthma diagnosis was 12.0 percent for metropolitan counties and 11.0 percent for non-metropolitan counties (p < 0.001). Prevalence of lifetime asthma diagnosis trended upwards across the rural-urban spectrum between 2000 and 2003, and states with the highest 2003 prevalence and the greatest increase in prevalence among non-metropolitan residents were concentrated in the West Census region (e.g., Arizona, California, Oregon and Washington). Asthma prevalence in non-metropolitan counties was highest for those aged 18 to 34 (15.9%), the unemployed (13.5%), American Indians (12.7%) and women (12.4%).
  • National Study of Obesity Prevalence and Trends by Type of Rural County
    Author(s): J. Elizabeth Jackson, Mark P. Doescher, Anthony F. Jerant, L. Gary Hart
    Research center: WWAMI Rural Health Research Center
    Topics: Health promotion and disease prevention, Obesity
    Citation: Journal of Rural Health, 21(2), 140-148
    Date: 2005
    To estimate the prevalence of and recent trends in obesity among US adults residing in rural locations, the authors analyzed data from the Behavioral Risk Factor Surveillance System for 1994-1996 and 2000-2001and found that in 2000-2001 the prevalence of obesity was 23.0% for rural adults and 20.5% for their urban counterparts, representing increases of 4.8% and 5.5%, respectively, since 1994-1996. The highest obesity prevalence occurred in rural counties in Louisiana, Mississippi, and Texas; obesity prevalence increased for rural residents in all states but Florida over the study period. African Americans had the highest obesity prevalence of any group, up to 31.4% in rural counties adjacent to urban counties.
  • Obesity Prevalence In Rural Counties: A National Study
    Author(s): J. Elizabeth Jackson, Mark P. Doescher, Anthony F. Jerant, L. Gary Hart
    Research center: WWAMI Rural Health Research Center
    Topics: Health promotion and disease prevention, Obesity, Rural statistics and demographics
    Report Number: Working Paper No. 87
    Date: 01 / 2004
    Using a random-digit telephone survey of adults aged 18 and older residing in states participating in the Behavioral Risk Factor Surveillance System in 1994-96 and 2000-2001, researchers found that the prevalence of obesity was 23 percent for rural adults and 20.5 percent for urban adults. This finding represents increases of 4.8 percent and 5.5 percent, respectively. The highest obesity prevalence occurred in rural counties of Mississippi, Texas, and Louisiana. Only Rhode Island and Colorado had rural counties that met the Healthy People 2010 goal of a maximum of 15 percent obese for adults. Report available on request.
  • Prevalence And Trends In Smoking: A National Rural Study
    Author(s): Mark P. Doescher, J. Elizabeth Jackson, Anthony F. Jerant, L. Gary Hart
    Research center: WWAMI Rural Health Research Center
    Topics: Health promotion and disease prevention, Substance abuse
    Report Number: Working Paper No. 85
    Date: 12 / 2003
    Using data from the Behavioral Risk Factor Surveillance System, the research showed that the prevalence of smoking between 1994-1996 and 2000-2001 did not change substantially for the United States as a whole. The prevalence of smoking for rural residents decreased by more than 2 percent in six states (CA, CT, MD, NC, TN, UT). However, it increased by 2 percent or more in ten states. Report available on request.
  • Prevalence and Trends in Smoking: A National Rural Study
    Author(s): Mark P. Doescher, J. Elizabeth Jackson, Anthony Jerant, L. Gary Hart
    Research center: WWAMI Rural Health Research Center
    Topics: Health promotion and disease prevention, Minority health, Substance abuse
    Citation: Journal of Rural Health, 22(2), 112-118
    Date: 2006
    Reports the results of a study to estimate the prevalence of and recent trends in smoking among adults by type of rural location and by state.
  • Problem Drinking: Rural and Urban Trends in America 1995/97 to 2003
    Author(s): J. Elizabeth Jackson, Mark P. Doescher, L. Gary Hart
    Research center: WWAMI Rural Health Research Center
    Topic: Substance abuse
    Citation: Preventive Medicine, 43(2), 122-124
    Date: 2006
    Examines recent trends in heavy and binge drinking in urban counties and three types of rural counties.
  • Production of Rural Female Generalists by U.S. Medical Schools
    Author(s): Katherine E Ellsbury, Mark P Doescher, L Gary Hart
    Research center: WWAMI Rural Health Research Center
    Topics: Physicians, Women, Workforce
    Date: 05 / 1999
    Compares the production of rural female generalists among medical schools. Data from the 1996 AMA Physician Masterfile for the 1988-96 graduate cohort were analyzed to compare the production of rural female generalists by medical school. Outcome measures included total number and percentage of rural female generalist graduates of each school. Only a few schools contribute most of ht erural female generalists. These schools' admissions policies, curricula, extracurricular programs, and career advising efforts may serve as models of schools who make it a priority to encourage more of their female graduates to enter rural practice.
  • Trends in Cervical and Breast Cancer Screening Practices Among Women in Rural and Urban Areas of the United States (Final Report)
    Author(s): Mark P. Doescher, J. Elizabeth Jackson
    Research center: WWAMI Rural Health Research Center
    Topics: Health promotion and disease prevention, Women
    Report Number: 121
    Date: 08 / 2008
    Reports on trends in breast cancer screening practices. Participation in mammography improved nationally, but women living in rural locations remained less likely to receive this test than those living in urban settings.
  • Trends in Cervical and Breast Cancer Screening Practices Among Women in Rural and Urban Areas of the United States (Policy Brief)
    Author(s): Mark P. Doescher, J. Elizabeth Jackson
    Research center: WWAMI Rural Health Research Center
    Topics: Health promotion and disease prevention, Women
    Date: 08 / 2008
    Documents the receipt of timely breast and cervical cancer screening using a rural-urban classification system and nationally representative data.
  • Trends in Professional Advice to Lose Weight Among Obese Adults, 1994-2000
    Author(s): J. Elizabeth Jackson, Mark P. Doescher, Barry G. Saver, L. Gary Hart
    Research center: WWAMI Rural Health Research Center
    Topics: Health promotion and disease prevention, Obesity
    Citation: Journal of General Internal Medicine, 20(9), 814-8
    Date: 2005
    The authors studied whether rising obesity prevalence in the U.S. was accompanied by an increasing trend in professional advice to lose weight among obese adults, and found that disparities in professional advice to lose weight associated with income and educational attainment increased from 1994 to 2000. They concluded that there is a need for mechanisms that allow health care professionals to devote sufficient attention to weight control and to link with evidence-based weight loss interventions, especially those that target groups most at risk for obesity

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.