Category: Rural Health Research Gateway

Nursing Homes in Rural America: A Chartbook

Date: July 8, 2022

Nursing Homes in Rural America: A Chartbook

In this chartbook, the Rural Health Research & Policy Centers document nursing home availability at the county level and identify counties without nursing homes. The Rural Health Research & Policy Centers also evaluate the supply of nursing home beds per 1,000 population aged 65 and older. In addition, the Rural Health Research & Policy Centers identify county-level nursing home availability for counties with and without hospitals with swing beds. Finally, the Rural Health Research & Policy Centers describe the resident and nursing home characteristics including occupancy levels, payer mix, demographics, and health care needs. The Rural Health Research & Policy Centers summarize data for the noncore, micropolitan, and metropolitan counties.

Key Findings

  • A lower proportion of noncore counties have nursing home post-acute care and long-term care services. Even the inclusion of hospitals with swing beds does not eliminate the differences in access to post-acute care and long-term care services between noncore counties and metro/micropolitan counties.
  • Many noncore counties have a higher number of nursing home beds per 1,000 population aged 65 and older, particularly in the Midwest. However, differences in the beds per 1,000 population aged 65 and older between noncore counties and metropolitan counties vary by states/regions.
  • Residents of nursing homes in noncore counties are less likely to have functional limitations but are more likely to have behavioral/mental health needs.

Contact Information:

Hari Sharma, PhD
RUPRI Center for Rural Health Policy Analysis
Phone: 319.384.4368
hari-sharma@uiowa.edu

Additional Resources of Interest:

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:

Prevalence of Chronic Conditions by Sexual Orientation and Rural-Urban Location

Date: June 23, 2022

Prevalence of Chronic Conditions by Sexual Orientation and Rural-Urban Location

Despite the similar challenges that rural residents and lesbian, gay, and bisexual (LGB) individuals face in accessing health care and achieving positive health outcomes, few studies focus on the intersection of rurality and sexual orientation. This policy brief addresses that gap using nationally representative data to examine rates of chronic conditions by rurality and sexual orientation.

Key Findings

  • Compared with heterosexual adults and urban LGB adults, rural LGB adults have the highest rates of chronic conditions overall and were the most likely to report having three or more chronic conditions (43.8% of rural LGB adults).
  • Rural LGB adults have statistically higher rates of arthritis, depression, and diabetes, compared with urban LGB adults.
  • Rural LGB adults have statistically higher rates of asthma, depression, and anxiety, compared with rural heterosexual adults.
  • More than half (54.0%) of rural LGB adults reported a diagnosis of depression, and 43.8% reported a diagnosis of anxiety — rural LGB adults reported higher levels of depression and anxiety than any other group.

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:

Non-Metropolitan and Metropolitan Trends in Mental Health Treatment Availability in Community Health and Community Mental Health Centers

Date: June 16, 2022

Non-Metropolitan and Metropolitan Trends in Mental Health Treatment Availability in Community Health and Community Mental Health Centers

Community mental health centers (CMHCs) and community health centers (CHCs) are two types of federally funded sites where persons may seek mental health treatment. The purpose of this study was to show how the supply of CMHCs and CHCs delivering mental health services changed over time, in non-metropolitan and metropolitan areas.

It was found that the supply of CMHCs decreased substantially from 2000 to 2019 in non-metropolitan counties. However, the supply of CHCs offering mental health services increased substantially over the same time period. These gains were pronounced in both non-metropolitan and metropolitan counties, although growth was faster in metropolitan counties.

Contact Information:

Ty Borders, PhD
Rural and Underserved Health Research Center
Phone: 859.218.2041
ty.borders@uky.edu

Additional Resources of Interest:

Click to view Research Alerts.

Northern Border Regional Commission State and Region Chartbooks – A Health-Focused Landscape Analysis

Date: June 7, 2022

Upcoming Webinar: Northern Border Regional Commission State and Region Chartbooks – A Health-Focused Landscape Analysis

Date: June 21, 2022
Time: 10:00 AM Pacific, 11:00 AM Mountain, 12:00 PM Central, 1:00 PM Eastern
Duration: Approximately 60 minutes
Website: ruralhealthresearch.org/webinars/northern-border-region-chartbooks

During this webinar, Dr. Katherine Ahrens will describe a project compiling the most recent publicly available data related to health and healthcare access at the county-level and state-level for the Northern Border Region: ME, NH, NY, and VT. Dr. Ahrens will discuss healthcare professional shortage areas and will highlight counties with worse health outcomes, as compared to the rest of the counties in the region.

Registration is free and required. Attendance of the live webinar is limited to 500 persons. If you are unable to attend, you will be able to access the recording, archived on the Gateway website.

Registration

Presenters

Katherine Ahrens, PhD, MPH

Additional Resources of Interest:

Click to view Research Alert.

Racial and Ethnic Diversity of the Family Physician Workforce in Non-Metropolitan and Metropolitan Counties

Date: June 6, 2022

The Racial and Ethnic Diversity of the Family Physician Workforce in Non-Metropolitan and Metropolitan Counties

In general, physicians are disproportionately White and male compared to the U.S. workforce and population, but little is known about racial and ethnic distribution of family physicians (FPs) according to rurality and how this compares to urban FPs. The objective was to determine the distribution of FPs in rural areas by race/ethnicity and also whether rural minority physicians were more likely to be in underserved rural areas.

Key Findings

  • The family physician workforce is becoming more racially diverse; however, non-metropolitan family physicians are not.
  • Early career family physicians are more diverse than later career physicians.
  • Minority non-metropolitan family physicians, particularly Black and Native American/Alaska Native physicians, are more likely to practice in persistent poverty counties.

Contact Information:

Lars E. Peterson, MD, PhD
Rural and Underserved Health Research Center
Phone: 859.538.7180
lpeterson@theabfm.org

Additional Resources of Interest:

Click to view Research Alert.

Trends in Revenue Sources among Rural Hospitals

Date: June 1, 2022

Trends in Revenue Sources among Rural Hospitals

This study estimates changes in outpatient care as a source of revenue for rural hospitals. It uses 2011-2019 data from the Healthcare Cost Report Information System to analyze trends in the percent of patient revenue coming from outpatient care.

For the average hospital in the sample of 1,866 rural hospitals, the percent of revenue coming from outpatient services increased from 66.5% in 2011 to 74.2% in 2019. Furthermore, total outpatient revenue for the average rural hospital increased by 56.4% from 2011-2019, after inflation adjustment. Conversely, total inpatient revenue for the average rural hospital only increased by 9.3% from 2011-2019, after inflation adjustment.

The findings suggest that many rural hospitals now receive most of their revenue from outpatient sources.

Contact Information:

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

Additional Resources of Interest:

Click to view Research Alert.

Association Between Rural Hospital Service Changes and Community Demographics

Date: May 31, 2022

Association Between Rural Hospital Service Changes and Community Demographics

This brief investigated the association between the proportion of a rural community belonging to an Agency for Healthcare Research and Quality-identified priority population and local hospital service changes. The results suggest that recent trends in service availability are often similar when comparing hospitals in non-metro counties with larger versus smaller priority populations. In aggregate, from 2011-2017, hospitals in non-metro counties generally experienced a net decrease in the availability of obstetric services and skilled nursing services and a net increase in the availability of oncology services, hospital-based outpatient services, orthopedic services, and emergency psychiatric services. Aggregate changes in the availability of home health and chemotherapy were generally smaller in magnitude. These aggregate results are consistent with previous work on rural hospital-based service availability.

Contact Information:

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

Additional Resources of Interest:

Click to view Research Alert.