East Tennessee State University continues to expand its long-standing presence as a leader in rural health research, earning millions of dollars in competitive grant awards and conducting research that impacts national, state, and Appalachian rural health issues.
“The past year has certainly been a busy and productive year for rural health research at ETSU,” said Michael Meit, Director of ETSU’s Center for Rural Health Research, part of the College of Public Health. “We have hired new faculty and staff to address all the needs, and we are working on 10 to 12 projects at any given time.”
The ETSU Center for Rural Health Research was created in 2019 with funding from the state of Tennessee and a generous gift from Ballad Health.
The center was instrumental in helping ETSU earn grant funding in 2020 from the Health Resources and Services Administration (HRSA), Federal Office of Rural Health Policy to create the ETSU/NORC Rural Health Research Center. This center is one of only eight federally funded rural health research centers in the country and is a collaboration between ETSU’s Center for Rural Health Research, ETSU’s Addiction Science Center, and the NORC Walsh Center for Rural Health Analysis.
“Key partnerships have been essential,” said Dr. Robert Pack, Director of the ETSU/NORC Rural Health Research Center. “Our relationship with Ballad Health allowed the College of Public Health to strengthen our rural health research team. Our partnership with NORC brings national-level data analytic expertise and a successful track record in rural health policy research. This is all very consistent with ETSU’s long-standing tradition of forging partnerships to improve our region.”
State and regional initiatives
Continuing to establish its leadership in addressing the health challenges facing the people of Appalachia, ETSU and NORC recently completed their third Diseases of Despair report for the Appalachian Regional Commission (ARC), analyzing the impact of diseases of despair (overdose, suicide, and alcoholic liver disease) on mortality within the Appalachian region.
ETSU is also working closely with ARC on its Investments Supporting Partnerships In Recovery Ecosystems (INSPIRE) initiative, which addresses the substance use disorder crisis across Appalachia by creating or expanding a recovery ecosystem that will lead to workforce entry or re-entry.
“We won a competitive award to evaluate their region-wide INSPIRE initiative,” Meit said. “ARC is funding communities in every one of the 13 Appalachian states to build recovery ecosystems, and we were selected as the region-wide evaluator for that work.”
“Key partnerships have been essential. Our relationship with Ballad Health allowed
the College of Public Health to strengthen our rural health research team. Our partnership
with NORC brings national-level data analytic expertise and a successful track record
in rural health policy research. This is all very consistent with ETSU’s long-standing
tradition of forging partnerships to improve our region.”
In Tennessee, ETSU is supporting regional implementation and statewide evaluation for the Tennessee Department of Health’s (TDH) COVID-19 Health Disparities grant. As part of this work, the center has been able to distribute more than $2 million throughout east Tennessee to community-based organizations while assisting TDH in data collection to understand the impact of this initiative in Tennessee.
“Most importantly, we have been focused in our own region,” Meit said. “We conduct a lot of work with Ballad Health and its regional partners to document strategies to improve health here in the Appalachian Highlands, which creates lessons learned to improve health in rural communities across the nation. We’re working with Ballad Health on a longitudinal study of mothers and children, studying their PEERhelp substance use disorder recovery initiative, and have helped them document the impact of the STRONG Accountable Care Communities initiative, among many other projects.”
National impact
The work of these centers has also provided resources and data used on a national scale.
For example, the ETSU/NORC Rural Health Research Center is producing briefs and reports affecting high-level policy work. In October 2022, the center released a policy brief examining the burden of public stigma associated with mental illness in the rural United States, and policy briefs will soon be released that examine the impact of block grant funding in rural communities, substance use disorder screening among rural residents, and many other topics.
In September 2022, ETSU, along with NORC at the University of Chicago and the Fletcher Group, Inc., released a mapping tool that enables users to measure the strength of substance use recovery ecosystems for every county in the United States and explore associations with overdose deaths and other sociodemographic and economic factors (rei.norc.org). The term “recovery ecosystem” is used to describe the factors in a community that supports individuals in recovery from substance use disorder.
ETSU also joined with five other universities for a collaboration called the Consortium for Workforce Research in Public Health, supported by a first-of-its-kind joint $4.7 million cooperative agreement from HRSA and the Centers for Disease Control and Prevention.
Through this collaboration, led by the Center for Public Health Systems at the University of Minnesota School of Public Health, researchers are conducting robust public health workforce research, evaluation, and analysis. Among the consortium members, ETSU is leading studies focused on the needs of public health workers serving in rural jurisdictions.
Future of rural health research
ETSU leaders identify many possibilities as they look to the next year of rural health research.
“Moving into the future, I see several broad interest areas where ETSU can leverage its expertise,” said Dr. Randy Wykoff, Dean of the ETSU College of Public Health. “One is rural aging, and the other is health care delivery analysis. These are two areas where there are tremendous challenges facing Appalachia and all rural areas in the United States.”
Wykoff also foresees a continued focus on Appalachian health, as ETSU is the oldest school of public health in Central Appalachia and has rooted its mission in improving the lives of the people in the region.
“In addition to the Center for Rural Health Research, we have several other centers working on rural health issues, including ETSU’s Addiction Science Center, CARE Women’s Health, and the Center for Cardiovascular Risks Research,” Wykoff said. “Working together and with other colleges and programs across the university, ETSU will continue to be a leader in rural health research for the foreseeable future.”