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Rural Health
Resources by Topic: Social determinants of health

Integrating Mental Health Support into Rural Libraries: Evaluation of the Libraries for Health (L4H) Initiative
Presents findings from an evaluation of the implementation of Libraries for Health (L4H), a pilot project embedding nonclinical adult mental health supports into ten libraries in rural Texas. Summarizes how libraries implemented L4H, barriers and facilitators of implementation, and efforts to to build and sustain the program and sustain their capacity to address patrons' mental health needs.
Additional links: Research Summary
Author(s): Lynsay Ayer, Karen Christianson, Ivy Todd, et al.
Date: 06/2025
Sponsoring organization: RAND Corporation
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Bridging the Gap: Examples of Medicaid Innovation Enhancing Health Care Access in Rural America
Describes ways state Medicaid programs can improve access to rural healthcare. Highlights policies implemented in Tennessee, Missouri, and Georgia to fund projects related to improving rural healthcare needs, address social determinants of health, and support rural hospitals that serve large Medicaid and uninsured populations.
Date: 06/2025
Sponsoring organization: National Association of Medicaid Directors
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Assessing Neighborhood Deprivation Reveals Rural-Urban Disparities in CGM Access Among Children With Type 1 Diabetes
Examines disparities in access to continuous glucose monitor (CGM) technology in rural versus urban and high deprivation versus low deprivation areas, utilizing 2016-2023 pediatric endocrine patient encounter data for a region including parts of Missouri and Kansas. Highlights interactions between rurality, deprivation, access, and neighborhood demographics.
Author(s): Daniel R. Tilden, Christie A. Befort, Brent Lockee, et al.
Citation: Diabetes Care, dc250077
Date: 05/2025
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County Economic Status in Appalachia, FY 2026
Shows levels of economic distress in Appalachian counties based on unemployment rates, income, and poverty levels. Includes interactive map, downloadable maps and data files, and data report.
Date: 05/2025
Sponsoring organization: Appalachian Regional Commission
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Economic Hardship and Health Within Sociodemographic and Occupational Groups — Behavioral Risk Factor Surveillance System, United States, 2022–2023
Reports on economic hardship measures and self-rated health among employed and recently unemployed adults. Hardship measures included lack of health insurance, cost of medical care, employment instability, food insecurity, housing insecurity, utility insecurity, lack of reliable transportation, and receipt of food benefits. Provides data by occupation, including for people employed in farming, fishing, and forestry.
Author(s): Sharon R. Silver, Jia Li, Taylor M. Shockey
Citation: MMWR (Morbidity and Mortality Weekly Report), 74(19), 326-333
Date: 05/2025
Sponsoring organization: Centers for Disease Control and Prevention
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The Protective Role of Community Cohesion Across Rural and Urban Contexts: Implications for Youth Mental Health
Examines the impact of community cohesion on youth resilience during adverse experiences and socioeconomic issues. Utilizes longitudinal data from the Adolescent Brain Cognitive Development (ABCD) Study and compares rural and urban youth across categories such as neighborhood characteristics, negative life events, community cohesion, and internalizing and externalizing mental health symptoms.
Author(s): Alexis Brieant, Keith B. Burt
Citation: Child and Adolescent Mental Health, 30(2), 140-148
Date: 05/2025
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The Future of Rural Health: Report on a Special Convening Held November 19-20, 2024
Summarizes discussions held during a November 2024 summit of rural health services delivery and finance experts that aimed to identify the needs of the rural health communities, build on existing strengths, and develop a cohesive approach to improving the health of rural residents. Describes the themes and policy options that emerged throughout the summit. Covers financing rural health services, payment policies, workforce considerations, the use of technology and data, and more.
Date: 04/2025
Sponsoring organizations: National Rural Health Association, Rural Policy Research Institute, The Leona M. and Harry B. Helmsley Charitable Trust, West Health Institute
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Better Health for Mothers and Babies Issue Brief: Reducing Maternal Mortality and Morbidity
Discusses maternal morbidity and mortality in the U.S. and the underlying causes. Focuses on access to care, medically at-risk patients, social factors, and maternal health challenges in rural areas. Includes suggestions to improve maternal health outcomes with examples from various healthcare facilities.
Date: 04/2025
Sponsoring organization: American Hospital Association
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Social Determinants of Health and Variability in Treatment for Patients with Early-Stage Non-Small Cell Lung Cancer
Examines census tract-level social determinants of health (SDOH) and their impact on lung cancer treatment. Utilizes 2017-2022 Syapse Learning Health Network data to analyze patient social and demographic variables, housing burden, broadband internet access, primary care shortage areas, and rurality, as correlated with radiation therapy and/or surgery.
Author(s): Molly Scannell Bryan, Xiaohan Hu, Monika A. Izano, et al.
Citation: JNCI Cancer Spectrum, 9(2)
Date: 04/2025
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The 10-20-30 Provision: Defining Persistent Poverty Counties
Defines persistent poverty counties. Discusses how differences in definitions and data can affect which counties are considered persistently poor and includes a map highlighting the impact of different rounding methods. Briefly addresses legislation targeting persistent poverty counties using the "10-20-30 provision," including rural development funding. Table 3 lists persistent poverty counties based on data from the 1993 Small Area Income and Poverty Estimates (SAIPE), Census 2000, and the 2023 SAIPE.
Date: 03/2025
Sponsoring organization: Congressional Research Service
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