Rural statistics and demographics: Rural Health Research Products & Journal Articles

2025

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.

2024

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.

2023

Medicare Advantage Enrollment Update 2023
Policy Brief
RUPRI Center for Rural Health Policy Analysis, Rapid Response to Requests for Rural Data Analysis
Date: 11/2023
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.
Unmet Needs for Help With Mobility Limitations Among Older Adults Aging in Place: The Role of Rurality
Journal Article
University of Minnesota Rural Health Research Center
Date: 10/2023
This study identifies differences in unmet mobility needs among older adults by rurality. It uses data from the National Health and Aging Trends Study, limiting analyses to respondents who had not moved since baseline (average housing tenure of 27 years; n = 3343).
Distributional Analysis of Variation in Medicare Advantage Participation Within and Between Metropolitan, Micropolitan, and Noncore Counties
Policy Brief
RUPRI Center for Rural Health Policy Analysis, Rapid Response to Requests for Rural Data Analysis
Date: 08/2023
This brief identifies patterns and trends in Medicare Advantage participation (penetration rates, number of plans, and enrollment), both within and across metropolitan and nonmetropolitan counties.
Multi-Sector Collaboration to Support Rural Aging
Journal Article
University of Minnesota Rural Health Research Center
Date: 08/2023
In this paper, researchers examine the lessons rural areas present for supporting aging, including the role that aging and social services, public health systems, and health care have to play.
Rural/Urban Differences in Rates and Predictors of Intimate Partner Violence and Abuse Screening Among Pregnant and Postpartum United States Residents
Journal Article
University of Minnesota Rural Health Research Center
Date: 08/2023
This paper uses the 2016-2020 Pregnancy Risk Assessment Monitoring System (PRAMS) data to describe rates and predictors of perinatal intimate partner violence (IPV) and rates and predictors of not being screened for abuse among rural and urban IPV victims who gave birth.
Ambulance Deserts: Geographic Disparities in the Provision of Ambulance Services
Chartbook
Maine Rural Health Research Center
Date: 05/2023
Access to timely ambulance service is an essential part of the emergency medical system. Yet ambulance access varies widely with significant gaps across the country. This research identifies places and people that are more than 25 minutes from an ambulance station, also called an ambulance desert.
Rural and Urban Differences in Insurance Coverage at Prepregnancy, Birth, and Postpartum
Journal Article
University of Minnesota Rural Health Research Center
Date: 03/2023
In this manuscript, the research team used data from the Pregnancy Risk Assessment Monitoring System to measure insurance coverage at prepregnancy, birth, and postpartum, and insurance coverage continuity across these periods among rural and urban U.S. residents.
Rural Healthy People 2030: New Decade, New Challenges
Journal Article
Southwest Rural Health Research Center
Date: 03/2023
This study reports the findings of Rural Healthy People 2030, a companion piece to the Healthy People 2030 initiative with a focus on health priorities of rural populations. Data was collected from a survey given to rural stakeholders. Mental health, substance use, health care access, and economic stability were among the most important priorities.

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

"They're Not Leaving Their Home; This Is Where They Were Born, This Is Where They Will Die.": Key Informant Perspectives From the U.S. Counties With the Greatest Concentration of the Oldest Old
Journal Article
University of Minnesota Rural Health Research Center
Date: 07/2021
Researchers share interview results with key informants from 50 rural U.S. counties with the highest percentage of the residents ages 85 and older or the "oldest old." Respondents shared unique challenges to serving this population, as well as positive attributes of rural communities that make them attractive places for growing older.
Tracking the Geographic Distribution and Growth of Clinicians With a DEA Waiver to Prescribe Buprenorphine to Treat Opioid Use Disorder
Journal Article
WWAMI Rural Health Research Center
Date: 03/2021
The increase in clinicians who can prescribe buprenorphine improves access to treatment for opioid use disorder. Small remote rural communities continue to experience access challenges. 63.1% of all rural counties had at least one clinician with a Drug Enforcement Administration waiver, but more than half of small remote rural counties did not.
Rural HIV Prevalence and Service Availability in the United States: A Chartbook
Chartbook
Maine Rural Health Research Center
Date: 02/2021
This chartbook examines 2016 HIV prevalence and the availability of HIV prevention, testing, and treatment services across the rural-urban continuum and by U.S. census region.

2020

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.

2018

The Importance of Rural Hospitals: Transfers and 30-day Readmissions Among Rural Residents and Patients Presenting at Rural Hospitals
Journal Article
University of South Carolina Rural Health Research Center
Date: 07/2018
This study looked at reasons why transfers and readmissions occurred among Medicare patients who first came to rural hospitals.

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.

2016

Telemedicine Penetration and Consultation Among Rural Trauma Patients in Critical Access Hospital Emergency Departments in North Dakota
Policy Brief
Rural Telehealth Research Center
Date: 09/2016
This study describes the penetration of ED-based telemedicine in North Dakota critical access hospitals and its use for rural trauma patients. Investigators showed that telemedicine subscription increased to 81 percent of rural North Dakota hospitals, and 11 percent of patients in a telemedicine-capable ED used telemedicine as part of their care.

2015

Rural Adults Delay, Forego, and Strategize to Afford Their Pre-ACA Health Care
Policy Brief
Maine Rural Health Research Center
Date: 11/2015
This study provides detailed information about rural-urban differences among adults younger than age 65 in perceived affordability of health insurance coverage and services prior to implementation of the Affordable Care Act.
Rural Disabled Medicare Beneficiaries Spend More Out-of-Pocket Than Their Urban Counterparts
Policy Brief
Maine Rural Health Research Center
Date: 11/2015
Most beneficiaries seek added coverage to close the gap between the care they need and the costs covered by Medicare. This study evaluated rural-urban differences in out-of-pocket spending, supplemental coverage, and variation in spending by type of service.
A Rural Taxonomy of Population and Health-Resource Characteristics
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 04/2015
This brief reports the newly developed taxonomy of rural places based on relevant population and health-resource characteristics and discusses how this classification tool can be utilized by policymakers and rural communities.
Use and Performance Variations in U.S. Rural Emergency Departments: Implications for Improving Care Quality and Reducing Costs
Policy Brief
North Dakota and NORC Rural Health Reform Policy Research Center
Date: 02/2015
This brief describes the variation in emergency department use for non-emergent health conditions across rural and urban areas as well as by U.S. Census regions. Potential risk factors, including patients' socioeconomic characteristics and levels of primary care resources, are identified. Quality of care indicators are also addressed.

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

Impact of the Recession on Rural America: Rising Unemployment Leading to More Uninsured in 2009
RUPRI Center for Rural Health Policy Analysis
Date: 06/2009
This brief presents the results of state and county analysis of unemployment rates nationally in urban and rural (non-metropolitan) areas during the period 2007-February 2009 and discusses the impact of rising unemployment on uninsurance in rural areas.
Profile of Rural Health Insurance Coverage: A Chartbook
Maine Rural Health Research Center
Date: 06/2009
Analyses of persons under age 65 from the 2004-05 Medical Expenditure Panel Survey reveal a greater proportion of rural vs. urban residents who are uninsured or covered through public sources. Uninsured rates are highest among adults over age 50 in the most remote rural places.
Rural Issues Related to Comparative Effectiveness Research and Dissemination
Policy Brief
Upper Midwest Rural Health Research Center
Date: 06/2009
This brief describes strategies for expanding clinical research in rural environments; implementing practice guidelines in rural settings; and improving access to current evidence-based information for rural health professionals and patients.
Private Health Insurance in Rural Areas: Challenges and Opportunities
Policy Brief
Maine Rural Health Research Center
Date: 04/2009
This brief discusses the challenges of expanding private coverage in rural areas and describes policy options to address them.

2008

Distribution of Substance Abuse Treatment Facilities Across the Rural - Urban Continuum (Research & Policy Brief)
Policy Brief
Maine Rural Health Research Center
Date: 02/2008
This research and policy brief highlights findings from a recent study examining the distribution of substance abuse treatment facilities in rural and urban counties and identifying the type and intensity of services provided.

2007

State Updates on Medicare Advantage Enrollment
RUPRI Center for Rural Health Policy Analysis
Date: 12/2007
This list contains reports for each state with the number of persons enrolled in Medicare Advantage and prepaid plans in December 2005 and September 2007 in rural and urban areas.
Distribution of Substance Abuse Treatment Facilities Across the Rural - Urban Continuum
Maine Rural Health Research Center
Date: 10/2007
This study examines the distribution of substance abuse treatment services across the continuum of rural and urban counties, identifying the type and intensity of services provided.

2006

Out-of-Pocket Health Spending and the Rural Underinsured
Journal Article
Maine Rural Health Research Center
Date: 11/2006
This article estimates underinsurance rates among privately insured rural residents and the characteristics associated with rural underinsurance.
Differences Between Newly Admitted Nursing Home Residents in Rural and Nonrural Areas in a National Sample
Journal Article
Southwest Rural Health Research Center
Date: 02/2006
This research investigates whether differences in acuity are a function of differences in resident payer status and occur for both individuals admitted for short stays, with Medicare as payer, and those needing chronic care.
Rural Health Research in Progress in the Rural Health Research Centers Program, 10th Edition
Maine Rural Health Research Center
Date: 02/2006
This book provides policy makers with a concise source of rural health services research underway in the Rural Health Research Centers funded by the Office of Rural Health Policy and provides a context for legislation that affects rural health services and populations.

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

Rural Health Research in Progress in the Rural Health Research Centers Program, 7th edition
Maine Rural Health Research Center
Date: 03/2003
This book provides policy makers 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 and proposed that affects rural health services and populations.

2002

Changing Rural Populations and Impact on Public Policy
RUPRI Center for Rural Health Policy Analysis
Date: 10/2002
This document is from a presentation on population movement in rural areas and health policy issues.

1999

Metropolitan, Urban and Rural Commuting Areas: Toward a Better Depiction of the U.S. Settlement System
Journal Article
WWAMI Rural Health Research Center
Date: 1999
Analyzes 1990 census-defined urbanized areas and tract-to-tract commuter flows. Results include a modest shift of population from metropolitan to nonmetropolitan, as well as a significant reduction in the areal size of metropolitan areas, disaggregation of many areas, and frequent reconfiguration to a more realistic settlement form.