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Rural Health
Resources by Topic: Social determinants of health

Future of Population Health Efforts for Rural Health Systems
Slides presented at the Becker's Hospital Review 10th Annual CEO + CFO Roundtable Conference in November 2022. Discusses approaches to understanding and addressing social determinants of health, including community health needs assessments (CHNAs) and Accountable Health Communities (AHCs), and offers links to tools and resources. Highlights needs addressed and implementation challenges faced by two rural AHCs.
Author(s): Keith J. Mueller
Date: 11/2022
Type: Document
Sponsoring organization: Rural Policy Research Institute
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Assessing Effectiveness of Early Childhood Home Visiting Models Implemented with Tribal Populations
Report assesses the efficacy of early childhood home visiting models for tribal populations. Reviews and assesses home visiting literature, information, and implementation procedures to establish best-practices for American Indian and Alaska Native populations.
Author(s): Rachel Bleiweiss-Sande, Emily Sama-Miller, Carla Chavez, Rebecca Coughlin, Andrea Mraz Esposito
Date: 10/2022
Type: Document
Sponsoring organization: Administration for Children and Families
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Assessment of Strategies Used in US Hospitals to Address Social Needs During the COVID-19 Pandemic
Presents findings on efforts to address social determinants of health (SDOH) by rural hospitals, Critical Access Hospitals (CAHs), and safety-net hospitals according to 2020 American Hospital Association survey data. Discusses rates of social needs among patient populations served by rural and urban hospitals and rates of SDOH screening and community partnerships.
Author(s): Jose F. Figueroa, Ciara Duggan, Cristina Toledo-Cornell, et al.
Citation: JAMA Health Forum, 3(10), e 223764
Date: 10/2022
Type: Document
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Using Z Codes to Improve Health Equity in Rural Indiana
Describes how Cameron Memorial Community Hospital, a Critical Access Hospital in Indiana, used ICD-10-CM Z codes to detect and address patients' social needs as part of its health equity strategy.
Date: 10/2022
Type: Document
Sponsoring organization: American Hospital Association
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Socioeconomic Factors Affecting Outcomes in Total Knee and Hip Arthroplasty: A Systematic Review on Healthcare Disparities
Examines health disparities in patient access, utilization, and outcomes related to total joint arthroplasty (TJA). Conducts a literature review of 44 studies that discuss socioeconomic factors associated with TJA disparities such as insurance type, socioeconomic status, hospital volume, and rural versus urban geographic location.
Author(s): Paul M. Alvarez, John F. McKeon, Andrew I. Spitzer, et al.
Citation: Arthroplasty, 4(36)
Date: 10/2022
Type: Document
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Health Panel Comment Letter – Medicare Shared Savings Program Requirements
Comments offered in response to a July 29, 2022, proposed rule regarding changes to the Medicare Shared Savings Program (SSP) to facilitate more widespread participation in Accountable Care Organizations (ACOs). Discusses how changes will impact rural Medicare beneficiaries, as well as challenges to extending ACOs to all rural counties. Covers advanced interest payments, extended time in one-sided risk, changes to calculating benchmarks, proposals to allow low revenue ACOs to realize shared savings at a lower minimum, a health equity adjustment, and social determinants of health measures.
Date: 09/2022
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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The State of Obesity 2022: Better Policies for a Healthier America
Presents the latest data available on adult and childhood obesity rates, with breakdowns by state and select demographic characteristics. Examines key current and emerging policies, includes funding opportunities, and outlines recommended policy actions. Includes a special feature highlighting food insecurity in children and families.
Author(s): Molly Warren, Stacy Beck, Madison West
Date: 09/2022
Type: Document
Sponsoring organization: Trust for America's Health
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Landscape of Area-Level Deprivation Measures and Other Approaches to Account for Social Risk and Social Determinants of Health in Health Care Payments
Examines social determinants of health (SDOH) at the community level and their impact on health-related social needs (HRSNs) of the individual. Discusses how policies related to federal payment systems can incentivize screening for HRSNs as well as referrals to appropriate social and behavioral services. Provides an environmental scan of what measures can be used to provide accountability for funding and policy efforts targeted at SDOH. Includes an appendix that defines and describes indices of social risk, such as the social vulnerability index (SVI) and area deprivation index (ADI), as well as payment models that include measures of social risk.
Author(s): Joshua Breslau, Laurie Martin, Justin Timbie, Nabeel Qureshi, Deborah Zajdman
Date: 09/2022
Type: Document
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, RAND Corporation
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Sparta Community Hospital Spotlight
Describes how the Sparta Community Hospital worked to identify the social determinants of health in its community. Discusses the addition of a mobile clinic to increase access to primary care, address barriers, and advance health equity.
Date: 09/2022
Type: Video/Multimedia
Sponsoring organization: National Rural Health Resource Center
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A Recap of Medicaid Non-Emergency Medical Transportation (NEMT) Listening Sessions
Provides an overview of the impact of Medicaid Non-Emergency Medical Transportation (NEMT) services as well as feedback from mobility providers and stakeholders during Center for Medicare & Medicaid Services (CMS) listening sessions. Presents discussions about public transportation coordination, the relationship between transportation services and social determinants of health, implications of Transportation Network Companies (TNCs) on users with disabilities, and data reporting. Includes information specific to rural populations.
Date: 09/2022
Type: Document
Sponsoring organization: National Aging and Disability Transportation Center
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