View Policy Brief

03/2024

In this brief, researchers assess the availability of in-county diabetes self-management education (DSME) and dialysis across rural and urban counties.

Key Findings:

Diabetes education:

• Nationally, 41.0% of all counties contained at least one location where DSME is offered. Rural counties were less likely to have DSME than urban counties (30.1% versus 59.6%).
• Within rural counties, noncore counties were less likely to have in-county DSME than micropolitan counties (21.3% versus 48.4%).
• Within high need counties (those in the top quartile for estimated diabetes prevalence), 36.7% of urban counties and 31.3% of micropolitan counties have a DSME site. Among high-need noncore rural counties, however, only 12.8% have this service available.

Dialysis:

• Across the U.S., at least one site for kidney dialysis services is available in 59.2% of all counties. Facilities are present in similar proportions of urban and micropolitan counties (79.5% and 80.5%, respectively) but present in only 31.1% of noncore rural counties.

Both services:

• Nationally, more rural counties contained dialysis facilities (931 counties; 47.1%) than contained DSME (594; 30.1%). Across 790 high diabetes need counties, 164 (20.8%) have DSME while 417 (52.8%) had an in-county dialysis facility.

Rural and Minority Health Research Center

Janice Probst, Nicholas Yell, Gabriel Benavidez, Mary Katherine McNatt, Teri Browne, Laura Herbert, Whitney Zahnd, Elizabeth Crouch

Care management, Chronic diseases and conditions, Diabetes, Medicare, Minority health, Public health