Rural Health
Research Gateway

Social determinants of health

Current Projects

  • Addressing Elder Abuse in Rural Areas
    Elder abuse, including financial, physical, and emotional abuse, as well as self-neglect, is widespread and impacts individual and population health outcomes. However, despite the fact that rural residents are older, in poorer health, and more financially vulnerable, little is known about rural/urban differences in the prevalence of and resources to address elder abuse; this project will address those gaps.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Aging, Disabilities, Health disparities and health equity, Social determinants of health, Violence and abuse
  • 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 will characterize differences in ADI in rural vs urban areas, summarize the existing literature on ADI, and describe expert considerations for utilizing the ADI for future policy.
    Research center: Rural Health Equity Research Center
    Topics: Frontier health, Health disparities and health equity, Poverty, Rural statistics and demographics, Social determinants of health
  • Clinical-Community Linkages in Non-Metropolitan and Metropolitan Hospitals: COVID-19 Impacts and Trends
    This study will examine trends in partnerships between hospitals and public health departments and other community linkages in both non-metropolitan and metropolitan hospitals with a particular focus on the impact of the COVID-19 pandemic.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Coronavirus Disease 2019 (COVID-19), Critical Access Hospitals (CAHs), Health services, Hospitals and clinics, Networking and collaboration, Public health, Social determinants of health
  • Concordance Between Social Needs Screening Provision, Programming, and Partnerships in Rural PPS Hospitals
    This study will examine how rural Prospective Payment System (PPS) hospitals differ from urban hospitals concerning social needs screening practices and alignment between social needs screening performance and corresponding programs/strategies and/or community partnerships to address social needs.
    Research center: RUPRI Center for Rural Health Policy Analysis
    Topics: Health services, Hospitals and clinics, Medicare Prospective Payment System (PPS), Networking and collaboration, Social determinants of health
  • Examining Differences in Rural and Urban Medicare FFS Beneficiaries' Emergency Department Use Pre-COVID-19 and During COVID-19
    This study describes and compares the differences in the utilization of emergency department (ED) services among rural and urban Medicare Fee-For-Service enrollees during 2018-2021. We will identify 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: Rural Health Equity Research Center
    Topics: Coronavirus Disease 2019 (COVID-19), Critical Access Hospitals (CAHs), Emergency medical services (EMS) and trauma, Health disparities and health equity, Healthcare access, Hospitals and clinics, Medicare, Social determinants of health
  • Extent and Coverage of Rural PACE Services
    Supporting independent living and aging in place for rural residents is more important than ever. This project will provide information on the extent and coverage of rural Program of All-Inclusive Care for the Elderly (PACE) programs, along with insights into the unique challenges and opportunities faced by PACE programs operating in rural areas.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Aging, Disabilities, Health disparities and health equity, Healthcare access, Home health, Social determinants of health
  • Geographic and Socio-Demographic Correlates of Medical Debt Among Rural Residents
    Medical debt is widespread and impacts financial well-being and access to care. While research suggests that medical debt is higher among rural residents compared to urban residents, more work is needed to conclusively demonstrate rural/urban differences in medical debt and within-rural risk factors for greater medical debt by geography and socio-demographic characteristics.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Health disparities and health equity, Healthcare access, Poverty, Public health, Rural statistics and demographics, Social determinants of health
  • Housing as a Social Determinant of Rural Health
    The purpose of this project is 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 will also identify 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, Health disparities and health equity, Poverty, Public health, Rural statistics and demographics, 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: Rural and Minority Health Research Center
    Topics: Chronic diseases and conditions, Diabetes, Health disparities and health equity, Healthcare access, Maternal health, Obesity, Oral health, Physicians, Poverty, Public health, Rural statistics and demographics, Social determinants of health, Uninsured and underinsured, Workforce
  • Improving Racial Equity for Rural Mothers and Infants
    The purpose of this project is to assess differences in maternal and infant health outcomes and access to perinatal care, among urban and rural counties. We will also compare health outcomes and availability of services, including evidence-based services and supports, between rural counties that are majority Black, Indigenous, and People of Color with those that are majority white.
    Research center: University of Minnesota Rural Health Research Center
    Topics: American Indians and Alaska Natives, Critical Access Hospitals (CAHs), Health disparities and health equity, Healthcare access, Hospitals and clinics, Maternal health, Minority health, Rural statistics and demographics, Social determinants of health, Women
  • Medicare Advantage Plan Growth in Rural America: Opportunities for Beneficiaries?
    County Medicare Advantage enrollment data and plan characteristic data will be used to create a model accounting for the availability of plans offering benefits addressing social determinants of health. Analyses will compare rural and urban counties, and examine county characteristics to explore potential equitable 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
  • Postpartum Morbidity and Mortality and Health Care Utilization in Rural vs. Urban Communities
    Using 2006-2018 data from the National Health Interview Survey linked to the National Death Index through 2019, this project will examine postpartum mortality among rural and urban residents. We will also evaluate differences in health, health care utilization, and barriers to care across rural and urban communities.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Health disparities and health equity, Healthcare access, Maternal health, Medicaid and CHIP, Mental and behavioral health, Private health insurance, Social determinants of health, Uninsured and underinsured, Women
  • Review of Current Research on Rural/Urban Differences in Social Determinants of Health
    Social determinants of health are social, economic, and community variables that influence health outcomes. This project will synthesize the extant literature on rural/urban differences in the social determinants of health, culminating in a comprehensive report that includes a summary of information gaps and further research needs.
    Research center: Rural and Underserved Health Research Center
    Topics: Health disparities and health equity, Healthcare access, Poverty, Quality, Social determinants of health, Uninsured and underinsured
  • Rural-Urban Differences in Domestic Violence as a Contributor to Maternal Morbidity and Mortality
    Using 2016-2020 data from the CDC's Pregnancy Risk Assessment Monitoring System, this project will assess the prevalence of domestic violence among rural and urban residents who give birth. We will also analyze 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
  • Socioeconomic Profiles and Market Characteristics Associated with Ambulance Deserts
    We will address the extent to which vulnerable, aging populations live in ambulance deserts and identify ambulance desert populations facing additional barriers to healthcare access. We will also assess the impact of hospital closures on travel distances to the nearest health care facilities.
    Research center: Maine Rural Health Research Center
    Topics: Emergency medical services (EMS) and trauma, Healthcare access, Rural statistics and demographics, Social determinants of health, Transportation
  • Specialist Physicians in the Rural and Urban U.S.: Supply, Distribution, and Access
    This project will describe the geographic distribution (rural/urban, regional, and intra-rural) of specialist physicians who care for patients experiencing conditions that account for the top four leading causes of rural mortality. It will also explore how patients in rural communities that lack these specialists obtain needed care.
    Research center: WWAMI Rural Health Research Center
    Topics: Cancer, Care management, Chronic diseases and conditions, Frontier health, Health disparities and health equity, Health services, Healthcare access, Physicians, Social determinants of health, Telehealth, Workforce
  • Use of Z Codes by Rural and Urban Providers to Capture Data on the Social Determinants of Health Impacting Medicare Beneficiaries
    Using a mixed methods approach, we will examine the use of Z codes by rural and urban providers to better capture information on the social determinants of health experienced by Medicare beneficiaries across the rural continuum.
    Research center: Maine Rural Health Research Center
    Topics: Health services, Medicare, Physicians, Social determinants of health