Jan Eberth, PhD

Rural and Minority Health Research Center

Email: jme336@drexel.edu
Twitter: @jmeberth

Department of Health Management and Policy
Drexel University

Current Projects - (1)
Completed Projects - (5)
Publications - (62)

Current Projects - (1)

Assessing Cancer Care Coordination in Rural Health Clinics During a Pandemic
This project will aim to understand how Rural Health Clinics perceive and implement evidence-based cancer screening and treatment and related intervention strategies before and during the COVID-19 pandemic.
Research center: Rural and Minority Health Research Center
Topics: Cancer, Coronavirus Disease 2019 (COVID-19), Rural Health Clinics (RHCs)

Completed Projects - (5)

Colorectal Cancer Screening Bypass Behavior and Outcomes
Studies have shown that increased distance to the closest endoscopy provider is associated with lower screening utilization among Medicare enrollees. The purpose of this study is to expand beyond the Medicare population to examine the travel behaviors of the entire population, comparing urban vs. rural residents in obtaining endoscopies for colorectal cancer screening.
Research center: Rural and Minority Health Research Center
Topics: Cancer, Health promotion and disease prevention, Medicare
Creating County Level Estimates of Childhood Obesity in the U.S.: A Spatial Multilevel Modeling Approach
Using the 2016 National Survey of Children's Health, spatial multilevel models were constructed to estimate county level rates of childhood obesity in the U.S. Particular emphasis was placed on rural areas, for which direct estimates are often unavailable because of small sample sizes in population-based surveys.
Research center: Rural and Minority Health Research Center
Topics: Children and adolescents, Obesity
Planning and Pilot Testing of Evidence-Based Cancer Prevention and Control Interventions with Rural Health Clinics
This project leveraged growing collaborative efforts between the Rural and Minority Health Research Center, South Carolina Office of Rural Health, South Carolina Primary Health Care Association, and Center for Rural and Primary Healthcare to assess and improve cancer prevention and control among rural South Carolina residents.
Research center: Rural and Minority Health Research Center
Topics: Cancer, Minority health, Rural Health Clinics (RHCs)
Potential Impact of ESRD Payment Reform on Rural Dialysis Patients
This study will estimate the potential implications of rural dialysis facility loss for rural patients. Specifically, we will identify low-volume dialysis facilities in rural areas, profile the patients they serve, and estimate the additional travel burden that these patients would experience if facilities close.
Research center: Rural and Minority Health Research Center
Topics: Health services, Hospitals and clinics
Rural Colon and Cervical Cancer Environmental Scan
Detailed research was needed to provide a complex, textured picture of rural healthcare and the ways in which existing federally supported providers could provide adequate services across the continuum of cancer care from prevention through survivorship.
Research center: Rural and Minority Health Research Center
Topics: Cancer, Minority health

Publications - (62)

2023

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.

2022

The Impact of the COVID-19 Pandemic on Rural Health Clinics' Operations and Cancer Prevention and Control Efforts
Policy Brief
Rural and Minority Health Research Center
Date: 11/2022
This study surveyed a stratified random sample of Rural Health Clinics throughout the country to examine how the pandemic has affected their overall operations and provision of cancer prevention and control services.
Rural Health Clinic Colorectal Cancer Screening Toolkit: A Toolkit for Implementing Evidence-Based Colorectal Cancer Screening Interventions in Rural Health Clinics
Rural and Minority Health Research Center
Date: 11/2022
The purpose of this project is to provide evidence-based interventions and other resources to Rural Health Clinics, throughout the United States, to improve colorectal cancer screening among their patient population.
Rural Health Clinic Colorectal Cancer Screening Toolkit: A Toolkit for Implementing Evidence-Based Colorectal Cancer Screening Interventions in South Carolina Rural Health Clinics
Rural and Minority Health Research Center
Date: 11/2022
The purpose of this project is to provide evidence-based interventions and other resources to Rural Health Clinics, throughout South Carolina, to improve colorectal cancer screening among their patient population.
Rural-Urban Disparities in Quality of Inpatient Psychiatric Care
Journal Article
Rural and Minority Health Research Center
Date: 11/2022
Using data from the Inpatient Psychiatric Facility Quality Reporting program 2015-2019, this study examined differences and changes in the quality of inpatient psychiatric care in rural and urban hospitals.
Changes in Access to Nearest Federally Qualified Health Centers and Rural Health Clinics Among Rural ZIP Codes That Did and Did Not Experience a Hospital Closure, 2006-2018
Policy Brief
Rural and Minority Health Research Center
Date: 10/2022
This brief explores changes in geographic accessibility within rural ZIP codes throughout the U.S. to Federally Qualified Health Centers and Rural Health Clinics, between 2016 and 2018.
The Involvement of Rural Health Clinic Practitioners in Cancer Treatment Decisions and Survivorship Care
Policy Brief
Rural and Minority Health Research Center
Date: 10/2022
This study examined Rural Health Clinics' practitioner involvement in cancer treatment decisions, management of side effects, surveillance, and survivorship care.
Availability of Hospital-based Cancer Services Before and After Rural Hospital Closure, 2008-2017
Journal Article
Rural and Minority Health Research Center
Date: 09/2022
Using American Hospital Association survey data from 2008 to 2017, the changes in access to cancer-related screening and treatment services were examined to determine the impact of hospital closures across hospital service areas.
Availability of Hospital-Based Emergency Department and Trauma Services in Minoritized Racial/Ethnic Group Areas
Policy Brief
Rural and Minority Health Research Center
Date: 09/2022
This brief is one of a series of findings briefs documenting disparities in geographic access to health services for ZIP code tabulation areas (ZCTAs) containing a high proportion of minoritized racial/ethnic residents. This report looks at the availability of hospital-based emergency department and trauma services at the ZCTA level.
Availability of Nursing Homes in Minoritized Racial/Ethnic Group Areas
Policy Brief
Rural and Minority Health Research Center
Date: 09/2022
This brief is one of a series of findings briefs documenting disparities in geographic access to health services for ZIP code tabulation areas (ZCTAs) containing a high proportion of minoritized racial/ethnic residents. This report looks at the availability of nursing homes at the ZCTA level.
Availability of Substance Use Disorder Treatment in Minoritized Racial/Ethnic Group Areas
Policy Brief
Rural and Minority Health Research Center
Date: 09/2022
This brief is one of a series of findings briefs documenting disparities in geographic access to health services for ZIP code tabulation areas (ZCTAs) containing a high proportion of minoritized racial/ethnic residents. This report looks at spatial availability and travel burden for substance use disorder care at the ZCTA level.
Availability of Home Health Services in Minoritized Racial/Ethnic Group Areas
Policy Brief
Rural and Minority Health Research Center
Date: 08/2022
This brief is one of a series of findings briefs documenting disparities in geographic access to health services for ZIP code tabulation areas containing a high proportion of minoritized racial/ethnic residents. This report looks at the availability of home health services in minoritized racial/ethnic areas.
Availability of Medicare-Certified Hospice Services in Minoritized Racial/Ethnic Group Areas
Policy Brief
Rural and Minority Health Research Center
Date: 08/2022
This is one of a series of briefs documenting disparities in geographic access to health services for ZIP code tabulation areas containing a high proportion of minoritized racial/ethnic residents. This brief explores access to hospice services.
Availability of Pharmacies in Minoritized Racial/Ethnic Areas
Policy Brief
Rural and Minority Health Research Center
Date: 08/2022
This brief is one of a series of findings briefs documenting disparities in geographic access to health services for ZIP code tabulation areas containing a high proportion of minoritized racial/ethnic residents. This report looks at access to pharmacies.
Examining the Association Between Rurality and Positive Childhood Experiences Among a National Sample
Journal Article
Rural and Minority Health Research Center
Date: 08/2022
Using the full National Survey of Children's Health with all 50 states and the District of Columbia, this study examined rural-urban differences in positive childhood experiences.
Spatial Access to Hospital-based Obstetric Units in Minoritized Racial/Ethnic Areas
Policy Brief
Rural and Minority Health Research Center
Date: 08/2022
This brief is one of a series of findings briefs documenting disparities in geographic access to health services for ZIP code tabulation areas containing a high proportion of minoritized racial/ethnic residents. This report looks at spatial access to hospital-based obstetric units in minoritized racial/ethnic areas.
Changes in Access to Community Health Services Among Rural Areas Affected and Unaffected by Hospital Closures Between 2006 and 2018: A Comparative Interrupted Time Series Study
Journal Article
Rural and Minority Health Research Center
Date: 07/2022
In this article, investigators compared access to Federally Qualified Health Centers and Rural Health Clinics by those in rural areas affected versus those in rural areas unaffected by hospital closures.
Rural Children with 4+ Adverse Childhood Experiences Often Lack Positive Experiences
Fact Sheet
Rural and Minority Health Research Center
Date: 07/2022
This research explored the proportion of rural children with adverse childhood experiences who lack positive childhood experience exposure.
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.
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.
Rates and Trends of Childhood Overweight/Obesity in the United States and South Carolina
Fact Sheet
Rural and Minority Health Research Center
Date: 03/2022
The goal of this project was to estimate childhood overweight/obesity rates across the United States at the region, state, and county level.
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.
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.
The Problem of the Color Line: Place, Race, and Access to Health Care in America
Journal Article
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.
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.

2021

Changes in Socioeconomic Mix and Health Outcomes in Rural Counties with Hospital Closures, 2005-2018
Policy Brief
Rural and Minority Health Research Center
Date: 09/2021
This brief examines the trend of hospital closures between 2005 and 2018 across definitions of rurality. Social, economic, and health structure trends at the county level across the contiguous United States were the study's focus.
Trends in Cancer Treatment Service Availability Across Critical Access Hospitals and Prospective Payment System Hospitals
Journal Article
Rural and Minority Health Research Center
Date: 08/2021
This study investigated trends in cancer services availability in urban and rural Prospective Payment System (PPS) hospitals and Critical Access Hospitals (CAHs). Compared with all PPS hospitals, CAHs offered fewer cancer treatment services and experienced a decline in service capability over time.
Identification of Rural Communities with Limited Access to Safety Net Healthcare Providers
Fact Sheet
Rural and Minority Health Research Center
Date: 07/2021
This fact sheet identifies rural U.S. counties with suboptimal access to safety net healthcare providers.
Estimates of Childhood Overweight and Obesity at the Region, State, and County Levels: A Multilevel Small Area Estimation Approach
Journal Article
Rural and Minority Health Research Center
Date: 06/2021
The goal of this study is to create a map of county-level obesity rates at the regional, county, and state levels.
Trends in Spatial Access to Colonoscopy in South Carolina, 2000-2014
Journal Article
Rural and Minority Health Research Center
Date: 06/2021
This study looks at the availability of colonoscopy screenings in South Carolina between 2000 and 2014 with a focus on changes in spatial access for these preventive services.
Rural and Racial Disparities in Colorectal Cancer Incidence and Mortality in South Carolina, 1996 - 2016
Journal Article
Rural and Minority Health Research Center
Date: 05/2021
This study investigated how race and rurality impact colorectal cancer incidence and mortality in South Carolina.
Disparities in Meeting USPSTF Breast, Cervical, and Colorectal Cancer Screening Guidelines Among Women in the United States
Journal Article
Rural and Minority Health Research Center
Date: 04/2021
The US Preventive Services Task Force provides recommendations for breast, cervical, and colorectal cancer screening. This manuscript examines the sociodemographic characteristics associated with women meeting these recommendations.
The Intersection of Rural Residence and Minority Race/Ethnicity in Cancer Disparities in the United States
Journal Article
Rural and Minority Health Research Center
Date: 02/2021
This manuscript summarizes how racism and social determinants of health disproportionately affect rural racial/ethnic minorities, offers a review of the cancer disparities rural racial/ethnic minorities face, and recommends policy, research, and intervention to reduce these disparities.

2020

Spatial Access to Vaccines for Children Providers in South Carolina: Implications for HPV Vaccination
Journal Article
Rural and Minority Health Research Center
Date: 12/2020
In South Carolina, rural children ages 13 to 17 years old have lower rates of HPV vaccination initiation. To better understand potential drivers of this rural-urban disparity, this study's objective was to examine spatial access to Vaccines For Children-enrolled clinics across rural and urban areas of the state.
Cervical Cancer Treatment Initiation and Survival: The Role of Residential Proximity to Cancer Care
Journal Article
Rural and Minority Health Research Center
Date: 10/2020
This study looked at the role drive time to cancer care facilities played on cancer treatment initiation and survival for cervical cancer patients.
Rural-Urban and Racial/Ethnic Trends and Disparities in Early-Onset and Average-Onset Colorectal Cancer
Journal Article
Rural and Minority Health Research Center
Date: 10/2020
The study's objective was to examine joint rural-urban differences in early onset colorectal cancer and average onset colorectal cancer incidence rates across racial/ethnic groups in the U.S.
Access to Colorectal Cancer Screening Programs for Underserved Populations in South Carolina
Fact Sheet
Rural and Minority Health Research Center
Date: 08/2020
This fact sheet identifies existing initiatives targeting colorectal cancer screening in rural South Carolina.
Cervical Cancer and HPV Vaccination Disparities in South Carolina
Fact Sheet
Rural and Minority Health Research Center
Date: 08/2020
This fact sheet identifies existing initiatives targeting cervical cancer prevention and control in rural South Carolina.
Rural and Racial Disparities In Colorectal Cancer Incidence and Mortality In South Carolina 1996 - 2016 (Fact Sheet)
Fact Sheet
Rural and Minority Health Research Center
Date: 08/2020
This fact sheet examines the burden of colorectal cancer among South Carolina residents by urban-rural status and race/ethnicity.
Development of a National Childhood Obesogenic Environment Index in the United States: Differences by Region and Rurality
Journal Article
Rural and Minority Health Research Center
Date: 07/2020
This study developed a novel childhood obesogenic environment index and highlighted important regional and rurality differences across U.S. counties.
Expanding Access to HPV Vaccination in South Carolina Through Community Pharmacies: A Geospatial Analysis
Journal Article
Rural and Minority Health Research Center
Date: 06/2020
Human papillomavirus (HPV) rates are higher in rural areas. The uptake of HPV vaccination is lower among rural populations. Pharmacies may be ideal for improving vaccination access. Does spatial access to pharmacies among adolescents and young adults in South Carolina vary by rurality and geographic access to primary care providers?
Factors Associated with Perceived Job Preparedness Among RNs: Results From a National Survey
Journal Article
Rural and Minority Health Research Center
Date: 05/2020
This article examines perceived job preparedness by demographic and professional characteristics among practicing registered nurses who completed a national survey. Rural and male nurses felt less prepared for nursing practice and may benefit from tailored educational experiences to improve perceptions of being prepared for the workforce.
A Bivariate Mapping Tutorial for Cancer Control Resource Allocation Decisions and Interventions
Journal Article
Rural and Minority Health Research Center
Date: 01/2020
This study demonstrates how geographic information systems software, specifically ArcGIS, can be used to develop bivariate choropleth maps to inform resource allocation and public health interventions.
Spatial Clustering Patterns and Regional Variations for Food and Physical Activity Environments Across the United States
Journal Article
Rural and Minority Health Research Center
Date: 01/2020
This study examined spatial patterns of obesogenic environments for U.S. counties. We mapped the geographic dispersion of food and physical activity (PA) environments, assessed spatial clustering, and identified differences across regions and rurality categories. This study highlights geographic clustering and disparities in food and PA access.
Travel Grant Program 2018-2019
Fact Sheet
Rural and Minority Health Research Center
Date: 01/2020
This project promoted attendance at cancer-related meetings by Rural Health Research Centers by facilitating the dissemination of information regarding important cancer meetings and handling the travel arrangements for Rural Health Research Center personnel.

2019

Rural-Urban Differences in Financial Burden Among Cancer Survivors: An Analysis of a Nationally Representative Survey
Journal Article
Rural and Minority Health Research Center
Date: 12/2019
Rural cancer survivors may disproportionately experience financial problems due to their cancer because of greater travel costs, higher uninsured/underinsured rates, and other factors. Our objective was to examine rural-urban differences in reported financial problems due to cancer using a nationally representative survey.
Financial Hardship Among Rural Cancer Survivors: An Analysis of the Medical Expenditure Panel Survey
Journal Article
Rural and Minority Health Research Center
Date: 11/2019
This study examined contrasts in financial hardship among 1,419 rural and urban cancer survivors using the 2011 Medical Expenditure Panel Survey supplement the Effects of Cancer and Its Treatment on Finances.
Geographic Disparities in Residential Proximity to Colorectal and Cervical Cancer Care Providers
Journal Article
Rural and Minority Health Research Center
Date: 11/2019
Persistent rural‐urban disparities for colorectal and cervical cancers raise concerns regarding access to treatment providers. To the authors knowledge, little is known regarding rural‐urban differences in residential proximity to cancer specialists.
Multilevel Analysis in Rural Cancer Control: A Conceptual Framework and Methodological Implications
Journal Article
Rural and Minority Health Research Center
Date: 09/2019
Our objective was two-fold: 1) to develop a multilevel conceptual framework describing how rural residence and relevant micro, macro, and supra-macro factors can be considered in evaluating disparities across the cancer control continuum and 2) to outline the unique considerations of multilevel statistical modeling in rural cancer research.
Challenges of Using Nationally Representative, Population-Based Surveys to Assess Rural Cancer Disparities
Journal Article
Rural and Minority Health Research Center
Date: 08/2019
Population-based surveys provide important information about cancer-related health behaviors across the cancer care continuum. However, due to small rural sample sizes, varying sampling methods, and/or other study design or analytical concerns, there are challenges in using population-based surveys for rural cancer control research and practice.
Development of a Childhood Obesogenic Environment Index
Policy Brief
Rural and Minority Health Research Center
Date: 08/2019
The purposes of this study were to describe the development of a childhood obesogenic environment index and examine differences in obesogenic environment index values by rurality and region across the U.S.
Identification of High-Need Rural Counties to Assist in Resource Location Planning
Policy Brief
Rural and Minority Health Research Center
Date: 05/2019
To identify high-need, low-resource locations, we began by identifying counties that lacked safety-net providers. For the purposes of this analysis, we identified Medicare-certified Rural Health Clinics (RHCs), Federally Qualified Health Centers (FQHCs) and Critical Access Hospitals (CAHs).
Identification of High-Need Rural Counties to Assist in Resource Location Planning for Primary Care
Policy Brief
Rural and Minority Health Research Center
Date: 05/2019
We examined simultaneously areas with poor health outcomes and limited access to primary care safety net settings. The combination of facility availability with health status indicators may help with identifying those areas in rural America that are in the greatest need of additional primary care resources.

2018

Rural-Urban Differences in Hospital Payer Mix in 2017
Fact Sheet
Rural and Minority Health Research Center
Date: 11/2018
This work revealed that rural hospitals heavily rely on Medicare.
Differences in Medicare Utilization and Expenditures in the Last Six Months of Life Among Patients with and without Alzheimer's Disease and Related Disorders
Journal Article
Rural and Minority Health Research Center
Date: 10/2018
The purpose of this study was to examine differences in utilization of inpatient services and Medicare expenditures (overall and by category) in the last six months of life for patients with, versus those without, a diagnosis of Alzheimer's disease and related disorders.
Rural-Urban Differences in Costs of End-of-Life Care for the Last 6 Months of Life Among Patients with Breast, Lung, or Colorectal Cancer
Journal Article
Rural and Minority Health Research Center
Date: 04/2018
Our findings indicate that Medicare expenditures are lower for rural beneficiaries with each type of cancer than urban beneficiaries, even after adjusting for age, gender, race, dual eligibility, region, chronic conditions, and type of service utilization.

2017

ESRD Facility Characteristics by Rurality and Risk of Closure
Report
Rural and Minority Health Research Center
Date: 11/2017
This study's purpose was to profile rural end stage renal disease (ESRD) facilities, focusing on those at greatest risk for closure. We examined the characteristics of these facilities, the quality of care provided, and the distance patients in rural areas would have to travel if the facilities closed.
Gender and Geographic Differences in Medicare Service Utilization During the Last Six Months of Life
Journal Article
Rural and Minority Health Research Center
Date: 11/2017
End-of-life issues are important for senior women, particularly rural women, who are more likely than their urban counterparts to live alone. The role of residence has yet to be investigated. The purpose of this study is to examine whether service utilization in the last six months of life differs across gender and rurality.
Who Performs Colonoscopy? Workforce Trends Over Space and Time
Journal Article
Rural and Minority Health Research Center
Date: 11/2017
Using data from South Carolina from 2001-2010, this study looked at changes in the types of facilities doing colonoscopies as well as the any changes in who is performing them.

2016

Health-Related Quality of Life Among Adults 65 years and Older in the United States, 2011-2012: A Multilevel Small Area Estimation Approach
Journal Article
Rural and Minority Health Research Center
Date: 10/2016
This study compiled estimates, at the county level, of poor health-related quality of life among those ages 65 and older. The study examined physical and mental health and found significant differences in health across the United States.
Colonoscopy Access and Utilization – Rural Disparities in the Carolinas, 2001-2010
Policy Brief
Rural and Minority Health Research Center
Date: 07/2016
This study aims to use data on where patients travel for their colonoscopies to determine the extent to which access is changing over space and time, and to better understand utilization patterns among rural residents of North and South Carolina between 2001 and 2010.
Ambulatory Care-Sensitive Condition Hospitalizations Among Medicare Beneficiaries
Journal Article
Rural and Minority Health Research Center
Date: 06/2016
Examines the relationship between the distribution of primary care physicians and Medicare beneficiaries' ambulatory care-sensitive condition hospitalizations using statistical and spatial analyses.