2022 Research Publications

Browse the full list of research publications from the Rural Health Research Centers.

Products – Freely accessible products include policy briefs, fact sheets, full reports, chartbooks, and interactive data websites.

Journal Articles – Articles in peer-reviewed journals may require a subscription or affiliation with a subscribing library. For these publications, Gateway lists the article citation, a brief summary, a link to additional information and access to the full-text of the article, if available.

  • Improving Access to LGBTQIA+-Friendly Care in Rural Areas
    University of Minnesota Rural Health Research Center
    Date: 06/2022
    The purpose of this case series is to highlight organizations doing exemplary work to improve access to and experiences of health care among lesbian, gay, bisexual, transgender, queer/questioning, and asexual/agender (LGBTQIA+) individuals in rural communities across the U.S.
  • Rural Community Organizations Building Inclusive Environments for LGBTQ+ Residents
    University of Minnesota Rural Health Research Center
    Date: 06/2022
    The purpose of this case series is to highlight rural organizations doing exemplary work to build community among lesbian, gay, bisexual, transgender, and queer/ questioning residents, and create a more inclusive environment in their communities.
  • Prevalence of Chronic Conditions by Sexual Orientation and Rural-Urban Location
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 06/2022
    This policy brief examines rates of individual chronic conditions, as well as differences in the number of chronic conditions by sexual orientation and rural-urban location.
  • Social and Emotional Support during the COVID-19 Pandemic by Sexual Orientation and Rurality
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 06/2022
    This brief identifies differences in social and emotional support and changes to that support during the COVID-19 pandemic by rurality and sexual orientation.
  • Small-Town Pride Celebrations Supporting Social Connectedness & Well-Being for LGBTQ+ Rural Residents
    University of Minnesota Rural Health Research Center
    Date: 06/2022
    The purpose of this case series is to highlight organizations in two states doing exemplary work to celebrate and affirm lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) individuals in their rural communities through Pride events. These may serve as examples to others considering this work.
  • Non-Metropolitan and Metropolitan Trends in Mental Health Treatment Availability in Community Health and Community Mental Health Centers
    Policy Brief
    Rural and Underserved Health Research Center
    Date: 06/2022
    This study shows how the supply of community mental health centers (CMHCs) and community health centers (CHCs) delivering mental health services changed from 2000 to 2019. While the supply of CHCs offering mental health services increased, the supply of CMHCs decreased.
  • The Racial and Ethnic Diversity of the Family Physician Workforce in Non-Metropolitan and Metropolitan Counties
    Policy Brief
    Rural and Underserved Health Research Center
    Date: 06/2022
    Racial/ethnic concordance of clinicians and patients may improve health outcomes by increasing access to care for underserved populations. Our objective was to determine the distribution of family physicians (FPs) in rural areas by race/ethnicity and also whether rural minority FPs were more likely to be in underserved rural areas.
  • Approaches to Serving Rural Older Adults in State Plans on Aging: A Policy Content Evaluation
    University of Minnesota Rural Health Research Center
    Date: 05/2022
    In this article, we share a policy content evaluation of State Plans on Aging from all 50 U.S. states, focusing on how the states will serve older adults and including common and innovative approaches to doing so.
  • Social Isolation and Safety Issues among Rural Older Adults Living Alone: Perspectives of Meals on Wheels Programs
    University of Minnesota Rural Health Research Center
    Date: 05/2022
    In this article, we share results from a survey of 42 Meals on Wheels programs in rural areas across the US. Respondents highlighted challenges to meeting both social and safety needs of rural older adults living alone, as well as policy recommendations to improve the health and safety of older adults living alone in rural areas.
  • Trends in Revenue Sources Among Rural Hospitals
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 05/2022
    Possible issues with existing rural hospital financing models suggest that outpatient-centric payment methods may be more effective in providing financial relief to rural hospitals. Given this, we explored the financial importance of outpatient care to rural hospitals by estimating changes in outpatient care as a source of revenue.
  • Association between Rural Hospital Service Changes and Community Demographics
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 05/2022
    Research has shown that among rural communities, those with a larger percentage of Black or Hispanic residents were more likely to experience a local hospital closure. This brief explores possible associations between the proportion of a rural community belonging to a AHRQ-identified priority population and local hospital service changes.
  • Community Characteristics and Financial and Operational Performance of Rural Health Clinics in the United States: A Chartbook
    Chartbook
    Maine Rural Health Research Center
    Date: 05/2022
    This chartbook provides an overview of Rural Health Clinic (RHC) characteristics and issues and will be useful to policymakers and others interested in the performance of RHCs nationally. It provides a discussion of the challenges related to collection and reporting of RHC quality data.
  • Prehospital Emergency Medical Services Personnel: Comparing Rural and Urban Professional Experience and Provision of Evidence-Based Care
    Policy Brief
    WWAMI Rural Health Research Center
    Date: 05/2022
    This policy brief examines the effects of emergency medical services (EMS) personnel level of experience and agency rurality on the provision of evidenced-based care. Compared with urban-serving EMS agencies, rural-serving agencies provided evidence-based care less often for stroke, hypoglycemia, and trauma but more often for seizures.
  • Racial/Ethnic Differences in Adverse and Positive Childhood Experiences Across Rural Communities: Results from the National Survey of Children's Health
    Policy Brief
    Rural and Minority Health Research Center
    Date: 05/2022
    This study examined whether ACE and PCE exposure varied by race/ethnicity, among rural children, finding that there were higher rates of four or more ACEs among racial/ethnic minority children.
  • Medicare Accountable Care Organization Characteristics Associated With Participation in 2‐sided Risk
    RUPRI Center for Rural Health Policy Analysis
    Date: 05/2022
    This study examined the associations of accountable care organization (ACO) characteristics with the likelihood of participation in 2-sided risk tracks in the Medicare Shared Savings Program. Small and rural ACOs were found to be less prepared to transition into 2-sided risk tracks than their urban counterparts.
  • Comparison of Cancer Treatment Services across Hospitals
    Fact Sheet
    Rural and Minority Health Research Center
    Date: 05/2022
    This research compared the availability of comprehensive oncology, chemotherapy, and radiation therapy in Critical Access Hospitals and non-Critical Access Hospitals.
  • The Northern Border Region: A Health-Focused Landscape Analysis
    Chartbook
    Maine Rural Health Research Center
    Date: 04/2022
    These chartbooks present a comprehensive set of state- and county-level population health and health care access measures for Maine, New Hampshire, New York, and Vermont. These data are intended to inform initiatives to support health and health care, particularly in rural counties and counties served by the Northern Border Regional Commission.
  • Vermont: A Health-Focused Landscape Analysis
    Chartbook
    Maine Rural Health Research Center
    Date: 04/2022
    These chartbooks present a comprehensive set of state- and county-level population health and health care access measures for Maine, New Hampshire, New York, and Vermont. These data are intended to inform initiatives to support health and health care, particularly in rural counties and counties served by the Northern Border Regional Commission.
  • New York: A Health-Focused Landscape Analysis
    Chartbook
    Maine Rural Health Research Center
    Date: 04/2022
    These chartbooks present a comprehensive set of state- and county-level population health and health care access measures for Maine, New Hampshire, New York, and Vermont. These data are intended to inform initiatives to support health and health care, particularly in rural counties and counties served by the Northern Border Regional Commission.
  • New Hampshire: A Health-Focused Landscape Analysis
    Chartbook
    Maine Rural Health Research Center
    Date: 04/2022
    These chartbooks present a comprehensive set of state- and county-level population health and health care access measures for Maine, New Hampshire, New York, and Vermont. These data are intended to inform initiatives to support health and health care, particularly in rural counties and counties served by the Northern Border Regional Commission.
  • Maine: A Health-Focused Landscape Analysis
    Chartbook
    Maine Rural Health Research Center
    Date: 04/2022
    These chartbooks present a comprehensive set of state- and county-level population health and health care access measures for Maine, New Hampshire, New York, and Vermont. These data are intended to inform initiatives to support health and health care, particularly in rural counties and counties served by the Northern Border Regional Commission.
  • Predictors of Hospital Choice Among Rural Patients Seeking Elective Surgery: A Scoping Review
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center, Rapid Response to Requests for Rural Data Analysis
    Date: 04/2022
    The purpose of this scoping review was to identify literature describing determinants of hospital choice among rural patients seeking elective surgery.
  • Rural Hospital Administrators' Beliefs About Safety, Financial Viability, and Community Need for Offering Obstetric Care
    University of Minnesota Rural Health Research Center
    Date: 03/2022
    This study offers results from a national survey of a sample of 292 rural hospitals that provided obstetric services in 2021. Obstetric unit administrators shared about their experiences, the challenges they face, and the decisions that factor into providing labor and birth care for their rural communities.
  • Rural Hospital Profitability During the Global COVID-19 Pandemic Requires Careful Interpretation
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center, Rapid Response to Requests for Rural Data Analysis
    Date: 03/2022
    Many small rural hospitals struggle with profitability compared to their urban counterparts. The findings brief describes the pre-pandemic (2011-19) trend of rural hospital profitability and explains why possible increases in reported profitability during the pandemic (2020-21) may mask the long-term financial challenges of rural hospitals.
  • The Economic Effects of Rural Hospital Closures
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 03/2022
    This study updates previous research (Holmes, et al. 2006) on the economic effects of rural hospital closures by measuring the economic changes over time among U.S. rural counties that had a hospital closure from 2001-2018.
  • Since 1990, Rural Hospital Closures Have Increasingly Occurred in Counties that Are More Urbanized, Diverse, and Economically Unequal
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 03/2022
    The brief describes the socio‐economic, demographic, and health system characteristics for rural counties with and without hospital closures between 1990 and 2020. We analyzed potential differences among counties that experienced rural hospital closures from 2010‐2020 compared to counties with rural hospital closures from 1990‐2009.
  • The Problem of the Color Line: Place, Race, and Access to Health Care in America
    Rural and Minority Health Research Center
    Date: 02/2022
    Using ZIP Code Tabulation Area boundaries and associated rural-urban commuting area codes, urban and rural places with the largest share of minoritized racial and ethnic groups were identified. A StoryMap was then created to illustrate disparities experienced based on where Indigenous populations and people of color reside spatially.
  • Quality of Home Health Agencies Serving Rural Medicare Beneficiaries
    Policy Brief
    WWAMI Rural Health Research Center
    Date: 02/2022
    This policy brief describes the quality of home health agencies (HHAs) by rural-serving status. While quality of patient care star ratings were not associated with rural-serving status, rural HHAs and urban HHAs that serve rural patients had higher patient experience star ratings than urban HHAs that do not serve rural patients.
  • Quality of Skilled Nursing Facilities Serving Rural Medicare Beneficiaries
    Policy Brief
    WWAMI Rural Health Research Center
    Date: 02/2022
    This policy brief describes the quality of skilled nursing facilities (SNFs) by rural-serving status. While overall star ratings and staffing star ratings were not associated with rural-serving status, rural SNFs and urban SNFs that serve rural patients had lower quality star ratings compared to urban SNFs that do not serve rural patients.
  • Perceptions and Practices for Colorectal and Cervical Cancer Prevention and Control in Rural Health Clinics in South Carolina
    Fact Sheet
    Rural and Minority Health Research Center
    Date: 02/2022
    This study investigated the perceptions and practices for colorectal and cervical cancer prevention and control in Rural Health Clinics in South Carolina. Health practitioner interviews were used to gather qualitative data.
  • Colorectal and Cervical Cancer Prevention in Rural Health Clinics in South Carolina
    Fact Sheet
    Rural and Minority Health Research Center
    Date: 02/2022
    This study investigated the perceptions and practices of cervical and colorectal cancer prevention in Rural Health Clinics. An online survey was administered to all Rural Health Clinics in South Carolina. Quantitative survey findings and key takeaways were reported.
  • Meeting the Behavioral Health Needs of Farm Families in Times of Economic Distress
    Policy Brief
    RUPRI Health Panel: Rural Policy Analysis and Applications
    Date: 02/2022
    Economic fluctuations and periods of distress in farming cannot be eliminated, however, their impact on communities and individuals can be mitigated. Strategies for meeting the behavioral health needs of farm families by supporting community-based services, and expanding behavioral health services in rural contexts are highlighted in this work.
  • Serious Mental Illness and Mental Health Treatment Utilization Among Adults Residing in Non-Metropolitan and Metropolitan Counties
    Policy Brief
    Rural and Underserved Health Research Center
    Date: 02/2022
    This report estimates and compares the prevalence of mental health treatment utilization and reasons for not seeking mental health treatment among adults with serious mental illness residing in non-metropolitan and metropolitan counties nationally.
  • Rural-Urban Differences in Adverse and Positive Childhood Experiences: Results from the National Survey of Children's Health
    Policy Brief
    Rural and Minority Health Research Center
    Date: 01/2022
    This brief examines the types and counts of adverse childhood experiences (ACEs) and positive childhood experiences (PCEs) for rural and urban children. The study reports on the differences between rural and urban ACEs and PCEs across all fifty states and the District of Columbia.
  • Social Cohesion and Social Engagement Among Older Adults Aging in Place: Rural/Urban Differences
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 01/2022
    This policy brief examines rural/urban differences in social cohesion and social engagement for older adults aging in place, as well as within-rural differences by race and ethnicity.
  • Evaluating the Rural HIV/AIDS Planning Program
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 01/2022
    The purpose of this policy brief is to understand the overall experiences of the first grantee cohort (2020-21) of the Rural HIV/AIDS Planning Program. We pay particular attention to any barriers to or facilitators of successful grant implementation, and the sustainability of programs and acquisition of future funding.
  • High-Performing Rural Health System
    Policy Brief
    RUPRI Health Panel: Rural Policy Analysis and Applications
    Date: 01/2022
    This document updates the RUPRI Health Panel's framework, for a high-performing rural health system, originally published in 2011. It offers a revised vision statement and updates the high-performing rural health system pillars (access, affordability, community health, and quality) and describes an underlying base of equity considerations.
  • An Enhanced Method for Identifying Hospital-Based Obstetric Unit Status
    University of Minnesota Rural Health Research Center
    Date: 01/2022
    The purpose of this methodology brief is to describe an enhanced method for identifying hospital-based obstetric unit status and for identifying closures of obstetric units.
  • Rural Hospitals that Closed between 2017‐20: Profitability and Liquidity in the Year Before Closure
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center, Rapid Response to Requests for Rural Data Analysis
    Date: 01/2022
    This brief examines the preclosure profitability and liquidity performance of rural hospitals that closed between 2017‐20 and compare it to the median performance of rural hospitals that remained open during the same year.