Whitney E. Zahnd, PhD
Deputy Director, RUPRI Center for Rural Health Policy Analysis
Email: whitney-zahnd@uiowa.edu
X: @WhitneyZahnd
Health Management and Policy
University of Iowa
145 N. Riverside Drive
Iowa City, IA 52242
- Current Projects - (3)
- Publications - (18)
Current Projects - (3)
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Concordance Between Social Needs Screening Provision, Programming, and Partnerships in Rural PPS Hospitals
This study will examine how rural Prospective Payment System (PPS) hospitals differ from urban hospitals concerning social needs screening practices and alignment between social needs screening performance and corresponding programs/strategies and/or community partnerships to address social needs.
Research center: RUPRI Center for Rural Health Policy Analysis
Topics: Health services, Hospitals and clinics, Medicare Prospective Payment System (PPS), Networking and collaboration, Social determinants of health
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Payer Mix of Rural Health Clinics and Federally Qualified Health Centers
This project will assess the payer mix of the more than 5,000 Rural Health Clinics and 1,400 Federally Qualified Health Center grantees throughout the country. The analysis will include assessing trends overtime and across types and ownership for RHCs and across regions for FQHCs.
Research center: RUPRI Center for Rural Health Policy Analysis
Topics: Federally Qualified Health Centers (FQHCs), Medicaid and CHIP, Medicare, Private health insurance, Rural Health Clinics (RHCs), Uninsured and underinsured
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Retention and Expansion of Hospital Services Offered by Rural Hospitals After Enrollment in 340B
The 340B Federal program is designed to provide hospitals with financial stability through provision of drug discounts which may, in turn, allow hospitals to maintain or expand their service line offerings. Using a series of event study analyses over an 11-year period, this study will examine the impact of enrollment in the 340B program on discontinuing services, maintaining services, and adding new services in eligible rural hospitals.
Research center: RUPRI Center for Rural Health Policy Analysis
Topics: Critical Access Hospitals (CAHs), Health services, Hospitals and clinics, Pharmacy and prescription drugs
Publications - (18)
2025
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Rural-Urban Differences in Barriers to Care and Utilization of Preventive Care Among Traditional Medicare and Medicare Advantage Beneficiaries
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 11/2025
This policy brief examined rural and urban differences in barriers to care and use of preventive care services among enrollees in traditional Medicare and Medicare Advantage. -
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.
2023
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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
University of South Carolina Rural 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.
2022
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Availability of Hospital-Based Cancer Services Before and After Rural Hospital Closure, 2008-2017
Journal Article
University of South Carolina Rural 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.
2021
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Trends in Cancer Treatment Service Availability Across Critical Access Hospitals and Prospective Payment System Hospitals
Journal Article
University of South Carolina Rural 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. -
Trends in Spatial Access to Colonoscopy in South Carolina, 2000-2014
Journal Article
University of South Carolina Rural 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. -
Disparities in Meeting USPSTF Breast, Cervical, and Colorectal Cancer Screening Guidelines Among Women in the United States
Journal Article
University of South Carolina Rural 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.
2020
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Spatial Access to Vaccines for Children Providers in South Carolina: Implications for HPV Vaccination
Journal Article
University of South Carolina Rural 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
University of South Carolina Rural 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. -
Expanding Access to HPV Vaccination in South Carolina Through Community Pharmacies: A Geospatial Analysis
Journal Article
University of South Carolina Rural 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
University of South Carolina Rural 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. -
Rural-Urban Differences in Educational Attainment Among Registered Nurses: Implications for Achieving an 80% BSN Workforce
Journal Article
University of South Carolina Rural Health Research Center
Date: 05/2020
Our primary objective was to provide updated information on rural-urban differences in educational attainment. We also examined rural-urban differences in employment type, salary, and demographics among registered nurses in different practice settings. -
A Bivariate Mapping Tutorial for Cancer Control Resource Allocation Decisions and Interventions
Journal Article
University of South Carolina Rural 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.
2019
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Rural-Urban Differences in Financial Burden Among Cancer Survivors: An Analysis of a Nationally Representative Survey
Journal Article
University of South Carolina Rural 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
University of South Carolina Rural 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
University of South Carolina Rural 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
University of South Carolina Rural 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
University of South Carolina Rural 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.