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Rural Health
Resources by Topic: Rural-urban differences

Illegally Made Fentanyl Use in the United States: 2022 and 2023
Report highlights findings from the 2022 and 2023 National Survey on Drug Use and Health (NSDUH) on the use of illegally made fentanyl across the U.S. Explores co-usage with other drugs, emergency room visits/hospitalizations, and breaks down user characteristics by age, poverty level, and rurality, among other measures.
Citation: NSDUH Data Brief, 2(2)
Date: 07/2025
Sponsoring organizations: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration
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Access and Quality of Mental Health Services in Rural and Urban America
Research brief brief documenting recent trends in mental healthcare access and quality in urban and rural communities. Features state-level maps showing locations of mental health facilities, a county-level map with shadings showing driving distances to any mental health facility or access to telehealth, and statistics on ZIP code area demographics, with breakdowns by urban, large rural, and small rural area.
Author(s): Peiyin Hung, Sophia N. D. Negaro, Rachel M. Hantman, et al.
Date: 07/2025
Sponsoring organization: University of South Carolina Rural Health Research Center
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2023 Quality Payment Program Experience Report
Reports on the clinician experience for those participating in the Quality Payment Program in 2023. Presents data on Merit-based Incentive Payment System (MIPS) eligibility and participation rates for clinicians in small practices and rural areas, mean and median final scores for 2023 and 2025 payment adjustments, and payment adjustment trends from 2021 through 2023.
Date: 06/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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The Impact of High Hospital Fixed-Cost Ratios on Rural Populations
Explores how rurality relates to hospital cost structures as categorized by Urban Influence Codes (UICs). Describes the characteristics of hospitals at different fixed-to-total-cost ratio levels, the demographics associated with hospitals at different ratio levels, and the share of nonmetropolitan hospitals that have Critical Access Hospital (CAH) or Low-Volume Hospital (LVH) designations. Discusses how findings could be used to refine hospital payment policies.
Author(s): Abigail Barker, Eliot Jost, Timothy McBride, Keith Mueller
Date: 06/2025
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Rural-Suburban-Urban Differences in Caregiving in the Northeast U.S. Region
Analyzes characteristics of caregiving experiences in the Northeast according to rural, suburban, or urban geography. Focuses on percentage of people who have provided caregiving, as well as their income, weekly care expenses, use of social safety net programs, desire to participate in the workforce, and demographic profile.
Author(s): Elena Pojman, Florence Becot
Date: 06/2025
Sponsoring organizations: North Central Regional Center for Rural Development, Northeast Regional Center for Rural Development, PennState
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Wireless Substitution: Early Release of Estimates from the National Health Interview Survey, July-December 2024
Provides data on households that rely on wireless telephones rather than landlines. Includes data on the percent of adults who live in wireless-only households and have their own wireless telephone, as well as data on phoneless adults. Provides data for nonmetropolitan compared to metropolitan areas. Discusses the need for surveys to include adequate representation of wireless-only households and households with landlines.
Author(s): Stephen J. Blumberg, Julian V. Luke
Date: 06/2025
Sponsoring organization: National Center for Health Statistics
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Self-Reported Reasons Preventing US Adults From Walking to Places Within 10 Minutes of Home
Examines environmental, access, and individual reasons given for not walking to places near home, utilizing 2022 SummerStyles survey data of 3,967 adults. Breaks down self-identified reasons for not walking by geographic and demographic characteristics, including rurality. Discusses the value of walkability for physical fitness and community accessibility.
Author(s): Hatidza Zaganjor, Tiffany J. Chen, Miriam E. Van Dyke, et al.
Citation: Preventing Chronic Disease, 22, 240394
Date: 06/2025
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Rural Health Disparities: Contemporary Solutions for Persistent Rural Public Health Challenges
Special issue of Preventing Chronic Disease featuring articles that examine rural health disparities and discuss rural public health strategies to address cancer, diabetes, and other chronic conditions, and to promote physical activity.
Citation: Preventing Chronic Disease
Date: 06/2025
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National Health Center Financial and Operational Performance Analysis: 2020–2023
Examines financial and operational characteristics of Federally Qualified Health Centers (FQHCs) from 2020-2023. Explores FQHC growth and expansion, patient and payer mix, revenue and growth mix, staffing and productivity, operational trends, financial performance, and more. Compares data on rural FQHCs to urban and national FQHC data. Requires name, email address, and organization information to download.
Date: 06/2025
Sponsoring organization: Capital Link
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Annual Net Migration Rates for Nonmetropolitan Counties, 2020-24
Bar graph showing average net migration rates for domestic and international migrants, with breakdowns by metropolitan adjacent areas, small cities, and remote-rural areas.
Author(s): John Cromartie, Justin B. Winikoff
Date: 06/2025
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