Health disparities and health equity

Completed Projects

Listed by project completion date. You can also view these projects alphabetically.

2020

  • A Chartbook of Rural Population Health
    This project creates a chartbook of population health for rural areas. This resource is designed to allow policymakers and practitioners to better understand rural-urban disparities across a wide variety of population health indicators.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Health disparities and health equity, Public health
  • Disparities in Preventive Care by Race and Ethnicity Among Rural Adults
    The purpose of this project is to identify differences in access to and use of preventive care by race and ethnicity among rural residents. Results from this project will identify racial/ethnic disparities that exist within rural communities and may guide targeted interventions to improve equity and increase access to high-quality healthcare for all rural residents.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Health disparities and health equity, Healthcare access, Hispanics, Minority health, Rural statistics and demographics
  • Healthcare Use and Access Among Rural & Urban Non-elderly Disabled Medicare Beneficiaries
    This project explored healthcare use and barriers to healthcare access among disabled Medicare beneficiaries under 65 in rural and urban areas. The study was based on quantitative analyses of the 2009-2013 Medicare Current Beneficiary Survey.
    Research center: Maine Rural Health Research Center
    Topics: Disabilities, Health disparities and health equity, Medicare
  • How Well are We Doing Meeting Healthy People 2020 Mortality Objectives at Midterm? Rural v. Urban Differences
    The purpose of this project was to conduct a midterm examination of urban versus rural disparities in meeting Healthy People 2020 mortality objectives for the top 10 leading causes of death in the U.S. utilizing existing secondary databases.
    Research center: Southwest Rural Health Research Center
    Topics: Chronic diseases and conditions, Health disparities and health equity
  • Mental Health Treatment Access: How Do Mental Health Treatment Use and Unmet Treatment Need Vary Among Rural and Urban Adults Nationally?
    This project will estimate the prevalence and policy-modifiable correlates of unmet mental health treatment need and utilization among metropolitan, micropolitan, and other non-metropolitan adults nationally who have a mental health condition. Additionally, the study will investigate the same issues among Native Americans/American Indians.
    Research center: Rural and Underserved Health Research Center
    Topics: American Indians and Alaska Natives, Health disparities and health equity, Health services, Mental and behavioral health
  • Understanding Rural-Urban Mortality Differences
    This study will address rural-urban mortality gaps in our understanding of rural mortality disparities using the 1985-2009 National Health Interview Survey (NHIS), linked to national death certificate data, to explore the individual-level characteristics and health behaviors of rural and urban adults and their association with mortality.
    Research center: Maine Rural Health Research Center
    Topic: Health disparities and health equity

2019

  • Community Health Worker Roles, Regulation and Growth in Rural America
    This study looked at the role of Community Health Workers in improving access to healthcare services in rural and urban environments. The project focused on the growing and changing roles of these influential actors and how their responsibilities vary based on setting (hospital, clinic, community, etc.), location (rural vs. urban), and regulations.
    Research center: Southwest Rural Health Research Center
    Topics: Health disparities and health equity, Healthcare access
  • Developing Rural-Relevant Strategies to Reduce Maternal Morbidity
    The purpose of this project was to distinguish and analyze predictors of maternal morbidity during childbirth hospitalization by geography and to develop recommendations to improve the safety of childbirth for rural residents. It also assessed the degree of rural focus and representation in current policy efforts to address this crisis.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Health disparities and health equity, Health services, Healthcare access, Hospitals and clinics, Legislation and regulation, Maternal health, Quality, Women
  • Do Rural Communities Have a Higher Rate of Avoidable Deaths?
    Based on some estimates, roughly half of deaths were avoidable in the sense they stem from risky behavior. What was less well known was the degree to which there was a rural-urban disparity in this rate.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topics: Cancer, Health disparities and health equity
  • Predictors of Buprenorphine Prescribing by Family Physicians in Rural Areas Nationally
    This project examined how physician and practice-level characteristics are associated with family physicians prescribing buprenorphine for opioid use disorder across rural and urban areas. The study made use of a unique dataset collected among family physicians nationally in 2017.
    Research center: Rural and Underserved Health Research Center
    Topics: Health disparities and health equity, Health services, Mental and behavioral health, Pharmacy and prescription drugs, Physicians, Substance use and treatment
  • Substance Use, Depression, and Suicide: What Are the Individual and Policy-Modifiable Correlates Amongst Metropolitan and Non-metropolitan Adults?
    We estimated the prevalence of depression and suicidal ideation and attempts amongst metropolitan and non-metropolitan adults nationally. We also investigated how demographic, social, economic, and health (including alcohol and drug abuse) as well as healthcare access factors explain depression and suicide indicators amongst residents.
    Research center: Rural and Underserved Health Research Center
    Topics: Health disparities and health equity, Health services, Mental and behavioral health, Substance use and treatment

2018

  • Barriers and Disparities Associated with Pneumococcal Immunization Among Rural Elderly Adults
    Our Center conducted analyses of national survey data and unique insurance claims data sets to identify how rurality of residence and key demographic, social, and economic characteristics serve as barriers or facilitators to vaccination against pneumococcal disease, which is relatively common although largely preventable among older Americans.
    Research center: Rural and Underserved Health Research Center
    Topics: Health disparities and health equity, Health promotion and disease prevention
  • For Amber "Waives" of Grain: The Impact of Medicaid Managed Care Waiver Programs on Care Choices in Rural America
    This project used a combination of systematic review of waiver content and structured interviews with key informants to assess the potential for rural disparities in access to care for Medicaid enrollees.
    Research center: Rural and Minority Health Research Center
    Topics: Health disparities and health equity, Medicaid and CHIP
  • Health Insurance Marketplaces, Medicaid, and Uncompensated Care: The Rural Impact
    This project provides an in-depth analysis of Health Insurance Marketplace (HIM) plan design, specifically measuring the availability and prevalence of high-deductible plans in rural as compared to urban areas.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Health disparities and health equity, Healthcare access, Medicaid and CHIP, Uninsured and underinsured
  • Implications of Rural Ambulance Service Closures
    The purpose of this project was to examine closed ambulance services and those ambulance services adjacent to the closed units. The ambulance services adjacent to those which closed were examined by service area, workload, and staffing for one year prior to and one year after the adjacent service closure.
    Research center: North Dakota and NORC Rural Health Reform Policy Research Center
    Topics: Allied health professionals, Emergency medical services and trauma, Frontier health, Health disparities and health equity, Health services, Workforce
  • Rural/Urban Differences in Chronic Diseases and Delay of Needed Care
    This project examined rural versus urban differences in the prevalence, incidence, stage, and severity of several chronic diseases, including heart disease, stroke, and selected cancers. There was a focus on delayed access to needed care and whether rural residents present later and with more advanced disease states.
    Research center: Southwest Rural Health Research Center
    Topics: Cancer, Chronic diseases and conditions, Health disparities and health equity
  • The Burden of Diabetes in Rural America
    The purpose of this project was to determine rural versus urban differences in type 2 diabetes prevalence, morbidity and mortality in the U.S. Diabetes complications, disparities and associated demographics were reported. A comparison of Mexican-American border versus non-border states was also included.
    Research center: Southwest Rural Health Research Center
    Topics: Chronic diseases and conditions, Diabetes, Health disparities and health equity, Minority health
  • The Impact of Medicaid Expansion on Rural/Urban Variations in Access to Substance Use Treatment
    Research indicates that substance use treatment access is insufficient in rural areas. We made use of our rare access to restricted use NSDUH data to offer new insights about the impact of Medicaid expansion on access to substance abuse treatment among individuals with substance abuse disorders, analyzing 13 years (2004-2016).
    Research center: Rural and Underserved Health Research Center
    Topics: Health disparities and health equity, Health services, Substance use and treatment
  • Variation in Scope of Practice and Medical Services Available at Family Physician Practices within Rural Areas
    Using data collected during recertification of family physicians by the American Board of Family Medicine, we examined variation in the scope of practice of family physicians and services available in the primary practice site by degree of rurality and within rural categories by community-level deprivation, as well as variation by Patient Centered Medical Home status.
    Research center: Rural and Underserved Health Research Center
    Topics: Health disparities and health equity, Health services, Physicians

2017

  • Exploring Regional Differences in Rural and Urban Mortality Trends
    Explores the differences in U.S. mortality rates by urban and rural location, census division, and urban and rural location within each census division. The gap in nationwide urban-rural mortality is often told as a national story, but the changes are regional. This implies different regions may need different strategies for addressing the gap.
    Research center: North Carolina Rural Health Research and Policy Analysis Center
    Topic: Health disparities and health equity
  • Exploring the Impact of Rural Hospital Closures on Use of Emergency Medical Services
    Using a unique national database, The Enterprise Data Trust, we will explore pre- and post-closure hospital emergency department use with specific emphasis on those who used public emergency medical transportation, testing for significant changes. This study will be the first to look at the impacts of rural hospital closure at the patient level.
    Research center: Rural and Underserved Health Research Center
    Topics: Emergency medical services and trauma, Health disparities and health equity, Health services, Transportation
  • Healthcare Access and Affordability Among Rural Children with Public Versus Private Health Insurance
    To examine differences in healthcare access and affordability among rural children with public (i.e., Medicaid or CHIP) and private health insurance coverage, the study will address the a number of research questions, using data from the 2011-12 National Survey of Children's Health.
    Research center: Maine Rural Health Research Center
    Topic: Health disparities and health equity

2015

  • Expanded Look at Rural Access to Care
    This study will use newly available national health survey data to examine rural-urban differences in access to medical care, access to insurance, and affordability of care.
    Research center: Maine Rural Health Research Center
    Topics: Health disparities and health equity, Uninsured and underinsured
  • Rural Area Deprivation and Hospitalizations Among Children for Ambulatory Sensitive Conditions
    Rural areas with reduced social and economic resources may be particularly vulnerable to inadequate primary care for children.
    Research center: Rural and Minority Health Research Center
    Topics: Children and adolescents, Health disparities and health equity, Hospitals and clinics
  • Rural Maternal Smoking Behaviors
    In this project, we will develop a chart book documenting the prevalence of mental health/substance abuse conditions and describing the utilization of mental health services in rural and urban settings.
    Research center: Maine Rural Health Research Center
    Topics: Health disparities and health equity, Mental and behavioral health, Substance use and treatment

2014

  • Examination of Trends in Rural and Urban Health: Establishing a Baseline for Health Reform
    The purpose of this project is to update and supplement the seminal Health, United States, 2001: Urban and Rural Health Chartbook. Resulting information can not only be compared to the 2001 Chartbook but provides a baseline from which to measure future change related to the Accountable Care Act implementation. Where appropriate additional charts are included wherein rural areas are subdivided by type.
    Research center: North Dakota and NORC Rural Health Reform Policy Research Center
    Topics: Health disparities and health equity, Health services, Public health
  • Prevalence and Impact of High Deductible Health Insurance Plans in Rural Areas
    This study will use national health survey data to examine whether privately insured rural residents are more likely than their urban counterparts to have plans with high deductibles. It will also assess whether high deductible health plans create health care barriers for rural residents, and if these differ from the barriers experienced by those in urban areas.
    Research center: Maine Rural Health Research Center
    Topics: Health disparities and health equity, Private health insurance
  • Rural and Urban Differences in Case-Mix Among Recipients of Home Health Care
    We will examine current patient case-mix for the Medicare population receiving skilled health care from a home health agency to determine if there are rural or race/ethnicity-based disparities with regards to receipt of services and clinical acuity indicators.
    Research center: Rural and Minority Health Research Center
    Topics: Health disparities and health equity, Home health, Medicare

2013

  • Patterns of Care for Rural and Urban Children with Mental Health Problems
    This study will assess whether use of office-based care and psychotropic medicine by children differs between rural and urban areas, as well as the role of insurance coverage and availability of mental health providers on use of these services.
    Research center: Maine Rural Health Research Center
    Topics: Children and adolescents, Health disparities and health equity, Mental and behavioral health
  • Perinatal Health in the Rural United States, 2005
    This study examines perinatal outcomes in rural areas across the United States in 2005.
    Research center: WWAMI Rural Health Research Center
    Topics: Children and adolescents, Health disparities and health equity, Women

2012

2011

  • Transitions in Care for Rural Medicare Beneficiaries with Diabetes
    Hospital readmission rates among persons with diabetes, as well as absolute admission rates, may be used to study health disparities among rural and minority populations. This project will use data from the Medicare Chronic Conditions Data Warehouse to explore residence- and race-based disparities in diabetes admission rates, effective transitions to outpatient care, and re-admission rates, to help guide rural policy-makers and healthcare providers.
    Research center: Rural and Minority Health Research Center
    Topics: Chronic diseases and conditions, Diabetes, Health disparities and health equity, Medicare, Minority health

2009

  • Chartbook: Racial and Ethnic Disparities in the Health of Rural Populations
    This study will provide a cross-sectional, descriptive study that uses large, nationally representative data sets to illustrate health and health care among rural populations. The data sets to be used include the 2005 Behavioral Risk Factor Surveillance Survey, the 2005 National Health Interview Survey, and the Area Resource File.
    Research center: Rural and Minority Health Research Center
    Topics: Health disparities and health equity, Minority health, Rural statistics and demographics

2008

  • Changes in U.S. Rural Perinatal and Infant Health Care During the Last Decade
    This study examined changes in rates of adverse birth outcomes and prenatal care among rural Americans of different racial and ethnic groups during two time periods. The study used national data from the Linked Birth Death Data Sets to assess differences in low birth weight, neonatal death, post neonatal mortality and inadequate prenatal care.
    Research center: WWAMI Rural Health Research Center
    Topics: Children and adolescents, Health disparities and health equity, Maternal health
  • Chartbook: Oral Health and Unmet Needs for Dental Care Among Children
    This study will characterize oral health status, dental care utilization, and unmet dental care needs among U.S. children by urban/rural residence. It will provide a descriptive analysis, using cross-sectional data from the 2003 National Survey of Children's Health.
    Research center: Rural and Minority Health Research Center
    Topics: Children and adolescents, Health disparities and health equity, Oral health, Rural statistics and demographics
  • National Study of Substance Abuse Prevalence and Treatment Services in Rural Areas
    This project will research the prevalence of the abuse of legal and illegal substances across rural populations and geographic areas, including the extent to which rural individuals are receiving treatment for their substance abuse and barriers to the receipt of treatment.
    Research center: Maine Rural Health Research Center
    Topics: Health disparities and health equity, Health services, Rural statistics and demographics, Substance use and treatment
  • Rural-Urban Differences In The Use, Type, And Quality Of Depression Treatment
    As access to evidence-based treatment for affective disorders (major depressive disorder, dysthymia, and bipolar disorder) improves in urban areas, it is critical to monitor rural-urban differences in the use and quality of treatment over time to identify and address rural disparities, especially for vulnerable populations such as the elderly and ethnic minorities.
    Research center: WICHE Center for Rural Mental Health Research
    Topics: Aging, Health disparities and health equity, Mental and behavioral health, Minority health

2007

  • Breast, Cervical, Colorectal, and Prostate Cancer Screening in Rural America: Does Proximity to a Metropolitan Area Matter?
    The study compared cancer screening rates among various levels of rural versus urban Behavioral Risk Factor Surveillance System respondents and among white respondents versus those from racial/ethnic minority groups.
    Research center: WWAMI Rural Health Research Center
    Topics: Cancer, Health disparities and health equity, Health promotion and disease prevention, Minority health
  • Burden of Asthma Among Rural Residents: A National Study
    This study uses data from the Behavioral Risk Factor Surveillance System (BRFSS) to examine the prevalence of and trends in asthma among rural residents by type of geographic location and by key risk factors.
    Research center: WWAMI Rural Health Research Center
    Topics: Chronic diseases and conditions, Health disparities and health equity, Minority health, Rural statistics and demographics
  • Diabetes Burden and the Lack of Preventive Care in the Rural United States
    The project is designed to determine if there are disparities in diabetes care provided to persons with diabetes residing in rural areas as compared to those in urban areas. Additionally, the project will examine diabetes related health care resource utilization with implications for improving care and reducing the economic burden.
    Research center: FORHP-funded Individual Grantees
    Topics: Chronic diseases and conditions, Diabetes, Health disparities and health equity, Public health

2006

  • Mode of Travel and Actual Distance Traveled for Medical or Dental Care by Rural Residents
    This project examined the influence of race and rural isolation on distance traveled to receive medical or dental care, and how the potential interaction of these factors might exacerbate disparities in access to care.
    Research center: Rural and Minority Health Research Center
    Topics: Health disparities and health equity, Health services, Minority health, Oral health, Transportation

2005

  • Depression and Generalized Anxiety Disorder across Rural Populations
    Research center: Rural and Minority Health Research Center
    Topics: Health disparities and health equity, Mental and behavioral health, Minority health
  • Diabetes and Hypertension in Rural Hispanics
    The project will examine the similarities and differences between rural and urban Hispanics and Caucasian adults diagnosed with diabetes mellitus and hypertension.
    Research center: Rural and Minority Health Research Center
    Topics: Chronic diseases and conditions, Diabetes, Health disparities and health equity, Hispanics, Minority health
  • Disability Burdens Among Rural and Urban Older Americans
    This project will use the 1994-2000 Second Longitudinal Study of Aging to develop detailed estimates of healthy, disabled, and total life expectancy among rural and urban populations. We will develop and compare the estimates between women and men, by race/ethnicity, and across differing levels of education.
    Research center: Rural and Minority Health Research Center
    Topics: Aging, Disabilities, Health disparities and health equity, Long-term care, Rural statistics and demographics
  • National Trends in the Perinatal and Infant Health Care of Rural and Urban American Indians (AIs) and Alaska Natives (ANs)
    This project examined and compared trends in prenatal care and mortality rates of rural and urban AI/AN and non-AI/AN populations in order to determine the level of disparity between these populations and their temporal changes.
    Research center: WWAMI Rural Health Research Center
    Topics: American Indians and Alaska Natives, Children and adolescents, Health disparities and health equity, Maternal health, Minority health
  • Rural Minority Health: A Comprehensive Assessment
    This study will profile demographics of rural African Americans by region of the U.S.; describe clinical problems prevalent in rural African American populations; explore available health care facilities and practitioners in rural areas; investigate outpatient treatment provided to rural African American populations by type of practitioner; explore expenditures for health care among rural African Americans by region of the U.S.; and determine barriers to care such as insurance, provider availability, and health beliefs and behaviors.
    Research center: Rural and Minority Health Research Center
    Topics: Health disparities and health equity, Minority health, Rural statistics and demographics

2003

2002