Completed Projects
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Assessment of the Area Deprivation Index in Rural Areas
The Area Deprivation Index (ADI) was created by University of Wisconsin researchers to provide a score for neighborhoods based on their level of disadvantage. This study will characterize differences in ADI in rural vs urban areas, summarize the existing literature on ADI, and describe expert considerations for utilizing the ADI for future policy. More info...
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Characteristics of Buprenorphine Therapy Among Commercially-Insured Pregnant and Post-Partum Women
Little is known about the degree to which evidence-based buprenorphine therapy is being accessed consistently and equitably by pregnant and postpartum women with opioid use disorder (OUD). The objective of this study is to analyze prescription claims from a national commercial insurance database to 1) characterize buprenorphine therapy initiation, persistence, and adherence among pregnant and postpartum women with OUD and 2) assess differences in buprenorphine OUD treatment characteristics among rural and urban pregnant/postpartum women. More info...
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Comparing Across Health Indices: Differences by Rurality, Missingness, and Associations With Health Outcomes
Area-level indices of vulnerability, deprivation, prosperity, and the like are increasingly being applied in policy, reimbursement methods, and resource allocation. The purpose of this study is to compare the area-level indices and score missingness by measures of rurality. Further, researchers will examine associations between indices and health-related outcomes of interest. More info...
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Examining the Burden of Public Stigma Associated with Mental Illness in the Rural U.S.
This study examined stigmatizing attitudes and beliefs toward any mental illness among the general population. Similar to prior research, a focus on any mental illness, as opposed to serious mental illness or specific types of mental illness, enhances the generalizability of the findings. More info...
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Examining Differences in Rural and Urban Medicare FFS Beneficiaries' Emergency Department Use Pre-COVID-19 and During COVID-19
This study described and compared the differences in the utilization of emergency department (ED) services among rural and urban Medicare Fee-For-Service enrollees during 2018-2021. Researchers identified factors associated with differences in ED use, including shifts in volume, primary diagnoses, and admission source, before and since the COVID-19 public health emergency in rural and urban areas. More info...
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Following the Money: Do Block Grant Resources Reach Rural Communities?
The overarching goal of this project was to document the distribution of block grant resources from federal agencies through states to local communities, particularly rural communities. We worked closely with the Federal Office of Rural Health Policy (FORHP) to identify two or three block grant programs for inclusion. More info...
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Hierarchical Condition Category (HCC) Risk Scores: Designed to Predict Future Cost and Health Care Resource Use – Do They Also Accurately Reflect Differences in Health Status between Rural and Urban Beneficiaries?
Accurately assessing risk promotes accountability and fairness in payment models and extend the utility of risk scores to additional aspects of care. This study will investigate CMS-HCC risk scores between rural and urban beneficiaries using recent data and analyze which factors drive observed differences. More info...
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Inpatient Treatment Costs Associated with Substance Use Disorders
Multivariate models will be used to explore the inpatient hospital resource costs associated with treatment for substance use disorders (SUD) for rural versus urban populations; how inpatient hospital resource costs vary by patient, market, and hospital characteristics; and whether length-of-stay (LOS), a major correlate of the resource cost of inpatient stays, differs between rural residents compared to urban residents. More info...
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Rural-Urban Analysis of Persistent Health Professional Shortage Areas
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Despite federal and state efforts to invest in the health workforce in underserved areas through loan repayment, technical assistance, and other funding, some communities continue to experience recruitment and retention challenges for many years. Previous studies completed by the University of North Carolina and WWAMI Rural Health Research Center identified persistent primary care HPSAs for whole or partial counties from 1996 to 2004. This study built upon this previous research, leveraging the existing definition of persistent HPSA to identify and explore the landscape of persistent HPSAs using the most recent data available. More info...
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Suicide Mortality: A Comparison of Urban and Rural Rates
Suicide contributes to significant mortality in the United States, accounting for over 48,000 deaths in 2021 alone. There are multiple risk factors for suicide, including age, access to mental health care, geographic isolation, stigma, at-risk substance use, access to firearms, and other social factors. Many of these factors disproportionately affect people living in rural areas.
This project will examine the differences in suicide rates by geography and explore its driving factors among urban and rural areas in the United States from 2018 to 2021. The research design of this study will adopt a cross-sectional, retrospective approach, using secondary data. More info...
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Understanding Rural Health Data Challenges through Analysis of Peer-Reviewed Publication Limitations
Health data are commonly used for decision-making, population health efforts, funding, and reporting at the national, state, and local level. Despite their importance, systematic assessment of the challenges of rural health data and how these challenges may be addressed is lacking. This study will systematically review a subset of the published rural health literature in order to summarize the most common challenges of rural health data, types of data used, and efforts used by researchers in the field to overcome these limitations. More info...