Rural Health
Research Gateway

Carrie Henning-Smith, PhD, MPH, MSW

Co-Director, University of Minnesota Rural Health Research Center

Phone: 612.626.4512
Email: henn0329@umn.edu
LinkedIn: Carrie on LinkedIn

Division of Health Policy and Management
University of Minnesota
2221 University Ave. SE, Suite 350
Minneapolis, MN 55414

Current Projects - (5)

  • Addressing Elder Abuse in Rural Areas
    Elder abuse, including financial, physical, and emotional abuse, as well as self-neglect, is widespread and impacts individual and population health outcomes. However, despite the fact that rural residents are older, in poorer health, and more financially vulnerable, little is known about rural/urban differences in the prevalence of and resources to address elder abuse; this project will address those gaps.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Aging, Disabilities, Social determinants of health, Violence and abuse
  • Extent and Coverage of Rural PACE Services
    Supporting independent living and aging in place for rural residents is more important than ever. This project will provide information on the extent and coverage of rural Program of All-Inclusive Care for the Elderly (PACE) programs, along with insights into the unique challenges and opportunities faced by PACE programs operating in rural areas.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Aging, Disabilities, Healthcare access, Home health, Social determinants of health
  • Geographic and Socio-Demographic Correlates of Medical Debt Among Rural Residents
    Medical debt is widespread and impacts financial well-being and access to care. While research suggests that medical debt is higher among rural residents compared to urban residents, more work is needed to conclusively demonstrate rural/urban differences in medical debt and within-rural risk factors for greater medical debt by geography and socio-demographic characteristics.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Healthcare access, Poverty, Public health, Rural statistics and demographics, Social determinants of health
  • Improving Health for "Homebound" Older Adults in Rural and Urban Areas
    This project will describe rural-urban differences in the risk of, and characteristics associated with, being classified as "homebound." We will also identify policy and programmatic interventions to reduce the risk of becoming homebound as well as to improve outcomes for those who are homebound.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Aging, Disabilities, Home health, Rural statistics and demographics, Social determinants of health
  • Rural-Urban Differences in Access to and Quality of Care for People With Disabilities
    The purpose of this project is to identify rural-urban differences in access to and quality of health care services for people with disabilities. Results from this project will help inform policy to improve access to and quality of care for this growing population in rural areas.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Aging, Disabilities, Healthcare access, Quality, Social determinants of health

Completed Projects - (14)

  • Access to Care for Rural Medicare Beneficiaries
    This project examined multiple dimensions of access to care, with a focus on rural Medicare beneficiaries, including rural-urban differences in access to care, and within-rural differences in access to care by region, coverage type (traditional fee-for-service vs. supplemental Medigap coverage), and socio-demographic characteristics.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Aging, Healthcare access, Medicare, Medicare Advantage (MA)
  • Addressing Rural Social Isolation as a Health and Mortality Risk Factor
    This project aimed to describe rural/urban differences in the prevalence of social isolation, as well as to identify challenges and strategies related to addressing rural social isolation in order to inform policy-making.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Aging, Health promotion and disease prevention
  • Aging in Place in Rural America: What Does It Look Like and How Can It Be Supported?
    In general, people want to age in place. This project looked at the structures in place to help them do so and how those structures vary by rurality. Federal, state, and local policy implications for improving health outcomes and quality of life for rural older adults aging in place were also be identified.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Aging, Disabilities, Healthcare access, Home health, Long-term care, Social determinants of health
  • Caring for Caregivers: Available Support for Unpaid Caregivers in Rural Areas
    This project describes rural-urban differences in the prevalence and intensity of informal caregiving for older adults and associated socio-demographic correlates and as well as identifies potential policy interventions to improve the quality of life and health outcomes of rural caregivers.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Aging, Home health, Long-term care
  • Community Context and Rural Strategies to Support the Oldest Old
    This project developed a chartbook profiling older adults (65 and older) in rural areas and assessed where rural residents ages 85 and older were most likely to live, what rural counties had experienced the fastest growth of those 85 and older, and what strategies were in place or were possible for supporting this population in aging in place.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Aging, Hospice and palliative care, Long-term care, Rural statistics and demographics
  • Evaluating the Rural Health Network Development Planning Grant Program
    This project identified factors that facilitate and impede success of Rural Health Network Development grantees, based on discussions with grantees from the 2019 cohort and surveys of prior grantees dating back more than 10 years, as well as with technical assistance providers.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Health services, Healthcare access, Healthcare financing, Networking and collaboration, Public health, Quality
  • Evaluating the Rural HIV/AIDS Planning Grant Program
    The Rural HIV/AIDS Planning Grant program is administered by the Federal Office of Rural Health Policy to plan and develop healthcare networks designed to address HIV/AIDS prevention and treatment in states disproportionately impacted by the virus. This project identified factors that facilitate and impede success of such planning efforts.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Care management, Chronic diseases and conditions, Healthcare access, Networking and collaboration
  • Housing as a Social Determinant of Rural Health
    The purpose of this project was to identify rural/urban and within-rural differences in housing quality and its relationship to health and disability status, especially for individuals living in poverty. We also identified rural-specific housing issues and innovative policy solutions to address housing challenges in order to improve rural health.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Disabilities, Environmental and agricultural health, Poverty, Public health, Rural statistics and demographics, Social determinants of health
  • Living Alone: Rural-Urban Differences in Prevalence, Socio-Demographic Correlates, and Health Needs Across the Lifespan
    This project's purpose was to document rural-urban differences in the prevalence of living alone across different age groups, describe rural-urban differences in the socio-demographic correlates and health needs of individuals living alone, and identify rural-relevant policies and programs to support rural residents living alone across the lifespan.
    Research center: University of Minnesota Rural Health Research Center
    Topic: Social determinants of health
  • Paving the Way: Addressing Transportation as a Social Determinant of Health for Rural Residents
    This project will use a mixed-methods design to examine ways in which transportation operates as a social determinant of health for vulnerable rural residents, and to identify exemplar transportation programs that are successfully improving health and well-being of those residents.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Aging, Health services, Networking and collaboration, Transportation
  • Ransomware Attacks on Rural Hospitals
    The rise in hospital ransomware attacks threatens to harm patients, especially in rural areas. This project used a novel dataset to analyze rural/urban differences in how ransomware attacks affect patients and hospitals.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Critical Access Hospitals (CAHs), Emergency medical services (EMS) and trauma, Health information technology, Hospitals and clinics
  • Rural-Urban Differences in Domestic Violence as a Contributor to Maternal Morbidity and Mortality
    Using 2016-2020 data from the Pregnancy Risk Assessment Monitoring System from the Centers for Disease Control and Prevention, this project assessed the prevalence of domestic violence among rural and urban residents who give birth. We also analyzed how screening and support services could be improved to support rural families that experience domestic violence, including during pregnancy and the postpartum period.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Maternal health, Social determinants of health, Violence and abuse, Women
  • Skilled Nursing Facility Care for Rural Residents with Complex Care Needs
    This project will examine barriers to skilled nursing facility placement for rural residents with complex care needs, including obesity, dementia, and behavioral health problems, and explore potential implications for access to and quality of care.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Health services, Hospitals and clinics, Long-term care
  • The Direct Care Workforce in Rural Areas
    In this study, we measured the supply of long-term care services and supports (LTSS) direct care workers relative to older adult populations in rural and urban areas and measure employer and industry turnover among LTSS direct care workers. We also explored how compensation levels – including wages and employer-based health insurance – are related to and predict worker turnover in the LTSS direct care workforce in rural and urban areas.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Aging, Allied health professionals, Health services, Home health, Long-term care, Post-acute care, Poverty, Rural statistics and demographics, Social determinants of health, Workforce

Publications - (88)

2025

2024

2023

2022

2021

2020

  • Making It Work: Models of Success in Rural Maternity Care
    University of Minnesota Rural Health Research Center
    Date: 11/2020
    The goal of this case series is to describe key factors that underlie three successful models of rural maternity care and to inform communities, clinicians, and hospitals that wish to keep obstetric services available locally.
  • Characteristics of U.S. Rural Hospitals by Obstetric Service Availability, 2017
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 08/2020
    This study described characteristics of rural U.S. hospitals by whether they provide labor and delivery care for pregnant patients. Researchers used the 2017 American Hospital Association Annual Survey to identify rural hospitals and detail their characteristics based on whether they provide obstetric services.
  • Providing Maternity Care in a Rural Northern Iowa Community
    University of Minnesota Rural Health Research Center
    Date: 08/2020
    This case study highlights how one rural hospital in northern Iowa has successfully sustained a maternity care practice and identifies opportunities for other rural hospitals and communities seeking to ensure local access to care for pregnancy and childbirth.
  • Rural-Urban Differences Among Older Adults
    Chartbook
    University of Minnesota Rural Health Research Center
    Date: 08/2020
    This chartbook presents the characteristics of older adults in rural counties, as well as rural-urban differences among older adults, across four domains: demographics, socioeconomic characteristics, healthcare access and use, and health characteristics.
  • Changes in Hospital-Based Obstetric Services in Rural U.S. Counties, 2014-2018
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 07/2020
    In 2014, 54% of rural U.S. counties had no hospital-based obstetric services, following a steady decrease during the previous decade. Loss of rural maternity care is tied to adverse maternal and infant health outcomes. This study shares hospital-based obstetric service losses in rural U.S. counties from 2014 to 2018.
  • Supporting the Health and Wellbeing of Middle-Aged Adults Living Alone in Rural Counties
    University of Minnesota Rural Health Research Center
    Date: 06/2020
    This report shares insights from healthcare providers in 14 rural counties with the highest rates of middle-aged adults living alone in order to inform policy and practice in how best to support the health and well-being of this demographic.
  • The Unique Impact of COVID-19 on Older Adults in Rural Areas
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 06/2020
    Older adults in rural areas of the U.S. face unique risks related to COVID-19, which puts them at risk of not only the virus, but of not being able to meet their healthcare, social, and basic needs.
  • Characteristics of Counties With the Highest Proportion of the Oldest Old
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 05/2020
    The "oldest old," or individuals age 85 and older, are one of the fastest-growing segments of the U.S. population, yet little is known about where those individuals tend to live and what their communities are like. This information is important for planning how to best respond to and support this growing population.
  • Differences by Rurality in Satisfaction With Care Among Medicare Beneficiaries
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 05/2020
    There are stark differences between rural and urban areas in demographic characteristics, health status, and healthcare. Yet less is known about rural‐urban differences in Medicare beneficiaries' satisfaction with care. We seek to understand rural‐urban differences in satisfaction with care for Medicare beneficiaries.
  • Rates of Living Alone by Rurality and Age
    University of Minnesota Rural Health Research Center
    Date: 04/2020
    In this infographic, we identify rates of living alone for all adults and within specific age groups using two classifications of rurality.

2019

  • Access and Capacity to Care for Medicare Beneficiaries in Rural Health Clinics
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 12/2019
    Access to timely, high-quality healthcare is essential for health, but rural areas face particular barriers to access, including for primary care. We present findings from an online survey of RHCs describing clinic characteristics related to healthcare access for rural Medicare beneficiaries.
  • Access to Specialty Care for Medicare Beneficiaries in Rural Communities
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 12/2019
    Access to care is a challenge in many rural communities for both primary care services and specialty care services. We present findings from an online survey of Rural Health Clinics describing access issues for rural Medicare beneficiaries in seeking care from specialty care providers.
  • Rural-Urban Differences in Access to and Attitudes Toward Care for Medicare Beneficiaries
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 12/2019
    Access to healthcare is important to health outcomes and well-being. Even among Medicare beneficiaries, access to care may differ by rural-urban location due to differences in the healthcare and socio-demographic landscape. We describe rural-urban differences in access to care for Medicare beneficiaries.
  • Rural-Urban Differences in Severe Maternal Morbidity and Mortality in the U.S., 2007-15
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 12/2019
    In the U.S., severe maternal morbidity and mortality (SMMM) is climbing—a reality that is especially challenging for rural communities, which face declining access to obstetric services. Using data for 2007-15 from the National Inpatient Sample, we analyzed SMMM during childbirth hospitalizations among rural and urban residents.
  • Severe Maternal Morbidity and Hospital Transfer Among Rural Residents
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 11/2019
    In this brief, we compare hospital transfer rates for rural and urban residents who gave birth. We also provide descriptive information about the relationship between transfer status and severe maternal morbidity and mortality for rural residents nationally who gave birth 2008-2014.
  • Rural Focus and Representation in State Maternal Mortality Review Committees: Review of Policy and Legislation
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 08/2019
    Between 1990 and 2013, maternal mortality nearly doubled in the U.S., and rural residents experienced decreasing access to obstetric care. To improve maternal health, many states have established maternal mortality and morbidity review committees (MMRCs). We assessed the extent of rural representation in state policy efforts related to MMRCs.
  • Measuring Access to Care in National Surveys: Implications for Rural Health
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 06/2019
    This brief presents data about how access to healthcare is measured, focusing on how this applies to rural populations.
  • Unmet Need for Personal Care Assistance Among Rural and Urban Older Adults
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 06/2019
    This brief presents data on rural-urban differences in unmet need for personal care among older adults with functional limitations.

2018

2017

2016

2015