Rural Health
Research Gateway

Social determinants of health

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

2024

2023

  • State Priorities and Needs: The Role of Block Grants
    Journal Article
    ETSU/NORC Rural Health Research Center
    Date: 11/2023
    This study looks at state-level funding allocations for 5 federal block grant programs from 2015-2019, and associations with state-level measures of need that align with the purposes of each block grant program.
  • Addressing Social Determinants of Health in Family Medicine Practices
    Journal Article
    Rural and Underserved Health Research Center
    Date: 10/2023
    This study evaluated physician, practice, and community characteristics as health care system elements to determine the ability of a primary care practice to address social determinants of health.
  • Key Informant Perspectives on Rural Housing and Health
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 10/2023
    In this policy brief, using content analysis of interview data, researchers share rural-specific housing barriers, including those that are related to health, as well as policy recommendations for addressing housing challenges to improve rural health.
  • 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).
  • Differences in Residential Stability by Rural/Urban Location and Socio-Demographic Characteristics
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 08/2023
    This policy brief identifies rural/urban differences in residential stability and examines rural/urban differences in regional, socio-demographic, and health characteristics associated with living in the same home for more than 20 years.
  • Eight Postpartum Support Programs in Rural Communities Across the United States
    University of Minnesota Rural Health Research Center
    Date: 08/2023
    This case study series highlights locally focused organizations working to improve postpartum health for rural residents across the United States. Interviews were conducted with eight unique organizations working in their local rural communities to support postpartum health.
  • 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.
  • Two National-Level Organizations Supporting Rural Postpartum Health Across the United States
    University of Minnesota Rural Health Research Center
    Date: 07/2023
    The purpose of this case study series is to highlight national-level organizations working in innovative ways to improve postpartum health for rural residents across the United States. These may serve as examples to others considering this work.
  • 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.
  • Rural Working-Age Adults Report More Cost Barriers to Health Care
    Policy Brief
    Maine Rural Health Research Center
    Date: 03/2023
    Using the 2019-2020 National Health Insurance Survey, this study examined rural-urban differences in affordability of care and cost-saving strategies among working-age adults.
  • Advancing the Age-Friendly Movement in Rural Communities
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 02/2023
    The research team looked at the role of Aging Life Care Managers® to help support the age-friendly movement in rural areas. The team explored ways in which Aging Life Care Managers® could advocate for the needs and interests of their clients, help them access care and support, and involve rural communities in the age-friendly movement.
  • Rural-Urban Differences in Workers' Access to Paid Sick Leave
    Journal Article
    Maine Rural Health Research Center
    Date: 02/2023
    The authors analyzed the prevalence of paid sick leave (PSL) among rural versus urban workers and found that rural workers had lower access to PSL than urban workers, even after adjusting for worker and employment characteristics.

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.
  • Examining the Association Between Rurality and Positive Childhood Experiences Among a National Sample
    Journal Article
    University of South Carolina Rural Health Research Center
    Date: 08/2022
    Using the full National Survey of Children's Health with all 50 states and the District of Columbia, this study examined rural-urban differences in positive childhood experiences.
  • 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.
  • Evaluating the Rural HIV/AIDS Planning Program
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 01/2022
    The purpose of this policy brief is to understand the overall experiences of the first grantee cohort (2020-21) of the Rural HIV/AIDS Planning Program. We pay particular attention to any barriers to or facilitators of successful grant implementation, and the sustainability of programs and acquisition of future funding.

2021

2020

  • Substance Use Among Rural and Urban Youth and Young Adults
    Policy Brief
    Maine Rural Health Research Center
    Date: 11/2020
    This study uses national data to examine rural-urban differences in the rates of substance use among youth and young adults. Findings can help inform rural-specific prevention strategies and research targeting rural communities.
  • 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.
  • 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

  • Healthy People 2020: Rural Areas Lag in Achieving Targets for Major Causes of Death
    Journal Article
    Southwest Rural Health Research Center
    Date: 12/2019
    For the period 2007-2017 rural death rates were higher than urban rates for the seven major causes of death analyzed, and disparities widened for five of the seven. In 2017 urban areas had met national targets for three of the seven causes, while rural areas had met none of the targets.
  • Preventive Health Service Use Among Rural Women
    Policy Brief
    Maine Rural Health Research Center
    Date: 04/2019
    This study used the National Health Interview Survey to examine differences in receipt of preventive health services among rural and urban women. It found that rural women are less likely to receive HPV vaccines and mammograms, even controlling for rural-urban sociodemographic and resource differences.

2018

  • Key Informant Perspectives on Rural Social Isolation and Loneliness
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 10/2018
    This policy brief uses data from interviews with 22 key informants in 12 states, all of whom were experts on the issue of social isolation and/or rural health, to describe key challenges and opportunities related to rural social isolation.
  • Practical Implications: Opioid-Affected Births to Rural Residents
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 09/2018
    This publication provides two physicians' reactions to research findings on rates of diagnosis of maternal opioid use disorder and infant neonatal abstinence syndrome at the time of childbirth for rural residents based on the type of hospital where the birth occurred.
  • Rural-Urban Differences in Risk Factors for Motor Vehicle Fatalities
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 09/2018
    This study uses 2017 County Health Rankings data to run stratified regression models to estimate county-level correlates of motor vehicle fatalities (MVFs) by rural and urban location. We found that rural counties have higher rates of MVFs than urban counties (22 vs. 14 per 100,000, p<0.001).
  • Non-Medical Opioid Use Among Rural and Urban Pregnant Women, 2007-2014
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 08/2018
    This policy brief presents data on rural-urban differences in non-medical opioid use among pregnant women to inform policy, programmatic, and clinical efforts to address this crisis.
  • Addressing Commuting as a Public Health Issue: Strategies Should Differ by Rurality
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 07/2018
    This policy brief estimates the rate of solo and long (greater than 30 minutes) solo car commutes by rurality and urban adjacency and identifies differences in factors that relate to commuting behavior.

2015

  • Care Coordination in Rural Communities Supporting the High Performance Rural Health System
    Report
    RUPRI Health Panel: Rural Policy Analysis and Applications
    Date: 06/2015
    This paper examines care coordination programs and processes that affect rural areas to discover what is happening in rural communities, how various programs and approaches are working, who benefits, and to make policy recommendations that will facilitate care coordination efforts in support of high performance rural health system development.

2005

  • The Effects of Rural Residence and Other Social Vulnerabilities on Subjective Measures of Unmet Need
    Journal Article
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 2005
    Are self-reports of unmet need a biased measure of access to healthcare? We examined the relationship between rural residence and perceived need for physician services and the likelihood of reporting a need for routine preventive care and/or specialty care using data from the National Survey of Children with Special Health Care Needs.