Rural Health
Research Gateway

Rural statistics and demographics

Research Products & Journal Articles

Browse the full list of research publications on this topic completed by the Rural Health Research Centers.

Products – Freely accessible products include policy briefs, fact sheets, full reports, chartbooks, and interactive data websites.

Journal Articles – Articles in peer-reviewed journals may require a subscription or affiliation with a subscribing library. For these publications, Gateway lists the article citation, a brief summary, a link to additional information and access to the full-text of the article, if available.

2025

  • 2010-2023 County-Level Hospital-Based Obstetric Care Status
    Rural Maternal Health Data Support and Analysis Program, University of Minnesota Rural Health Research Center
    Date: 10/2025
    This data resource is a county-level dataset containing the county FIPS code, state, and an indicator of whether each US county had hospital-based obstetrics care in each year, 2010-2023. It is available for download as an XLS file.
  • Examining the Burden of Chronic Disease and Low SES to Identify High-Need Rural Counties
    Journal Article
    University of South Carolina Rural Health Research Center
    Date: 09/2025
    This study identifies rural counties with high chronic disease burden and low socioeconomic status; describes the geographic and demographic patterns of these high-need counties; and examines whether counties with greater need also experience reduced geographic access to critical health care services.
  • Reasons for Experiencing Delayed or Forgone Health Care Among Rural American Indian/Alaska Native and Rural Non-Hispanic White Individuals, 2022
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 09/2025
    The purpose of this policy brief is to show reported reasons for experiencing delayed or forgone health care and how this differs between rural American Indian/Alaska Native (AI/AN) and rural non-Hispanic white people as well as by Indian Health Service care access among rural AI/AN people.
  • A Review of Common Limitations in Rural-Related Studies in the Peer-Reviewed Literature
    Policy Brief
    ETSU/NORC Rural Health Research Center
    Date: 09/2025
    This study describes limitations commonly reported in rural-related studies on health, with a focus on studies using secondary, quantitative data.
  • 2010-2022 County-Level Hospital-Based Obstetric Care Status
    Rural Maternal Health Data Support and Analysis Program, University of Minnesota Rural Health Research Center
    Date: 07/2025
    This data resource is a county-level dataset containing the county FIPS code, state, and an indicator of whether each United States county had hospital-based obstetrics care in each year, 2010-2022. It is available for download as an XLS file.
  • Access and Quality of Mental Health Services in Rural and Urban America
    Policy Brief
    University of South Carolina Rural Health Research Center
    Date: 07/2025
    Access to and quality of mental health facilities is a significant concern in the United States. This research identified disparities in mental health access and care quality by residence rurality.
  • An Assessment of Area-Level Vulnerability and Resilience Indices by Geography: A Rural-Urban Comparison
    Journal Article
    ETSU/NORC Rural Health Research Center
    Date: 07/2025
    Area-level vulnerability and resilience indices are widely used to address health needs by informing resource allocation and policy. Researchers found that indices differ from each other and by rurality, contributing to the growing body of evidence to inform the use and improvement of these indices.
  • Geographic and Demographic Correlates of Living in Manufactured Homes: Implications for Health
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 07/2025
    This brief examines rates of living in manufactured homes by rural and urban location, as well as rates among rural residents by region and socio-demographic characteristics. It also examines differences in crowded housing, housing quality, and housing cost burden by manufactured vs. more permanent housing structures.
  • The Impact of High Hospital Fixed-Cost Ratios on Rural Populations
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 06/2025
    This brief focuses on rural hospitals with high fixed-to-total-cost ratios and describes characteristics of those hospitals, including Critical Access Hospital and Low-Volume Hospital status, and provides some demographics on the communities they serve.
  • Rural and Urban Differences in Suicide in the United States, 2018-2021
    Policy Brief
    ETSU/NORC Rural Health Research Center
    Date: 05/2025
    Suicide remains a significant cause of mortality in the United States. This policy brief examines state-level differences in suicide rates by demographics and geography, with a focus on rural and urban areas from 2018 to 2021. The study employs a cross-sectional, retrospective design using secondary data sources.
  • Medicare Advantage Enrollment Update 2024
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis, Rapid Response to Requests for Rural Data Analysis
    Date: 01/2025
    This policy brief continues RUPRI Center's annual update of Medicare Advantage (MA) enrollment including the changes in enrollment in types of MA plans, and health policy changes that may have had an impact.
  • Resources for Measuring Rurality in Research on Maternity Care
    University of Minnesota Rural Health Research Center
    Date: 01/2025
    The primary objective of this brief is to explore the complexities inherent in defining rurality in maternal health research. In addition, this brief aims to provide insights into how different measures of rurality influence research outcomes, with the goal of informing best practices in maternal health research.

2024

  • Variation in Elder Abuse State Statutes by State Level of Rurality
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 12/2024
    This policy brief examines elements of state-level elder abuse statutes' definitions and reporting requirements to investigate potential differences in these policies by state rurality that could influence one's understanding of elder abuse among rural and urban areas.
  • Identifying Rural Health Clinics Within the Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files
    Policy Brief
    Maine Rural Health Research Center
    Date: 03/2024
    This brief describes a methodology for identifying Rural Health Clinic encounters within the Medicaid claims data using Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files.
  • Rural-Urban Differences in Housing Cost Burden Across the U.S.
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 03/2024
    Housing is closely tied to health and well-being, but affordable housing is out of reach for many households. This policy brief examines the proportion of households who are housing cost burdened by rural-urban location across different U.S. geographic spaces in order to identify how housing affordability varies by location.

2023

2022

  • Community Sociodemographics and Rural Hospital Survival
    Journal Article
    Center for Economic Analysis of Rural Health
    Date: 12/2022
    This study examines whether community sociodemographic factors are associated with the survival or closure of rural hospitals at risk of financial distress between 2010 and 2019.
  • Patterns of Health Care Use Among Rural-Urban Medicare Beneficiaries Age 85 and Older, 2010-2017
    Policy Brief
    Maine Rural Health Research Center
    Date: 11/2022
    This study examines rural-urban differences in health care use among Medicare beneficiaries age 85+.
  • Review of Rural U.S. Economic and Health Care Trends
    Report
    Center for Economic Analysis of Rural Health
    Date: 09/2022
    This report reviews recent literature and publicly available data to explore important issues at the nexus of health care and local economic vibrancy. The report also explores the economic implications associated with COVID-19, however full impacts will not be known for several years.
  • Update on Rural Independently Owned Pharmacy Closures in the United States, 2003-2021
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis, Rapid Response to Requests for Rural Data Analysis
    Date: 08/2022
    Independently owned retail pharmacies in rural areas experienced a higher rate of closure than micropolitan and metropolitan areas. Closures have raised concerns about access to prescription medications as well as pharmacist-provided primary care services, which are often the sole source in rural areas for obtaining health services.
  • County-Level Availability of Obstetric Care and Economic Implications of Hospital Closures on Obstetric Care
    Policy Brief
    Center for Economic Analysis of Rural Health
    Date: 07/2022
    This policy brief draws out demographic and economic differences between counties with obstetric care facilities and those without. It provides descriptive data on the economic changes underway in counties that lost obstetric care facilities between 2012 and 2019.
  • Higher Electronic Health Record Functionality Is Associated With Lower Operating Costs in Urban—but Not Rural—Hospitals
    Journal Article
    Center for Economic Analysis of Rural Health
    Date: 07/2022
    This study examines the relationship between electronic health record use/functionality and hospital operating costs and compares the results across rural and urban facilities.
  • Social Isolation and Safety Issues Among Rural Older Adults Living Alone: Perspectives of Meals on Wheels Programs
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 05/2022
    In this article, we share results from a survey of 42 Meals on Wheels programs in rural areas across the US. Respondents highlighted challenges to meeting both social and safety needs of rural older adults living alone, as well as policy recommendations to improve the health and safety of older adults living alone in rural areas.
  • Maine: A Health-Focused Landscape Analysis
    Chartbook
    Maine Rural Health Research Center
    Date: 04/2022
    These chartbooks present a comprehensive set of state- and county-level population health and health care access measures for Maine, New Hampshire, New York, and Vermont. These data are intended to inform initiatives to support health and health care, particularly in rural counties and counties served by the Northern Border Regional Commission.
  • New Hampshire: A Health-Focused Landscape Analysis
    Chartbook
    Maine Rural Health Research Center
    Date: 04/2022
    These chartbooks present a comprehensive set of state- and county-level population health and health care access measures for Maine, New Hampshire, New York, and Vermont. These data are intended to inform initiatives to support health and health care, particularly in rural counties and counties served by the Northern Border Regional Commission.
  • New York: A Health-Focused Landscape Analysis
    Chartbook
    Maine Rural Health Research Center
    Date: 04/2022
    These chartbooks present a comprehensive set of state- and county-level population health and health care access measures for Maine, New Hampshire, New York, and Vermont. These data are intended to inform initiatives to support health and health care, particularly in rural counties and counties served by the Northern Border Regional Commission.
  • The Northern Border Region: A Health-Focused Landscape Analysis
    Chartbook
    Maine Rural Health Research Center
    Date: 04/2022
    These chartbooks present a comprehensive set of state- and county-level population health and health care access measures for Maine, New Hampshire, New York, and Vermont. These data are intended to inform initiatives to support health and health care, particularly in rural counties and counties served by the Northern Border Regional Commission.
  • Vermont: A Health-Focused Landscape Analysis
    Chartbook
    Maine Rural Health Research Center
    Date: 04/2022
    These chartbooks present a comprehensive set of state- and county-level population health and health care access measures for Maine, New Hampshire, New York, and Vermont. These data are intended to inform initiatives to support health and health care, particularly in rural counties and counties served by the Northern Border Regional Commission.

2021

2020

  • Rural-Urban Differences Among Older Adults
    Chartbook
    University of Minnesota Rural Health Research Center
    Date: 08/2020
    This chartbook presents the characteristics of older adults in rural counties, as well as rural-urban differences among older adults, across four domains: demographics, socioeconomic characteristics, healthcare access and use, and health characteristics.
  • Supporting the Health and Wellbeing of Middle-Aged Adults Living Alone in Rural Counties
    University of Minnesota Rural Health Research Center
    Date: 06/2020
    This report shares insights from healthcare providers in 14 rural counties with the highest rates of middle-aged adults living alone in order to inform policy and practice in how best to support the health and well-being of this demographic.
  • Characteristics of Counties With the Highest Proportion of the Oldest Old
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 05/2020
    The "oldest old," or individuals age 85 and older, are one of the fastest-growing segments of the U.S. population, yet little is known about where those individuals tend to live and what their communities are like. This information is important for planning how to best respond to and support this growing population.
  • Considerations for Defining Rural Places in Health Policies and Programs
    Report
    RUPRI Health Panel: Rural Policy Analysis and Applications
    Date: 05/2020
    Rural definitions in statute and policy are used to direct resources to underserved people. But changes in population behavior and census processes have led to concern about historic methods of defining rural. This paper identifies key questions, reviews rural definitions, and discusses options for reconsidering rural definitions.
  • Rural-Urban Residence and Mortality Among Three Cohorts of U.S. Adults
    Policy Brief
    Maine Rural Health Research Center
    Date: 05/2020
    Rural residents have a shorter life expectancy than urban residents. We analyzed national linked survey and death certificate data and found risk of death was 10% higher for rural than urban residents and has increased over time. Findings suggest the overall mortality penalty in rural areas may be partly driven by social determinants of health.
  • Rates of Living Alone by Rurality and Age
    University of Minnesota Rural Health Research Center
    Date: 04/2020
    In this infographic, we identify rates of living alone for all adults and within specific age groups using two classifications of rurality.

2019

  • Measuring Access to Care in National Surveys: Implications for Rural Health
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 06/2019
    This brief presents data about how access to healthcare is measured, focusing on how this applies to rural populations.
  • Do Hospital Closures Affect Patient Time in an Ambulance?
    Policy Brief
    Rural and Underserved Health Research Center
    Date: 02/2019
    Our study explores how a local hospital closure changes patient time in an ambulance for 9-1-1 calls. Access to emergency department services in communities, especially rural communities, persists as a priority for the Medicare program. We found when hospitals close, rural patients requiring ambulance services are disproportionately affected.

2018

2017

  • Rural-Urban Enrollment in Part D Prescription Drug Plans: June 2017 Update
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 12/2017
    As of June 2017, the percentage of rural enrollment in Part D plans, which include stand-alone prescription drug plans (PDPs) and Medicare Advantage with Prescription Drug (MA-PD) plans, lags urban enrollment despite significant growth overall in the number of Medicare beneficiaries with prescription drug coverage through Medicare Part D plans.
  • Ambulance Services for Medicare Beneficiaries: State Differences in Usage, 2012-2014
    Policy Brief
    Rural and Underserved Health Research Center
    Date: 10/2017
    Ambulance services are at risk of scaling back or dissolving in some places. We analyzed Medicare beneficiaries' use of ambulance services across the U.S. Improved understanding of how beneficiaries, most of whom are elderly, use these services provides vital information for policymakers who set rules and regulations about access to the services.

2016

2015

2010

  • Rural Health Snapshot 2010
    Rapid Response to Requests for Rural Data Analysis
    Date: 08/2010
    The Rural Health Snapshot displays selected indicators of access to healthcare, health behavior/risk factors, and mortality rates, comparing rural to urban residents.

2009

2008

2007

2006

2005

  • Community-Level Risk Factors for Depression Hospitalizations
    Policy Brief
    WICHE Center for Rural Mental Health Research
    Date: 09/2005
    This policy brief examines the association between depression hospitalization rates and community-level socio-demographic, economic, and healthcare system characteristics.
  • Utilization of Home Health Services Among Rural Medicare Beneficiaries Before and After the PPS
    NORC Walsh Center for Rural Health Analysis
    Date: 08/2005
    This report describes a study conducted on the rural effects of the PPS, including whether the PPS contributed to changes in the demographic and clinical characteristics of home care users, the likelihood of using each of six home care disciplines, and the intensity of services.
  • Rural Definitions for Health Policy and Research
    Journal Article
    WWAMI Rural Health Research Center
    Date: 07/2005

    Defining "rural" for health policy and research purposes requires researchers and policy analysts to specify which aspects of rurality are most relevant to the topic at hand and then select an appropriate definition. Rural and urban taxonomies often do not discuss important demographic, cultural, and economic differences across rural places-differences that have major implications for policy and research. Factors such as geographic scale and region also must be considered. Several useful rural taxonomies are discussed and compared in this article. Careful attention to the definition of "rural" is required for effectively targeting policy and research aimed at improving the health of rural Americans.

  • Rural Health Research in Progress in the Rural Health Research Centers Program, 9th Edition
    Maine Rural Health Research Center
    Date: 02/2005
    This book provides policymakers with a concise source of rural health services research underway in the Rural Health Research Centers funded by the Office of Rural Health Policy. It provides a context for legislation current that affects rural health services and populations.

2004

  • Obesity Prevalence in Rural Counties: A National Study
    WWAMI Rural Health Research Center
    Date: 01/2004
    Using a telephone survey of adults ages 18 and older residing in states participating in the Behavioral Risk Factor Surveillance System in 1994-96 and 2000-01, researchers found that the prevalence of obesity was 23% for rural adults and 20.5% for urban adults.

2003

2002

2000

  • Influence of Rural Residence on the Use of Preventative Health Care Services
    University of Minnesota Rural Health Research Center
    Date: 11/2000
    This paper details a study of the utilization of specific preventive healthcare services by rural women and men to assess the impact of rural residence, the availability of healthcare providers and technology, demographic factors, and health insurance status on the likelihood of obtaining several preventive healthcare services.

1999