Rural Health Disparities – Resources
Selected recent or important resources focusing on Rural Health Disparities.
Second Report to Congress: Social Risk Factors and Performance in 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: Executive Summary
Date: 03/2020
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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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: Executive Summary
Date: 03/2020
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 and patient demographic characteristics. 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
Sponsoring organization: Government Accountability Office
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Examines trends in pregnancy-related deaths between 2007 and 2016, Analyzes data by cause of death and patient demographic characteristics. 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
Sponsoring organization: Government Accountability Office
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Urban–Rural Infant Mortality Disparities by Race and Ethnicity and Cause of Death
Analyzes data on infant mortality across county-classifications and broken down by race/ethnicity and large metro, medium/small metro, and nonmetropolitan areas. Notes differences regarding cause of death by race/ethnicity, including sudden unexpected infant death, congenital anomalies, and preterm-related.
Author(s): Lindsay S. Womack, Lauren R. Rossen, Ashley H. Hirai
Citation: American Journal of Preventative Medicine, 58(2), 254-260
Date: 02/2020
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Analyzes data on infant mortality across county-classifications and broken down by race/ethnicity and large metro, medium/small metro, and nonmetropolitan areas. Notes differences regarding cause of death by race/ethnicity, including sudden unexpected infant death, congenital anomalies, and preterm-related.
Author(s): Lindsay S. Womack, Lauren R. Rossen, Ashley H. Hirai
Citation: American Journal of Preventative Medicine, 58(2), 254-260
Date: 02/2020
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A Prospective Cohort Analysis of Gut Microbial Co-metabolism in Alaska Native and Rural African People at High and Low Risk of Colorectal Cancer
Presents a study examining the role of diet and gut microbiota in rates of colorectal cancer. Compares the diets of Alaska Natives, who have the highest rates of colorectal cancer in the world, with the diets of rural Africans, who have some of the lowest.
Author(s): Soeren Ocvirk, Annette S. Wilson, Joram M. Posma, et al.
Citation: The American Journal of Clinical Nutrition, 111(2), 406-419
Date: 02/2020
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Presents a study examining the role of diet and gut microbiota in rates of colorectal cancer. Compares the diets of Alaska Natives, who have the highest rates of colorectal cancer in the world, with the diets of rural Africans, who have some of the lowest.
Author(s): Soeren Ocvirk, Annette S. Wilson, Joram M. Posma, et al.
Citation: The American Journal of Clinical Nutrition, 111(2), 406-419
Date: 02/2020
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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
Sponsoring organization: Clinical Advisor
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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
Sponsoring organization: Clinical Advisor
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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
Sponsoring organization: Centers for Disease Control and Prevention
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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
Sponsoring organization: Centers for Disease Control and Prevention
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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
Sponsoring organization: Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
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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
Sponsoring organization: Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
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Rural–Urban Disparities in Pregnancy Intentions, Births, and Abortions Among US Adolescent and Young Women, 1995–2017
Study examining disparities in intendedness and resolution of first pregnancies among rural and urban adolescent and young women using 2002-2017 data from the National Survey of Family Growth. Breaks down data by race/ethnicity, by urban, rural, and suburban residence, and by state. Discusses public health implications of the findings.
Author(s): April Sutton, Daniel T. Lichter, Sharon Sassler
Citation: American Journal of Public Health, 109(12), 1762-1769
Date: 12/2019
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Study examining disparities in intendedness and resolution of first pregnancies among rural and urban adolescent and young women using 2002-2017 data from the National Survey of Family Growth. Breaks down data by race/ethnicity, by urban, rural, and suburban residence, and by state. Discusses public health implications of the findings.
Author(s): April Sutton, Daniel T. Lichter, Sharon Sassler
Citation: American Journal of Public Health, 109(12), 1762-1769
Date: 12/2019
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Divergent Trends in Life Expectancy Across the Rural-Urban Gradient and Association with Specific Racial Proportions in the Contiguous United States 2000-2005
Study estimating life expectancy at age 25 by rural and urban residence, race, and sex using county-level data from 2000 - 2005. Discusses geographic determinants of disparities in life expectancy in the contiguous U.S., comparing rurality and the proportion of specific race populations to life expectancy. Features color-coded maps of the contiguous U.S. that represents life expectancy at age 25 for White, Black, American Indian/Alaska Native, and Asian males and females.
Author(s): Yun Jian, Lucas Neas, Lynne C. Messer, et al.
Citation: International Journal of Public Health, 64(9), 1367-1374
Date: 12/2019
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Study estimating life expectancy at age 25 by rural and urban residence, race, and sex using county-level data from 2000 - 2005. Discusses geographic determinants of disparities in life expectancy in the contiguous U.S., comparing rurality and the proportion of specific race populations to life expectancy. Features color-coded maps of the contiguous U.S. that represents life expectancy at age 25 for White, Black, American Indian/Alaska Native, and Asian males and females.
Author(s): Yun Jian, Lucas Neas, Lynne C. Messer, et al.
Citation: International Journal of Public Health, 64(9), 1367-1374
Date: 12/2019
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Declines In Pediatric Mortality Fall Short For Rural US Children
Examines pediatric mortality rates from 1999-2017 and related factors of race/ethnicity and rurality. Provides data according to age, race/ethnicity, cause-specific mortality, and rural versus urban county.
Author(s): Janice Probst, Whitney Zahnd, Charity Breneman
Citation: Health Affairs, 38, 12
Date: 11/2019
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Examines pediatric mortality rates from 1999-2017 and related factors of race/ethnicity and rurality. Provides data according to age, race/ethnicity, cause-specific mortality, and rural versus urban county.
Author(s): Janice Probst, Whitney Zahnd, Charity Breneman
Citation: Health Affairs, 38, 12
Date: 11/2019
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Additional resources are available related to this guide. See the full list of resources by topic for:
- Appalachia
- Delta Region
- Health disparities
- Rural-urban differences
- The South
- U.S.-Mexico Border Region
Last Updated: 11/14/2025