This website is being reviewed for updates. Some information is offline. We apologize for any inconvenience.
Rural Health
Research Gateway

2025 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.

  • Rural Beneficiary Access to Medicare Advantage-Part D Plans
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis, Rapid Response to Requests for Rural Data Analysis
    Date: 08/2025
    This policy brief updates RUPRI's analysis of Medicare Advantage Prescription Drug Plans (MA-PDs) including enhanced benefit plan availability and variations in characteristics across metropolitan, micropolitan, and noncore areas.
  • Rural/Urban Differences in Health, Health Care Use, and Barriers to Care for Postpartum and Parenting Women, 2006-2018
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 08/2025
    The goal of this analysis was to describe rural/urban differences in health, health care utilization, and barriers to care for reproductive-age females, with specific focus on those who are parents of young children (ages 1-4) and those who are postpartum (gave birth in the last year).
  • Supply, Distribution, and Access to Cardiologists, Neurologists, Oncologists, and Pulmonologists in the Rural and Urban U.S.
    Report
    WWAMI Rural Health Research Center
    Date: 08/2025
    This report describes the supply of four specialist physicians (cardiologists, neurologists, oncologists, and pulmonologists) in the rural U.S.
  • An Assessment of Area-Level Vulnerability and Resilience Indices by Geography: A Rural-Urban Comparison
    Journal Article
    ETSU/NORC Rural Health Research Center
    Date: 07/2025
    Area-level vulnerability and resilience indices are widely used to address health needs by informing resource allocation and policy. Researchers found that indices differ from each other and by rurality, contributing to the growing body of evidence to inform the use and improvement of these indices.
  • 2010-2022 County-Level Hospital-Based Obstetric Care Status
    Rural Maternal Health Data Support and Analysis Program, University of Minnesota Rural Health Research Center
    Date: 07/2025
    This data resource is a county-level dataset containing the county FIPS code, state, and an indicator of whether each United States county had hospital-based obstetrics care in each year, 2010-2022. It is available for download as an XLS file.
  • Rural and Urban Differences in Family Physician Burnout Before and During the COVID-19 Pandemic
    Journal Article
    WWAMI Rural Health Research Center
    Date: 07/2025
    This study describes burnout for rural and urban family physicians before and during the COVID-19 pandemic. Findings highlight the importance of addressing the unique challenges of rural family physicians that contribute to burnout.
  • Geographic and Demographic Correlates of Living in Manufactured Homes: Implications for Health
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 07/2025
    This brief examines rates of living in manufactured homes by rural and urban location, as well as rates among rural residents by region and socio-demographic characteristics. It also examines differences in crowded housing, housing quality, and housing cost burden by manufactured vs. more permanent housing structures.
  • Access and Quality of Mental Health Services in Rural and Urban America
    Policy Brief
    University of South Carolina Rural Health Research Center
    Date: 07/2025
    Access to and quality of mental health facilities is a significant concern in the United States. This research identified disparities in mental health access and care quality by residence rurality.
  • Interstate Occupational Licensure Arrangements to Expand Access to Behavioral Health Services
    Policy Brief
    WWAMI Rural Health Research Center
    Date: 07/2025
    To increase the availability of behavioral health care, some states are utilizing streamlined licensure pathways for clinicians who wish to practice across state lines. This policy brief describes state-based provisions to expand behavioral health services through interstate licensure arrangements for various behavioral health professions.
  • Preventing Medical Debt Among Rural Residents: Example Programs From Hospitals in Minnesota and Montana
    University of Minnesota Rural Health Research Center
    Date: 06/2025
    This case series highlights efforts by rural hospitals to prevent medical debt for their patients. These may serve as examples to others considering ways to address health care affordability in their rural communities.
  • The Impact of High Hospital Fixed-Cost Ratios on Rural Populations
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 06/2025
    This brief focuses on rural hospitals with high fixed-to-total-cost ratios and describes characteristics of those hospitals, including Critical Access Hospital and Low-Volume Hospital status, and provides some demographics on the communities they serve.
  • Rural and Urban Differences in Suicide in the United States, 2018-2021
    Policy Brief
    ETSU/NORC Rural Health Research Center
    Date: 05/2025
    Suicide remains a significant cause of mortality in the United States. This policy brief examines state-level differences in suicide rates by demographics and geography, with a focus on rural and urban areas from 2018 to 2021. The study employs a cross-sectional, retrospective design using secondary data sources.
  • Impact of Hospital Closure on Rural Communities: A Qualitative Study
    Report
    RUPRI Center for Rural Health Policy Analysis
    Date: 05/2025
    Rising rates of rural hospital closures have prompted concerns about access to care in affected communities. This paper summarizes findings from interviews with state and community leaders who experienced hospital closures between May 2010 and December 2017, detailing their impact on rural communities and how local communities adapted to them.
  • Rural Access to Certified Community Behavioral Health Clinics (CCBHCs)
    Policy Brief
    Rural and Underserved Health Research Center
    Date: 05/2025
    This study compares rural/urban access to Certified Community Behavioral Health Centers and the services they offer.
  • Federal and State Reimbursement for Youth Behavioral Health Services
    Report
    WWAMI Rural Health Research Center
    Date: 04/2025
    Medicaid is an important source of health care coverage for children and youth in rural areas. This policy brief details the state and federal policies that impact access to behavioral health care services for youth in rural areas, including Medicaid reimbursement policies in all 50 states and the District of Columbia.
  • The Rural and Urban Supply of Clinicians With a DEA Waiver to Prescribe Buprenorphine in 2022 Prior to the Elimination of the Waiver Requirement
    WWAMI Rural Health Research Center
    Date: 04/2025
    This data brief describes the supply of all clinicians with a DEA waiver to prescribe medication for opioid use disorder from 2017 to 2022. The supply of eligible clinicians grew in both rural and urban counties in five years. More rural counties lacked waivered clinician compared to urban counties.
  • Are HCC Risk Scores a Reliable Health Status Indicator Across Rural and Urban Areas?
    Policy Brief
    ETSU/NORC Rural Health Research Center
    Date: 04/2025
    This brief explores differences in CMS Hierarchical Condition Category (HCC) risk scores between rural and urban Medicare beneficiaries, revealing lower scores for rural populations despite higher chronic disease prevalence. The brief highlights HCC score limitations and suggests improvements and alternatives for accurate health representation.
  • Impact of Rural Exposure During General Surgery Residency on Practice in a Rural Community
    Journal Article
    WWAMI Rural Health Research Center
    Date: 03/2025
    This retrospective study of 11,407 U.S. general surgery residency graduates between 2011 and 2020 investigated the association between exposure to rural surgery care in residency and practice in a rural location.
  • Medicare Advantage and Rural Hospital Profitability
    Journal Article
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 01/2025
    Researchers compared the profitability of rural and urban hospitals located in varying rates of Medicare Advantage (MA) penetration. Results will increase our understanding of rural hospitals in areas with lower versus higher rates of MA penetration.
  • A New Model-based Approach for Estimating Rural Hospital Markets
    Journal Article
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 01/2025
    Researchers developed a new method for defining rural hospital markets that uses publicly available data with models of patient care-seeking behavior. This approach identifies the ZIP codes estimated to provide a majority of patient volume to a particular hospital. Findings can be used to examine key market characteristics of rural hospitals.
  • Opioid Use Among Rural Medicare Beneficiaries
    Policy Brief
    Maine Rural Health Research Center
    Date: 01/2025
    This study used the Medicare Current Beneficiary Survey (MCBS) to address the lack of literature on the rural-urban difference in the use and misuse of prescription opioids. Over years 2010-2017, rural community and facility-dwelling Medicare beneficiaries were more likely to receive opioid prescriptions than their urban counterparts.
  • Examining Differences in Rural and Urban Medicare FFS Beneficiaries' Emergency Department Use Before and During Covid
    Policy Brief
    ETSU/NORC Rural Health Research Center
    Date: 01/2025
    The brief examines changes in emergency department (ED) use among rural and urban Medicare Fee-for-Service (FFS) beneficiaries during the COVID-19 pandemic. Key findings included a moderate increase in rural ED use, higher mortality and inpatient admissions, and decreased use among dual-eligible beneficiaries.
  • Evaluating Medicare Advantage Benchmark Setting Methodology on Rural Counties
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 01/2025
    This brief explores how the process for setting benchmark payments for Medicare Advantage plans may create different incentives across rural and urban counties.
  • Medicare Advantage Enrollment Update 2024
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis, Rapid Response to Requests for Rural Data Analysis
    Date: 01/2025
    This policy brief continues RUPRI Center's annual update of Medicare Advantage (MA) enrollment including the changes in enrollment in types of MA plans, and health policy changes that may have had an impact.