Anxiety, Depression, and Access to Mental Health Care by Sexual Orientation and Rurality

Date: June 30, 2022

Anxiety, Depression, and Access to Mental Health Care by Sexual Orientation and Rurality

The purpose of this policy brief is to illustrate the differences in two of the most common mental health disorders (anxiety and depression) and in access to mental health care by sexual orientation and rurality.

Key Findings

  • Rural lesbian, gay, and bisexual (LGB) adults reported the highest rates of depression and anxiety disorder diagnosis, as well as the highest levels of depressed feelings, compared with urban LGB adults and rural and urban heterosexual adults.
  • Urban LGB adults reported the most barriers to accessing health care.
  • Both rural and urban LGB adults were more likely to have delayed mental health care in the past 12 months because of cost, compared with their heterosexual counterparts.

Contact Information:

Carrie Henning-Smith, PhD, MPH, MSW
University of Minnesota Rural Health Research Center
Phone: 612.626.4512

Additional Resources of Interest:

Engaging the Primary Care Provider as Part of the HCV Workforce

Date: June 30, 2022

Now Available On-Demand: Engaging the Primary Care Provider as Part of the Hepatitis C (HCV) Workforce


What is the role of primary care in combating the hepatitis C (HCV) epidemic? This on-demand webinar is designed to build knowledge and skills of the primary care provider workforce to implement effective HCV care and treatment in their practices, including the use of simplified HCV treatment strategies and strategies for providing culturally-responsive, comprehensive HCV care. The webinar is formatted as a panel discussion with presentations from two faculty.

1.0 free CME, CE, and CPE are available for this webinar. 

Educational Objectives

Upon completion of this activity, participants will be able to:

  • Describe how to incorporate evidence-based guidelines for screening and evaluating patients for HCV infection in the primary care setting.
  • Explain the importance of effective follow-up and counseling for patients upon a confirmed diagnosis of HCV infection.
  • Describe how to implement direct-acting antiviral agents into individualized treatment plans for patients with HCV infection in accordance with current guidelines and expert recommendations.

Identify strategies that support a multidisciplinary team-based approach for treating HCV infection, to distinguish patients who can be managed in the primary care setting versus those requiring linkage to specialist care.

Access the webinar by visiting HealthHIV Medical Education.


Primary care providers, nurse practitioners, physician assistants, and other clinicians in primary care settings involved in the care of patients with HCV.


Arun B. Jesudian, MD, Weill Cornell Medicine. Dr. Arun Jesudian is a Transplant Hepatologist and Associate Professor of Clinical Medicine, as
well as Director of Inpatient Liver Services at New York Presbyterian Hospital/Weill Cornell Medicine.

Christian Ramers, MD, Family Health Centers of San Diego. Dr. Ramers is the Chief of Population Health and Director of Graduate Medical Education at the
Family Health Centers of San Diego (FHCSD), a large Federally Qualified Health Center (FQHC).

Joint Accreditation Statement:

In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and HealthHIV. PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

This activity is supported by an educational grant from Gilead Sciences, Inc.

Upcoming Vulnerability Assessment Stakeholder Meetings

Date: June 30, 2022

The Missouri Department of Health and Senior Services has been granted Overdose Data to Action funding to update the Missouri Opioid Overdose and Bloodborne Infection Vulnerability Assessments. These assessments were last published in 2020 and identified counties at highest risk for 1) opioid overdoses and 2) bloodborne infections (i.e., HIV, hepatitis C, hepatitis B) associated with nonsterile drug injection. The overall purpose of the assessments is to raise awareness of areas more impacted by these health conditions and allow stakeholders to use the findings to better target services that will reduce risk of overdoses and risk of bloodborne infection spread through nonsterile drug injection.

In order to gain community-level feedback on the 2022 update and gather suggestions for possible future updates, DHSS is holding stakeholder meetings in each of Missouri’s six HIV Care Regions. DHSS is partnering with the Disaster and Community Crisis Center at the University of Missouri to facilitate the meetings.

Due to the need to gather very specific feedback on the assessments (rather than comments on the opioid epidemic in general) in a relatively short amount of time and due to the need for social distancing, a limited number of stakeholders will be accepted to each meeting. Registration is required and will be accepted on a first come, first served basis. Lunch will be provided at the meetings. DHSS will take additional steps to gather feedback from a broader audience in the future. 

For more information on the overall Overdose Data to Action funding, visit the web page.

The 2020 Missouri Opioid Overdose and Bloodborne Infection Vulnerability Assessments and related materials are available here. 

Use the links below to register for currently scheduled meetings.

Liberty, Missouri (Clay County Public Health Center) – Tuesday, July 12 Registration Link

St. Joseph, Missouri (Remington Nature Center) – Wednesday, July 13 Registration Link

St. Louis, Missouri – Date to be determined

Cape Girardeau, Missouri – Date to be determined

Springfield, Missouri – Date to be determined

Columbia, Missouri – Date to be determined

New Case Studies on LGBTQ+ Health in Rural Areas

Date: June 30, 2022

Small-Town Pride Celebrations Supporting Social Connectedness & Well-Being for LGBTQ+ Rural ResidentsFeelings of social connectedness and belonging vary by sexual orientation and gender identity. For example, lesbian, gay, and bisexual (LGB) adults report lower social cohesion in their neighborhoods, which may be perpetuated by discrimination and homophobia from members of their community. In addition, recent research found that rural LGB adults reported the lowest levels of having their social and emotional needs met, compared with urban LGB adults, urban heterosexual adults, and rural heterosexual adults. This case series highlights examples of two small-town Pride celebrations that contribute to social connectedness and belonging for rural lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) community members.

Rural Community Organizations Building Inclusive Environments for LGBTQ+ ResidentsCommunity organizations play a key role in providing services and programming in rural communities. This case study series highlights examples of rural community organizations providing LGBTQ+ welcoming and inclusive programming and services from different regions across the U.S.

Improving Access to LGBTQIA+-Friendly Care in Rural AreasLesbian, gay, bisexual, transgender, queer/questioning, and asexual/agender (LGBTQIA+) individuals face many barriers to accessing health care, including lack of health insurance, a shortage of health care providers that are skilled in treating LGBTQIA+ patients, as well as stigma and discrimination in health care settings. This case study series features two organizations that are working toward improving health care for rural LGBTQIA+ patients.

Contact Information:

Mariana Story Tuttle, MPH
University of Minnesota Rural Health Research Center
Phone: 612.626.8401

Additional Resources of Interest:

$5 Million for RHC Behavioral Health Initiative Included in House Appropriations Report

Date: June 30, 2022

The National Association of Rural Health Clinics (NARHC) is excited to share that the just-released House Committee on Appropriations report, which serves as an explanation of the appropriations bill for the Departments of Labor, Health and Human Services, and Education, and Related Agencies, includes $5 million to support expanded access to behavioral health services at rural health clinics, as described in President Biden’s 2023 budget request.

As NARHC announced following the release of the proposed budget, the initiative is intended to “allow clinics in rural areas where there are no existing behavioral health providers to fund the salary of a behavioral health provider, address provider burnout, and expand the availability of services such as mental health screenings, counseling, and therapy.”

Over the last few months, NARHC has communicated support of this initiative to the relevant House and Senate committees, through various advocacy letters and meetings with key members. NRHC worked collaboratively with the National Rural Health Association (NRHA) and the National Organization of State Offices of Rural Health (NOSORH) who are united in support of this initiative to support the behavioral health needs of rural communities.

Congress is still several months away from passing the final appropriations package, however, this is a very positive first step in securing the first congressionally appropriated grant for RHCs! NARHC will continue to advocate on the important provision and provide updates to the RHC community.

Email Nathan Baugh at or Sarah Hohman at with any questions.

CDC Resources for Community Health Workers

Date: June 29, 2022

CDC Resources for Community Health Workers

The Centers for Disease Control and Prevention (CDC) wants to celebrate and recognize Community Health Workers (CHWs) and their role as an essential connector between communities, health care and social systems, and state health departments.

Explore this resource collection and enhance CHW work.

Guiders for CHWs to engage people with diabetes and those at risk for developing type 2 diabetes.

Both resources include expanded content and tips for virtual delivery.

Historic Funding Opportunity to Address Unsheltered Homelessness as a Social Determinant of Health in Rural Communities

Date: June 29, 2022

Join the Federal Office of Rural Health Policy on Thursday, June 30 at 2:00 PM ET to learn more about new federal funding that links housing to health care for at-risk individuals and families. The Initiative for Unsheltered and Rural Homelessness is the first of its kind from the U.S. Department of Housing and Urban Development (HUD), investing $322 million in HUD’s Continuum of Care Program, with $54 million set aside for projects in rural areas. The primary objective is collaboration among housing authorities, local health care organizations, and those providing support for issues that often lead to homelessness – such as domestic violence, youth trauma, and substance use disorder.

During this session for rural health providers, listeners will learn about a program model in rural Vermont that helps individuals maintain their housing through long-term mental health services and psycho-social support. An expert from HUD will also explain how rural providers can connect with the grantees who will receive this funding through its Continuum

Webinar Date: June 30, 202

Time: 11:00 AM Pacific, 12:00 PM Mountain, 1:00 PM Central, 2:00  PM Eastern

Register to join at the Rural Health Information Hub*.

*Note that this is a separate session from HUD’s Kick-Off Webinars on June 28 and 29.  More information about these can be found on HUD’s Notice of Funding Opportunity page for this program.

Building Bridges to Better Health: A Primary Health Care Challenge

Date: June 29, 2022

The Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced the launch of Building Bridges to Better Health: A Primary Health Care Challenge, a national competition with a total of $1 million in cash prizes to encourage innovation through technical assistance to health centers. Participants will accelerate the development of low-cost, scalable solutions to help health centers improve patient access to primary care and strengthen the link between health care and social services.

The competition is open to broad public participation, including individuals, groups, health care organizations, and other entities. Phase 1 submissions are due Tuesday, August 2.

To learn more about the challenge, join a HRSA webinar:

Date:  Wednesday, June 29, 2022

Time:  2:00 PM – 3:00 PM CT | 3:00 PM – 4:00 PM ET

Register here.