Category: Research

Self-Rated Health Among Gay, Lesbian, and Bisexual Adults: Rural/Urban Differences

Date: July 6, 2022

Self-Rated Health Among Gay, Lesbian, and Bisexual Adults: Rural/Urban Differences

This study examines the intersections of sexual orientation, geographic context, and race/ethnicity and their associations with self-rated health. The Rural Health Research & Policy Centers leveraged three nationally representative and population-based datasets in this brief; the National Health Interview Survey (NHIS), the Behavioral Risk Factor Surveillance System (BRFSS), and the Health Information National Trends Survey.

Key Findings

  • Two national datasets (NHIS and BRFSS) revealed statistically significant differences in self-rated health between rural lesbian, gay, and bisexual (LGB) respondents and heterosexual respondents, with LGB respondents more likely to report fair or poor self-rated health.
  • In multivariable models adjusting for age, sex, race, ethnicity, educational attainment, and income, LGB rural adults had lower likelihood of excellent/very good/good self-rated health, compared with heterosexual rural adults in both the NHIS and the BRFSS datasets.
  • Among rural adults, there were differences in self-rated health by race and ethnicity and sexual orientation.

Contact Information:

Carrie Henning-Smith, PhD, MPH, MSW
University of Minnesota Rural Health Research Center
Phone: 612.626.4512
henn0329@umn.edu

Additional Resources of Interest:

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
henn0329@umn.edu

Additional Resources of Interest:

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 Residents: Feelings 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+ Residents: Community 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 Areas: Lesbian, 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
tuttl090@umn.edu

Additional Resources of Interest:

Social and Emotional Support during the COVID-19 Pandemic by Sexual Orientation and Rurality

Date: June 22, 2022

Social and Emotional Support during the COVID-19 Pandemic by Sexual Orientation and Rurality

Rural residents face distinct risks for social isolation and loneliness, as do lesbian, gay, and bisexual (LGB) adults. This policy brief examines nationally representative data on social and emotional supports during the COVID-19 pandemic by rurality and sexual orientation.

Key Findings

  • Rural LGB adults reported the lowest levels of having their social and emotional needs met.
  • Approximately 32.7% of rural LGB adults said those needs were always met (versus 55.7% of rural heterosexual adults).
  • Rural LGB adults also reported the greatest decrease in social and emotional support during the COVID-19 pandemic, with 23.5% saying they had less support than they had a year ago.

Contact Information:

Mariana Story Tuttle, MPH
University of Minnesota Rural Health Research Center
Phone: 612.626.8401
tuttl090@umn.edu

Additional Resources of Interest:

Rural Health Research Gateway

Date: March 8, 2022

Since 1990, Rural Hospital Closures Have Increasingly Occurred in Counties that Are More Urbanized, Diverse, and Economically Unequal

Between 1990 and 2020, there were 334 documented rural hospital closures in 44 states. Closures were more likely to occur in a county with more non‐white residents between 1990 and 2020; and conversely, the share of white residents decreased in rural closure counties. It was also found that between 1990 and 2020, rural closure counties became more economically unequal, with higher unemployment, lower per capita income, and lower median household incomes compared with rural counties overall. Finally, it was found that between 1990 and 2020, rural closure counties were increasingly likely to be primary care and dental health service professional shortage areas prior to the closure of a hospital within their borders.

Contact Information:

Arrianna Marie Planey, PhD, MA
North Carolina Rural Health Research and Policy Analysis Center
amplaney@email.unc.edu

Additional Resources of Interest:

More information from the Rural Health Information Hub’s topic guides: Healthcare Access in Rural Communities, Rural Hospitals, Rural Health Disparities, Rural Health Policy

Click to view Research Alert.

Trends in Network Focus Areas Among Network Development Planning Grantees, 2003-2020

May 26, 2021

Click here to view the policy brief!

In this policy brief, researchers examine the focus areas of the networks funded by the Network Planning Grant program in order to determine if there are trends in the scope and substance of rural health networks. Researchers examined these network focus areas retrospectively in order to see how they have changed over time.

Contact Information:

Katie Rydberg, MPH
University of Minnesota Rural Health Research Center
Phone: 612.626.8401
reedx472@umn.edu

Success Among Rural Health Network Development Planning Grant Awardees: Barriers and Facilitators

May 25, 2021

Success among Rural Health Development

In this policy brief, researchers identify the barriers to and facilitators of success for rural organizations implementing the Rural Health Network Development Planning Grant. As the U.S. healthcare landscape looks increasingly at different ways of funding services, and focus shifts toward value-based payment systems and an emphasis on preventive care, the need for strong networks has become even more apparent. Understanding the challenges and opportunities grantees have faced in forming health networks will have implications for both future grant offerings, as well as other policies and programs that support health care and health in rural areas at the local level.

Contact Information:

Mariana Story Tuttle, MPH
University of Minnesota Rural Health Research Center
Phone: 612.626.8401
tuttl090@umn.edu

Changes in Provision of Selected Services by Rural and Urban Hospitals Between 2009 and 2017

April 19, 2021

During the past decade, access to healthcare services provided by rural hospitals has changed in two major ways. First, there has been a substantial increase in the number of rural hospitals that have closed or converted (provide some healthcare services but not inpatient care). Secondly, and less understood, many rural hospitals have reduced or terminated services historically considered to be essential hospital services. This brief describes and compares the changes in service provision for rural and urban hospitals between 2009 and 2017.

  • The percentage of rural hospitals that provided skilled nursing, obstetrics, labor and delivery, and home health services declined between 2009 and 2017.
  • The percentage of rural hospitals that provided orthopedic services, oncology services, hospital-based outpatient services, emergency psychiatric services, and chemotherapy services increased between 2009 and 2017.
  • Substantial differences in trends were observed between rural and urban hospitals. Across all selected services, there were no declines in the percentage of urban hospitals providing a service, with most services expanding in urban hospitals.

Click HERE to view the full brief.

Contact Information:

George H. Pink, PhD
North Carolina Rural Health Research and Policy Analysis Center
Phone: 919.843.2728
gpink@email.unc.edu

Nationwide Study Shows Continued Rise in Opioid Affected Births

January 12, 2021

A new study conducted by researchers at the U.S. Department of Health and Human Services (HHS) shows that the rates of pregnant women diagnosed with opioid use disorder and of babies born with withdrawal symptoms increased from 2010-2017. The study, published today in the Journal of American Medicine indicates that mothers with opioid-related diagnoses documented at delivery increased by 131%. Additionally, the incidence of babies born with withdrawal symptoms, known as neonatal abstinence syndrome or NAS, increased by 82% nationally over the same period. Increases were seen for nearly all states and demographic groups.

Read the release.