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Rural Health
Resources by Topic: Rural-urban differences

Nursing Home Staffing Study: Comprehensive Report
Examines the level and type of staffing needed to promote acceptable nursing home quality and safety. Explores the potential implications and feasibility of increased staffing and costs to nursing homes. Presents four options for minimum staffing requirements and their cost, quality, and safety impacts. Includes rural references and considerations throughout.
Additional links: Literature Review Results Table, State Minimum Staffing Requirement
Date: 06/2023
Sponsoring organizations: Abt Associates, Centers for Medicare & Medicaid Services
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Impact of the COVID-19 Vaccination Mandate on the Primary Care Workforce and Differences Between Rural and Urban Settings to Inform Future Policy Decision-Making
Analyzes the impact of COVID-19 vaccination mandates on the primary healthcare workforce in rural and urban settings. Examines 2021 survey data from 38 rural and 42 urban clinics in Oregon about issues such as job losses, vaccination waivers, and newly vaccinated staff. Includes data on clinic characteristics and impacts of the COVID-19 vaccine mandate across rural and urban clinics, as well as qualitative feedback from survey respondents.
Author(s): Brigit A. Hatch, Erin Kenzie, NithyaPriya Ramalingam, et al.
Citation: PLoS One, 18(6)
Date: 06/2023
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Competencies, Training Needs, and Turnover Among Rural Compared With Urban Local Public Health Practitioners: 2021 Public Health Workforce Interests and Needs Survey
Analyzes the rural and urban differences in 29,751 public health workers surveyed regarding competencies, training needs, and workplace stressors. Discusses COVID-19 impacts on public health work.
Author(s): Paula M. Kett, Betty Bekemeier, Davis G. Patterson, Kay Schaffer
Citation: American Journal of Public Health, 113(6), 689-699
Date: 06/2023
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Impact of Higher Payments for Rural Home Health Episodes on Rehospitalizations
Examines the impact of home health rural add-on payments on beneficiary outcomes, specifically on rehospitalizations. Uses Medicare data from 2007 to 2014 to compare rehospitalizations between rural and urban post-acute home health episodes before and after the implementation of the add-on payments in 2010. Discusses the implications of the findings on home health payment policy.
Author(s): Lacey Loomer, Momotazur Rahman, Tracy M. Mroz, Pedro L. Gozalo, Vincent Mor
Citation: Journal of Rural Health, 39(3), 604-610
Date: 06/2023
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2023 Minnesota Adolescent Sexual Health Report
Highlights the rates of pregnancies and births among Minnesota adolescents from 1990-2021, and sexually transmitted infections from 2010-2022. Features sections on variations across demographic groups, adolescent sexual health and COVID-19, and geographic disparities between urban and rural areas, including a county-level map showing counties with the highest chlamydia and gonorrhea rates among adolescents.
Author(s): Jill Farris, H. Olson
Date: 06/2023
Sponsoring organizations: Minnesota Department of Health, University of Minnesota
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Oral Health Disparities Through the Lifespan: Challenges and Opportunities
Recording of a June 7, 2023, conference session on oral health disparities as part of the Centers for Medicare & Medicaid Services (CMS) Health Equity Conference. Features a presentation from the CMS Office of the Administrator comparing differences in rural and urban dental opioid prescribing to adolescent/young adult and adult Medicaid/CHIP enrollees by patient and county characteristics. Transcript available in the video description.
Additional links: Carla Shoff, Centers for Medicare & Medicaid Services Office of the Administrator - Presentation Slides
Date: 06/2023
Sponsoring organization: Centers for Medicare & Medicaid Services
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Pennsylvania Summer Food Service Program Sites, by Rural and Urban County
County-level map showing locations of USDA Summer Food Service Program meal sites, with shadings indicating rural or urban counties.
Date: 06/2023
Sponsoring organization: Center for Rural Pennsylvania
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Disparities in Mental Health Care and Outcomes: A Healthy Metric Report for Wisconsin 2023
Provides an overview of mental health disparities in Wisconsin according to race/ethnicity, insurance type, age, and rural versus urban location. Utilizes 2021 Wisconsin Collaborative for Healthcare Quality (WCHQ) member organization data to report on mental health screenings, diagnoses, telehealth, and opportunities to improve mental healthcare in Wisconsin.
Date: 06/2023
Sponsoring organizations: Advancing a Healthier Wisconsin Endowment, Wisconsin Partnership Program
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Expanded Report to Congress: Non-Emergency Medical Transportation in Medicaid, 2018–2021
Examines the Medicaid analysis of non-emergency medical transportation (NEMT) using Transformed Medicaid Statistical Information System (T-MSIS) data from 2018-2021. Explores the number and percentage of Medicaid beneficiaries using NEMT, the average number of NEMT "ride days" per NEMT user per month enrolled in Medicaid, the types of medical services accessed when using NEMT, monthly trends in the use of NEMT versus telehealth services before and during the COVID-19 public health emergency (PHE), and the volume of NEMT services used by type of NEMT delivery model. Offers recommendations for states and local stakeholders regarding Medicaid coverage of NEMT. Presents data by state and by beneficiary characteristics, including Medicaid eligibility category, health conditions, and urban-rural location.
Date: 06/2023
Sponsoring organizations: Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services
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Predicting Firm Creation in Rural Texas: A Multi-Model Machine Learning Approach to a Complex Policy Problem
Evaluates Texas counties between 2008 and 2018 to identify factors contributing to entrepreneurship for rural areas. Discusses how healthcare, elder care, and child care predict growth in entrepreneurship. Compares predictive factors for rural areas with urban predictive factors. Makes recommendations for research, policy, and scholarship for rural entrepreneurship.
Author(s): Mark C. Hand, Vivek Shastry, Varun Rai
Citation: PLOS ONE, 18(6), e0287217
Date: 06/2023
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