Rural Health
Resources by State: California
State Innovations in Improving Access to Care for Adults with Complex Needs in Rural Communities
Discusses Medicaid policy and financing strategies that can help improve rural delivery systems and access to care for rural older adults, people with disabilities, and others with complex health and social needs. Describes effective approaches undertaken in California, Missouri, North Dakota, South Dakota, and Virginia across three promising strategies. Identifies four factors critical to successful program design and implementation and key considerations for states.
Author(s): Molly Knowles, Nida Enehizena, Gretchen Bell, Ellen Breslin
Date: 07/2026
Sponsoring organization: Center for Health Care Strategies
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Discusses Medicaid policy and financing strategies that can help improve rural delivery systems and access to care for rural older adults, people with disabilities, and others with complex health and social needs. Describes effective approaches undertaken in California, Missouri, North Dakota, South Dakota, and Virginia across three promising strategies. Identifies four factors critical to successful program design and implementation and key considerations for states.
Author(s): Molly Knowles, Nida Enehizena, Gretchen Bell, Ellen Breslin
Date: 07/2026
Sponsoring organization: Center for Health Care Strategies
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Food Service Directors' Knowledge and Beliefs About Ultraprocessed Foods in California's San Joaquin Valley Schools
Examines food service director (FSD) perspectives on ultraprocessed foods (UPFs) while planning meals for schools in the largely rural San Joaquin Valley of California. Utilizes interview data from 20 FSDs and discusses themes such as healthfulness of UPFs, scratch-cooked foods versus UPFs, and reasons for including or not including UPFs in school menus.
Author(s): Anjali Gupta, Alix Zuceth Duran Gomez, Donna Matheson, et al.
Citation: Preventing Chronic Disease, 23
Date: 07/2026
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Examines food service director (FSD) perspectives on ultraprocessed foods (UPFs) while planning meals for schools in the largely rural San Joaquin Valley of California. Utilizes interview data from 20 FSDs and discusses themes such as healthfulness of UPFs, scratch-cooked foods versus UPFs, and reasons for including or not including UPFs in school menus.
Author(s): Anjali Gupta, Alix Zuceth Duran Gomez, Donna Matheson, et al.
Citation: Preventing Chronic Disease, 23
Date: 07/2026
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When Ambulances Wait at the Emergency Department: Hospital Factors and Offload times in California
Analyzes ambulance patient offload time (APOT) between emergency medical services (EMS) and 310 emergency departments (ED) in California in 2022 to determine associations with hospital characteristics including rurality and number of ED treatment stations. The study data precedes a 2023 state law establishing statewide standards for APOT and so aims to offer baseline metrics for understanding policy impact.
Author(s): Esmeralda Melgoza, Madeline Fedmeier, Crystal Chen, Hiram Beltrán-Sánchez, Renee Y. Hsia
Citation: Health Affairs Scholar, 4(5)
Date: 05/2026
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Analyzes ambulance patient offload time (APOT) between emergency medical services (EMS) and 310 emergency departments (ED) in California in 2022 to determine associations with hospital characteristics including rurality and number of ED treatment stations. The study data precedes a 2023 state law establishing statewide standards for APOT and so aims to offer baseline metrics for understanding policy impact.
Author(s): Esmeralda Melgoza, Madeline Fedmeier, Crystal Chen, Hiram Beltrán-Sánchez, Renee Y. Hsia
Citation: Health Affairs Scholar, 4(5)
Date: 05/2026
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Distance to a Drying Saline Lake and Lung Function Development in a Rural Border Cohort of Children
Examines the relationship between children's lung function and proximity to the drying Salton Sea in rural southeastern California. Analyzes lung function of 369 first to third grade children with breakdowns according to demographics, health factors, air pollution, and proximity to the Salton Sea.
Author(s): Fangqi Guo, Elizabeth M. Kamai, Sandrah P. Eckel, et al.
Citation: JAMA Network Open, 9(4), e264812
Date: 04/2026
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Examines the relationship between children's lung function and proximity to the drying Salton Sea in rural southeastern California. Analyzes lung function of 369 first to third grade children with breakdowns according to demographics, health factors, air pollution, and proximity to the Salton Sea.
Author(s): Fangqi Guo, Elizabeth M. Kamai, Sandrah P. Eckel, et al.
Citation: JAMA Network Open, 9(4), e264812
Date: 04/2026
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Racial and Ethnic Disparities in Access to Acute Stroke Capabilities in California: Association with Rurality and Telestroke Access
Examines disparities in presentation to emergency departments (EDs) with or without acute stroke capability among patients with acute stroke by race and ethnicity, and variations in these associations by patient rurality and ED telestroke status, using 2021 NEDI-California and NEDI-USA survey data.
Author(s): Kori S. Zachrison, Renee Y. Hsia, Krislyn M. Boggs, et al.
Citation: Journal of Stroke & Cerebrovascular Diseases, 35(4), 108607
Date: 04/2026
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Examines disparities in presentation to emergency departments (EDs) with or without acute stroke capability among patients with acute stroke by race and ethnicity, and variations in these associations by patient rurality and ED telestroke status, using 2021 NEDI-California and NEDI-USA survey data.
Author(s): Kori S. Zachrison, Renee Y. Hsia, Krislyn M. Boggs, et al.
Citation: Journal of Stroke & Cerebrovascular Diseases, 35(4), 108607
Date: 04/2026
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Selected Rural Healthcare Facilities in California
Shows the state's Critical Access Hospitals (CAHs), Rural Emergency Hospitals (REHs), and Rural Health Clinics (RHCs), as well as Federally Qualified Health Center (FQHC) sites and short term/PPS (Prospective Payment System) hospitals located in rural areas.
Additional links: California Rural Health Facility Table
Date: 04/2026
Sponsoring organization: Rural Health Information Hub
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Shows the state's Critical Access Hospitals (CAHs), Rural Emergency Hospitals (REHs), and Rural Health Clinics (RHCs), as well as Federally Qualified Health Center (FQHC) sites and short term/PPS (Prospective Payment System) hospitals located in rural areas.
Additional links: California Rural Health Facility Table
Date: 04/2026
Sponsoring organization: Rural Health Information Hub
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Assessing Healthcare Access among Residents in Rural Eastern San Diego County: A Qualitative Study
Examines patient healthcare experiences, healthcare access, and public health infrastructure in rural Eastern San Diego County. Utilizes interview data from 24 residents and discusses issues such as geographical isolation, financial constraints, transportation issues, administrative burdens, limited access to rural aging health programming, and public health infrastructure.
Author(s): Loretta Sosa Ortiz, Pamela Padilla, Gina Chung, et al.
Citation: BMC Primary Care, 27, 149
Date: 03/2026
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Examines patient healthcare experiences, healthcare access, and public health infrastructure in rural Eastern San Diego County. Utilizes interview data from 24 residents and discusses issues such as geographical isolation, financial constraints, transportation issues, administrative burdens, limited access to rural aging health programming, and public health infrastructure.
Author(s): Loretta Sosa Ortiz, Pamela Padilla, Gina Chung, et al.
Citation: BMC Primary Care, 27, 149
Date: 03/2026
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Access to Oral Health Care in California: Barriers and Opportunities
Issue brief summarizing the state of oral health care access in California and prior efforts to address this issue. Discusses geographic barriers for people in rural areas, and Dental Health Professional Shortage Areas in California.
Author(s): Miranda Davis, Elizabeth Mertz
Date: 03/2026
Sponsoring organization: Healthforce Center at UCSF
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Issue brief summarizing the state of oral health care access in California and prior efforts to address this issue. Discusses geographic barriers for people in rural areas, and Dental Health Professional Shortage Areas in California.
Author(s): Miranda Davis, Elizabeth Mertz
Date: 03/2026
Sponsoring organization: Healthforce Center at UCSF
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Assessment of Rebound in Cancer Diagnoses in California in 2022, by Stage, Sociodemographic Factors, and Rurality
Examines how cancer diagnoses differed in California in 2022 by sociodemographic and geographic group, using 2001-2022 NCI SEER data. See Supplementary Tables for data breakdowns by cancer type and level of rurality.
Author(s): Erin L. Van Blarigan, Alison J. Canchola, Li Zhu, et al.
Citation: Cancer Epidemiology, Biomarkers & Prevention, 35(3), 415-419
Date: 03/2026
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Examines how cancer diagnoses differed in California in 2022 by sociodemographic and geographic group, using 2001-2022 NCI SEER data. See Supplementary Tables for data breakdowns by cancer type and level of rurality.
Author(s): Erin L. Van Blarigan, Alison J. Canchola, Li Zhu, et al.
Citation: Cancer Epidemiology, Biomarkers & Prevention, 35(3), 415-419
Date: 03/2026
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A Stubborn Problem: Unaffordable Health Costs Continue to Strain Californians' Finances
Examines healthcare affordability in California from 2019 to 2024, comparing pre-COVID-19 pandemic experiences to after the pandemic had subsided, alongside the implementation of related state and federal policy impacting affordability. Provides percentages of Californians who have trouble paying medical bills, who use credit cards to pay medical bills, who have private insurance with deductibles above $2,000, and more, according to coverage type, demographics, region, and rural versus urban location.
Date: 03/2026
Sponsoring organization: State Health Access Data Assistance Center
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Examines healthcare affordability in California from 2019 to 2024, comparing pre-COVID-19 pandemic experiences to after the pandemic had subsided, alongside the implementation of related state and federal policy impacting affordability. Provides percentages of Californians who have trouble paying medical bills, who use credit cards to pay medical bills, who have private insurance with deductibles above $2,000, and more, according to coverage type, demographics, region, and rural versus urban location.
Date: 03/2026
Sponsoring organization: State Health Access Data Assistance Center
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