Social determinants of health

Completed Projects

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

2025

• Examining Differences in Rural and Urban Medicare FFS Beneficiaries' Emergency Department Use Pre-COVID-19 and During COVID-19
  This study described and compared the differences in the utilization of emergency department (ED) services among rural and urban Medicare Fee-For-Service (FFS) enrollees during 2018-2021. Researchers identified factors associated with differences in ED use, including shifts in volume, primary diagnoses, and admission source, before and since the COVID-19 public health emergency in rural and urban areas.
  Research center: ETSU/NORC Rural Health Research Center
  Topics: Coronavirus Disease 2019 (COVID-19), Critical Access Hospitals (CAHs), Emergency medical services (EMS) and trauma, Healthcare access, Hospitals and clinics, Medicare, Social determinants of health
  

2024

• Assessment of the Area Deprivation Index in Rural Areas
  The Area Deprivation Index (ADI) was created by University of Wisconsin researchers to provide a score for neighborhoods based on their level of disadvantage. This study characterized differences in ADI in rural vs urban areas, summarized the existing literature on ADI, and described expert considerations for utilizing the ADI for future policy.
  Research center: ETSU/NORC Rural Health Research Center
  Topics: Frontier health, Poverty, Rural statistics and demographics, Social determinants of health
  
• Housing as a Social Determinant of Rural Health
  The purpose of this project was to identify rural/urban and within-rural differences in housing quality and its relationship to health and disability status, especially for individuals living in poverty. We also identified rural-specific housing issues and innovative policy solutions to address housing challenges in order to improve rural health.
  Research center: University of Minnesota Rural Health Research Center
  Topics: Disabilities, Environmental and agricultural health, Poverty, Public health, Rural statistics and demographics, Social determinants of health
  
• Medicare Advantage Plan Growth in Rural America: Opportunities for Beneficiaries?
  County Medicare Advantage enrollment data and plan characteristic data were used to create a model accounting for the availability of plans offering benefits addressing social determinants of health. Analyses compared rural and urban counties, and examined county characteristics to explore opportunities for rural beneficiaries because of geography and other factors.
  Research center: RUPRI Center for Rural Health Policy Analysis
  Topics: Medicare, Medicare Advantage (MA), Medicare Part D, Social determinants of health, Telehealth, Transportation
  
• Rural-Urban Differences in Domestic Violence as a Contributor to Maternal Morbidity and Mortality
  Using 2016-2020 data from the Pregnancy Risk Assessment Monitoring System from the Centers for Disease Control and Prevention, this project assessed the prevalence of domestic violence among rural and urban residents who give birth. We also analyzed how screening and support services could be improved to support rural families that experience domestic violence, including during pregnancy and the postpartum period.
  Research center: University of Minnesota Rural Health Research Center
  Topics: Maternal health, Social determinants of health, Violence and abuse, Women
  

2023

• Assessing Geographic Variability in Key Indicators of Water Quality and Air Quality: A Comparison of Urban vs. Rural Communities
  The purpose of this project was to compare air and water quality indicators across U.S. Census tracts specifically focusing on rural vs. urban differences.
  Research center: University of South Carolina Rural Health Research Center
  Topics: Environmental and agricultural health, Public health, Social determinants of health
  
• Rural Family Physicians' Ability to Address Patients' Social Drivers of Health Needs
  This project examines how practice-level and community-level characteristics are associated with a family physician's assessment of their practice's ability to address patients' social needs.
  Research center: Rural and Underserved Health Research Center
  Topics: Physicians, Poverty, Social determinants of health
  
• Rural Health Access: Affordability and Barriers to Care
  Rural-urban comparisons of healthcare access and affordability predate many policy reform efforts aimed at increasing access and decreasing costs—ongoing concerns of rural families. This study used 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 reform, Health services, Healthcare access, Healthcare financing, Private health insurance, Public health, Social determinants of health
  
• The Direct Care Workforce in Rural Areas
  In this study, we measured the supply of long-term care services and supports (LTSS) direct care workers relative to older adult populations in rural and urban areas and measure employer and industry turnover among LTSS direct care workers. We also explored how compensation levels – including wages and employer-based health insurance – are related to and predict worker turnover in the LTSS direct care workforce in rural and urban areas.
  Research center: University of Minnesota Rural Health Research Center
  Topics: Aging, Allied health professionals, Health services, Home health, Long-term care, Post-acute care, Poverty, Rural statistics and demographics, Social determinants of health, Workforce
  

2022

• Aging in Place in Rural America: What Does It Look Like and How Can It Be Supported?
  In general, people want to age in place. This project looked at the structures in place to help them do so and how those structures vary by rurality. Federal, state, and local policy implications for improving health outcomes and quality of life for rural older adults aging in place were also be identified.
  Research center: University of Minnesota Rural Health Research Center
  Topics: Aging, Disabilities, Healthcare access, Home health, Long-term care, Social determinants of health
  
• Living Alone: Rural-Urban Differences in Prevalence, Socio-Demographic Correlates, and Health Needs Across the Lifespan
  This project's purpose was to document rural-urban differences in the prevalence of living alone across different age groups, describe rural-urban differences in the socio-demographic correlates and health needs of individuals living alone, and identify rural-relevant policies and programs to support rural residents living alone across the lifespan.
  Research center: University of Minnesota Rural Health Research Center
  Topic: Social determinants of health
  
• Northern Border Regional Commission State and Region Chartbooks: A Health-Focused Landscape Analysis
  The aim of this study was to compile the most recent publicly available data related to health and healthcare access at the county-level and state-level for the Norther Border Region and the individual states: ME, NH, VT, and NY. We highlighted counties with worse health outcomes, as compared to the rest of the counties in the region.
  Research center: Maine Rural Health Research Center
  Topics: Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), Rural statistics and demographics, Social determinants of health, Substance use and treatment, Telehealth, Uninsured and underinsured, Workforce
  

2021

• The Association of Occupation with Mental Illnesses and Death by Suicide
  This study examined the association of occupational risk factors with mental illnesses, all-cause mortality, and suicide.
  Research center: Rural and Underserved Health Research Center
  Topics: Mental and behavioral health, Social determinants of health
  

2016

• Exploring Rural and Urban Mortality Differences
  This project examines the impact of rurality on mortality and explores the regional differences in the primary and underlying causes of death. It also explores the role of the rural public health systems in addressing social determinants of health.
  Research center: North Dakota and NORC Rural Health Reform Policy Research Center
  Topics: Public health, Social determinants of health