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Rural Health
Resources by Topic: Rural-urban differences

Impact of COVID-19 on Clinical Trials Costs to Patients
Examines the direct and indirect costs of COVID-19 clinical trial participation to patients and the impact of utilizing remote technologies. Presents an environmental scan of articles published between 2010 and 2023 and discusses barriers to clinical trial participation experienced by underrepresented and rural populations.
Author(s): Keri Calkins, Emily Crabtree, Emily Harrison, Nyna Williams, Kirsten Barrett
Date: 06/2025
Type: Document
Sponsoring organization: Mathematica
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Screening and Referral Programs for Diabetes and Cardiovascular Disease: Can Community Pharmacists Bridge the Care Gap?
Examines the community-based valued-driven care initiative (CVCI) in community pharmacies to evaluate its effectiveness related to screening and referral (S&R) to treat cardiovascular disease (CVD) and diabetes mellitus (DM). Analyzes patient demographics and success rates of CVD and DM S&R in 6 community pharmacies, with both rural and urban locations represented.
Author(s): Melanie Livet, Amber Watson, Shweta Pathak, et al.
Citation: Exploratory Research in Clinical and Social Pharmacy, 17, 100539
Date: 03/2025
Type: Document
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Eighth Biennial Report 2025: Health Issues for the State of North Dakota
Updates the previous seven editions of this report with a comprehensive examination of healthcare workforce licensure data related to number of licensed professionals, locations, specialties, and demographics in rural and urban North Dakota. Includes three new chapters on indigenous health, women's and children's health, and the community impacts of the School of Medicine and Health Sciences.
Additional links: Executive Summary
Date: 01/2025
Type: Document
Sponsoring organization: University of North Dakota School of Medicine & Health Sciences
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Evaluating Access to Psychosocial Services for the Medicaid-Insured Children in Georgia
Assesses mental health workforce supply and demand for psychosocial services for the Medicaid-insured children in Georgia, and examines the impact of policy interventions to increase availability of services for the Medicaid-insured population. Analyzes factors associated with unmet demand, including data on rurality, travel distance, and more.
Author(s): Yujia Xie, Pravara Harati, Janani Rajbhandari-Thapa, Nicoleta Serban
Citation: BMC Public Health, 25, 244
Date: 01/2025
Type: Document
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Predictors of County-Level Diabetes-Related Mortality Risks in Florida, USA: A Retrospective Ecological Study
Examines geographic disparities in diabetes-related mortality risk (DRMR) in Florida. Explores the association between county-level factors and DRMR, including data on rurality, age, health behaviors, and more.
Author(s): Nirmalendu Deb Nath, Agricola Odoi
Citation: PeerJ Life & Environment, 13, e18537
Date: 01/2025
Type: Document
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Behavioral Health Diagnosis, Service Utilization, and Spending Among Older Adult Medicare Beneficiaries: A Chartbook
Examines the prevalence of behavioral health (BH) conditions among older adults. Utilizes 2017-2019 Medicare claims and administrative data to examine BH diagnoses, BH service utilization, cost of services, and more. Includes data breakdowns according to diagnosis, substance use, rates of diagnoses and service utilization, service type, rurality, and additional demographic factors.
Date: 01/2025
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Examining Differences in Rural and Urban Medicare FFS Beneficiaries' Emergency Department Use Before and During Covid
Results of a study describing changes from 2018-2022 in emergency department use among rural and urban Medicare Fee-for-Service (FFS) beneficiaries. Features statistics including patient demographics, primary diagnoses, and admission sources, with breakdowns by urban and rural areas.
Author(s): Alana Knudson, Craig D. Holden, Marilyn Klug, Tricia Stauffer, Shena Popat
Date: 01/2025
Type: Document
Sponsoring organization: ETSU/NORC Rural Health Research Center
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Lessons from the Pandemic: Relationship Between Patient Visits and Patient Length of Stay in California's Health System
Examines impacts of the COVID-19 pandemic on patient utilization of California hospitals. Analyzes 2019-2021 COVID-19 cases, mortality, patient length of stay (LOS), and more in 56 California counties, with rural versus urban comparisons.
Author(s): David D. Cho, Yu Wang
Citation: Health Research Policy and Systems, 23, 11
Date: 01/2025
Type: Document
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Impact of the Medicare Improvements for Patients And Providers Act on Mental Health Service Utilization And Spending among Older Adults
Examines the impact of the Medicare Improvements for Patients and Providers Act (MIPPA) on outpatient mental healthcare utilization. Utilizes 2008-2017 Medicare claims and administrative data to analyze MIPPA in a pre-implementation phase as well as 4 post-implementation phases. Includes data on mental healthcare outpatient visits by age group, race, dual eligibility status, substance use disorder, comorbidities, and urban, large rural, small rural, or isolated rural location.
Author(s): Matt Toth, Brent Gibbons, Abbie Levinson, et al.
Date: 01/2025
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Postpartum Health Care Use in Medicaid During the COVID-19 Public Health Emergency: Implications for Extending Postpartum Coverage
Examines the impact of Medicaid continuous enrollment during the COVID-19 public health emergency (PHE) on postpartum healthcare utilization. Utilizes 2018-2023 claims data from the Centers for Medicare and Medicaid Services (CMS) Transformed Medicaid Statistical Information System (T-MSIS) to analyze a pre-PHE versus PHE cohort of women. Includes healthcare utilization data with breakdowns according to age, race/ethnicity, eligibility group (Medicaid or other form), rural versus urban location, maternity care desert status, severe maternal morbidity and/or chronic health condition, postpartum month, and state.
Author(s): Amelia Whitman, Anupama Warrier, Sarah Gordon, et al.
Date: 01/2025
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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