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Social Determinants of Health for Rural People Resources

Selected recent or important resources focusing on Social Determinants of Health for Rural People.

Confronting Adverse Childhood Experiences to Improve Rural Kids’ Lifelong Health
Highlights a western North Carolina school district and a Native American tribe in Wisconsin that are working to address adverse childhood experiences (ACEs). Provides an overview of the impact ACEs have on health and provides data on ACE exposure among rural adults.
Author(s): Jenn Lukens
Location: Rural Monitor
Date: 09/2017
Type: Document
Sponsoring organization: Rural Health Information Hub
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2016 Child Poverty Rate Sees Largest Decline Since Before Great Recession: Poverty Persists as Challenge for the United States
Data snapshot showing trends in the U.S. child poverty rate between 2007 and 2016, organized by city, rural, or suburban location. Also includes an aggregate rate for all locations. Linked appendix provides state-by-state and regional (Northeast, Midwest, South, West) rates.
Additional links: Appendix Table
Author(s): Beth Mattingly, Andrew Schaefer, Jessica Carson
Date: 09/2017
Type: Document
Sponsoring organization: Carsey School of Public Policy
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Social Determinants of Health: A Quick Reference Guide for State Offices of Rural Health and State and Territorial Health Officials
Provides an overview of social determinants of health (SDOH) in rural communities, and lists partners, resources, and national level initiatives related to four significant SDOH in rural areas: housing, transportation, education, and food insecurity. Intended to serve as a starting point and guide for rural organizations that wish to address SDOH through multi-sector collaboration.
Date: 09/2017
Type: Document
Sponsoring organizations: Association of State and Territorial Health Officials, National Organization of State Offices of Rural Health
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Income and Poverty in the United States: 2016
Reports on income levels and the number of people in poverty for 2015 and 2016, along with the percent change from 2015 to 2016. Includes statistics for metropolitan and non-metropolitan areas (see Table 1 and Table 3). Based on data from the 2017 Current Population Survey Annual Social and Economic Supplement.
Author(s): Jessica L. Semega, Kayla R. Fontenot, Melissa A. Kollar
Date: 09/2017
Type: Document
Sponsoring organization: U.S. Census Bureau
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Household Food Security in the United States in 2016
Reports on household food security, food expenditures, and use of federal food and nutrition assistance programs in 2016. Includes food insecurity statistics for metropolitan and non-metropolitan areas.
Additional links: Report Summary, Statistical Supplement
Author(s): Alisha Coleman-Jensen, Matthew P. Rabbitt, Christian A. Gregory, Anita Singh
Date: 09/2017
Type: Document
Sponsoring organization: USDA Economic Research Service
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Housing and the Role of Hospitals
Provides an overview of the role of housing in health, and discusses what hospitals can can do to address housing instability as a social determinant of health. Offers five case studies of innovative hospital and health system programs related to housing, including a rural California program that provides safe transitional housing to chronically homeless patients after discharge from the hospital.
Date: 08/2017
Type: Document
Sponsoring organizations: American Hospital Association, Health Research & Educational Trust
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The Justice Gap: Measuring the Unmet Civil Legal Needs of Low-income Americans
Reports on civil legal needs experienced by low-income Americans who do not seek professional legal help and the paths they take when facing civil legal problems. Includes information on legal needs related to healthcare access and other issues that impact health, such as housing. Provides details for specific groups, including rural residents, seniors, veterans, people with disabilities, parents of children under 18, and domestic violence survivors.
Additional links: Appendix B2 Tables, Appendix B3 Tables, Full Report, Special Focus: Rural Residents
Date: 06/2017
Type: Document
Sponsoring organization: Legal Services Corporation
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Rural and Urban Differences in Air Quality, 2008-2012, and Community Drinking Water Quality, 2010-2015 — United States
Examines air- and water-quality data and discusses how these environmental hazards vary across a spectrum of urban to rural counties. Includes rural-urban air pollutant data for ozone and particulate matter and data for 10 water contaminants for rural and urban community water systems.
Author(s): Heather Strosnider, Caitlin Kennedy, Michele Monti, Fuyuen Yip
Location: MMWR Surveillance Summaries, 66(13), 1-10
Date: 06/2017
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Rural Health Literacy: Understanding Skills and Demands is Key to Improvement
Provides an overview of the health literacy concerns in rural areas, with insights from researchers and other health literacy experts. Discusses both the skills and demands sides of health literacy and how rural healthcare providers can help their patients.
Author(s): Kay Miller Temple
Location: Rural Monitor
Date: 04/2017
Type: Document
Sponsoring organization: Rural Health Information Hub
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Rural Education At A Glance, 2017 Edition
Provides an overview of rural educational attainment. Compares education levels in rural and urban areas in 2000 and 2015. Also provides rural-urban data by gender, age, and race/ethnicity. Examines rural educational attainment in relation to employment, income, and poverty.
Date: 04/2017
Type: Document
Sponsoring organization: USDA Economic Research Service
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Nonmetro Poverty Has Been Higher Than Metro Poverty Since 1959
Line chart showing the metropolitan and nonmetro poverty rates, as well as the nonmetro-metro gap, from 1959 through 2015.
Date: 03/2017
Type: Chart/Graph
Sponsoring organization: USDA Economic Research Service
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Promising Gains, Persistent Gaps: Youth Disconnection in America
Presents data on disconnected youth in America - young people between the ages of 16 and 24 who are neither in school nor working. Disconnection has been shown to have lasting negative effects, such as lower incomes and poorer physical and mental health. Report includes rural-specific data, and interactive tool allows data to be sorted by state, county, race/ethnicity, gender, congressional district, and more.
Additional links: Executive Summary, Full Report, Interactive Data
Date: 03/2017
Type: Document
Sponsoring organization: Measure of America
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Deep Poverty Rates by Metro/Nonmetro Residence, 1989-2015
Chart comparing metropolitan and nonmetro deep poverty rates, based on 1990-2013 Current Population Survey data combined with 2009-2015 American Community Survey data.
Date: 03/2017
Type: Chart/Graph
Sponsoring organization: USDA Economic Research Service
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Poverty Rates by Age Group and Metro/Nonmetro Residence, 2015
Bar chart showing metropolitan and nonmetro poverty rates for all ages, for children under 6, children under 18, adults aged 18-64, and seniors over 65.
Date: 03/2017
Type: Chart/Graph
Sponsoring organization: USDA Economic Research Service
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Poverty Rates by Race/Ethnicity and Metro/Nonmetro Residence, 2015
Bar chart comparing metropolitan and nonmetro poverty levels for whites, African Americans, American Indian/Alaska Natives, and Hispanic populations.
Date: 03/2017
Type: Chart/Graph
Sponsoring organization: USDA Economic Research Service
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Social Determinants of Health
Policy brief informed by a September 2016 National Advisory Committee on Rural Health and Human Services meeting held in Albuquerque, New Mexico, with site visits to update the committee about factors that affect health outcomes. Identifies emerging payment models and financing strategies, and provides policy recommendations for addressing the social determinants of health in rural communities.
Date: 01/2017
Type: Document
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Housing Needs of American Indians and Alaska Natives in Tribal Areas: A Report From the Assessment of American Indian, Alaska Native, and Native Hawaiian Housing Needs
Provides an overview of housing conditions and needs among American Indian and Alaska Native (AI/AN) households in tribal areas. Includes AI/AN demographic, social, and economic characteristics. Also discusses housing produced by tribes using HUD housing funds available through the Native American Housing Assistance and Self-Determination Act (NAHASDA) of 1996.
Author(s): Nancy Pindus, G. Thomas Kingsley, Jennifer Biess, et al.
Date: 01/2017
Type: Document
Sponsoring organization: U.S. Department of Housing and Urban Development
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Screening for Social Determinants of Health in Michigan Health Centers
Examines screening practices for social determinants of health in Michigan health centers (HCs) including Federally Qualified Health Centers, settings in which the screening was done, and by whom. Includes map of Michigan with HC locations and statistics on characteristics of HCs and patients in the study and percentages of HC screenings for core domains.
Author(s): Elena Byhoff, Alicia J. Cohen, Mary C. Hamati, et al.
Location: Journal of the American Board of Family Medicine, 30(4), 418-427
Date: 2017
Type: Document
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Employment, Poverty, and Public Assistance in the Rural United States
Compares economic and demographic characteristics of rural counties by county income level. Includes data on employment, race/ethnicity, and English-language proficiency. Also examines reliance on public sector supports: the Earned Income Tax Credit (EITC), the Supplemental Nutrition Assistance Program (SNAP), and children's health insurance.
Author(s): Rebecca Glauber, Andrew Schaefer
Date: 2017
Type: Document
Sponsoring organization: Carsey School of Public Policy
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2017 Impact Report: Measuring the Economic and Human Impact of Nonprofit Organizations in Rural America
Highlights key federal programs that support affordable housing and community infrastructure, including water and wastewater disposal. Features 23 successful rural housing programs, describing their work and impact, including health-related improvements and services.
Date: 2017
Type: Document
Sponsoring organization: National Rural Housing Coalition
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Gains in Reducing Child Poverty, but Racial-Ethnic Disparities Persist
Reports on child poverty in 2015 by race/ethnicity and region, with data for rural areas, suburban areas, and cities. Includes information on changes in child poverty since 2014 and since 2009.
Author(s): Jessica A. Carson, Marybeth J. Mattingly, Andrew Schaefer
Date: 2017
Type: Document
Sponsoring organization: Carsey School of Public Policy
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Involuntary Part-Time Employment: A Slow and Uneven Economic Recovery
Examines trends in involuntary part-time employment from 2000 through 2015. Includes data for rural men and rural women, compared to the overall population. Also compares rural and urban involuntary part-time work for those below the poverty line before, during, and after the recession.
Author(s): Rebecca Glauber
Date: 2017
Type: Document
Sponsoring organization: Carsey School of Public Policy
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Small Area Income and Poverty Estimates (SAIPE): 2015
Provides highlights from the 2015 SAIPE, which provides single-year median household income and poverty statistics. Includes many county-level maps showing income and poverty rates in 2015 and changes from 2007 to 2015. Figure 8 lists poverty data for metropolitan, micropolitan, and non-metropolitan areas.
Additional links: SAIPE Release Highlights of 2015 - Data Tables and Maps
Date: 12/2016
Type: Document
Sponsoring organization: U.S. Census Bureau
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Addressing the Social Determinants of Health: The Role of Health Professions Education: Thirteenth Annual Report to the Secretary of the United States Department of Health and Human Services and the Congress of the United States
Includes recommendations for redesign of health professional training to meet needs of an aging and diverse population, to become more team-based and interprofessional, and to prepare students to serve in rural and underserved communities.
Date: 12/2016
Type: Document
Sponsoring organization: Advisory Committee on Training in Primary Care Medicine and Dentistry
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Findings from the National Agricultural Workers Survey (NAWS) 2013-2014: A Demographic and Employment Profile of United States Farmworkers
Reports on demographic and employment characteristics of hired agricultural workers in the United States. Includes data on health insurance and healthcare access, as well as information on social determinants of health such as income, education level, language skills, and housing. Based on data collected from face-to-face interviews with 4,235 crop farmworkers conducted between October 1, 2012 and September 30, 2014.
Author(s): Trish Hernandez, Susan Gabbard, Daniel Carroll
Date: 12/2016
Type: Document
Sponsoring organization: U.S. Department of Labor
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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 nine 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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A Comparison of Rural and Urban America: Household Income and Poverty
Provides an overview of rural and urban income and poverty levels, based on 2011-2015 American Community Survey data. Includes rural-urban data on these topics by age, sex, race/ethnicity, and region.
Author(s): Alemayehu Bishaw, Kirby G. Posey
Date: 12/2016
Type: Document
Sponsoring organization: U.S. Census Bureau
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Teen Birth Rates for Urban and Rural Areas in the United States, 2007-2015
Reports on trends in teen birth rates from 2007 through 2015 in urban and rural areas. Also includes 2015 teen birth rates by race and Hispanic origin for rural and urban counties.
Author(s): Brady E. Hamilton, Lauren M. Rossen, Amy M. Branum
Date: 11/2016
Type: Document
Sponsoring organization: National Center for Health Statistics
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Federal Interagency Health Equity Team Compendium of Publicly Available Datasets and Other Data-Related Resources
Identifies and describes publicly available data that could be used by projects working to reduce health disparities. Includes datasets and data-related resources from agencies within the U.S. Department of Health and Human Services, as well as from the U.S. Census Bureau and U.S. Department of Commerce.
Date: 11/2016
Type: Document
Sponsoring organization: National Partnership for Action to End Health Disparities
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Child Care Deserts
A report analyzing child care centers by zip code in eight states, with a specific focus on how limited or complete lack of access disproportionately affects rural areas. Includes a discussion of what constitutes a child care desert and what may prevent families from finding needed care, such as prohibitive cost based on income ratio.
Date: 10/2016
Type: Document
Sponsoring organization: Center for American Progress
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Bringing Law and Medicine Together to Help Rural Patients
Describes how medical-legal partnerships can help address patients' health-harming legal needs. Features rural medical-legal partnerships in Minnesota and Illinois.
Author(s): Allee Mead
Location: Rural Monitor
Date: 10/2016
Type: Document
Sponsoring organization: Rural Health Information Hub
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The Supplemental Poverty Measure: 2015
Provides estimates of poverty for the official poverty measure and the supplemental poverty measure, which takes into account government programs that support low-income families. Tables 2 and 6 provide data for metropolitan and non-metropolitan areas.
Author(s): Trudi Renwick, Liana Fox
Date: 09/2016
Type: Document
Sponsoring organization: U.S. Census Bureau
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What Works? Strategies to Improve Rural Health
A guide for rural community health improvement. Explains how to find strategies that are likely to be effective. Identifies interventions related to health behaviors, healthcare access and quality, social and economic factors, and the physical environment.
Date: 07/2016
Type: Document
Sponsoring organization: County Health Rankings & Roadmaps
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The Reverend’s Revolution: A Kid-First Approach to Community Health
Features the work of Reverend Richard Joyner and the Conetoe Family Life Center, a North Carolina nonprofit focused on youth development and improving community health.
Author(s): Jenn Lukens
Location: Rural Monitor
Date: 06/2016
Type: Document
Sponsoring organization: Rural Health Information Hub
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Understanding the Rise in Rural Child Poverty, 2003-14
Examines the causes of a decade-long net increase in rural child poverty. Provides data on rural and urban child poverty and discusses different ways of measuring child poverty. Also provides rural-urban data on income, demographics, and income inequality.
Additional links: Report Summary
Author(s): Thomas Hertz, Tracey Farrigan
Date: 05/2016
Type: Document
Sponsoring organization: USDA Economic Research Service
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LGBTQ Healthcare: Building Inclusive Rural Practices
Discusses the challenges rural LGBTQ individuals face in accessing quality care and what rural healthcare providers can do to improve the healthcare experience for this patient population.
Author(s): Zachary Toliver
Location: Rural Monitor
Date: 05/2016
Type: Document
Sponsoring organization: Rural Health Information Hub
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Adverse Childhood Experiences in Rural and Urban Contexts
Reports on a study analyzing the rural prevalence of individual adverse childhood experiences (ACEs), the level of exposure to ACEs in rural regions, and the rural-urban differences of exposure to ACEs by adults using data from the Behavioral Risk Factor Surveillance System (BRFSS).
Author(s): Jean A. Talbot, Donald Szlosek, Erika C. Ziller,
Date: 04/2016
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Stakeholders' Recommendations to Improve Patient-Centered "LGBTQ" Primary Care in Rural and Multicultural Practices
Discusses the results of a pilot study to identify the need to improve primary care practices when treating rural and ethnic-minority lesbian/gay/bisexual/transgender (LGBT) and queer persons within the mostly rural and multicultural state of New Mexico, and offers guidelines to enhance services for the LGBT population within clinical settings.
Author(s): Miria Kano, Alma Rosa Silva-Bañuelos, Robert Sturm, Cathleen E. Willging
Location: Journal of the American Board of Family Medicine, 29(1) 156-160
Date: 02/2016
Type: Document
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Climate Justice in Rural Southeastern United States: A Review of Climate Change Impacts and Effects on Human Health
Reviews the literature from 2010 to 2015 regarding the health effects due to climate change on vulnerable populations in the rural Southeastern part of the U.S. Offers suggestions for climate change mitigation in this region at the local, regional, and national level.
Author(s): Kristie S. Gutierrez, Catherine E. LePrevost
Location: International Journal of Environmental Research and Public Health, 13(2), 189
Date: 02/2016
Type: Document
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A Special Governors' Roundtable: State and County Collaboration to Tackle Chronic Rural Poverty
Video recording of a bi-partisan panel of governors at the National Association of Counties' Annual Meeting discussing issues surrounding childhood poverty in rural America. Focuses on the Rural Impact Challenge, a collaborative effort between county, state, and national leaders to fight rural poverty. Includes discussion of substance abuse prevention and treatment, job creation, economic development, situational and inter-generational poverty, and food insecurity. USDA Secretary Tom Vilsack moderated the panel, which included governors from Tennessee, Virginia, Pennsylvania, and Utah and took place February 22, 2016.
Date: 02/2016
Type: Video/Multimedia
Sponsoring organization: National Association of Counties
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Child Poverty Higher and More Persistent in Rural America
Examines counties with high child poverty and persistent poverty over a 30 year period from 1980 to 2010, with data for metropolitan and nonmetropolitan counties. Includes maps showing regional trends. Also looks at poverty at the county level related to minority child population distribution.
Author(s): Andrew Schaefer, Marybeth J. Mattingly, Kenneth M. Johnson
Date: 02/2016
Type: Document
Sponsoring organization: Carsey School of Public Policy
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Demographic and Economic Characteristics of Immigrant and Native-Born Populations in Rural and Urban Places
Describes demographic and economic characteristics of immigrant and native-born people by metropolitan status. Includes data on education level, English language proficiency, poverty level, and other topics. Also provides selected data by citizenship status for rural and urban immigrants.
Author(s): Andrew Schaefer, Marybeth J. Mattingly
Date: 2016
Type: Document
Sponsoring organization: Carsey School of Public Policy
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After a Parent Left Employment, One in Five Children Lost Private Insurance
Examines children’s loss of private health insurance after parental job loss. Includes data on rural compared to urban privately insured children. Reports that, after parental job loss, rural and urban children were similarly impacted related to health insurance coverage.
Author(s): Kristin Smith
Date: 2016
Type: Document
Sponsoring organization: Carsey School of Public Policy
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Achieving Health Equity: How Academic Medicine Is Addressing the Social Determinants of Health
Includes essays on healthcare challenges faced by rural veterans and on the characteristics of rural immersion training programs for physicians.
Date: 2016
Type: Document
Sponsoring organization: Association of American Medical Colleges
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Screening for Adverse Childhood Experiences in a Family Medicine Setting: A Feasibility Study
Reports on a study set in 3 rural clinical sites exploring the feasibility of using the Adverse Childhood Experience (ACE) screening model for adults during routine office visits. ACEs are generally accepted as predictors in adult health outcomes.
Author(s): Patricia T. Glowa, Ardis L. Olson, Deborah J. Johnson
Location: Journal of the American Board of Family Medicine, 29(3), 303-307
Date: 2016
Type: Document
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Understanding the Social Determinants of Health: A Self-Guided Learning Module for Rural Health Care Teams
Provides information and resources concerning the concept of social determinants of health, and encourages activities to help rural healthcare providers address these issues and improve the health of the communities they serve.
Date: 2016
Type: Document
Sponsoring organization: Rural Health Value
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Child Poverty in Rural America
A policy brief describing the needs, challenges, and experiences of rural children and families living in poverty, and how poverty affects their health. Offers recommendations to the Secretary of Health and Human Services to develop appropriate and integrated health and human service delivery programs, and to create flexible grant opportunities that will reach children and families in need.
Date: 12/2015
Type: Document
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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The Realities of Child Poverty: Insights from a National Advisory Committee Meeting
Reports on discussion at a September 2015 meeting of the National Advisory Committee on Rural Health and Human Services focused on the needs of rural children and families living in poverty. Included a special focus on tribal needs, as the meeting was held at the White Earth Indian Reservation in rural Minnesota.
Author(s): Brandon Baumbach, Kate Menzies
Location: Rural Monitor
Date: 10/2015
Type: Document
Sponsoring organization: Rural Health Information Hub
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Unemployment Rates for Nonmetro Adults 25 and Older by Educational Attainment, 2007-14
Chart showing unemployment rates for rural adults year-by-year, for those with less than a high school diploma, a high school diploma, some college, an associate's degree, a bachelor's degree, or graduate/professional degree.
Date: 09/2015
Type: Chart/Graph
Sponsoring organization: USDA Economic Research Service
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Poverty and Employment Indicators for Nonmetro Counties by Educational Attainment, 2009-14
Chart comparing rural counties where 20% or more of the adult population lack a high school diploma to other rural counties, for poverty, child poverty, and unemployment.
Date: 09/2015
Type: Chart/Graph
Sponsoring organization: USDA Economic Research Service
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Counties Where 20 Percent or More of Adults 25-64 Do Not Have a High School Diploma/Equivalent, 2008-12
Map showing which metropolitan and non-metro counties had 20% or more of adults without a high school diploma.
Date: 09/2015
Type: Map/Mapping System
Sponsoring organization: USDA Economic Research Service
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Understanding the Geography of Growth in Rural Child Poverty
Discusses variations in child poverty among rural counties, based on 2009-2013 American Community Survey data. Includes a map showing rural counties with high child poverty. Discusses family- and community-level factors impacting child poverty. A related Rural Child Poverty Chart Gallery is also available.
Author(s): David McGranahan
Location: Amber Waves
Date: 07/2015
Type: Document
Sponsoring organization: USDA Economic Research Service
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From Rural Poverty to Rural Prosperity: A Lesson in Quilting
Describes the roles that education, healthcare, employment, and human services play in supporting the well-being of rural children and families. Discusses how the availability of these supports can help those living in poverty.
Author(s): Kathleen Belanger
Location: Rural Monitor
Date: 06/2015
Type: Document
Sponsoring organization: Rural Health Information Hub
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Sex in the (Non) City: Teen Childbearing in Rural America
Reports on the high rates of teen births in rural counties and why these rates are higher than urban counties.
Author(s): Alison Stewart Ng, Kelleen Kaye
Date: 05/2015
Type: Document
Sponsoring organization: National Campaign to Prevent Teen and Unplanned Pregnancy
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Opportunity for All: Fighting Rural Child Poverty
Examines trends in poverty in rural areas, including comparison with urban areas. Provides a discussion of the impact of safety net programs that address poverty, and support healthy children and their families in rural areas.
Date: 05/2015
Type: Document
Sponsoring organization: White House (Obama Administration)
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Kick the Bucket: The Future of Rural Sanitation in Alaska
Discusses the challenges rural Alaska communities face related to installing and maintaining water and sewage treatment facilities, particularly as climate change impacts the region's infrastructure. Discusses the health impacts of a lack of running water and flush toilets. Includes links to other stories in a series reporting on water and sewage treatment in rural Alaska.
Date: 05/2015
Type: Document
Sponsoring organization: Alaska Public Media
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Geographies of Opportunity: Ranking Well-Being by Congressional District
Ranks the top and bottom congressional districts based on indicators related to residents' health, access to knowledge, and living standards. Identifies some districts as primarily rural in discussing ranking on specific issues and within certain regions. Includes a comparison of a primarily rural district and primarily urban/suburban district in Virginia in case study on p. 17-19.
Author(s): Sarah Burd-Sharps, Kristen Lewis
Date: 04/2015
Type: Document
Sponsoring organization: Measure of America
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Native American Housing: Obstacles and Opportunities
Recording of a March 24, 2015 panel discussion addressing the challenges involved in supplying and maintaining tribal housing.
Date: 03/2015
Type: Video/Multimedia
Sponsoring organization: U.S. Department of Housing and Urban Development
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Rural Water Infrastructure: Federal Agencies Provide Funding but Could Increase Coordination to Help Communities
Discusses the issues impacting rural water and wastewater systems, including the need to upgrade aging and obsolete infrastructure. Identifies federal agencies that provide funding and technical assistance to rural communities related to drinking water and wastewater.
Date: 02/2015
Type: Document
Sponsoring organization: Government Accountability Office
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Perceptions of Housing Conditions Among Migrant Farmworkers and Their Families: Implications for Health, Safety and Social Policy
Provides insight into the housing conditions of migrant farmworkers in North Carolina and its effect on their health and safety.
Author(s): Jessica Keim-Malpass, Chaya R. Spears Johnson, Sara A. Quandt, Thomas A. Arcury
Location: Rural and Remote Health, 15, 3076
Date: 02/2015
Type: Document
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Ground Water Contamination - Getting Up to Speed
An overview of natural and man-made sources of ground water contamination. Discusses the health effects of contamination, as well as federal regulations related to water quality.
Date: 2015
Type: Document
Sponsoring organization: U.S. Environmental Protection Agency
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The Social Determinants of Health of Type 2 Diabetes and Obesity: A Research Framework
Examines the social determinants of health related to childhood obesity and type 2 diabetes from a Native perspective, considering historical trauma, self-determination, and cultural factors. Looks at currently available information, identifies gaps, and provides a research framework to help build a better understanding of the causes of child obesity among Native Americans.
Date: 2015
Type: Document
Sponsoring organization: Notah Begay III Foundation
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Rural Healthy People 2020: A Companion Document to Healthy People 2020, Volume 2
Provides a rural focus for the Healthy People 2020 priorities with an overview for each of the top health priorities ranked 11 through 20 identified by rural stakeholders. (Volume 1 discussed the top 10 priorities.) Topics include: cancer, health education, oral health, immunizations and infectious disease, public health, sexual health and family planning, injury and violence prevention, and social determinants of health. Includes reviews of the relevant literature and model programs appropriate for rural communities. 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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Behind at the Starting Line: Poverty Among Hispanic Infants
Discusses the economic conditions of the Hispanic/Latino population in rural and urban areas with a focus on the infant population, the prevalence of poverty, and the risks associated with children born into poverty.
Author(s): Daniel T. Lichter, Scott R. Sanders, Kenneth M. Johnson
Date: 2015
Type: Document
Sponsoring organization: Carsey School of Public Policy
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Rural Child Poverty Chart Gallery
Collection of maps on rural child poverty and related factors, including economic conditions, educational attainment, and other issues. A companion to the the July 2015 Amber Waves feature, Understanding the Geography of Growth in Rural Child Poverty.
Date: 2015
Type: Map/Mapping System
Sponsoring organization: USDA Economic Research Service
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Rural Areas Lag Urban Areas in College Completion
Compares rural to urban post-high school educational attainment, with a focus on college completion rates, based on 2008-2012 American Community Survey data. Shows trends via comparison to 2000 Census data.
Author(s): Alexander Marré
Location: Amber Waves
Date: 12/2014
Type: Document
Sponsoring organization: USDA Economic Research Service
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Compassionate Collaboration Reduces Homelessness in Utah
Highlights Utah’s Housing First plan which is decreasing the number of homeless in the state while saving thousands of dollars in emergency medical bills and other costs.
Author(s): Candi Helseth
Location: Rural Monitor, 2014(Fall)
Date: 11/2014
Type: Document
Sponsoring organization: Rural Health Information Hub
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Rural Employment in Recession and Recovery
Describes the impact of the 2007-2008 recession and the recovery that followed, with a focus on rural employment. Discusses regional variation in unemployment. Compares rural to urban employment growth from 2007 to 2014.
Author(s): Thomas Hertz, Lorin Kusmin, Alexander Marré, Timothy Parker
Location: Amber Waves
Date: 10/2014
Type: Document
Sponsoring organization: USDA Economic Research Service
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The 2014 Update of the Rural-Urban Chartbook
Provides an update to information provided 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; 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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Shaping Our Appalachian Region (SOAR) Health Work Group Final Report
Discusses ideas, presented during community listening sessions to the SOAR Health Work Group, to improve health outcomes for residents in the Appalachian region of Eastern Kentucky, where most of the population resides in rural areas. Focuses on coordinated school health, environmental health, smoke-free legislation, substance abuse, wellness and prevention programs, and more.
Date: 09/2014
Type: Document
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Homelessness in Rural America
Discusses the unique needs and characteristics of individuals and families experiencing homelessness in rural America. It covers issues of access and barriers to care for rural human service delivery for homeless populations as well as makes recommendation to the Secretary of the Department of Health and Human Services to address these issues.
Date: 07/2014
Type: Document
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Persistent Poverty Dynamics: Understanding Poverty Trends Over 50 Years
Reports on high-poverty counties, with a poverty rate of 20% or more, based on data from the 2007-2011 American Community Survey, compared to 1970, 1980, 1990 and 2000 Census data. Includes comparison of rural (micropolitan and noncore) counties and metropolitan counties. Identifies counties with persistent and intermittent high poverty, as well as newly high poverty counties.
Author(s): Kathleen Miller, Bruce Weber
Date: 07/2014
Type: Document
Sponsoring organization: Rural Policy Research Institute
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Residential Mobility Across Local Areas in the United States and the Geographic Distribution of the Healthy Population
Examines the potential impact that migration from one community to another may have on population health data, in terms of our understanding of how place impacts health status. Looked at moves over one 5-year period, from 1995 to 2000, for selected urban and rural communities, with information on disability status and education. Considered geographic relocation for blacks and whites, between urban and rural areas, between high-poverty and low-poverty areas, and between North and South.
Author(s): Arline T. Geronimus, John Bound, Annie Ro
Location: Demography, 51(3), 777-809
Date: 06/2014
Type: Document
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Lead Poisoning: Not Just a Problem for Urban Youth
Discusses the risks and health consequences for rural children exposed to lead paint in older rural homes. Also identifies other sources of exposure to lead in housing. Describes "healthy homes" principles and lists other housing quality issues that can impact health.
Author(s): Ron Rupp
Location: Rural Voices, 19(1), 19-21
Date: 03/2014
Type: Document
Sponsoring organization: Housing Assistance Council
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Poverty and Deep Poverty Increasing in Rural America
Examines trends in poverty from 1976-2012, showing poverty and deep poverty data for the rural and urban population, and for rural and urban children. Reports that the 2007-2009 recession resulted in the highest rural poverty rates since the mid-1980s.
Author(s): Tracey Farrigan
Location: Amber Waves
Date: 03/2014
Type: Document
Sponsoring organization: USDA Economic Research Service
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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.
Date: 02/2014
Type: Document
Sponsoring organization: American Congress of Obstetricians and Gynecologists
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The Intersection of Rural Poverty and Federal Human Services Programs
Policy brief discusses the challenges faced by federal human services programs and how they address rural poverty by highlighting two case studies offering two different approaches to meeting those challenges.
Date: 01/2014
Type: Document
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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The Role of Community Health Centers in Assessing the Social Determinants of Health for Planning and Policy: The Example of Frontier New Mexico
Discusses the use of the Tool for Health and Resilience in Vulnerable Environments (THRIVE) by a frontier-based community health center in New Mexico for evaluating and addressing social determinants of health.
Author(s): Sean Bruna, Lisa Cacari Stone, Susan Wilger, Jeremy Cantor, Carolina Guzman
Location: Journal of Ambulatory Care Management, 37(3), 258-268
Date: 2014
Type: Document
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The Long-Term Unemployed in the Wake of the Great Recession: Percent of Unemployed Americans Seeking Work for Longer Than Six Months More Than Doubled Between 2007 and 2013
Reports that the long-term unemployed differ depending on where they live. The urban long-term unemployed are older, have more education, and are more racially diverse than their rural counterparts. The rural long-term unemployed have lower median family incomes and are more likely to be impoverished.
Author(s): Andrew Schaefer
Date: 2014
Type: Document
Sponsoring organization: Carsey School of Public Policy
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Identifying Environmental Health Priorities in Underserved Populations: A Study of Rural Versus Urban Communities
Reports on a study using community engaged focus groups to compare environmental health concerns among minorities in rural and urban communities in Alabama.
Author(s): M.C. Bernhard, M.B. Evans, S.T. Kent, et al.
Location: Public Health, 127(11), 994-1004
Date: 11/2013
Type: Document
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Childhood Poverty and Late Adolescents’ Blood Pressure Reactivity to and Recovery from an Acute Stressor: The Mediating Role of Family Conflict
Reports findings from a study of rural adolescents examining the impact of childhood poverty and family conflict on blood pressure recovery after a stress. Discusses the potential impact of childhood deprivation on health.
Author(s): Gary W. Evans, Deinera Exner-Cortens, Pilyoung Kim, Daniel Bartholomew
Location: Psychosomatic Medicine, 75(7), 691-700
Date: 08/2013
Type: Document
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Middle-Skill Jobs Remain More Common Among Rural Workers
Explores employment trends among middle-skill jobs including the healthcare sector and the recession’s impact on middle-skill workers in rural compared to urban areas.
Author(s): Justin R. Young
Date: 06/2013
Type: Document
Sponsoring organization: Carsey School of Public Policy
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Challenges to Head Start and Early Childhood Development Programs in Rural Communities
Seeks to address the challenges to providing quality early childhood development programs including health screenings in rural communities.
Date: 12/2012
Type: Document
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Culture as a Social Determinant of Health: Examples from Native Communities
Describes the role that culture plays in health for Native Americans. Discusses the importance of cultural competence for healthcare providers, and includes recommendations for healthcare providers and policymakers.
Author(s): James Knibb-Lamouche
Date: 11/2012
Type: Document
Sponsoring organization: Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
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Taking Stock: Rural People, Poverty, and Housing in the 21st Century
Comprehensive assessment of rural poverty and housing in the United States using data from the 2010 Census and American Community Survey (ACS). Includes information on substandard housing in rural areas. Includes sections addressing rural housing for high poverty areas and populations, including the Border Colonias, Appalachia, the Mississippi Delta and housing for Native Americans and farmworkers.
Date: 11/2012
Type: Document
Sponsoring organization: Housing Assistance Council
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Community Health Centers Leveraging the Social Determinants of Health
Provides an overview of how community health centers (CHCs) are working to address the social, economic, and physical conditions that impact their patients' health. Presents 10 case studies, including several rural examples, of CHCs addressing the social determinants of health.
Date: 03/2012
Type: Document
Sponsoring organization: Institute for Alternative Futures
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The Impact of Marcellus Gas Drilling on Rural Drinking Water Supplies
Provides a study of water quality in private water wells in rural Pennsylvania before and after the drilling of nearby Marcellus Shale gas wells.
Author(s): Elizabeth W. Boyer, Bryan R. Swistock, James Clark, Mark Madden, Dana E. Rizzo
Date: 03/2012
Type: Document
Sponsoring organization: Center for Rural Pennsylvania
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Strengths and Silences: The Experiences of Lesbian, Gay, Bisexual and Transgender Students in Rural and Small Town Schools
A report compiled by the Gay, Lesbian, & Straight Education Network (GLSEN) that examines safety, harassment and assault of LGBT students in rural schools based on data collected in the GLSEN's National School Climate Survey (2010-2011). Includes demographics broken down by gender identity, race, sexual orientation, age, region, school type, and school size.
Author(s): Neal A. Palmer, Joseph G. Kosciw, Mark J. Bartkiewicz
Date: 2012
Type: Document
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The Geography of Need: Identifying Human Service Needs in Rural America
Uses American Community Survey five year average county-level data to compare the type and degree of human service needs in metropolitan versus non-metropolitan counties.
Author(s): Colleen Heflin, Kathleen Miller
Date: 06/2011
Type: Document
Sponsoring organization: Rural Policy Research Institute
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A Rural Socioeconomic Risk and Resiliency Inventory and Associated Health Outcomes
Creates an index of social and economic variables that are related to population health outcomes among rural and urban U.S. counties, and examines variability in this index across rural and urban counties.
Additional links: Policy Brief, July 2011: A Rural Socioeconomic Vulnerability and Resiliency Index and Associated Health Outcomes
Author(s): Joel A. Halverson, Michael Hendryx
Date: 03/2011
Type: Document
Sponsoring organization: West Virginia Rural Health Research Center
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Social Determinants of Health Among African Americans in a Rural Community in the Deep South: An Ecological Exploration
Reports on a study that identified potential social determinants of health among African Americans in a rural community in the Deep South.
Author(s): Alison Scott, Rebecca Wilson
Location: Rural and Remote Health, 11, 1634
Date: 02/2011
Type: Document
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Upstream Ecological Risks for Overweight and Obesity Among African American Youth in a Rural Town in the Deep South, 2007
Data from interviews with adult African American community members who interact with youth in varying contexts in a small southeastern Georgia town. Presents their perception that factors including the built environment, laws and policies, and issues such as race and class contribute to the prevalence and perpetuation of obesity.
Author(s): Alison J. Scott, Rebecca F. Wilson
Location: Preventing Chronic Disease, 8(1)
Date: 01/2011
Type: Document
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Why Place & Race Matter
Examines, with a focus on race and ethnicity, how environmental factors can be strengthened to benefit the health of all communities, including rural. Focuses on California.
Date: 2011
Type: Document
Sponsoring organization: PolicyLink
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Rural Workers Have Less Access to Paid Sick Days
Analyzes paid sick time rates of workers by place and type of work and reports that a greater proportion of rural workers than urban workers lack access to at least five paid sick days per year.
Author(s): Andrew Schaefer, Kristin Smith
Date: 2011
Type: Document
Sponsoring organization: Carsey School of Public Policy
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National Stakeholder Strategy for Achieving Health Equity
Identifies 20 strategies to address health disparities, developed through a collaborative process. The section on the current context includes data on rural minorities. Several of the strategies include a objectives related to rural and tribal populations.
Date: 2011
Type: Document
Sponsoring organization: U.S. Department of Health and Human Services
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Toxics Release Inventory Discharges and Population Health Outcomes in Rural and Urban Areas of the United States
Examines whether chemical releases from facilities monitored through the Toxics Release Inventory (TRI) program were associated with population mortality rates and birth outcomes for both rural and urban populations.
Additional links: Policy Brief
Author(s): Michael Hendryx, Evan Fedorko, Juhua Luo
Date: 08/2010
Type: Document
Sponsoring organization: West Virginia Rural Health Research Center
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Patterns of Food Insecurity, Food Availability, and Health Outcomes Among Rural and Urban Counties
Reports that rural counties are disproportionately associated with high food insecurity risk relative to urban counties.
Additional links: Policy Brief
Author(s): Joel Halverson, Cheryl Brown, Melissa Olfert, Melissa Ahern, Christiaan Abildso
Date: 06/2010
Type: Document
Sponsoring organization: West Virginia Rural Health Research Center
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Key Environmental Health Competencies for Rural Primary Care Providers
Identifies a set of basic environmental health competencies that are needed by all rural primary care providers to direct healthcare and education policy, covering assessment, diagnosis, management, and evaluation. Describes the process used in developing the list of key competencies.
Additional links: Policy Brief
Author(s): Cynthia Armstrong Persily, Johnna S. Beane, Mary Glenn Rice
Date: 05/2010
Type: Document
Sponsoring organization: West Virginia Rural Health Research Center
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Pollution Sources and Mortality Rates Across Rural-Urban Areas in the United States
Addresses potential pollution sources and corresponding health outcomes, with particular attention to pollution hazards in rural settings.
Additional links: Policy Brief
Author(s): Michael Hendryx, Evan Fedorko, Joel Halverson
Date: 02/2010
Type: Document
Sponsoring organization: West Virginia Rural Health Research Center
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Health Extension in New Mexico: An Academic Health Center and the Social Determinants of Disease
Discusses New Mexico’s Health Extension Rural Offices (HEROs) program that was developed in response to the Agricultural Cooperative Extension Service methodologies for academic health centers for community engagement focused on rural areas that can address the social determinants of disease.
Author(s): Arthur Kaufman, Wayne Powell, Charles Alfero, et al.
Location: Annals of Family Medicine, 8(1), 73-81
Date: 01/2010
Type: Document
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HUD's Homeless Assistance Programs: Rural Continuums of Care
Provides an overview of the challenges faced by the rural homeless population, including healthcare access barriers. Includes strategies for providers to help them meet the needs of homeless families and individuals who live in rural areas.
Date: 06/2009
Type: Document
Sponsoring organization: U.S. Department of Housing and Urban Development
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Health Literacy Practices in Primary Care Settings: Examples from the Field
Describes health literacy practices at safety net providers, based on a survey as well as site visits to five Federally Qualified Health Centers, including one in frontier Arizona and one in rural Montana. Identifies five promising health literacy practices for primary care settings.
Author(s): Sharon E. Barrett, Jennifer Sheen Puryear, Kathie Westpheling
Date: 01/2008
Type: Document
Sponsoring organization: Commonwealth Fund
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Concentrated Rural Poverty and the Geography of Exclusion
Reports that social exclusion and isolation in poor communities often reinforce racial and class inequality.
Author(s): Daniel Lichter, Domenico Parisi
Date: 2008
Type: Document
Sponsoring organization: Carsey School of Public Policy
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MedlinePlus and the Challenge of Low Health Literacy: Findings From the Colonias Project
Describes the Colonias Project, a health literacy outreach project using promotoras in low-income Hispanic communities along the Texas-Mexico border.
Author(s): Cynthia A. Olney, Debra G. Warner, Greysi Reyna, Fred B. Wood, Elliot R. Siegel
Location: Journal of the Medical Library Association, 95(1), 31-39
Date: 01/2007
Type: Document
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Healthy Housing Reference Manual
Provides information on housing-related health and safety issues, including those particular to rural areas. Chapter 8 focuses on rural water supply and water quality issues.
Date: 2006
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Rebuilding the Unity of Health and the Environment in Rural America: Workshop Summary
Covers rural environmental health, including the social, the natural, and the built environment. Report on a regional workshop at the University of Iowa on November 29-30, 2004 addressing rural environmental health issues.
Date: 2006
Type: Document
Sponsoring organization: Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
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National Tribal Water Center
Information and tools for tribal communities that manage water and wastewater systems. Offers a water resource library, toolkit, and other resources for water utility staff and local leaders.
Type: Website
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Mapping Broadband Health in America
Connect2Health mapping tool for visualizing broadband access, demographics, and health data at the national, state, and county levels. Includes a rural filter based on the percent of the population that is rural.
Type: Map/Mapping System
Sponsoring organization: Federal Communications Commission
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Rural Services Integration Toolkit
Resources and information to help rural communities integrate health and human services. Describes a range of different program models for service integration. Identifies evidence-based and promising models that have been implemented in rural communities.
Type: Website
Sponsoring organization: Rural Health Information Hub
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Population Health Mapper
Customizable maps showing county-level data for issues related to population health, including health status, healthcare services, health behaviors, demographics, socioeconomic factors, and the physical environment. Part of the HealthLandscape set of tools.
Type: Map/Mapping System
Sponsoring organization: American Academy of Family Physicians
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EPA's Study of Hydraulic Fracturing for Oil and Gas and Its Potential Impact on Drinking Water Resources
Provides access to information on an EPA study examining the relationship between hydraulic fracturing (fracking) and drinking water. Includes access to findings from the study, which address how rural communities' drinking water may be impacted.
Type: Website
Sponsoring organization: U.S. Environmental Protection Agency
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EPA Enforcement and Compliance History Online
Access to community-level information on facilities and their compliance with environmental regulations. Includes information on air emissions, surface water discharges, hazardous waste, and drinking water systems.
Type: Database
Sponsoring organization: U.S. Environmental Protection Agency
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Drinking Water Dashboard
Access to data on public water systems regulated under the Safe Drinking Water Act program. Includes information on which public water systems are regulated, inspections, violations, and enforcement actions. To access information on specific water systems, select a state and then click on the bars in the charts to see which systems have been inspected, have violations, and so on.
Type: Database
Sponsoring organization: U.S. Environmental Protection Agency
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diversitydatakids.org
State and county-level profiles and maps providing data on children, including population, race/ethnicity, types of households, teenage mother births, low birthweight, and more.
Type: Website
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The Rural Data Portal
Provides over 350 data indicators identifying the social, economic, and housing characteristics of communities in the United States using Housing Assistance Council (HAC) tabulations of public use data sets that include the Census of Population and Housing, the American Community Survey (ACS), and Home Mortgage Disclosure Act Data.
Type: Website
Sponsoring organization: Housing Assistance Council
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West Virginia Rural Health Research Center Publications
Projects and publications focused on environmental health and social and economic risk and resiliency in rural populations relative to health outcomes. Provides access to products of a former rural health research center funded by Federal Office of Rural Health Policy from 2008-2013.
Type: Website
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Model-based Small Area Income & Poverty Estimates (SAIPE) for School Districts, Counties, and States
Provides access to annual estimates of income and poverty by state, county, and school district. Includes county-level maps and visualizations on child poverty, household income, and overall poverty rates. Data from this source is used in the administration of federal grant programs and the allocation of funds to local districts.
Type: Website
Sponsoring organization: U.S. Census Bureau
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Rural Poverty & Well-being
Provides an overview of rural poverty, as well as access to related Economic Research Service resources. Includes maps, charts, and data on child poverty, poverty by race/ethnicity, and other topics related to rural poverty.
Type: Website
Sponsoring organization: USDA Economic Research Service
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KIDS COUNT Data Center
Provides child well-being data by state, county, city, and congressional district. Includes the following topics: demographics, economic well-being, education, family & community, health, and safety & risky behaviors.
Type: Website
Sponsoring organization: Annie E. Casey Foundation
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Rural Matters
Newsletter focused on ensuring that small and very small drinking water systems are developed and managed.
Type: Journal/Newsletter
Sponsoring organization: Rural Community Assistance Partnership
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Online Services for Key Low-Income Benefit Programs
Provides state-by-state information on online services related to SNAP (Supplemental Nutrition Assistance Program, formerly known as Food Stamps), Medicaid, CHIP (Children's Health Insurance Program), TANF (Temporary Assistance for Needy Families), and child care assistance.
Type: Website
Sponsoring organization: Center on Budget and Policy Priorities
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Additional resources are available related to this guide. See the full list of resources by topic for:


Last Updated: 9/20/2017