Research Alert: September 11, 2025

A Review of Common Limitations in Rural-Related Studies in the Peer-Reviewed Literature

Health-related data inform policy and programming activities at the national, state, local, and tribal levels, yet there are known challenges inherent in the use of available data. This study systematically reviewed a subset of published, rural-related studies on health that use secondary, quantitative data to identify commonly reported limitations. Despite common limitations, the high prevalence of rural-related studies from high impact, peer-reviewed journals included in this study underscores the importance of rural analyses.

Key Findings:

• Rural-related studies commonly reported limitations on: missing, unmeasured, or proxy variables and confounding; under/over-reporting, under/over-estimating, or other measurement errors; and narrow generalizability, sample characteristics or representatives, or selection bias.
• Over one-third of rural-related studies described limitations specific to definitions of rurality or geographic measures.
• Approximately one in five rural-related studies identified outdated data, delayed data, or other time-related limitations.

Additional Resources of Interest:

• More FORHP-funded research on Rural statistics and demographics
• More information about the ETSU/NORC Rural Health Research Center