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Rural Health Disparities – Resources

Selected recent or important resources focusing on Rural Health Disparities.

Mortality in Rural Areas: Insights from National Research and Community-Based Initiatives
Webinar recording discusses mortality rates in rural and urban areas, as well as the causes of rural mortality. Features presentations from representatives of the Health Resources and Services Administration, the National Center for Health Statistics, and the Armstrong-Indiana-Clarion Drug & Alcohol Commission.
Additional links: Audio Recording, PowerPoint Handout, Webinar Transcript
Date: 11/2020
Type: Video/Multimedia
Sponsoring organization: Rural Health Information Hub
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Rural-Urban Disparities in Health Care in Medicare
Examines rural/urban differences in the quality of healthcare received by Medicare beneficiaries in 2019, with breakdowns by race and ethnicity. Focuses on patient experience and clinical care measures, including screening for and management of health conditions and medication-related issues.
Date: 11/2020
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Appalachian Diseases of Despair
Uses data from the 2018 Multiple Cause of Death database to provide information on mortality from overdose, suicide, and alcoholic liver disease/cirrhosis among people ages 15-64. Includes data and statistics, with information broken down by Appalachian state, region, gender, and metropolitan or nonmetropolitan status.
Author(s): Michael Meit, Megan Heffernan, Erin Tanenbaum, Maggie Cherney, Victoria Hallman
Date: 10/2020
Type: Document
Sponsoring organizations: Appalachian Regional Commission, NORC Walsh Center for Rural Health Analysis
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The U.S. Rural Mortality Penalty is Wide and Growing
Policy brief examining rural-urban differences in mortality rates among non-Hispanic White people from 1990-2018. Features statistics with breakdowns by age group, sex, metropolitan and nonmetropolitan location, cause of death, and mortality rate per 100,000 people.
Author(s): Shannon M. Monnat
Date: 10/2020
Type: Document
Sponsoring organizations: Center for Aging and Policy Studies, Lerner Center for Public Health Promotion
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Health Equity Report 2019-2020: Special Feature on Housing and Health Inequalities
Provides an overview of the Health Resources and Services Administration's (HRSA) program efforts in reducing health disparities and promoting health equity for various populations at the national, state, and local levels. Chapter 10 addresses rural-urban health disparities, with a focus on rural housing inequities and the opioid epidemic, and describes Federal Office of Rural Health Policy programs.
Date: 10/2020
Type: Document
Sponsoring organization: Health Resources and Services Administration
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Rural/Urban Differences in Children's Health
Examines differences in child health conditions by rural and urban residency. Explores differences in mental and behavioral health, weight status and physical activity, adverse childhood experiences, and access to healthcare.
Date: 10/2020
Type: Document
Sponsoring organization: Maternal and Child Health Bureau
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Half of Rural Residents at High Risk of Serious Illness Due to COVID-19, Creating Stress on Rural Hospitals
Highlights a study on the risk of hospitalization due to a serious illness caused by COVID-19 in rural communities. Compares rural areas with metro and micropolitan areas. Makes policy recommendations regarding supply chain and financial assistance policies.
Author(s): Brystana G. Kaufman, Rebecca Whitaker, George Pink, G. Mark Holmes
Citation: Journal of Rural Health, 36(4), 584-590
Date: 10/2020
Type: Document
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Traffic Safety Facts: Preview of Motor Vehicle Traffic Fatalities In 2019
Presents a preview of the motor vehicle related fatalities for 2019. Compares new data with statistics from 2018 by a number of measures, including rural and urban fatalities. Highlights state-by-state breakdowns by person/vehicle type.
Date: 10/2020
Type: Document
Sponsoring organization: National Highway Traffic Safety Administration
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America's Children in Brief: Key National Indicators of Well-Being, 2020
Examines the relationship between child well-being and community type, including metropolitan, micropolitan, or rural. Provides rural/urban breakdowns on child race/ethnicity, maltreatment, poverty, mortality, health conditions, and more.
Date: 09/2020
Type: Document
Sponsoring organization: Federal Interagency Forum on Child and Family Statistics
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A Century Later: Rural Public Health's Enduring Challenges and Opportunities
Discusses rural health disparities that have persisted over the past century, with information on infectious disease, access to healthcare, maternal and child health, and racial health disparities in the United States. Discusses public health challenges and solutions for rural communities.
Author(s): Erika Ziller, Carly Milkowski
Citation: American Journal of Public Health, e1-e9
Date: 09/2020
Type: Document
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Racial and Ethnic Differences in Self-Rated Health Among Rural Residents
Uses 2011-2017 data from the National Health Interview Survey to identify differences in self-reported health ratings among racial and ethnic populations in rural areas. Examines relationships between self-rated health and sociodemographic characteristics, such as sex, marital status, educational attainment, poverty level, and more.
Author(s): Carrie Henning-Smith, Ashley Hernandez, Katy Kozhimannil
Citation: Journal of Community Health
Date: 09/2020
Type: Document
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COVID‐19 Death Rates Are Higher in Rural Counties With Larger Shares of Blacks and Hispanics
Highlights a study on the COVID-19 mortality rate of rural U.S. counties based on their racial/ethnic composition. Compares mortality rates of all nonmetro counties from March 2-July 26, 2020 and looks at the number of Black and Hispanic populations in those counties.
Author(s): Kent Jason G. Cheng, Yue Sun, Shannon M. Monnat
Citation: Journal of Rural Health
Date: 09/2020
Type: Document
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Traffic Safety Facts, 2018 Data: Children
Offers national data on traffic crashes involving children 14 and younger. Features statistics from 2009-2018 with breakdowns by age group, restraint use, state, and rural or urban location, among other measures.
Date: 08/2020
Type: Document
Sponsoring organization: National Highway Traffic Safety Administration
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Maternal and Obstetric Care Challenges in Rural America from the National Advisory Committee on Rural Health and Human Services
Webinar recording discusses a National Advisory Committee on Rural Health and Human Services' policy brief on the challenges of providing maternal and obstetric care in rural communities. Features presentations from representatives of the National Advisory Committee on Rural Health and Human Services, Centers for Medicare and Medicaid Services, Mercer University, and MSMP Anesthesia Services LLC.
Additional links: Audio Recording, PowerPoint Handout, Webinar Transcript
Date: 08/2020
Type: Video/Multimedia
Sponsoring organization: Rural Health Information Hub
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Access to Colorectal Cancer Screening Programs for Underserved Populations in South Carolina
Fact sheet outlines the rates of access to colorectal cancer screening for rural and racial minorities in South Carolina. Compares cancer screening rates between rural and urban areas, as well as Black an White populations in those areas, and by type of evidence-based intervention.
Date: 08/2020
Type: Document
Sponsoring organization: Rural and Minority Health Research Center (formerly the South Carolina Rural Health Research Center)
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Cervical Cancer and HPV Vaccination Disparities in South Carolina
Fact sheet outlines the rates of HPV vaccination in rural South Carolina. Compares rates of vaccination initiation and completion between metro and nonmetro areas in SC and nationally, as well as by provider type in rural and urban counties in SC.
Date: 08/2020
Type: Document
Sponsoring organization: Rural and Minority Health Research Center (formerly the South Carolina Rural Health Research Center)
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Rural and Racial Disparities in Colorectal Cancer Incidence and Mortality in South Carolina 1996-2016
Fact sheet outlines the rates of colorectal cancer and mortality for rural and racial minorities in South Carolina from 1996 to 2016. Compares cancer rates between rural and urban areas, as well as Black an White populations in those areas.
Date: 08/2020
Type: Document
Sponsoring organization: Rural and Minority Health Research Center (formerly the South Carolina Rural Health Research Center)
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Addressing Rural Health Disparities in a Pandemic
Public Health Review podcast in which 3 speakers discuss the impact of COVID-19 on rural health infrastructure and workforce. Describes how to improve conditions in rural communities, increase access to quality healthcare, and implement innovative strategies for health workforce recruitment and retention.
Date: 08/2020
Type: Audio
Sponsoring organization: Association of State and Territorial Health Officials
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Assessment of Racial Disparities in Mortality Rates Among Older Adults Living in US Rural vs Urban Counties From 1968 to 2016
Study using CDC WONDER data from 3,131 counties over a 49-year period. Features statistics on adjusted and unadjusted mortality rates among people 65 years and older, with breakdowns by race, gender, and urban, rural adjacent, and rural nonadjacent locations.
Author(s): Nasim B. Ferdows, Maria P. Aranda, Julie A. Baldwin, et al.
Citation: JAMA Network Open, 3(8)
Date: 08/2020
Type: Document
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Defining Rural Population Health and Health Equity
Establishes a unified definition of population health and health equity in rural and frontier communities. Intended to educate rural health and clinical partners and to help engage rural health stakeholders in discussions to improve the health and well-being of rural people. Provides examples of community-based programs addressing health inequities.
Citation: NOSORH Issue Brief, 2(5), 1-4
Date: 07/2020
Type: Document
Sponsoring organization: National Organization of State Offices of Rural Health
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American Communities Experience Deaths of Despair at Uneven Rates
Analyzes nationally representative data from 2014-2018 on deaths of despair (DoD), or deaths resulting from substance use or suicide. Includes county-level statistics on DoD, with information broken down by rurality and race/ethnicity.
Author(s): Dante Chinni
Date: 07/2020
Type: Document
Sponsoring organization: American Communities Project
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Telehealth in Response to the Covid-19 Pandemic: Implications for Rural Health Disparities
Investigates the potential effects of telehealth implementation during the COVID-19 pandemic on rural health disparities. Includes discussion on telehealth initiatives and barriers to accessing broadband, and provides recommendations for researchers and policymakers.
Author(s): Kelly A Hirko, Jean M Kerver, Sabrina Ford, et al.
Citation: Journal of the American Medical Informatics Association
Date: 06/2020
Type: Document
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Population Health in Rural America in 2020 - A Virtual Workshop
Recording of a 2-day workshop on rural population health. Features presentations by experts in the field, with discussion on rural demographics and social determinants of health; health disparities; public health, healthcare, and community efforts to improve health outcomes in rural America; health policy; and more. Presentation slides and workshop agenda are available to download.
Author(s): Roundtable on Population Health Improvement
Date: 06/2020
Type: Video/Multimedia
Sponsoring organization: National Academies of Sciences, Engineering, and Medicine
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Urban-Rural Inequities in Acute Stroke Care and In-Hospital Mortality
Examines rural/urban differences and trends in treatment patterns and outcomes for individuals hospitalized for stroke, including mortality rates, length of hospital stay, and discharge rates. Provides data and statistics on patient characteristics, such as age, race/ethnicity, comorbidities, use of thrombolytics and endovascular therapy, and more.
Author(s): Gmerice Hammond, Alina Luke, Lauren Elson, Amytis Towfighi, Karen Joynt Maddox
Citation: Stroke, 51, 2131–2138
Date: 06/2020
Type: Document
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Community Susceptibility and Resiliency to COVID‐19 Across the Rural‐Urban Continuum in the United States
Presents a county-level susceptibility scale for COVID-19. Highlights 7 susceptibility factors related to health and socioeconomic resiliency and discusses the different vulnerabilities of rural and urban communities.
Additional links: COVID-19 Susceptibility Map
Author(s): David J. Peters
Citation: Journal of Rural Health
Date: 06/2020
Type: Document
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Rural/Urban Disparities in Utilization of Diabetes Self-Management Training to the Fee-for-Service Medicare Population
Compares the utilization of Diabetes Self-Management Training (DSMT) services of Medicare recipients in rural and urban areas in 2016. Includes data on DSMT providers, service units, beneficiaries, and average utilization rate in rural and urban counties.
Author(s): Christian Rhudy, Aric Schadler, Jeffery Talbert
Date: 06/2020
Type: Document
Sponsoring organization: Rural and Underserved Health Research Center
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Rural/Urban Disparities in Utilization of Medical Nutrition Therapy to the Fee-for-Service Medicare Population
Compares the utilization of Medical Nutrition Therapy (MNT) services by Medicare recipients in rural and urban areas in 2016. Includes data on MNT providers, service units, beneficiaries, and average utilization rate in rural and urban counties.
Author(s): Christian Rhudy, Eugene Shin, Jeffery Talbert
Date: 06/2020
Type: Document
Sponsoring organization: Rural and Underserved Health Research Center
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Rural/Urban Disparities in the Utilization of Health and Behavioral Assessments/Interventions in the Fee-for-Service Medicare Population
Compares the utilization of Health and Behavioral Assessments and Interventions (HBAI) services by Medicare recipients in rural and urban areas. Includes data on HBAI providers, service units, beneficiaries, and average utilization rate in rural and urban counties.
Author(s): Christian Rhudy, Eugene Shin, Jeffery C. Talbert
Citation: Rural and Underserved Health Research Center Publications
Date: 06/2020
Type: Document
Sponsoring organization: Rural and Underserved Health Research Center
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Traffic Safety Facts, 2018 Data: Rural/Urban Comparison of Traffic Fatalities
Reports 2018 Fatality Analysis Reporting System (FARS) data describing fatal motor vehicle crashes. Provides rural versus urban statistics for fatal motor vehicle crashes by time of day, speed, alcohol use, seat belt use, and rollover crashes.
Date: 05/2020
Type: Document
Sponsoring organization: National Highway Traffic Safety Administration
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Rural-Urban Residence and Mortality among Three Cohorts of U.S. Adults
Reports on a study to address gaps in what is known of the rural-urban mortality disparity by analyzing time-to-event birth cohorts using data from the 1997-2009 National Health Interview Survey (NHIS) linking deaths through December 2011. Results of this study may identify potential policy and practice interventions to reduce the disparity in rural-urban mortality.
Author(s): Erika C. Ziller, Jennifer D. Lenardson, Katherine Ahrens M.
Date: 05/2020
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Prevalence of Self-Reported Hypertension and Antihypertensive Medication Use by County and Rural-Urban Classification — United States, 2017
Examines self-reported prevalence of diagnosed hypertension and antihypertensive medication use. Includes data for metropolitan, micropolitan, and noncore (rural) areas. Also discusses geographic trends at the county level, with maps showing county-level hypertension prevalence and medication use. Highlights higher prevalence of hypertension in the Southeast, Appalachia, and the Great Plains.
Author(s): Claudine M. Samanic, Kamil E. Barbour, Yong Liu, et al.
Citation: MMWR (Morbidity and Mortality Weekly Report), 69(18), 533-539
Date: 05/2020
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Caring for Miners During the Coronavirus Disease‐2019 (COVID‐19) Pandemic
Highlights the particular vulnerabilities of miners in the Southwestern U.S. to COVID-19. Discusses preexisting conditions, such as COPD, as well as issues related to access to care.
Author(s): Akshay Sood, Charles Pollard, Kyla Le Suer, Kevin Vlahovich, Jolene Walker
Citation: Journal of Rural Health
Date: 04/2020
Type: Document
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Increase in Suicide Mortality in the United States, 1999–2018
Reports on changes in suicide rates in the U.S. from 1999 through 2018. Includes 2018 age-adjusted suicide rates for men and women by county of residence for urban and rural counties.
Author(s): Holly Hedegaard, Sally C. Curtin, Margaret Warner
Date: 04/2020
Type: Document
Sponsoring organization: National Center for Health Statistics
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2020 County Health Rankings Key Findings Report
Discusses county-level health disparities by examining health factors and outcomes throughout the U.S. Covers life expectancy, racial and ethnic opportunity gaps, homeownership rates, child poverty, and more. Includes key findings and examples of community efforts to improve health outcomes.
Additional links: 2020 State Health Reports
Date: 03/2020
Type: Document
Sponsoring organization: County Health Rankings & Roadmaps
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Second Report to Congress on Social Risk and Medicare's Value-Based Purchasing Programs
Analyzes the effect of individuals' social risk factors on quality measures, resource utilization, and other Medicare program measures using Medicare and non-Medicare data sources. Describes how Medicare value-based purchasing (VBP) programs impact providers who serve socially at-risk beneficiaries. Categorizes rurality as a social risk factor. Explores emerging trends among providers addressing social risk factors through cooperation with social services and community-based organizations. Offers policy recommendations for the U.S. Department of Health and Human Services to account for social risk factors in VBP programs and achieve better outcomes for those with social risk factors. Second of two reports required by the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014. See the first report.
Additional links: Full Report
Date: 03/2020
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Maternal Mortality: Trends in Pregnancy-Related Deaths and Federal Efforts to Reduce Them
Examines trends in pregnancy-related deaths between 2007 and 2016, Analyzes data by cause of death, racial and ethnic groups, and age. Appendix III lists ongoing Department of Health and Human Services funding opportunities to address maternal mortality, including the Rural Maternity and Obstetrics Management Strategies (RMOMS) Program. Appendix V provides an overview of efforts to reduce maternal mortality in California, Georgia, Illinois, Maryland, and Texas.
Additional links: Full Report
Date: 03/2020
Type: Document
Sponsoring organization: Government Accountability Office
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Healthy People 2020 Progress for Leading Causes of Death in Rural and Urban America: A Chartbook
Provides a description of progress toward Health People 2020 benchmarks among racial and ethnic groups, men and women, and residents of the 4 United States census regions. Features statistics including deaths from heart disease, cancer, COPD, unintentional injury, stroke, diabetes, and suicide from 2007-2017, with breakdowns by 6 levels of population density.
Author(s): Timothy H. Callaghan, Alva O. Ferdinand, Marvellous Akinlotan, et al.
Date: 03/2020
Type: Document
Sponsoring organization: Southwest Rural Health Research Center
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2020 Census Engagement Opportunities for Rural Health Stakeholders
#RuralHealthChat discusses the upcoming 2020 census and what's at stake for "hard-to-count" rural communities. Co-hosts RHIhub and NOSORH feature experts from the Census Project, the National Association of Counties, and the Rural Policy Institute, among others.
Date: 02/2020
Type: Document
Sponsoring organization: Rural Health Information Hub
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Health Disparities in Rural America: Current Challenges and Future Solutions
Describes health risks experienced by rural people and the problems they face in accessing healthcare in shortage areas, and offers possible solutions. Includes a map showing Primary Care Health Professional Shortage Areas by county, and a list of states allowing full practice authority for nurse practitioners as of 2019.
Author(s): Theresa Capriotti, Tiffany Pearson, Lillian Dufour
Date: 02/2020
Type: Document
Sponsoring organization: Clinical Advisor
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Rural Disparities in Health and Healthcare by Race and Ethnicity
Webinar recording discusses the role race and ethnicity play in rural health disparities. Explores measures pertaining to disparities in health and wellness, preventative screenings, and healthcare access for American Indian, Black, Hispanic, White, and Asian populations in rural areas.
Additional links: Presentation Slides, Webinar Transcript
Date: 01/2020
Type: Video/Multimedia
Sponsoring organizations: Rural Health Research Gateway, University of Minnesota Rural Health Research Center
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Examining Rural Cancer Prevention and Control Efforts from the National Advisory Committee on Rural Health and Human Services
Webinar discusses cancer prevalence and prevention in rural areas. Highlights policy recommendations from the National Advisory Committee on Rural Health and Human Services on rural cancer prevention efforts.
Additional links: PowerPoint Handout, Transcript
Date: 01/2020
Type: Website
Sponsoring organization: Rural Health Information Hub
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QuickStats: Infant Mortality Rates For Metro and Nonmetro Counties, by Race and Hispanic Origin — National Vital Statistics System, United States, 2017
Bar chart showing metropolitan and nonmetro infant mortality rates for infants of non-Hispanic White mothers, non-Hispanic Black mothers, and Hispanic mothers.
Citation: MMWR (Morbidity and Mortality Weekly Report), 69(3), 95
Date: 01/2020
Type: Chart/Graph
Sponsoring organization: Centers for Disease Control and Prevention
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Factors Associated with Lung Cancer Screening in Urban vs. Rural Individuals at Risk for Lung Cancer
Presentation slides on a study investigating rural/urban differences in Low-Dose Computed Tomography (LDCT) cancer screening. Study participants included current and former smokers ages 55-80 with a smoking history of 30 or more years.
Author(s): Anja Zgodic, Gabriel Benavidez, Whitney Zahnd, Jan Eberth
Date: 2020
Type: Presentation Slides
Sponsoring organization: Rural and Minority Health Research Center (formerly the South Carolina Rural Health Research Center)
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Birth Settings in America: Outcomes, Quality, Access, and Choice
Examines factors that influence maternal and newborn care in the United States, including social determinants such as geographic variability in access to birth settings. Explores challenges faced by women in rural and underserved areas. Includes statistics on infant mortality rates in 2014 with breakdowns by rural or urban locations, and county-level maps showing access to providers and hospitals offering obstetric services.
Additional links: Read Online
Author(s): Board on Children, Youth, and Families
Date: 2020
Type: Document
Sponsoring organization: Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
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Differences in Preventive Care Among Rural Residents by Race and Ethnicity
Explores race and ethnicity as a factor in rural preventive care delivery. Breaks down vaccination rates and cancer screening rates by race/ethnicity and discusses potential implications of the findings.
Author(s): Carrie Henning-Smith, Marizen R. Ramirez, Ashley Hernandez, Rachel Hardeman, Katy Kozhimannil
Date: 11/2019
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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Lung Cancer Incidence in Nonmetropolitan and Metropolitan Counties — United States, 2007–2016
Reports on lung cancer incidence rates in metropolitan and nonmetropolitan counties, with data by sex and by age at diagnosis. Includes data for 2007 and 2016, as well as the change in rate from 2007 to 2016. Discusses strategies to reduce exposure to lung cancer risk factors and how those strategies might be targeted to decrease disparities.
Author(s): Mary Elizabeth O'Neil, S. Jane Henley, Elizabeth A. Rohan, et al.
Citation: MMWR (Morbidity and Mortality Weekly Report), 68(44), 993-998
Date: 11/2019
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Potentially Excess Deaths from the Five Leading Causes of Death in Metropolitan and Nonmetropolitan Counties — United States, 2010–2017
Reports on the rural-urban disparities regarding potentially preventable deaths caused by heart disease, cancer, unintentional injury, chronic lower respiratory disease (CLRD), and stroke for populations less than 80 years of age. Updates a January 2017 report on the same topic, with the new report using a 6-level urban-rural classification scheme and adding additional years and annual percentage change information.
Additional links: Supplementary Table 1: Number of Potentially Excess Deaths, by HHS Region and Urban-Rural Classification, Supplementary Table 2: Percentage of Potentially Excess Deaths, by HHS Region and Urban-Rural Classification, Supplementary Table 3: Number of Potentially Excess Deaths, by State for Metro and Nonmetro, Supplementary Table 4: Percentage of Potentially Excess Deaths, by State for Metro and Nonmetro
Author(s): Macarena C. Garcia, Lauren M. Rossen, Brigham Bastian, et al.
Citation: MMWR Surveillance Summaries, 68(10), 1-11
Date: 11/2019
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Indian Health Disparities
Fact sheet providing statistics on American Indian and Alaska Native health disparities and mortality disparities.
Date: 10/2019
Type: Document
Sponsoring organization: Indian Health Service
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2018 National Healthcare Quality and Disparities Report
Provides a comprehensive summary and data analysis of healthcare quality and access in the U.S. Includes a discussion of disparities encountered by race/ethnicity and geographic locations along the rural-urban continuum. Addresses access to healthcare, patient safety, person-centered care, care coordination, affordability, healthy living, and effective treatment.
Date: 10/2019
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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Risk Factors and Potentially Preventable Deaths in Rural Communities
Compares rates of potentially avoidable deaths in rural and urban communities and shows how these deaths vary by census region. Features statistics on modifiable risk factors, such as smoking, excessive alcohol use, and obesity, and percent of potentially preventable deaths attributable to specific health conditions, with breakdowns by rural and urban areas.
Author(s): Mark Holmes, Kristie W. Thompson
Date: 10/2019
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Reported Importance and Access to Health Care Providers Who Understand or Share Cultural Characteristics With Their Patients Among Adults, by Race and Ethnicity
Examines the importance and frequency of seeing culturally competent health care providers among U.S. adults, with data by race and ethnicity. Includes metropolitan and nonmetro data for Hispanic, non-Hispanic White, non-Hispanic Black, and other non-Hispanic adults.
Author(s): Emily P. Terlizzi, Eric M. Connor, Carla E. Zelaya, et al.
Date: 10/2019
Type: Document
Sponsoring organization: National Center for Health Statistics
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Compendium of Federal Datasets Addressing Health Disparities
Identifies and describes publicly available data relevant to addressing health disparities, including data on socioeconomic factors and social determinants of health. Includes datasets and data-related resources from agencies within the U.S. Department of Health and Human Services, as well as from nine other federal departments and agencies.
Author(s): Data Workgroup of the Interdepartmental Health Equity Collaborative (IHEC)
Date: 09/2019
Type: Document
Sponsoring organization: U.S. Department of Health and Human Services Office of Minority Health
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Watered Down Justice
Report focuses on water quality standards, violations, and potential solutions, specifically for social and economic minority populations. Features county-level maps showing the intersection of various drinking water violations and length of violations with racial, ethnic, and language vulnerability.
Author(s): Kristi Pullen Fedinick, Steve Taylor, Michele Roberts
Date: 09/2019
Type: Document
Sponsoring organizations: Coming Clean, Environmental Justice Health Alliance, Natural Resources Defense Council
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Have Healthy People 2020 Benchmarks for Leading Causes of Death Been Met in Rural and Urban Areas?
Presentation slides from an August 20, 2019 webinar, with analysis of death rates for 7 major causes of death, in light of Healthy People 2020 benchmarks. Features mortality statistics from 2007-2017 for diabetes, heart disease, suicide, cancer, stroke, unintentional injury, and chronic obstructive pulmonary disease, with breakdowns by gender, race, and region, with 6 levels of population density.
Author(s): Alva O. Ferdinand, Timothy Callaghan, Marvellous Akinlotan, Kristie Primm
Date: 08/2019
Type: Presentation Slides
Sponsoring organizations: Southwest Rural Health Research Center, Texas A&M Health Science Center
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Selection Biases in Technology-based Intervention Research: Patients' Technology Use Relates to Both Demographic and Health-related Inequities
Details a study on selection bias in health research, specifically the patient characteristics of people with implantable cardioverter defibrillators who were not included in an intervention on the basis of their inability to access the internet or a computer. Looks at patient demographics, such as age, race, education, and rural status, among other measures.
Author(s): Tammy Toscos, Michelle Drouin, Jessica Pater, et al.
Citation: Journal of the American Medical Informatics Association, 26(8-9), 835–839
Date: 08/2019
Type: Document
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Health Informatics and Health Equity: Improving Our Reach and Impact
Outlines the goals of the Journal of the American Medical Informatics Association's Special Focus Issue on health equity. Highlights the underserved populations addressed in the issue, such as those that face barriers relating to their racial, cultural, socioeconomic, and/or rural status, among others.
Author(s): Tiffany C Veinot, Jessica S Ancker, Suzanne Bakken
Citation: Journal of the American Medical Informatics Association, 26(8-9), 689–695
Date: 08/2019
Type: Document
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Advancing Health Equity and Access Using Telemedicine: A Geospatial Assessment
Highlights a study on the effectiveness of a virtual urgent care (VUC) program in expanding healthcare access and addressing health equity in rural populations in North Carolina. Compares rural versus urban areas and breaks down data by rates of poverty, Medicare and Medicaid enrollment, and broadband access, among other measures.
Author(s): Saif Khairat, Timothy Haithcoat, Songzi Liu, et al.
Citation: Journal of the American Medical Informatics Association, 26(8-9), 796–805,
Date: 08/2019
Type: Document
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Unintentional Injury Death Rates in Rural and Urban Areas: United States, 1999–2017
Examines trends in unintentional injury deaths from 1999 through 2017. Provides urban versus rural age-adjusted death rates related to motor vehicle traffic injuries, unintentional drug overdoses, and unintentional falls, with data for 2014 and 2017.
Author(s): R. Henry Olaisen, Lauren M. Rossen, Margaret Warner, Robert N. Anderson
Date: 07/2019
Type: Document
Sponsoring organization: National Center for Health Statistics
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Access to Hospital Maternity Care Units in Rural America
Webinar slides discusses the state of hospital-based obstetric units in rural areas. Looks at some of the characteristics of rural communities that correlate with obstetric closures and highlights some of the implications of lacking obstetric care.
Author(s): Peiyin Hung, Katy B. Kozhimannil, Ira S. Moscovice, et al.
Date: 06/2019
Type: Document
Sponsoring organization: Rural and Minority Health Research Center (formerly the South Carolina Rural Health Research Center)
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Rural, Remote, and Resilient: How to Build Better Outcomes Outside of America's Cities
Explores public health outcomes in rural communities and presents 5 different strategies for addressing rural health disparities. Compares health disparities of rural versus urban counties across the country.
Date: 06/2019
Type: Document
Sponsoring organization: Baylor University Master of Public Health Online Program
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Overcoming Racial Disparities and Social Determinants in the Maternal Mortality Crisis
Provides testimonies and the recording of a hearing before the U.S. House Ways and Means Committee on disparities in maternal mortality. Discusses disparities by race and geographic location, social determinants of health, challenges in rural access to obstetrics, and potential steps for action. Includes testimony from the American Medical Association, American College of Obstetricians and Gynecologists, Maternal Mortality Projects Coordinator at the Virginia Department of Health, and others.
Additional links: Lisa Hollier Testimony, Loren Robinson Testimony, Melanie Rouse Testimony, Patrice Harris Testimony, American Medical Association, Video Recording
Date: 05/2019
Type: Video/Multimedia
Sponsoring organization: House Ways and Means Committee
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Rural Residence and Poverty Are Independent Risk Factors for Chronic Obstructive Pulmonary Disease in the United States
Uses data from the National Health Interview Survey 2012–2015 to determine whether urban–rural status, poverty, and other individual- or community-level factors are associated with chronic obstructive pulmonary disease (COPD) prevalence in the United States. Compares COPD predictors among current or past smokers and individuals who have never smoked.
Author(s): Sarath Raju, Corinne Keet, Laura Paulin, et al.
Citation: American Journal of Respiratory and Critical Care Medicine, 199(8), 961-969
Date: 04/2019
Type: Document
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Health Disparities Related to Smoking in Appalachia: Practical Strategies and Recommendations for Communities
Offers statistics on smoking in rural Appalachian communities. Highlights strategies and resources to reduce tobacco use. Covers recommendations to assist policymakers, funders, and leaders working to reduce health disparities related to smoking and tobacco use.
Author(s): Kate Beatty, Nathan Hale, Michael Meit, et al.
Date: 04/2019
Type: Document
Sponsoring organization: Appalachian Regional Commission
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Health Disparities Related to Obesity in Appalachia: Practical Strategies and Recommendations for Communities
Offers statistics on obesity in rural Appalachian communities. Highlights strategies and resources to prevent and reduce obesity. Covers recommendations to assist policymakers, funders, and leaders working to reduce obesity related health disparities.
Author(s): Kate Beatty, Nathan Hale, Michael Meit, et al.
Date: 04/2019
Type: Document
Sponsoring organization: Appalachian Regional Commission
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Health Disparities Related to Opioid Misuse in Appalachia: Practical Strategies and Recommendations for Communities
Offers statistics on opioid misuse and overdose deaths in rural Appalachian communities. Highlights strategies and resources to address opioid issues. Covers recommendations to assist policymakers, funders, and leaders working to reduce opioid related health disparities.
Author(s): Kate Beatty, Nathan Hale, Michael Meit, et al.
Date: 04/2019
Type: Document
Sponsoring organization: Appalachian Regional Commission
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Cancer-Related Beliefs and Perceptions in Appalachia: Findings from 3 States
Highlights a study on the beliefs and perceptions about cancer held by people in Appalachia. Bases conclusions on the results of a survey of rural Appalachian counties in Kentucky, Ohio, and Pennsylvania.
Author(s): Robin C. Vanderpool, Bin Huang, Yangyang Deng, et al.
Citation: Journal of Rural Health, 35(2), 176-188
Date: 03/2019
Type: Document
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The Health Equity Implementation Framework: Proposal and Preliminary Study of Hepatitis C Virus Treatment
Describes an implementation framework used to evaluate barriers to hepatitis C virus (HCV) treatment for elderly, rural, Black, U.S. Department of Veterans Affairs (VA) patients in the South. Identifies barriers and facilitators for HCV treatment. Discusses how the Health Equity Implementation Framework can be used to help research and address health disparities.
Author(s): Eva N. Woodward, Monica M. Matthieu, Uchenna S. Uchendu, Shari Rogal, JoAnn E. Kirchner
Citation: Implementation Science, 14(1), 26
Date: 03/2019
Type: Document
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Dying Too Soon: County-level Disparities in Premature Death by Rurality, Race, and Ethnicity
Examines differences in years of potential life lost prior to age 75. Includes statistics with breakdowns by 6 races or ethnicities and urban or rural status, and U.S. map with majority racial and ethnic group by county.
Author(s): Carrie Henning-Smith, Ashley M. Hernandez, Marizen Ramirez, Rachel Hardeman, Katy Kozhimannil
Date: 03/2019
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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Putting Patients First: Today's Disparities Research Leading to Health Equity Tomorrow
Editorial describing efforts of the Centers for Medicare & Medicaid Services to promote health equity in urban and rural areas, through increasing awareness of disparities, developing solutions, and implementing actions. Summarizes articles included in a special Health Services Research issue devoted to health disparities research.
Author(s): Cara V. James
Citation: Health Services Research, 54(1), Part II, 203-205
Date: 02/2019
Type: Document
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Growth and Persistence of Place-Based Mortality in the United States: The Rural Mortality Penalty
Examines CDC online epidemiologic research data from 1970 to 2016 for urban and rural county mortality trends. Uses U.S. Census data and Bureau of Economic Analysis data to investigate the effects of rurality, education, poverty, income, and race on mortality.
Author(s): Arthur G. Cosby, M. Maya McDoom-Echebiri, Wesley James, et al.
Citation: American Journal of Public Health, 109(1), 155–162
Date: 01/2019
Type: Document
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Establishing a Community-Based Participatory Research Partnership in a Rural Community in the Midwest
Reports on a research approach to address health disparities in a rural Midwestern community identified as a "new destination" location for immigrants including Latinos. Describes the creation of a partnership between the University of Iowa (UI) Prevention Research Center (PRC) and the community of Ottumwa, Iowa to develop an intervention to increase the physical activity within the population that lacks access to primary care, and has high rates of obesity, diabetes, substance abuse, and mental health issues.
Author(s): Edith A. Parker, Barbara Baquero, Jason Daniel-Ulloa, Lynelle Diers, Heidi Haines, et al.
Citation: Progress in Community Health Partnership,13(2), 201-208
Date: 2019
Type: Document
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Health, United States, 2018
Presents an annual overview of national trends in health statistics. Covers health status and determinants, healthcare utilization, access, and expenditures. Includes rural data - see the Trend Tables Data Finder and select "Metropolitan and nonmetropolitan" under Population Subgroups.
Additional links: Trend Tables Data Finder
Date: 2019
Type: Document
Sponsoring organization: National Center for Health Statistics
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Proposed Rural-Specific Objectives for Healthy People 2030
Supports adding a category for rural health to Healthy People 2030 along with specific objectives related to mortality, obesity, healthcare access, and more. Identifies rural/urban disparities for each objective, rationales for including them, possible measures for them, and data sources.
Date: 2019
Type: Document
Sponsoring organization: National Organization of State Offices of Rural Health
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Rural-Urban Differences in Cancer Incidence and Trends in the United States
Examines the North American Association of Central Cancer Registries' public use dataset to compare rural and urban population-based cancer incidence rates from 2009-2013 and trends from 1995-2013. Explores factors associated with rural cancer disparities, including demographic, geographic, and socioeconomic characteristics as well as exposure to carcinogens, like tobacco and HPV.
Author(s): Whitney Zahnd, Aimee James, Wiley Jenkins, et al.
Citation: Cancer Epidemiology, Biomarkers & Prevention, 27(11), 1265-1274
Date: 11/2018
Type: Document
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Suicide Mortality in the United States, 1999-2017
Reports on trends in suicide mortality from 1999 through 2017. Includes data by urbanization level of the decedent's county of residence, with information for metropolitan, micropolitan, and noncore counties.
Author(s): Holly Hedegaard, Sally C. Curtin, Margaret Warner
Date: 11/2018
Type: Document
Sponsoring organization: National Center for Health Statistics
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Update: Rural/Urban Disparities in Pneumococcal Vaccine Service Delivery Among the Fee-for-Service Medicare Population, 2012-2015
Updated report on a study to identify disparities in vaccine provision to people ages 65 and over, and to assess the impact of pharmacies as alternate site providers in rural areas. Revised version specifically assesses the uptake of the 13-valent pneumococcal conjugate vaccine, in response to the revised vaccination recommendations issued in 2014. Includes statistics on pneumococcal vaccine services provided by fee-for-service pharmacies and primary care providers, with breakdowns by rural and urban frequency, and state-level maps with rate of service delivery per eligible population, using 2014 and 2015 data.
Author(s): Joseph C. Vanghelof, Aric Schadler, Patricia R. Freeman, Jeffery C. Talbert
Date: 11/2018
Type: Document
Sponsoring organization: Rural and Underserved Health Research Center
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A Portfolio Analysis of Culturally Tailored Trials to Address Health and Healthcare Disparities
Examines the cultural tailoring strategies used in behavioral health trials among racial and ethnic minorities, rural populations, people with low socioeconomic status, individuals with disabilities, people with low health literacy, and lesbian, gay, bisexual, and transgender (LGBT) communities to improve quality of healthcare, and reduce health and healthcare disparities.
Author(s): Marisa Torres-Ruiz, Kaitlynn Robinson-Ector, Dionna Attinson, et al.
Citation: International Journal of Environmental Research and Public Health, 15(9), 1859
Date: 09/2018
Type: Document
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Closing the Gap between Urban and Rural HPV Vaccination Rates
Webinar recording features a discussion of the Center for Disease Control and Prevention's (CDC's) Morbidity and Mortality Weekly Report on adolescent vaccination coverage, which includes data on HPV vaccination rates in rural areas. Features presentations from researchers at the CDC, Ohio State University, and the University of Kentucky College of Public Health.
Additional links: Audio Recording, Webinar Slides, Webinar Transcript
Date: 09/2018
Type: Video/Multimedia
Sponsoring organization: Rural Health Information Hub
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Better Data and Better Outcomes: Reducing Maternal Mortality in the U.S.
Provides the House Subcommittee on Health hearing recording and related documents on preventing maternal deaths. Addresses disparities in rural maternal mortality. Features testimonies from the American College of Obstetricians and Gynecologists, the National Birth Equity Collaborative, March of Dimes, and more.
Additional links: Joia Crear Perry Testimony, Stacey Stewart Testimony
Date: 09/2018
Type: Video/Multimedia
Sponsoring organization: House Energy and Commerce Committee, Subcommittee on Health
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2017 National Healthcare Quality and Disparities Report
Provides a comprehensive summary and data analysis of healthcare quality and access in the U.S. Includes a discussion of disparities encountered by race/ethnicity and geographic locations along the rural-urban continuum. Addresses access to healthcare, patient safety, person-centered care, care coordination, affordability, healthy living, and effective treatment.
Date: 09/2018
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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Heart Matters: A Study Protocol for a Community Based Randomized Trial Aimed at Reducing Cardiovascular Risk in a Rural, African American Community
Presents a study evaluating an intervention aimed at addressing cardiovascular disease among African Americans in rural North Carolina. Evaluates program data collection, implementation, and outcomes.
Author(s): Giselle Corbie-Smith, Crystal Wiley-Cene, Kiana Bess, et al.
Citation: BMC Public Health, 18, 938
Date: 07/2018
Type: Document
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Rural Insights from the National Center for Health Statistics on Teen Births and Infant Mortality
Webinar presents rural research from the National Center for Health Statistics (NCHS) on teen childbirth and infant mortality rates for rural and urban areas from 2007 to 2015. Discusses the implications of these two health indicators on maternal and child health.
Additional links: Audio Recording, PowerPoint Handout, Transcript
Date: 06/2018
Type: Video/Multimedia
Sponsoring organization: Rural Health Information Hub
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The Rise of the Current Mortality Pattern of the United States, 1890–1930
Uses nationwide data to examine patterns and rural/urban differences in mortality from 1890-1930, with a focus on the 1918 influenza pandemic and the shift in leading causes of death from infectious disease to degenerative disease. Includes death rates per 100,000 people, with data broken down by rurality and disease type, including infectious disease, influenza, influenza and pneumonia, and degenerative disease.
Author(s): Hiroshi Maeda
Citation: American Journal of Epidemiology, 187(4), 639-646
Date: 04/2018
Type: Document
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Achieving Rural Health Equity and Well-Being: Proceedings of a Workshop
Proceedings of a workshop designed to explore impacts of economic issues, immigration, and racial inequities in healthcare in rural communities and to learn about asset-based approaches to addressing these challenges. Features statistics including average life expectancy at birth from 1969-2009 with breakdowns by metropolitan and nonmetropolitan areas, U.S. maps showing levels of poverty and employment, and a chart showing numbers of rural hospital closures from 2005-2017.
Additional links: Read Online
Date: 03/2018
Type: Document
Sponsoring organization: Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
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Urban-Rural County and State Differences in Chronic Obstructive Pulmonary Disease — United States, 2015
Examines rural-urban chronic obstructive pulmonary disease (COPD) disparities. Compares age-adjusted COPD prevalence, Medicare hospitalizations for COPD, and mortality for rural, micropolitan, and metropolitan residents. Also includes state-level data on the percentage rural residents and age-adjusted estimates of selected COPD measures.
Author(s): Janet B. Croft, Anne G. Wheaton, Yong Liu, et al.
Citation: MMWR (Morbidity and Mortality Weekly Report), 67(7), 205-211
Date: 02/2018
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Differences Between Rural and Urban Areas in Mortality Rates for the Leading Causes of Infant Death: United States, 2013–2015
Examines mortality rates for the five leading causes of infant, neonatal, and postneonatal death for rural, small and medium urban, and large urban counties, based on location of the mother's residence. Causes examined are congenital malformations, low birthweight, sudden infant death syndrome, maternal complications, and unintentional injuries.
Additional links: Questions for the Author, NCHStats blog
Author(s): Danielle M. Ely, Donna L. Hoyert
Date: 02/2018
Type: Document
Sponsoring organization: National Center for Health Statistics
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Exploring Strategies to Improve Health and Equity in Rural Communities
Identifies the strengths and assets of rural communities, key partners, change agents, and opportunities to leverage assets to improve rural health and equity through a national forum of over 400 national and regional cross-sector stakeholders. Findings were organized into four categories: individual assets, organizational assets, community assets, and cultural assets. Includes discussion on challenges and opportunities for action for each asset category.
Additional links: Leveraging Culture and History to Improve Health and Equity in Rural Communities, Recommendations for Philanthropies and Government Agencies to Improve Health and Equity in Rural Communities, Supporting Change Agents Across Sectors to Improve Health and Equity in Rural Communities
Author(s): Michael Meit
Date: 02/2018
Type: Document
Sponsoring organization: NORC Walsh Center for Rural Health Analysis
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Assessment of Dietary Patterns, Physical Activity and Obesity from a National Survey: Rural-Urban Health Disparities in Older Adults
Examines the association between rural-urban status, physical activity, consumption of fruits and vegetables, and obesity prevalence in older adults by analyzing data derived from respondents aged 65 and above from the 2012 Behavioral Risk Factor Surveillance System (BRFSS).
Author(s): Steven A. Cohen, Mary L. Greaney, Natalie J. Sabik
Citation: PLoS One, 13(12)
Date: 2018
Type: Document
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Health Equity Report 2017
Reports on trends in health equity and health disparities in the U.S. Provides statistics and information on multiple program areas, including: maternal and child health, primary care, access, quality, HIV/AIDS, mental and behavioral health, chronic disease, health promotion, health workforce, rural versus urban, and geographic disparities. Addresses disparities patterns for three priority areas: mental health, opioid use, and childhood obesity.
Author(s): Gopal Singh, Andrew "Drew" De Los Reyes, Michelle Allender, et al.
Date: 2018
Type: Document
Sponsoring organization: Health Resources and Services Administration
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Understanding Health Disparities in Rural America - Insights from the CDC MMWR Rural Health Series
Webinar recording discusses the CDC's Morbidity and Mortality Weekly Report (MMWR) on Racial/Ethnic Health Disparities Among Rural Adults - United States, 2012-2015. Features presentations from the CMS Office of Minority Health, the CDC Office of Minority Health and Health Equity, and two FORHP Outreach grantees about their efforts to address racial and ethnic disparities in rural areas.
Additional links: Audio Recording, Webinar Slides, Webinar Transcript
Date: 12/2017
Type: Document
Sponsoring organization: Rural Health Information Hub
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Mortality Rates Have Increased for Working-age Rural Adults Since 2000
Line chart showing the change in mortality rates for nonmetropolitan and metropolitan residents, comparing 3-year averages for 1999-2001 and 2013-2015. Data is presented by age group.
Date: 12/2017
Type: Chart/Graph
Sponsoring organization: USDA Economic Research Service
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Racial/Ethnic Health Disparities Among Rural Adults — United States, 2012-2015
Reports on racial/ethnic health disparities among rural residents. Includes data by race/ethnicity for health-related quality of life, healthcare access and use, chronic health conditions, and health-related behaviors. Based on data from the 2012–2015 Behavioral Risk Factor Surveillance System.
Author(s): Cara V. James, Ramal Moonesinghe, Shondelle M. Wilson-Frederick, et al.
Citation: MMWR Surveillance Summaries, 66(23), 1-9
Date: 11/2017
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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QuickStats: Infant Mortality Rate, by Urbanization Level — National Vital Statistics System, United States, 2007 and 2015
Bar chart comparing infant mortality rates in rural counties, small and medium urban counties, and large urban counties in 2007 and 2015.
Citation: MMWR (Morbidity and Mortality Weekly Report), 66(41), 1122
Date: 10/2017
Type: Chart/Graph
Sponsoring organization: Centers for Disease Control and Prevention
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2016 National Healthcare Quality and Disparities Report: Chartbook on Rural Health Care
Summarizes trends in healthcare quality and disparities for rural populations. Includes quality measures for access to healthcare, patient safety, person- and family-centered care, care coordination, affordability, healthy living, and effective treatment.
Author(s): Barbara Barton, Irim Azam
Date: 10/2017
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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Suicide Trends Among and Within Urbanization Levels by Sex, Race/Ethnicity, Age Group, and Mechanism of Death — United States, 2001–2015
Reports on county-level trends in suicide rates during 2001–2015 for large metropolitan, medium/small metropolitan, and nonmetro counties. Includes data by gender, race/ethnicity, and age group. Covers the mechanism of death, with data on firearms, hanging/suffocation, drug poisoning, non-drug poisoning, and other causes.
Author(s): Asha Z. Ivey-Stephenson, Alex E. Crosby, Shane P. D. Jack, Tadesse Haileyesus, Marcie-jo Kresnow-Sedacca
Citation: MMWR Surveillance Summaries, 66(18), 1-16
Date: 10/2017
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Despair as a Cause of Death: More Complex Than It First Appears
Describes studies showing urban-rural and racial/ethnic comparisons of premature deaths due to self-destructive behaviors and possible underlying social and economic factors in the communities.
Author(s): Ana V. Diez Roux
Citation: American Journal of Public Health, 107(10), 1566-1567
Date: 10/2017
Type: Document
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Infant Mortality Rates in Rural and Urban Areas in the United States, 2014
Reports on infant mortality in 2014 among rural, small and medium urban, and large urban counties. Includes data by infant age at death for neonatal (0-27 days) and postneonatal (28-364 days) deaths. Provides infant mortality data by mother's age and by mother's race for non-Hispanic White, non-Hispanic Black, and Hispanic mothers.
Author(s): Danielle M. Ely, Anne K. Driscoll, T.J. Mathews
Date: 09/2017
Type: Document
Sponsoring organization: National Center for Health Statistics
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Pollution and Regional Variations of Lung Cancer Mortality in the United States
Identifies counties in the U.S. with higher rates of lung cancer mortality and related community-level factors, including rurality, socioeconomic status, level of particulate matter pollution, and access to healthcare. Includes a map showing lung cancer mortality clusters and a "lung cancer mortality belt" from eastern Oklahoma through central Appalachia.
Author(s): Justin Xavier Moore, Tomi Akinyemiju, Henry E. Wang
Citation: Cancer Epidemiology, 49, 118-127
Date: 08/2017
Type: Document
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Diabetes Mortality in Rural America: 1999-2015
Examines diabetes-related mortality, with a particular focus on the roles of rurality and race, during a 16-year period from 1999-2015.
Author(s): Timothy H. Callaghan, Samuel D. Towne Jr., Jane Bolin, Alva O. Ferdinand
Date: 08/2017
Type: Document
Sponsoring organization: Southwest Rural Health Research Center
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Diabetes and Forgone Medical Care Due to Cost in the U.S. (2011-2015): Individual-level & Placed-based Disparities
Identifies national trends in diabetes rates and forgone medical care among those with diabetes, along with geographic determinants and other social determinants of health disparities. Assesses rurality as a factor that affects diabetes patients' decision to forgo medical care because of cost.
Author(s): Samuel D. Towne Jr., Jane Bolin, Alva O. Ferdinand, et al.
Date: 08/2017
Type: Document
Sponsoring organization: Southwest Rural Health Research Center
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Health Disparities in Appalachia
Measures population health in Appalachia and explores disparities within the region and between Appalachia and the country as a whole. Features statistics on mortality, morbidity, behavioral health, child health, community characteristics, lifestyle, healthcare systems, quality of care, and social determinants, with breakdowns between urban and rural areas.
Author(s): Julie L. Marshall, Logan Thomas, Nancy M. Lane, et al.
Date: 08/2017
Type: Document
Sponsoring organizations: Appalachian Regional Commission, PDA, Inc., The Cecil G. Sheps Center for Health Services Research
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Bringing Change for Rural COPD Patients: Possibilities with the COPD National Action Plan
Highlights the mounting costs of chronic obstructive pulmonary disease (COPD), the substantial impact the disease has on rural communities, and the growing divide between COPD-related rural and urban mortality rates. The recently released COPD National Action Plan (CNAP) is set to bring COPD into the spotlight as a national health concern, and rural America will likely play a major role.
Author(s): Kay Miller Temple
Citation: Rural Monitor
Date: 08/2017
Type: Document
Sponsoring organization: Rural Health Information Hub
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Health Conditions and Behaviors of Native Hawaiian and Pacific Islander Persons in the United States, 2014
Offers detailed statistics on health conditions and behaviors for the Native Hawaiian and Pacific Islander (NHPI) population and for multiple and single-race NHPI populations, with comparisons to other racial groups and to the U.S. population as a whole. Topics covered include general health status, specific health conditions, disabilities, body mass index, physical activity, and substance use.
Author(s): Adena M. Galinsky, Carla E. Zelaya, Catherine Simile, Patricia M. Barnes
Citation: Vital and Health Statistics, 3(40)
Date: 07/2017
Type: Document
Sponsoring organization: National Center for Health Statistics
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Invasive Cancer Incidence, 2004-2013, and Deaths, 2006-2015, in Nonmetropolitan and Metropolitan Counties — United States
Provides a comprehensive assessment of cancer incidence and deaths by cancer type in nonmetropolitan and metropolitan counties. Includes rural-urban data by gender, age, race/ethnicity, and cancer site. Discusses cancer risk factor prevalence and evidence-based interventions.
Author(s): S. Jane Henley, Robert N. Anderson, Cheryll C. Thomas, et al.
Citation: MMWR Surveillance Summaries, 66(14), 1-13
Date: 07/2017
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Assessing Diabetes and Factors Associated with Foregoing Medical Care among Persons with Diabetes: Disparities Facing American Indian/Alaska Native, Black, Hispanic, Low Income, and Southern Adults in the U.S. (2011-2015)
Identifies trends in care of and prevalence of diabetes in terms of socioeconomic and demographic characteristics, and explores individual and community factors related to diabetes and diabetics' unmet medical needs. Features statistics on percentages of adults diagnosed with diabetes from 2011-2015 and distribution of diabetes and foregone medical care, with breakdowns including race or ethnicity, income, and levels of rurality.
Author(s): Samuel D. Towne, Jr., Jane Bolin, Alva Ferdinand, et al.
Citation: International Journal of Environmental Research and Public Health, 14(5), 464
Date: 05/2017
Type: Document
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Prevalence of Arthritis and Arthritis-Attributable Activity Limitation by Urban-Rural County Classification — United States, 2015
Provides detailed data on prevalence of arthritis and arthritis-attributable activity limitation for six urban-rural categories. Includes urban-rural data by age, gender, race/ethnicity, education, employment, body mass index, smoking status, physical activity, self-rated health, and functionally disabled status.
Author(s): Michael A. Boring, Jennifer M. Hootman, Yong Liu, et al.
Citation: MMWR (Morbidity and Mortality Weekly Report), 66(20), 527-532
Date: 05/2017
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Extending Work on Rural Health Disparities: A Commentary on Matthews and Colleagues' Report
Commentary on the CDC MMWR report, Health-Related Behaviors by Urban-Rural County Classification — United States, 2013. Discusses the value of the data provided in the report, which highlights health-related behaviors for six geographic levels. Offers recommendations to build on this work.
Author(s): Paul A. Gilbert, Helena H. Laroche, Robert B. Wallace, Edith A. Parker, Susan J. Curry
Citation: Journal of Rural Health
Date: 04/2017
Type: Document
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Differences in Health Care, Family, and Community Factors Associated with Mental, Behavioral, and Developmental Disorders Among Children Aged 2–8 Years in Rural and Urban Areas — United States, 2011–2012
Provides rural and urban data on a variety of health-related factors for children 2-8 years of age with and without mental, behavioral, and developmental disorders. Topics addressed include demographics, health insurance coverage, having a medical home, parental mental health, family financial difficulties, and community factors.
Author(s): Lara R. Robinson, Joseph R. Holbrook, Rebecca H. Bitsko, et al.
Citation: MMWR Surveillance Summaries, 66(8), 1-11
Date: 03/2017
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Early Death After Discharge From Emergency Departments: Analysis of National US Insurance Claims Data
Report regarding the incidence of early death after release from emergency departments in the United States and what risk factors may contribute to those deaths. Compares urban and rural hospital location, with data for Critical Access Hospitals (CAHs) and rural non-CAHs. Includes data for rural and urban populations as well as poverty level, previous healthcare use, and other demographics.
Author(s): Ziad Obermeyer, Brent Cohn, Michael Wilson, Anupam B Jena, David M Cutler
Citation: BMJ, 356(j239)
Date: 02/2017
Type: Document
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Health-Related Behaviors by Urban-Rural County Classification — United States, 2013
Provides data on five self-reported health-related behaviors for residents of rural and urban areas. Behaviors include sufficient sleep, current nonsmoking, nondrinking or moderate drinking, maintaining normal body weight, and meeting aerobic leisure time physical activity recommendations. Includes data for each behavior for metropolitan, micropolitan, and noncore (rural) areas, as well as prevalence of 4-5 health behaviors by sex, age, race/ethnicity, and education level. Based on 2013 Behavioral Risk Factor Surveillance System (BRFSS) data.
Author(s): Kevin A. Matthews, Janet B. Croft, Yong Liu, et al.
Citation: MMWR Surveillance Summaries, 66(5), 1-8
Date: 02/2017
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Rural Americans at Higher Risk of Death from Five Leading Causes: Demographic, Environmental, Economic, Social Factors Might Be Key to Difference
Press release describing a study examining rural and urban differences in mortality rates from leading causes of death, including heart disease, cancer, unintentional injuries, chronic lower respiratory disease, and stroke. Discusses rural health disparities and lists ways healthcare providers can address these disparities and improve rural health.
Date: 01/2017
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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State Data Accompanying MMWR Surveillance Summary 66 (No. SS-1): 1-8: Potentially Excess Deaths from the Five Leading Causes of Death in Nonmetropolitan and Metropolitan Areas, United States, 2005-2015
Interactive data visualization that provides state-level metropolitan and non-metro data on expected and potentially excess deaths from cancer, chronic lower respiratory disease, heart disease, stroke, and unintentional injury. Under the Options heading, select "Numbers of Potentially Excess Deaths by State" or "Potentially Excess and Expected Deaths by State and Locality" to access the data.
Citation: MMWR Surveillance Summaries, 66(SS-1), 1-8
Date: 01/2017
Type: Website
Sponsoring organization: Centers for Disease Control and Prevention
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Leading Causes of Death in Nonmetropolitan and Metropolitan Areas — United States, 1999–2014
Investigates the differences in metropolitan and nonmetropolitan regions of the U.S. for the 5 leading causes of death (heart disease, cancer, unintentional injury, chronic lower respiratory disease, and stroke) by analyzing and comparing mortality data derived from the National Vital Statistics System. Discusses the trends in annual age-adjusted death rates for unintentional injury for metropolitan and nonmetropolitan areas of the U.S.
Additional links: Supplemental Maps: Figure 5, Supplemental Tables: Figures 2-5
Author(s): Ernest Moy, Macarena C. Garcia, Brigham Bastian, et al.
Citation: MMWR Surveillance Summaries, 66(1), 1-8
Date: 01/2017
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Reducing Potentially Excess Deaths from the Five Leading Causes of Death in the Rural United States
Reports on the rural-urban disparities regarding potentially preventable deaths caused by heart disease, cancer, unintentional injury, chronic lower respiratory disease (CLRD), and stroke for populations less than 80 years of age. Discusses factors impacting the rural-urban gap, and offers suggestions for reducing these disparities and improving health. Updated in a November 2019 report.
Author(s): Macarena C. Garcia, Mark Faul, Greta Massetti, et al.
Citation: MMWR Surveillance Summaries, 66(2), 1-7
Date: 01/2017
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Communities in Action: Pathways to Health Equity
Identifies elements of effective solutions to advance health equity at the local or community level. Featured examples include the Delta Health Center, a rural Federally Qualified Health Center that uses a community-oriented primary care model to address population health. A brief overview of rural health disparities which includes a discussion on Appalachian health is found on pages 2-19 and 2-20. Appendix A provides a historical and legal context for understanding Native American health disparities.
Additional links: Read Online
Author(s): Committee on Community Based Solutions to Promote Health Equity in the United States
Date: 01/2017
Type: Document
Sponsoring organization: Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
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Considering Culture: Building the Best Evidence-Based Practices for Children of Color
Examines how culture impacts the effectiveness of evidence-based practices in communities of color, suggestions for how that efficacy may be improved, and options beyond the traditional programs that are proving to be valuable for the children in those communities. Discussion the Strong African American Families (SAAF) program in Georgia and gives a rural perspective to the issue.
Date: 2017
Type: Document
Sponsoring organization: Annie E. Casey Foundation
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Report to Congress: Social Risk Factors and Performance Under Medicare's Value-Based Purchasing Program
Uses Medicare data to examine the relationship between social risk factors and the performance of value-based purchasing programs. Discusses policy considerations that could help ensure value-based purchasing programs achieve their intended results, especially among high social risk populations. Categorizes rurality as a community risk factor and discusses whether beneficiaries with social risk factors such as rurality have worse outcomes due to their social risk profile, or because of the providers they see. Also provides rural-specific statistics and recommendations for using value-based purchasing to improve health outcomes among high social risk populations. Appendices summarize and provide additional details for each of the 9 programs evaluated.
Additional links: Appendices
Date: 12/2016
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Chronic Disease Disparities by County Economic Status and Metropolitan Classification, Behavioral Risk Factor Surveillance System, 2013
Examines health disparities in the U.S. using county economic data for unemployment, poverty, and per capita market income to compare metropolitan and nonmetropolitan counties economic status with the prevalence of hypertension, arthritis and self-rated health.
Author(s): Kate M. Shaw, Kristina A. Theis, Shannon Self-Brown, Douglas W. Roblin, Lawrence Barker
Citation: Preventing Chronic Disease, 13
Date: 09/2016
Type: Document
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Colonoscopy Access and Utilization - Rural Disparities in the Carolinas, 2001-2010
Describes the geographic distribution of colonoscopy providers, the utilization rate for colonoscopies in urban and rural populations, and the influence of the availability of colonoscopy providers on patients when seeking care in their local area for North and South Carolina using ambulatory surgery discharge data for colonoscopies from 2001-2010.
Additional links: Fact Sheet
Author(s): Jan M. Eberth, Michele Josey, Tushar Trivedi, James Hibbert, Janice C. Probst
Date: 07/2016
Type: Document
Sponsoring organization: Rural and Minority Health Research Center (formerly the South Carolina Rural Health Research Center)
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Disparities in Adolescents' Residence in Neighborhoods Supportive of Physical Activity — United States, 2011–2012
Discusses the connection between adolescents living in neighborhoods that support physical activity (have sidewalks and walking paths, parks, playgrounds, and/or recreation centers) and overall health. Indicates differences in access to neighborhoods supportive of physical activity based on ethnicity and race, income level, parental education level, and rural areas, with recommendations for community-based projects for improvement.
Author(s): Kathleen B. Watson, Carmen D. Harris, Susan A. Carlson, Joan M. Dorn, Janet E. Fulton
Citation: MMWR (Morbidity and Mortality Weekly Report), 65(23), 598-601
Date: 06/2016
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
view details
Disparities in the Health and Well-Being of Children and Youth in Rural Areas of the United States
Recording of a May 2016 DataSpeak webinar. Topics addressed include trends in rural children's health, rural child mortality, and challenges facing American Indian children. Speakers included Janice Probst of the South Carolina Rural Health Research Center, Alana Knudson of the NORC Walsh Center for Rural Health Analysis, and Steve Holve of Indian Health Service.
Author(s): Janice Probst, Alana Knudson, Steve Holve
Date: 05/2016
Type: Video/Multimedia
Sponsoring organization: Maternal and Child Health Bureau
view details
Association of Blood Lead Levels in Children 0-72 Months with Living in Mid-Appalachia: A Semi-Ecologic Study
Compares the blood lead levels in children ages 0–72 months in Mid-Appalachia with children of same age throughout the U.S. Includes a relational comparison of the number of housing units built before 1950 and 1940 in both regions.
Author(s): R. Constance Wiener, Richard Jurevic
Citation: Rural and Remote Health, 16(2), 3597
Date: 04/2016
Type: Document
view details
2015 National Quality Healthcare and Disparities Report: Chartbook for Health Care for Blacks
Summarizes and illustrates trends in healthcare for the Black population regarding access to healthcare and the priorities of National Quality Strategy (NQS). Includes a comparison of the rural and urban Black population and discusses poverty rates in rural areas.
Date: 02/2016
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
view details
NACRHHS Webinar: Mortality and Life Expectancy in Rural America
Slides from a January 28, 2016 webinar that examined increasing mortality and decreasing life expectancy in rural America, highlighting findings from a report from the National Advisory Committee on Rural Health and Human Services.
Author(s): Ronnie Musgrove, Wayne Myers, Curt Mueller, Alana Knudson, Jocelyn Richgels
Date: 01/2016
Type: Presentation Slides
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Increases in Acute Hepatitis B Virus Infections - Kentucky, Tennessee, and West Virginia, 2006-2013
Reports on increased rates of hepatitis B infections in three Appalachian states, particularly among injection drug users and in non-urban areas.
Author(s): Aaron M. Harris, Kashif Iqbal, Sarah Schillie, et al.
Citation: MMWR (Morbidity and Mortality Weekly Report), 65(3), 47-50
Date: 01/2016
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
view details
2016 County Health Rankings Key Findings Report
Features state-by-state and rural/urban comparisons on health factors and outcomes throughout the United States, including information on premature death, adult obesity, child poverty, and more. Provides county-level data on residential segregation, drug overdose deaths, and insufficient sleep.
Date: 2016
Type: Document
Sponsoring organization: County Health Rankings & Roadmaps
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HHS Action Plan to Reduce Racial and Ethnic Health Disparities: A Nation Free of Disparities in Health and Health Care
Describes efforts by the U.S. Department of Health and Human Services (HHS) to coordinate programs and assess progress toward addressing disparities in health and healthcare among racial and ethnic minorities. Includes discussion of the CDC Community Transformation Grant Program, which places emphasis on reducing health disparities in rural and frontier areas.
Date: 2016
Type: Document
Sponsoring organization: U.S. Department of Health and Human Services Office of Minority Health
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Aging Well in the 21st Century: Strategic Directions for Research on Aging
Outlines the priorities of the National Institute on Aging (NIA). Goal F focuses on improving the health status of older adults in diverse populations, including rural older adults.
Date: 2016
Type: Document
Sponsoring organization: National Institute on Aging
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Mortality and Life Expectancy in Rural America: Connecting the Health and Human Service Safety Nets to Improve Health Outcomes over the Life Course
Policy brief describing the driving forces behind rural health disparities in Appalachian Kentucky. Offers nationally relevant recommendations for addressing these challenges. Discusses rural and urban differences in life expectancy and mortality rates, and other significant factors including behavioral health, substance abuse, population health, trauma care, and transportation.
Date: 10/2015
Type: Document
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Environmental Scan of Programs and Policies Addressing Health Disparities Among Rural Children in Poverty
Examines policies and programs aimed to address health disparities of rural children living in poverty and offers recommendations based on the findings. Provides an environmental scan of community- and state-level interventions aimed to address obesity, behavioral health, oral health, prenatal and postnatal care, and respiratory health.
Author(s): Brenda Natzke, Luke Horner
Date: 09/2015
Type: Document
Sponsoring organization: Mathematica Policy Research
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Do Rural and Urban Women Experience Differing Rates of Maternal Rehospitalizations?
Compares rural and urban differences in maternal hospital readmission rates for women who delivered with minor assistance and for women who delivered by cesarean section, using data from the 2011 California Healthcare Cost and Utilization Project.
Author(s): Wei-Chen Lee, Charles Phillips, Robert Ohsfeldt
Citation: Rural and Remote Health, 15(3), 3335
Date: 08/2015
Type: Document
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The Intersection of Residence and Area Deprivation: The Case of Hospitalizations from Ambulatory Care Sensitive Conditions among Children
Analyzes the role of residence and community deprivation on potentially avoidable hospitalizations among children. Examines rates of potentially avoidable hospitalizations by rural/urban geography across 9 states and discusses policy and research implications of the findings. Part 2 of a 2-part series.
Additional links: Fact Sheet
Author(s): Nathan Hale, Janice C. Probst, Ashley Robertson
Date: 08/2015
Type: Document
Sponsoring organization: Rural and Minority Health Research Center (formerly the South Carolina Rural Health Research Center)
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Area Deprivation Is Higher among Rural Counties — but Not All Rural Counties Are Deprived
Examines the role of residence and community deprivation on potentially avoidable hospitalizations among children. Introduces the Area Deprivation Index, applies the index to counties across the United States, and analyzes rates of potentially avoidable hospitalizations by urban and rural locations across 9 states. (Part 1 of a 2-part series.)
Additional links: Fact Sheet
Author(s): Nathan Hale, Janice C. Probst, Ashley Robertson
Date: 08/2015
Type: Document
Sponsoring organization: Rural and Minority Health Research Center (formerly the South Carolina Rural Health Research Center)
view details
Unequal Lives: The State of Black Women and Families in the Rural South
Analyzes the health and well-being of low-income Black women in nine rural counties across Mississippi, Alabama, and Georgia. Identifies barriers to success and economic security, including poverty, low educational attainment, and inadequate access to public infrastructure, healthcare, and more. Includes statistics and demographics for each of the states and counties included in the study.
Date: 07/2015
Type: Document
Sponsoring organization: Southern Rural Black Women's Initiative
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Differences in Stroke Mortality Among Adults Aged 45 and Over: United States, 2010-2013
Provides data on stroke mortality among adults aged 45 and over by age, race/ethnicity, income, urban-rural residence, and residence inside or outside the Stroke Belt. Figure 4 shows stroke rates for metropolitan and nonmetro counties.
Author(s): Deborah D. Ingram, Jessica A. Montresor-Lopez
Date: 07/2015
Type: Document
Sponsoring organization: National Center for Health Statistics
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Rural Healthy People 2020: New Decade, Same Challenges
Uses results from a nationally representative survey to identify rural health priorities from Healthy People 2020's national priorities. Top rural health priorities include access to quality healthcare, nutrition and weight status, diabetes, and others.
Author(s): Jane Bolin, Gail Bellamy, Alva Ferdinand, et al.
Citation: The Journal of Rural Health, 31(3), 326-333
Date: 05/2015
Type: Document
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Disparities in Colorectal Cancer Treatment Delay Within Appalachia – The Role of For-Profit Hospitals
Discusses the timeliness of colorectal cancer (CRC) treatment in rural hospitals of the Appalachian regions of Kentucky, Ohio, Pennsylvania, and North Carolina. Study uses data from the 2006-2008 Central Cancer Registry (CCR) as well as Medicare claims to identify delays between diagnosis and treatment in healthcare facilities with various funding models.
Author(s): Eric E. Seiber, Fabian Camacho, Muhammad Fazal Zeeshan, et al.
Citation: Journal of Rural Health, 31(4), 382-391
Date: 05/2015
Type: Document
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Deaths From Unintentional Injury Among Adults Aged 65 and Over: United States, 2000–2013
Provides data on unintentional death rates in the U.S., and highlights differences by age, race/ethnicity, and urbanization. Figure 5 compares unintentional deaths for metropolitan and non-metropolitan areas by cause of death. Includes rural and urban data on deaths caused by falls, motor vehicle accidents, suffocation, poisoning, and fire.
Author(s): Ellen Kramarow, Li-Hui Chen, Holly Hedegaard, Margaret Warner
Date: 05/2015
Type: Document
Sponsoring organization: National Center for Health Statistics
view details
The Health and Well-Being of Children in Rural Areas: A Portrait of the Nation 2011–2012
Describes data from the National Survey of Children's Health demonstrating the health and well-being of children, as well as the family environment and the characteristics of the community that affect rural children and their families.
Date: 04/2015
Type: Document
Sponsoring organization: Maternal and Child Health Bureau
view details
Child Health USA 2014
Collection of data on the physical, mental, and emotional health of the Nation's children. Addresses poverty, education, child care, and health service utilization and financing. Includes selected data by rural and urban residence.
Date: 03/2015
Type: Document
Sponsoring organization: Maternal and Child Health Bureau
view details
Reducing Cancer Screening Disparities in Medicare Beneficiaries Through Cancer Patient Navigation
Features a study of an intervention to counter the cancer screening disparities of Native Hawaiian, Asian, and Pacific Islander Medicare beneficiaries in rural Hawaii. Breaks down data by race, age, and comorbidity, among other factors.
Author(s): Kathryn L. Braun, William L. Thomas Jr, Jermy‐Leigh B. Domingo, et al.
Citation: Journal of the American Geriatrics Society, 63(2)
Date: 02/2015
Type: Document
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QuickStats: Percentage of Adults Aged ≥45 Years with Selected Diagnosed Chronic Conditions, by Number of Conditions and Urban/Rural Classification - National Health Interview Survey, 2013
Chart showing the percentage of adults 45 and older with zero, one, or two or more chronic conditions, for rural areas, urban areas, and the U.S. overall.
Citation: MMWR (Morbidity and Mortality Weekly Report), 63(53), 1247
Date: 01/2015
Type: Chart/Graph
view details
New England Regional Health Equity Profile & Call to Action
Report of the New England Regional Health Equity Council (RHEC) identifying disparities in health among racial, ethnic, and disability populations and suggesting pathways for health equity. Includes statistics broken down by race/ethnicity, disability status, gender, age, and urban/rural status.
Author(s): C.E. Drum, K.G. Phillips, K. Chiu
Date: 2015
Type: Document
Sponsoring organizations: National Partnership for Action to End Health Disparities, New England Regional Health Equity Council
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A Cross-Sectional Study on Health Differences Between Rural and Non-Rural U.S. Counties Using the County Health Rankings
Examines the rural and urban differences in health and healthcare within the U.S. using data accessed from the 2013 County Health Rankings and Roadmaps. Vital health factors evaluated include mortality, morbidity, health behaviors, clinical care, social and economic factors, and the physical environment.
Author(s): Timothy J. Anderson, Daniel M. Saman, Martin S. Lipsky, M. Nawal Lutfiyya
Citation: BMC Health Services Research, 15, 441
Date: 2015
Type: Document
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Rural Healthy People 2020: A Companion Document to Healthy People 2020, Volume 1
Provides a rural focus for the Healthy People 2020 priorities. Includes overviews of the top 10 rural health priority areas identified by rural stakeholders. (Volume 2 discusses priorities 11-20.) Topics addressed include: health insurance, primary care, emergency services, nutrition and weight status, diabetes, mental health, substance abuse, heart disease and stroke, physical activity, older adults, maternal and child health, and tobacco use. Each overview includes reviews of the relevant literature and models that rural communities can use to address the issues. Document is available for free download, after providing brief information about intended use.
Author(s): Jane N. Bolin, Gail Bellamy, Alva O. Ferdinand, Bita Kash, Janet W. Helduser
Date: 2015
Type: Document
Sponsoring organization: Southwest Rural Health Research Center
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The Role of Medicare and the Indian Health Service for American Indians and Alaska Natives: Health, Access and Coverage
Examines the health, healthcare access, income, and education disparities that exist within the Native American and Alaskan Native population, as well as the roles of Medicare and the Indian Health Service (IHS) in addressing these disparities.
Author(s): Cristina Boccuti, Christina Swoope, Samantha Artiga
Date: 12/2014
Type: Document
Sponsoring organization: Kaiser Family Foundation
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QuickStats: Age-Adjusted Death Rates from Chronic Obstructive Pulmonary Disease (COPD) Among Persons Aged ≥55 Years, by Sex and Urbanization of County of Residence - United States, 2009-2011
Bar chart showing death rates from Chronic Obstructive Pulmonary Disease for metropolitan and nonmetropolitan areas by gender among adults over 55.
Citation: MMWR (Morbidity and Mortality Weekly Report), 63(44), 1016
Date: 11/2014
Type: Chart/Graph
Sponsoring organization: Centers for Disease Control and Prevention
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Disparities in Obesity Among Rural and Urban Residents in a Health Disparate Region
Reports on a community-based study to measure and compare the current levels of obesity and associated lifestyle behaviors of physical activity and diets of fruits and vegetables among rural and urban residents in south central Virginia and north central North Carolina.
Author(s): Jennie L Hill, Wen You, Jamie M Zoellner
Citation: BMC Public Health, 2014(14), 1051
Date: 10/2014
Type: Document
view details
The 2014 Update of the Rural-Urban Chartbook
Updates information presented in Health, United States, 2001: With Urban and Rural Health Chartbook. Highlights current trends and disparities across different levels of metro and nonmetropolitan counties, including population characteristics; health-related behaviors and risk factors; mortality rates; healthcare access and use; mental health measures; and other health measures such as teen birth rates, tooth loss, and activity limitations due to chronic disease. Individual data tables are available in an Excel file.
Author(s): Michael Meit, Alana Knudson, Tess Gilbert, et al.
Date: 10/2014
Type: Document
Sponsoring organization: Rural Health Reform Policy Research Center
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Rural-Urban Disparities in Heart Disease
Policy brief reporting on rural disparities in heart disease and the associated risk factors of obesity and physical inactivity. Includes heart disease-related death rates and information on obesity prevalence by sex, region, and rural/urban status from 2008-2010. Based on data from the 2014 Update of the Rural-Urban Chartbook.
Author(s): Alana Knudson, Michael Meit, Shena Popat
Date: 10/2014
Type: Document
Sponsoring organization: Rural Health Reform Policy Research Center
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Rural Border Health Chartbook II
Presents an analysis of border counties, both urban and rural, by comparing these counties to other counties within the four border states, and to rural and urban counties in the rest of the U.S. Provides county-level rates and statistics for socio-demographic factors, the physical environment, access to care, and health outcomes.
Additional links: Fact Sheet
Author(s): Grishma P. Bhavsar, Amy Brock Martin, Janice C. Probst, et al.
Date: 10/2014
Type: Document
Sponsoring organization: Rural and Minority Health Research Center (formerly the South Carolina Rural Health Research Center)
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Geographic Variation in Potentially Preventable Hospitalizations for Acute and Chronic Conditions, 2005-2011
Examines potentially preventable hospitalizations for adults from 2005 to 2011. Includes data for acute and chronic conditions by location of patient residence for large and small metropolitan, micropolitan, and remote rural areas.
Author(s): Celeste M. Torio , Roxanne M. Andrews
Date: 09/2014
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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The Geography of Disability in America: On Rural-Urban Differences in Impairment Rates
Shows how adult disability rates vary between rural and urban areas in the U.S. Includes statistics on six types of impairment with breakdowns by age group and three levels of county population density.
Author(s): Christiane von Reichert, Lillie Greiman, Andrew Myers,
Date: 08/2014
Type: Document
Sponsoring organization: University of Montana Rural Institute: A Center for Excellence in Developmental Disabilities
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Assessment of Appalachian Region Pediatric Hearing Healthcare Disparities and Delays
Reports on a study to analyze the timeliness of diagnostic and rehabilitative services for children with severe hearing loss in rural areas of Appalachia which may postpone or delay cochlear implantation and other intervention services.
Author(s): Matthew L. Bush, Mariel Osetinsky, Jennifer B. Shinn, et al.
Citation: Laryngoscope, 124(7), 1713-1717
Date: 07/2014
Type: Document
view details
Effect of Rurality on Screening for Breast Cancer: A Systematic Review and Meta-Analysis Comparing Mammography
Examines urban and rural differences among adult women who utilize mammography screenings.
Author(s): Janni Leung, Samantha McKenzie, Jennifer Martin, Deirdre McLaughlin
Citation: Rural and Remote Health, 14(2), 2730
Date: 06/2014
Type: Document
view details
'Heart Attack' Symptoms and Decision-Making: The Case of Older Rural Women
Identifies barriers to care for heart attack symptoms from interviewing rural women, including difficulty identifying symptoms, perception of ambulance response times, privacy concerns, and more. Interviews rural woman about myocardial infarction prevention, recognition, and treatment.
Author(s): Melanie Jackson, B Jan McCulloch
Citation: Rural and Remote Health, 14(2), 2560
Date: 05/2014
Type: Document
view details
Widening Rural–Urban Disparities in All-Cause Mortality and Mortality from Major Causes of Death in the USA, 1969–2009
Examines U.S. mortality rates between 1969 and 2009 to identify growth or reduction of mortality disparities between rural and urban settings. Addresses the impact or race/ethnicity, gender, and poverty.
Author(s): Gopal K. Singh, Mohammad Siahpush
Citation: Journal of Urban Health, 91(2), 272-292
Date: 04/2014
Type: Document
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Health Disparities in Rural Women
Discusses the health disparities that exist for rural women in all categories of women's health, including obstetric and gynecologic outcomes and access to care. Covers programs to improve healthcare services for rural women and recommendations to reduce health disparities.
Date: 02/2014
Type: Document
Sponsoring organization: American College of Obstetricians and Gynecologists
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Urban-Rural Differences in Coronary Heart Disease Mortality in the United States: 1999-2009
Describes the trends and magnitude of variations in death rates, with statistical breakdowns by age group, sex, race, geographical region, urbanization level, and year. Examines possible contributing factors for the disparities, including physical activity levels, access to health care, socioeconomic status, and education level.
Author(s): Ambar Kulshreshtha, Abhinav Goyal, Kaustubh Dabhadkar, Emir Veledar, Viola Vaccarino
Citation: Public Health Reports, 129(1)
Date: 01/2014
Type: Document
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The State of Health Equity Research: Closing Knowledge Gaps to Address Inequities
Reports results of an analysis of health disparities research funded between 2007 and 2011. Finds that certain populations which experience disparities, including rural populations and Native Americans, are underrepresented in the research. Reports on the health conditions most studied and geographic distribution of studies. Describes a trend to more research on solutions rather than just description of health disparities.
Author(s): AAMC Health Equity Research and Policy Staff
Date: 2014
Type: Document
Sponsoring organization: AcademyHealth
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Ancel Keys Lecture: Adventures (and Misadventures) in Understanding (and Reducing) Disparities in Stroke Mortality
Discusses the racial and geographic disparities in stroke mortality in the U.S. with a goal of determining which intervention methods will best reduce disparities.
Author(s): George Howard
Citation: Stroke, 44(11), 3254-3259
Date: 11/2013
Type: Document
Sponsoring organization: National Institute of Neurological Disorders and Stroke
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CDC Health Disparities and Inequalities Report - United States, 2013
Addresses the differences in mortality and disease risk factors related to behaviors, access to healthcare, and social determinants of health in both rural and urban settings.
Citation: MMWR (Morbidity and Mortality Weekly Report), 62(3)
Date: 11/2013
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Rural Residence and Cancer Outcomes in the US: Issues and Challenges
Analyzes the current literature regarding outcomes of cancer patients who live in rural locations. Discusses several methods of defining rural.
Author(s): Ashley Meilleur, S.V. Subramanian, Jesse J. Plascak, et al.
Citation: Cancer Epidemiology, Biomarkers & Prevention, 22(10), 1657-1667
Date: 10/2013
Type: Document
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Rural-Urban Disparities in Quality of Life among Patients with COPD
Compares the health status of rural and urban patients with Chronic Obstructive Pulmonary Disease (COPD) and identifies the factors associated with differences in two different locations.
Author(s): Bradford E. Jackson, David B. Coultas, Sumihiro Suzuki, Karan P. Singh, Sejong Bae
Citation: Journal of Rural Health, 29(1), 62-69
Date: 08/2013
Type: Document
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All-Cause and Cause-Specific Mortality Among US Youth: Socioeconomic and Rural-Urban Disparities and International Patterns
Analyzes the socioeconomic and rural-urban disparities in all-cause mortality and mortality from leading causes of death, including homicide, suicide, unintentional injuries, and HIV/AIDS, among U.S. youth aged 15–24.
Author(s): Gopal K. Singh, Romuladus E. Azuine, Mohammad Siahpush, Michael D. Kogan
Citation: Journal of Urban Health, 90(3), 388-405
Date: 06/2013
Type: Document
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A Vision for Wellness and Health Equity for American Indian and Alaska Native Boys and Men
Discusses the health and wellness disparities among American Indian and Native Alaska boys and men.
Date: 05/2013
Type: Document
Sponsoring organization: Men's Health Network
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Rural Women's Health
Provides information and statistics on the state of women's health in rural America and how legislation and national trends can affect women's health.
Author(s): Kevin J. Bennett, John E. Lopes Jr., Kathleen Spencer, Saskia van Hecke
Date: 01/2013
Type: Document
Sponsoring organization: National Rural Health Association
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An Analysis of Oral Health Disparities and Access to Services in the Appalachian Region
Analyzes disparities in oral health status and access to oral healthcare in the Appalachian Region. Examines relationships between oral health disparities and socioeconomic status indicators. Focuses on aiding efforts to develop targeted interventions to reduce disparities in Appalachia.
Author(s): Denise D. Krause, Warren L. May, Nancy M. Lane, et al.
Date: 12/2011
Type: Document
Sponsoring organizations: Appalachian Regional Commission, The Cecil G. Sheps Center for Health Services Research
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National Partnership for Action to End Health Disparities: Toolkit for Community Action
Toolkit for professionals, organizations, and policymakers to support and develop community efforts to address health disparities. Covers promoting health equity in rural and urban areas.
Date: 2011
Type: Document
Sponsoring organizations: National Partnership for Action to End Health Disparities, U.S. Department of Health and Human Services Office of Minority Health
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Native Hawaiian and Pacific Islander Health Disparities
Provides an overview of Native Hawaiian and Pacific Islander (NHPI) health in the U.S. Includes data on the health status of NHPIs living in the U.S.-Affiliated Pacific Islands (USAPI) where possible.
Author(s): Won Kim Cook, Corina Chung, Taunu'u Ve'e
Date: 08/2010
Type: Document
Sponsoring organization: Asian & Pacific Islander American Health Forum
view details
Health Disparities: A Rural-Urban Chartbook
Presents data on health disparities experienced by people living in rural America. Includes national and state-level data on health status, health behaviors, healthcare access, preventive care, and diabetes care.
Additional links: Fact Sheet: Health Disparities: A Rural-Urban Chartbook, Fact Sheet: Progress in Women's Cancer Screening, But Colon Cancer Lags, Fact Sheet: Rural Minorities Lag on Flu, Pneumonia Immunization
Author(s): Kevin J. Bennett, Bankole Olatosi, Janice C. Probst
Date: 06/2008
Type: Document
Sponsoring organization: Rural and Minority Health Research Center (formerly the South Carolina Rural Health Research Center)
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Where We Call Home: LGBT in Rural America
Series of reports and resources highlighting the social challenges LGBT people face living in rural America, including one focused on LGBT people of color. Includes recommendations for healthcare providers, policy makers, and educators.
Type: Website
Sponsoring organization: Movement Advancement Project
view details
Life and Health in Rural America
Series of articles based on reports by the Robert Wood Johnson Foundation on life and health in rural America.
Type: Website
Sponsoring organization: Robert Wood Johnson Foundation
view details
Journal of Appalachian Health
Highlights issues relating to the health and wellness of rural Appalachian communities. Features peer-reviewed, open access research on health outcomes in Appalachia.
Type: Journal/Newsletter
Sponsoring organization: University of Kentucky College of Public Health
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Rural Health and Well-Being in America
Features rural health initiatives, articles, and other related content to demonstrate the connection between health, rural community and economic development.
Type: Website
Sponsoring organization: Robert Wood Johnson Foundation
view details
POLARIS: Rural Health
Collection of CDC's policy-relevant research, data, and resources related to rural health issues. Provides an overview of challenges rural areas face and identifies public health strategies to address specific health concerns.
Type: Website
Sponsoring organization: Centers for Disease Control and Prevention
view details
Blue Cross Blue Shield Health Index
Provides access to state and county-level comprehensive health scores based on over 200 health condition categories. Includes data by condition for the top 10 national conditions. Identifies top conditions impacting each state and county. Based on claims data of over 41 million Blue Cross Blue Shield commercially insured members.
Additional links: National Health Index, State and County Views
Type: Website
Sponsoring organization: Blue Cross Blue Shield
view details
DATA2020
Interactive tool to explore data and technical information related to the Healthy People 2020 objectives. Includes data for metropolitan and nonmetro locations for some topics. After selecting a topic and measure, choose "View data by group" and look for Geographic Location to find rural/urban data. Topics addressed include healthcare access, health-related behaviors, specific health conditions, specific populations, and more.
Additional links: Health Disparities Widget
Type: Website
Sponsoring organization: Healthy People
view details
Insights from the CDC MMWR Rural Health Series Webinars
Collection of recorded webinars focused on studies featured in the CDC MMWR Rural Health Series and rural programs funded by the Federal Office of Rural Health Policy (FORHP) that are working to address rural health disparities.
Type: Video/Multimedia
Sponsoring organization: Rural Health Information Hub
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CDC Rural Health
Provides an overview of rural health concerns, access to CDC-produced reports highlighting rural health issues, and examples of resources and successful approaches to improve health in rural communities. Topics addressed include antibiotic use, arthritis, cancer, child health, chronic obstructive pulmonary disease (COPD), leading causes of death, diabetes, drug overdose, health behaviors, motor vehicle safety, suicide, seat belt use, vaccination, and zoonotic diseases in rural communities.
Type: Website
Sponsoring organization: Centers for Disease Control and Prevention
view details
MMWR Rural Health Series
A series of Morbidity and Mortality Weekly Report articles focused on rural health issues.
Type: Website
Sponsoring organization: Centers for Disease Control and Prevention
view details
Mapping Medicare Disparities
Provides access to county-level data and comparisons on chronic disease prevalence, Medicare spending, hospital and emergency department utilization, preventive services, and preventable hospitalizations, readmissions, and mortality rates for Medicare beneficiaries. Includes hospital-level quality of care and cost of care data and comparisons.
Type: Map/Mapping System
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Exploring Rural and Urban Mortality Differences
Offers a variety of data tables and online tools that display indicators of mortality rates by age, rurality, region, and sex to help researchers examine the impact of rurality on mortality.
Type: Website
Sponsoring organization: Rural Health Reform Policy Research Center
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Rural Healthy People 2020
Outlines the strategic plan for Rural Healthy People (RHP) 2020, identifying top rural health priority areas. Includes links to volumes one and two of the RHP2020 report which provide detailed insights on the rural health priority topics.
Type: Website
Sponsoring organization: Southwest Rural Health Research Center
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U.S. Health Map
Interactive map that provides county-level data by gender on life expectancy, mortality rates, and risk factors, including diabetes, hypertension, obesity, physical activity, alcohol use, and smoking.
Type: Map/Mapping System
Sponsoring organization: Institute for Health Metrics and Evaluation
view details
PubMed Search: Healthcare Disparities and Rural Health
Searches PubMed's collection of journal article citations on healthcare disparities and rural health published in the U.S.
Type: Literature Search
Sponsoring organization: U.S. National Library of Medicine
view details
National Healthcare Quality and Disparities Reports
Provides access to reports and data on healthcare quality and disparities information, including strengths, weaknesses, and opportunities for improvement. State View provides information on how each state compares to national healthcare quality benchmarks.
Type: Website
Sponsoring organization: Agency for Healthcare Research and Quality
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IHS Fact Sheets
Offers information on specific healthcare topics concerning American Indians and Alaska Natives. Covers health disparities, IHS programs, health services, and more.
Type: Website
Sponsoring organization: Indian Health Service
view details
State Health Facts
Contains state-level data on demographics, health status, healthcare costs and access, healthcare providers, and more. Includes individual state profiles and 50-state comparisons.
Type: Database
Sponsoring organization: Kaiser Family Foundation
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Additional resources are available related to this guide. See the full list of resources by topic for:


Last Updated: 11/23/2020