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Rural Health
Resources by Topic: Rural-urban differences

Utilizing the USDA's National Household Food Acquisition and Purchase Survey to Calculate a Household-Level Food Environment Measure
Offers the Food Retail Environment Healthfulness Quality measure, a calculation measuring a household's exposure to healthy food retail spaces. Uses the measure to show rural and urban comparisons of distance to healthy food options in addition to demographic analysis.
Author(s): Michele Ver Ploeg, Benjamin Scharadin, Lauren Miller, Jeffrey Gonzalez, Rodney Odom
Date: 03/2024
Sponsoring organization: USDA Economic Research Service
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Partnerships to Address Social Needs Across Metropolitan and Non-Metropolitan Prospective Payment System Hospitals and Critical Access Hospitals
Explores the extent to which hospitals partner with community organizations to address population and/or community health needs. Analyzes data from the 2021 American Hospital Association Social Determinants of Health (SDOH) Supplement to describe the number and types of hospital partnerships with community-based organizations. Compares results by hospital type - metropolitan prospective payment system (PPS), Critical Access Hospital (CAH), and nonmetropolitan PPS - and by U.S. Census region, ownership status, and Accountable Care Organization (ACO) participation.
Author(s): Whitney E. Zahnd, Khyathi Gadag, Kristin D. Wilson, Keith J. Mueller
Date: 03/2024
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Reaching the Unheard: Overcoming Challenges in Health Research with Hard-to-Reach Populations
Analyzes strategies to engage hard-to-reach populations in health research. Discusses two case studies focused on specific issues in health research: breast cancer screening among rural and urban Mexican women in Illinois and mental health needs of Afghan refugees in Oklahoma. Provides reflection on issues such as cultural competency, language used in research, cultural identity and representation of research staff, choosing appropriate research sites, and more.
Author(s): Venera Bekteshi, Munjireen Sifat, Darla E. Kendzor
Citation: International Journal for Equity in Health, 23, 61
Date: 03/2024
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Evaluation of the USDA Summer EBT Demonstrations: Lessons Learned From More Than a Decade of Research
Reports results of the Summer EBT (Electronic Benefits Transfer) demonstration project, 2015-2018 and 2019-2022. Describes Summer EBT use patterns, nutritional value, and effect on childhood food insecurity. Identifies strategies for better program planning, implementation, and administration. Discusses program operation and challenges in tribal organizations and rural communities.
Additional links: 2015-2018 Evaluation, 2019-2022 Evaluation, Summary
Author(s): René Nutter, Ayesha Enver, Maria Boyle, et al.
Date: 03/2024
Sponsoring organization: USDA Food and Nutrition Administration
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Report to Congress on Medicaid and CHIP, March 2024
Reports on three aspects of Medicaid of interest to Congress: 1) improving the Medicaid beneficiary experience through Medical Care Advisory Committees (MCACs) and federal government actions to aid states, 2) increasing the transparency and improving the monitoring of the denials and appeals process in Medicaid managed care, and 3) reviewing hospital payment policy for the nation's safety net hospitals. Chapter 3 examines the relationship between disproportionate share hospital (DSH) allotments to states and the number of uninsured individuals, the amounts and sources of hospitals' uncompensated care costs, and the number of hospitals with high levels of uncompensated care that also provide essential community services. Table 3-1 details DSH spending for urban and rural hospitals and for Critical Access Hospitals.
Date: 03/2024
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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2023 National Healthcare Quality and Disparities Report: Chartbook on Patient Safety
Summarizes trends in healthcare quality across 28 measures of patient safety. Presents findings for four settings of care: ambulatory care, home health, hospitals, and nursing homes. Highlights differences in maternal morbidity and mortality measures by rurality.
Author(s): Barbara Barton, Darryl Gray, Cecilia Hahn, et al.
Date: 03/2024
Sponsoring organization: Agency for Healthcare Research and Quality
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Urban–Rural Differences in School Districts' Local Wellness Policies and Policy Implementation Environments
Compares urban and rural local wellness policies (LWPs) and implementation environments of 117 Texas school districts. Provides data on LWP goals, including nutrition and physical activity goals, as well as availability of district wellness plans, LWP assessments, and school health advisory councils. Highlights implications for rural school policy and student health.
Author(s): Swati Iyer, Timothy J. Walker, Alexandra L. MacMillan Uribe, et al.
Citation: Nutrients, 16(6), 801
Date: 03/2024
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Mortality for Time-Sensitive Conditions at Urban vs Rural Hospitals During the COVID-19 Pandemic
Analyzed hospitalizations in 3,813 rural and urban facilities to determine patient mortality outcomes for non-COVID-19 time sensitive conditions before and during the pandemic. Discusses rural and urban disparities.
Author(s): H. Joanna Jiang, Rachel M. Henke, Kathryn R. Fingar, Lan Liang, Denis Agniel
Citation: JAMA Network Open, 7(3)
Date: 03/2024
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COVID-19 Affected Rural and Urban Hospital Uncompensated Care
Offers data comparing the impact of COVID-19 on uncompensated hospital care on rural and urban facilities using Medicare Cost Report data for acute care hospitals. Discusses uncompensated care trends over time and analyzes operating expenses.
Author(s): Emmaline Keesee
Date: 03/2024
Sponsoring organization: The Cecil G. Sheps Center for Health Services Research
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Rural-Urban Differences in Housing Cost Burden Across the U.S.
Examines rural-urban differences in housing affordability across Census regions, divisions, states, and counties, using data from the 2017-2021 American Community Survey. Features statistics including the highest proportion of households experiencing housing cost burden by state and rural-urban location, and a county-level map showing percentages of cost-burden households.
Author(s): Alexis Swendener, Jonathan Schroeder, Carrie Henning-Smith
Date: 03/2024
Sponsoring organization: University of Minnesota Rural Health Research Center
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