Rural Health
Research Gateway

2023 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.

  • Maniilaq Health Center: Providing High-Quality Obstetric Care to American Indian/Alaska Native People in Rural Kotzebue, Alaska
    University of Minnesota Rural Health Research Center
    Date: 06/2023
    This case study highlights a hospital providing care to rural American Indian and Alaska Native patients within the state of Alaska. The study examines the maternity care context with attention to the intersection of race and geography with social determinants of health.
  • Diabetes Prevalence and Monitoring in Nonmetropolitan and Metropolitan Areas Within a Commercially Insured U.S. Population
    Policy Brief
    Rural and Underserved Health Research Center
    Date: 06/2023
    This study used recent claims data, from services received between 2018 and 2020, to examine the prevalence of diabetes and to determine if patients with diabetes are more or less likely to receive annual hemoglobin A1c screening.
  • Understanding and Overcoming Barriers to Rural Training in Family Medicine Obstetrics Fellowships
    Policy Brief
    WWAMI Rural Health Research Center
    Date: 06/2023
    This policy brief describes the results of a survey on the characteristics and challenges faced by rurally oriented family medicine obstetrics fellowship programs. All survey respondents reported their programs had a mission to train family physicians for rural practice, yet less than one-third of programs reported they required rural training.
  • Policy Implications of Fixed-to-Total-Cost Ratio Variation Across Rural and Urban Hospitals
    Journal Article
    RUPRI Center for Rural Health Policy Analysis
    Date: 05/2023
    This article utilizes hospital cost report data to estimate the relationship between adjusted volume and total costs of patient care. These results are used to estimate fixed-to-total-cost ratios for all nonfederal, short-term acute care hospitals in the U.S. These ratios were then stratified by rurality and Critical Access Hospital status.
  • Ambulance Deserts: Geographic Disparities in the Provision of Ambulance Services
    Chartbook
    Maine Rural Health Research Center
    Date: 05/2023
    Access to timely ambulance service is an essential part of the emergency medical system. Yet ambulance access varies widely with significant gaps across the country. This research identifies places and people that are more than 25 minutes from an ambulance station, also called an ambulance desert.
  • Rural Healthy People 2030: Common Challenges, Rural Nuances
    Policy Brief
    Southwest Rural Health Research Center
    Date: 05/2023
    This study analyzes the most important Healthy People 2030 priorities for rural America. Data collected from a survey found mental health, substance use, health care access, and economic stability were among the most important priorities. This information could be used to accelerate health improvements in rural America.
  • Distribution of Direct Care Workforce COVID-19 Funding Between Rural and Urban Counties in Minnesota and Illinois
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 05/2023
    The purpose of this policy brief is to examine trends in the distribution of federal Coronavirus Aid, Relief, and Economic Securities Act of 2020 (CARES Act) funding designed to support the direct care workforce between rural and urban counties in Minnesota and Illinois.
  • Factors Associated With Lengths-of-Stay for Inpatients With Substance Use Disorders
    Policy Brief
    Rural Health Equity Research Center
    Date: 04/2023
    This policy brief identifies factors associated with inpatient length-of-stay (LOS) for the treatment of substance use disorders (SUDs), and whether there are systematic differences in LOS for rural and urban residents.
  • Rural and Urban Differences in Factors Associated With Inpatient Hospital Stays for Substance Use Disorder
    Policy Brief
    Rural Health Equity Research Center
    Date: 04/2023
    Using 2018 all-payer claims data from seven states, this brief describes the lengths and costs of inpatient hospital stays for substance use disorders and examines whether there were differences between stays for rural and urban residents.
  • Rural Healthy People 2030: New Decade, New Challenges
    Journal Article
    Southwest Rural Health Research Center
    Date: 03/2023
    This study reports the findings of Rural Healthy People 2030, a companion piece to the Healthy People 2030 initiative with a focus on health priorities of rural populations. Data was collected from a survey given to rural stakeholders. Mental health, substance use, health care access, and economic stability were among the most important priorities.
  • Understanding and Overcoming Barriers to Rural Obstetric Training for Family Physicians
    Journal Article
    WWAMI Rural Health Research Center
    Date: 03/2023
    Family physicians are the most common health professional providing rural obstetric (OB) care, but the number of family physicians practicing OB is declining. This mixed-methods study aimed to inform policy and practice solutions to address the training landscape and inform sustainable initiatives for rural family medicine obstetrical training.
  • Rural Working-Age Adults Report More Cost Barriers to Health Care
    Policy Brief
    Maine Rural Health Research Center
    Date: 03/2023
    Using the 2019-2020 National Health Insurance Survey, this study examined rural-urban differences in affordability of care and cost-saving strategies among working-age adults.
  • COVID-19 Vaccination Rates
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis, Rapid Response to Requests for Rural Data Analysis
    Date: 03/2023
    This rural data brief provides a longitudinal examination of completion of primary COVID-19 vaccination series in the age-eligible population in metropolitan, micropolitan, and noncore counties.
  • Indicators of Familial Social Support by Rurality and Gender Identity
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 03/2023
    Social and emotional support from family significantly contributes to positive health outcomes. Understanding how familial social support differs for those with overlapping marginalized identities is critical to advance population health and health equity. This brief examines differences in familial social support by rurality and gender identity.
  • Analysis of an Innovative Approach to Target Rural Communities in Public Health Funding
    Policy Brief
    Southwest Rural Health Research Center
    Date: 03/2023
    The CDC launched a new initiative to address COVID-19 related health disparities and to advance health equity among underserved and at-risk populations. Based on stakeholder interviews, this project explores the formation of this initiative, its impact on rural health, and lessons learned that can be applied to future rural-focused funds.
  • Financial Risk Acceptance Among Rural Health Care Providers Participating in the Quality Payment Program
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 03/2023
    This policy brief summarizes non-metropolitan and metropolitan providers' participation in different Centers for Medicare & Medicaid Services Quality Payment Program tracks and subdivisions, and evaluates provider and patient-panel characteristics associated with financial risk acceptance.
  • Access to Health Services Across Rural and Urban Minoritized Racial/Ethnic Group Areas
    Policy Brief
    Rural and Minority Health Research Center
    Date: 03/2023
    This brief summarizes selected results from a series of reports documenting disparities in geographic access to health services for rural and urban places that have a relatively high proportion of residents from minoritized racial and ethnic groups. "Areas" were examined at the ZIP Code Tabulation Area level.
  • Assessing Geographic Variability in Key Indicators of Air Quality: A Rural vs. Urban Comparison of Pollution and Socio-Economic Factors
    Policy Brief
    Rural and Minority Health Research Center
    Date: 03/2023
    The purpose of this study was to examine rates of air pollution between rural and urban census tracts. In addition, urban-rural disparities in exposure to polluted air across Environmental Protection Agency-defined regions were examined.
  • The COVID-19 Pandemic Impact on Independent and Provider-Based Rural Health Clinics' Operations and Cancer Prevention and Screening Provision in the United States
    Journal Article
    Rural and Minority Health Research Center
    Date: 03/2023
    The provision of Rural Health Clinic (RHC) cancer prevention and screening services was examined to identify any changes pre- and peri-pandemic. The research examined overall provision of cancer prevention and screening services by RHCs and the provision of these services by independent RHCs and by provider-based RHCs .
  • Crowded Housing and Housing Cost Burden by Disability, Race, Ethnicity, and Rural-Urban Location
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 03/2023
    Housing is closely tied to health outcomes and well-being; however, little research examines housing factors by location. In this policy brief, we examine rates of crowded housing and housing cost burden by rural-urban location, as well as at the intersections of race, ethnicity, and disability status.
  • Rural School- and Community-Based Programs Supporting LGBTQ+ Youth
    University of Minnesota Rural Health Research Center
    Date: 02/2023
    The purpose of this case series is to highlight youth-focused and school- and community-based organizations that affirm and support LGBTQ+ individuals in their rural communities. These may serve as examples to others considering this work.
  • Rural Population Health in the United States: A Chartbook
    Chartbook
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 02/2023
    This chartbook uses a range of indicators to describe population health in rural America and document health disparities between rural and urban areas. This report includes 33 measures of population health, organized into five domains: Access to Care, Health Outcomes and Risks, Mortality, Social Determinants of Health, and Socioeconomics.
  • Community Sociodemographics and Rural Hospital Survival Analysis
    Policy Brief
    Center for Economic Analysis of Rural Health
    Date: 01/2023
    This study examines which community sociodemographic characteristics are associated with increased risk of rural hospital closure between 2010-2019. Results show that rural hospitals at risk of financial distress are more likely to experience closure if their communities have higher unemployment and higher uninsurance for those under 65.
  • Medicare Advantage Enrollment Update 2022
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis, Rapid Response to Requests for Rural Data Analysis
    Date: 01/2023
    The 2022 report continues the RUPRI Center's annual series of Medicare Advantage (MA) enrollment updates. In addition to tracking overall and nonmetropolitan/metropolitan enrollment, this brief also reports on changes in enrollment in types of MA plans and considers policy changes from previous years that may have impacted MA plan enrollment.
  • Changes in Service Offerings Post-System Affiliation in Rural Hospitals
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 01/2023
    This policy brief aims to understand the range of effects on service offerings after rural hospitals become part of, or leave, a regional or national healthcare system.
  • COVID-19 Mortality Rates Across Noncore, Micropolitan, and Metropolitan Counties by Community Characteristics, December 2020-January 2021
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 01/2023
    This policy brief examines differences in COVID-19 mortality rates across rural-urban designations and stratifications by geography, county-level sociodemographic factors, and county-level healthcare factors.
  • Variations in Affordability of Health Care by Non-Metropolitan/Metropolitan and Race/Ethnicity Status Across Eight Geographically Dispersed States
    Policy Brief
    Rural and Minority Health Research Center
    Date: 01/2023
    This research examined rural-urban (i.e., non-metropolitan/metropolitan) differences in affordability inclusive of insurance coverage and cost barriers. The research also examined forgoing medical care/medication and medical debt using Behavioral Risk Factor Surveillance System survey data from the healthcare access optional module.