Rural Health
Resources by Topic: Rural-urban differences
The Golden Hour Is Elusive in Rural Trauma: A 10-year Analysis from a Level I Trauma Center in Montana
Analyzed 4,213 trauma patients between 2012 and 2022 at a Level 1 trauma facility in Montana to determine whether trauma transfer patterns and rurality impacted outcomes. Discusses the goal of offering definitive care within 1 hour of injury and the impact of workforce shortages in rural areas.
Author(s): Jung G. Min, Maggie Smith, Michael S. Englehart, et al.
Citation: The American Journal of Emergency Medicine, 103, 127-131
Date: 05/2026
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Analyzed 4,213 trauma patients between 2012 and 2022 at a Level 1 trauma facility in Montana to determine whether trauma transfer patterns and rurality impacted outcomes. Discusses the goal of offering definitive care within 1 hour of injury and the impact of workforce shortages in rural areas.
Author(s): Jung G. Min, Maggie Smith, Michael S. Englehart, et al.
Citation: The American Journal of Emergency Medicine, 103, 127-131
Date: 05/2026
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Average Salary Expense in Rural and Urban Hospitals in 2022 Compared with 2018, by Hospital Characteristics
Explores how the COVID-19 pandemic may have affected wage disparities across rural and urban hospitals. Describes the median wages by total employee full-time equivalents (FTE) for rural and urban hospitals from 2017-2018 to 2021-2022. Compares the growth in labor cost for rural and urban hospitals by selected hospital characteristics, including system affiliation, hospital ownership, and number of acute care beds.
Date: 04/2026
Sponsoring organization: North Carolina Rural Health Research Program
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Explores how the COVID-19 pandemic may have affected wage disparities across rural and urban hospitals. Describes the median wages by total employee full-time equivalents (FTE) for rural and urban hospitals from 2017-2018 to 2021-2022. Compares the growth in labor cost for rural and urban hospitals by selected hospital characteristics, including system affiliation, hospital ownership, and number of acute care beds.
Date: 04/2026
Sponsoring organization: North Carolina Rural Health Research Program
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Average Salary Expense in Rural and Urban Hospitals Before and During the Low Wage Index Policy, 2018–2022
Examines and compares wage patterns of Critical Access Hospitals (CAHs), Rural Prospective Payment System (PPS) hospitals, and Urban PPS hospitals as related to the Low Wage Index Policy (LWIP) in effect from 2020-2022. Utilizes hospital data from the Centers for Medicare & Medicaid Services (CMS) Healthcare Cost Report Information System (HCRIS) between 2018 and 2022 and analyzes median salaries. Discusses the impact of Medicare payments and LWIP on hospitals.
Author(s): Saleema Karim, George Pink, Kristie Thompson, Mark Holmes
Date: 04/2026
Sponsoring organization: North Carolina Rural Health Research Program
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Examines and compares wage patterns of Critical Access Hospitals (CAHs), Rural Prospective Payment System (PPS) hospitals, and Urban PPS hospitals as related to the Low Wage Index Policy (LWIP) in effect from 2020-2022. Utilizes hospital data from the Centers for Medicare & Medicaid Services (CMS) Healthcare Cost Report Information System (HCRIS) between 2018 and 2022 and analyzes median salaries. Discusses the impact of Medicare payments and LWIP on hospitals.
Author(s): Saleema Karim, George Pink, Kristie Thompson, Mark Holmes
Date: 04/2026
Sponsoring organization: North Carolina Rural Health Research Program
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The Distribution of the Youth Behavioral Health Workforce in Rural and Urban America in 2025
Examines the distribution of school counselors; youth, family, or school psychologists; youth or family mental health nurses; school social workers; and pediatric psychiatrists or behavioral pediatricians across rural and urban areas of the U.S. Features statistics with breakdowns by provider type and location by 6 levels of population density, and a county-level map with shadings showing rural counties with and without youth behavioral health clinicians.
Author(s): Janessa M. Graves, Sara C. Woolcock, Lisa A. Garberson, C. Holly A. Andrilla
Date: 04/2026
Sponsoring organization: WWAMI Rural Health Research Center
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Examines the distribution of school counselors; youth, family, or school psychologists; youth or family mental health nurses; school social workers; and pediatric psychiatrists or behavioral pediatricians across rural and urban areas of the U.S. Features statistics with breakdowns by provider type and location by 6 levels of population density, and a county-level map with shadings showing rural counties with and without youth behavioral health clinicians.
Author(s): Janessa M. Graves, Sara C. Woolcock, Lisa A. Garberson, C. Holly A. Andrilla
Date: 04/2026
Sponsoring organization: WWAMI Rural Health Research Center
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Factors Associated With Mortality in Appalachian Nursing Homes During the COVID-19 Pandemic
Examines neighborhood characteristics related to Appalachian nursing home (NH) mortality during the COVID-19 pandemic. Analyzes 1,259 NHs in Appalachia for COVID-19 death rates and overall mortality, with breakdowns according to NH characteristics, patient sociodemographics, and rurality.
Author(s): Erica Gigas, Baiming Zou, Lorinda A Coombs, et al.
Citation: The Permanente Journal, 1-9
Date: 04/2026
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Examines neighborhood characteristics related to Appalachian nursing home (NH) mortality during the COVID-19 pandemic. Analyzes 1,259 NHs in Appalachia for COVID-19 death rates and overall mortality, with breakdowns according to NH characteristics, patient sociodemographics, and rurality.
Author(s): Erica Gigas, Baiming Zou, Lorinda A Coombs, et al.
Citation: The Permanente Journal, 1-9
Date: 04/2026
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Influenza Vaccination Coverage Among Nursing Home Residents and Health Care Personnel — United States, 2024–25 Influenza Season
Reports on influenza vaccination during the 2024–25 influenza season for nursing home residents and healthcare workers. Provides pooled influenza coverage data by facility for nursing home residents and for nursing home personnel, with data by urbanicity for metropolitan, micropolitan, and noncore areas.
Author(s): Jeneita M. Bell, Kira Barbre, Lu Meng, et al.
Citation: MMWR (Morbidity and Mortality Weekly Report), 75(15), 195-201
Date: 04/2026
Sponsoring organization: Centers for Disease Control and Prevention
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Reports on influenza vaccination during the 2024–25 influenza season for nursing home residents and healthcare workers. Provides pooled influenza coverage data by facility for nursing home residents and for nursing home personnel, with data by urbanicity for metropolitan, micropolitan, and noncore areas.
Author(s): Jeneita M. Bell, Kira Barbre, Lu Meng, et al.
Citation: MMWR (Morbidity and Mortality Weekly Report), 75(15), 195-201
Date: 04/2026
Sponsoring organization: Centers for Disease Control and Prevention
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Comparing the Care, Distance Traveled, and Health Workforce Clinician Mix for Rural and Urban Commercially Insured Enrollees With Opioid Use Disorder
Examines characteristics of opioid treatment in rural and urban communities across the United States. Utilizes 2019 commercial claims data from the Health Care Cost Institute (HCCI) to analyze rural versus urban differences in opioid use disorder and overdose diagnoses, healthcare utilization, healthcare visits by clinician type, average distance traveled to utilize healthcare, and location of received care.
Author(s): C. Holly A. Andrilla, Sara C. Woolcock, Lisa A. Garberson, Janessa M. Graves
Date: 04/2026
Sponsoring organization: WWAMI Rural Health Research Center
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Examines characteristics of opioid treatment in rural and urban communities across the United States. Utilizes 2019 commercial claims data from the Health Care Cost Institute (HCCI) to analyze rural versus urban differences in opioid use disorder and overdose diagnoses, healthcare utilization, healthcare visits by clinician type, average distance traveled to utilize healthcare, and location of received care.
Author(s): C. Holly A. Andrilla, Sara C. Woolcock, Lisa A. Garberson, Janessa M. Graves
Date: 04/2026
Sponsoring organization: WWAMI Rural Health Research Center
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Rural-Urban Variation in Opioid Use Disorder Treatment Access among Commercially Insured Children and Adolescents
Details a study on the geographic factors that affect access to treatment for youth and adolescents, aged 0-17, with an opioid use disorder (OUD) and covered by commercial insurance in 2019. Discusses the effects of rurality, provider type, travel burden, and residing in a county without a clinician with a DEA waiver, among other measures.
Author(s): C. Holly A. Andrilla, Lisa A. Garberson, Sara C. Woolcock, Janessa M. Graves
Date: 04/2026
Sponsoring organization: WWAMI Rural Health Research Center
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Details a study on the geographic factors that affect access to treatment for youth and adolescents, aged 0-17, with an opioid use disorder (OUD) and covered by commercial insurance in 2019. Discusses the effects of rurality, provider type, travel burden, and residing in a county without a clinician with a DEA waiver, among other measures.
Author(s): C. Holly A. Andrilla, Lisa A. Garberson, Sara C. Woolcock, Janessa M. Graves
Date: 04/2026
Sponsoring organization: WWAMI Rural Health Research Center
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Comparing the Care and Distance Traveled by Rural and Urban Children and Adolescents with Medicaid Insurance and Opioid Use Disorder
Presents a study on the geographic factors that affect access to treatment for youth and adolescents, aged 0-17, with an opioid use disorder (OUD) and enrolled in Medicaid in 2019. Discusses the effects of rurality, travel burden, and residing in a county without a clinician with a DEA waiver, among other measures.
Author(s): Janessa M. Graves, Lisa A. Garberson, Sara C. Woolcock, C. Holly A. Andrilla
Date: 04/2026
Sponsoring organization: WWAMI Rural Health Research Center
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Presents a study on the geographic factors that affect access to treatment for youth and adolescents, aged 0-17, with an opioid use disorder (OUD) and enrolled in Medicaid in 2019. Discusses the effects of rurality, travel burden, and residing in a county without a clinician with a DEA waiver, among other measures.
Author(s): Janessa M. Graves, Lisa A. Garberson, Sara C. Woolcock, C. Holly A. Andrilla
Date: 04/2026
Sponsoring organization: WWAMI Rural Health Research Center
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First Covid-19 Vaccination Rates Among Pregnant Tennessee Women by Month of Conception and Urbanization Level: March 2021 - November 2021
Describes rates of COVID-19 vaccination during pregnancy among Tennessee women with a live birth who conceived from March-November 2021. Features statistics with breakdowns by month and by 4 levels of population density.
Author(s): Claudia Valenzuela, Anne K. Driscoll, Elizabeth Harvey, Heather Wingate
Citation: Journal of Appalachian Health, 8(1), 85-95
Date: 04/2026
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Describes rates of COVID-19 vaccination during pregnancy among Tennessee women with a live birth who conceived from March-November 2021. Features statistics with breakdowns by month and by 4 levels of population density.
Author(s): Claudia Valenzuela, Anne K. Driscoll, Elizabeth Harvey, Heather Wingate
Citation: Journal of Appalachian Health, 8(1), 85-95
Date: 04/2026
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