Rural Health
Research Gateway

Julia Interrante, PhD, MPH

University of Minnesota Rural Health Research Center

Phone: 612.626.8401
Email: inter014@umn.edu

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

Current Projects - (3)

  • Access to and Use of Midwifery Care for Rural Residents
    Rural obstetric unit closures and health care workforce shortages limit access to care for pregnant rural residents. Our goal is to describe the midwifery workforce in rural communities and at rural hospitals that provide obstetric care, and to assess rural-urban differences in use of midwifery care at the time of childbirth.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Hospitals and clinics, Maternal health, Nurses and nurse practitioners, Women, Workforce
  • Postpartum Morbidity and Mortality and Health Care Utilization in Rural vs. Urban Communities
    Using 2006-2018 data from the National Health Interview Survey linked to the National Death Index through 2019, this project will examine postpartum mortality among rural and urban residents. We will also evaluate differences in health, health care utilization, and barriers to care across rural and urban communities.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Health disparities and health equity, Healthcare access, Maternal health, Medicaid and CHIP, Mental and behavioral health, Private health insurance, Social determinants of health, Uninsured and underinsured, Women
  • Rural Obstetric Unit Closures
    The goal of this project is to update prior research to include the latest information on the loss of hospital-based obstetric services in rural U.S. counties. This project is important because ensuring obstetric care access and reducing maternal mortality in rural and underserved areas is a key focus of national, state, and local policies.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Critical Access Hospitals (CAHs), Healthcare access, Hospitals and clinics, Maternal health, Women, Workforce

Completed Projects - (3)

  • Improving Racial Equity for Rural Mothers and Infants
    The purpose of this project was to assess differences in maternal and infant health outcomes and access to perinatal care, among urban and rural counties. We also compared health outcomes and availability of services, including evidence-based services and supports, between rural counties that are majority Black, Indigenous, and People of Color with those that are majority white.
    Research center: University of Minnesota Rural Health Research Center
    Topics: American Indians and Alaska Natives, Critical Access Hospitals (CAHs), Health disparities and health equity, Healthcare access, Hospitals and clinics, Maternal health, Minority health, Rural statistics and demographics, Social determinants of health, Women
  • Rural/Urban Differences in Postpartum Health Insurance, Healthcare Use, and Health Outcomes
    The purpose of this project was to identify rural/urban differences in health insurance, healthcare use, and health outcomes among postpartum individuals, and to describe policy-relevant implications or strategies to improve insurance coverage, receipt of recommended healthcare, and, ultimately, health outcomes among rural residents who give birth. With a lens towards health equity, all analyses were stratified by race/ethnicity and income.
    Research center: University of Minnesota Rural Health Research Center
    Topics: American Indians and Alaska Natives, Health disparities and health equity, Healthcare access, Healthcare financing, Hispanics, Hospitals and clinics, Legislation and regulation, Maternal health, Medicaid and CHIP, Minority health, Private health insurance, Women
  • Safe Obstetric Care Access for All Rural Residents: Minimum Standards for Clinical, Workforce, and Financial Viability of Rural Obstetric Units
    The goal of this project was to analyze data from rural hospitals to understand the criteria by which hospitals and communities assess their need and capacity for obstetric care access in rural counties and to describe effective ways to operationalize minimum standards for clinical safety and financial viability for rural obstetric units.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Critical Access Hospitals (CAHs), Health disparities and health equity, Healthcare access, Hospitals and clinics, Maternal health, Women, Workforce

Publications - (23)

2023

2022

2021

2020

  • Local Capacity for Emergency Births in Rural Hospitals Without Obstetrics Services
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 11/2020
    As increasing numbers of rural hospitals stop offering maternity care, limited information is available about local preparedness to address obstetric emergencies. This paper explores the capacity to treat obstetric emergencies encountered among rural hospitals without obstetric units.
  • Obstetric Emergencies in Rural Hospitals: Challenges and Opportunities
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 09/2020
    The purpose of this policy brief is to describe the challenges rural hospitals face in providing emergency obstetric care and to highlight resources that could help rural hospitals more safely respond to obstetric emergencies.
  • 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.
  • 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.
  • Loss of Hospital-Based Obstetric Services in Rural Counties in the United States, 2004-2018
    University of Minnesota Rural Health Research Center
    Date: 07/2020
    The purpose of this infographic is to show the loss of hospital-based obstetric services from 2004-2018 and how this differs by county type (micropolitan vs. noncore).

2019

  • 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.