This website is being reviewed for updates. Some information is offline. We apologize for any inconvenience.
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, Social determinants of health, Violence and abuse
  • Availability and Characteristics of Outpatient and Residential Substance Use Treatment in Rural and Urban Areas
    This study will look at: 1) the availability of residential and outpatient treatment centers in rural and urban counties, including identifying counties with no facilities; and 2) characteristics of services offered (e.g., residential, outpatient), demographics of persons treated, and insurance plans accepted by rural vs urban centers.
    Research center: Rural and Underserved Health Research Center
    Topics: Health services, Healthcare access, Mental and behavioral health, Pharmacy and prescription drugs, Social determinants of health, Substance use and treatment
  • Comparing Across Health Indices: Differences by Rurality, Missingness, and Associations With Health Outcomes
    The purpose of this study is to describe and compare existing area-level indices of vulnerability by rurality and to examine associations between indices and health outcomes of interest by area-level measures of rurality.
    Research center: ETSU/NORC Rural Health Research Center
    Topics: Healthcare access, Poverty, Rural statistics and demographics, Social determinants of health, Uninsured and underinsured
  • 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
  • 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
  • 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, 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: Healthcare access, 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: 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
  • Improving Health for "Homebound" Older Adults in Rural and Urban Areas
    This project will describe rural-urban differences in the risk of, and characteristics associated with, being classified as "homebound." We will also identify policy and programmatic interventions to reduce the risk of becoming homebound as well as to improve outcomes for those who are homebound.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Aging, Disabilities, Home health, Rural statistics and demographics, Social determinants of health
  • 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: 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 Drivers of Health
    Social drivers 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 drivers 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: Healthcare access, Poverty, Quality, Social determinants of health, Uninsured and underinsured
  • Rural and Urban Sepsis Outcomes as a Measure of Health Care Quality: A Nationwide Comparative Analysis Using HCUP Data
    This study examines differences in sepsis prevalence, outcomes, costs, and treatment between rural and urban hospitals using the HCUP Nationwide Readmissions Database. It aims to inform policies related to access to timely, high-quality sepsis care and identify strategies to enhance healthcare outcomes across diverse hospital settings.
    Research center: ETSU/NORC Rural Health Research Center
    Topics: Care management, Critical Access Hospitals (CAHs), Emergency medical services (EMS) and trauma, Healthcare access, Hospitals and clinics, Medicaid and CHIP, Medicare, Medicare Advantage (MA), Private health insurance, Quality, Social determinants of health
  • Rural-Urban Differences in Access to and Quality of Care for People With Disabilities
    The purpose of this project is to identify rural-urban differences in access to and quality of health care services for people with disabilities. Results from this project will help inform policy to improve access to and quality of care for this growing population in rural areas.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Aging, Disabilities, Healthcare access, Quality, Social determinants of health
  • 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 services, Healthcare access, Physicians, Social determinants of health, Telehealth, Workforce