Rural Health
Research Gateway

Public health

Current Projects

  • Changes in Medicare Fee-for-Services Health Care Expenditures in Rural and Urban Communities after Passage of the Affordable Care Act
    This project will assess changes in Medicare per-beneficiary spending across rural and urban counties from 2007 to 2020. It will examine differences in rural versus urban per-beneficiary spending on hospital inpatient, hospital outpatient, physician, and post-acute care after the Affordable Care Act (ACA).
    Research center: University of South Carolina Rural Health Research Center
    Topics: Care management, Chronic diseases and conditions, Health services, Hospitals and clinics, Public health
  • Considerations for the Use of Area-Level Vulnerability and Resilience Indices and Rurality in Funding Formulas
    The purpose of this study is to model potential funding formulas within states to understand how structural elements in formulas (i.e., inclusion of the Social Vulnerability Index, use of rural carve-outs or floor amounts, and other factors) affect county-level allocations compared to simple, population-based formulas.
    Research center: ETSU/NORC Rural Health Research Center
    Topics: Healthcare financing, Public health, Social determinants of health
  • Environmental Influences on Child Health: A Snapshot of Children's Health in the United States
    The environment in which a child grows up strongly influences their health in childhood, adolescence, and adulthood. Using data for 2022 and 2023 from five national data sets, this project will provide a comprehensive update on rural-urban differences in child health in the U.S.
    Research center: University of South Carolina Rural Health Research Center
    Topics: Children and adolescents, Chronic diseases and conditions, Healthcare access, Obesity, Oral health, Poverty, Public health, Social determinants of health
  • Examining the Costs Associated With Dental Restorative Services in the Absence of Preventive Services Among Pediatric Medicaid Beneficiaries by Rurality
    This project will examine the costs associated with pediatric dental restorative services in the absence of preventive services. This study focuses on children with Medicaid who have historically been less likely to receive preventive dental care with subsequent impacts on pain, infections, and overall development.
    Research center: University of South Carolina Rural Health Research Center
    Topics: Children and adolescents, Health promotion and disease prevention, Medicaid and CHIP, Oral health, Poverty, Public health, Social determinants of health
  • Identifying High-Need Counties for Resource Planning
    The primary aim of this project is to use data examining health care infrastructure, chronic disease prevalence, and the socioeconomic environment to create a metric for classifying rural counties based on needs and resources.
    Research center: University of South Carolina Rural Health Research Center
    Topics: Chronic diseases and conditions, Diabetes, Healthcare access, Maternal health, Obesity, Oral health, Physicians, Poverty, Public health, Rural statistics and demographics, Social determinants of health, Uninsured and underinsured, Workforce
  • Out-of-Pocket Spending Among Privately Insured Rural and Urban Residents
    Out-of-pocket spending for healthcare services has been on the rise as deductibles and other cost-sharing requirements among the privately insured increase. This study compares rural and urban out-of-pocket healthcare spending to identify whether rural residents have been disproportionately affected by this trend.
    Research center: Maine Rural Health Research Center
    Topics: Healthcare access, Healthcare financing, Private health insurance, Public health, Uninsured and underinsured
  • Preventive Cancer Screenings and Behaviors Among Rural and Urban Populations
    This study examines rural use of preventive cancer screenings and related behaviors using BRFSS data. It will examine rural-urban differences in adherence to USPSTF guidelines for colorectal, breast, lung, and prostate cancer screening and explore associated behavioral risk factors.
    Research center: Northeast Rural Health Research Center
    Topics: Cancer, Chronic diseases and conditions, Health promotion and disease prevention, Healthcare access, Public health, Rural statistics and demographics, Women
  • Rural-Urban Differences in Addressable Drivers of Staff Turnover in Skilled Nursing Facilities
    The aim of the proposed study is to assess facility-level turnover rates for total nursing and registered nursing personnel across levels of rurality and by region looking at factors such as staffing ratios that can be managed by facility administrators.
    Research center: University of South Carolina Rural Health Research Center
    Topics: Health services, Hospitals and clinics, Nurses and nurse practitioners, Public health, Rural Health Clinics (RHCs), Workforce
  • Rural-Urban Differences in Food-Store Access and Food Security
    This study will inform rural community members and policy makers about access to food supply and food security that can help guide the development and implementation of relevant interventions.
    Research center: University of South Carolina Rural Health Research Center
    Topics: Health promotion and disease prevention, Poverty, Public health, Social determinants of health, Transportation
  • Rural-Urban Differences in Provider Counseling About Physical Activity Among U.S. Adults
    This study examines rural-urban differences in health professional counseling about physical activity among U.S. adults, using NHIS data (2020-2024). It explores how advice relates to meeting activity guidelines and whether differences vary by age, chronic condition prevalence, and other factors.
    Research center: Northeast Rural Health Research Center
    Topics: Children and adolescents, Chronic diseases and conditions, Health promotion and disease prevention, Healthcare access, Obesity, Physicians, Public health
  • Screening, Brief Intervention and Referral to Treatment (SBIRT) Penetration in Rural vs. Urban Healthcare Settings in the U.S.
    This study will include an analysis of 2018/2019 Medicare, Medicaid and Commercial claims to compare the penetration of Screening, Brief Intervention and Referral to Treatment (SBIRT) and its different components in rural compared to urban healthcare settings. Within the overarching analysis, the study team will examine the type of interventions conducted within the SBIRT framework stratified by provider type, healthcare setting, and rural and urban provider ZIP codes. Findings will be analyzed within the context of county-level substance use rates, historical enactment of state SBIRT billing codes, overdoses, and alcohol poisoning-based hospital admissions contrasting trends in SBIRT administration with a proxy for community need.
    Research center: ETSU/NORC Rural Health Research Center
    Topics: Chronic diseases and conditions, Health promotion and disease prevention, Medicaid and CHIP, Medicare, Mental and behavioral health, Private health insurance, Public health, Substance use and treatment
  • The Impact of Chronic Pain on the Functional Wellbeing of Rural Residents
    Research indicates that rural adults experience chronic pain at higher rates than urban adults. This study uses National Health Interview Survey data to examine rural-urban differences in chronic pain impacts on functioning, quality of life, and treatment use.
    Research center: Northeast Rural Health Research Center
    Topics: Chronic diseases and conditions, Healthcare access, Mental and behavioral health, Public health, Social determinants of health, Substance use and treatment