Celebrating National Rural Health Day: Highlighting Policy and Research

More than 60 million Americans live in rural communities—small towns, farming communities and villages—which are the social and economic backbone of the nation. Yet while these communities may be great places to live and work, they have their own special healthcare challenges.

Rural residents tend to be older and in poorer health than their urban counterparts. They experience greater rates of chronic disease than other U.S. populations. And they have few resources to deal with their medical and behavioral health needs. About 2,000 rural communities have only one pharmacist nearby and that pharmacist is often the only local healthcare provider.

Policy changes to Medicare, Medicaid, healthcare workforce and health information technology can have substantial impacts on rural residents that are different from the effects to urban residents.

That is why the work of the Rural Health Research Centers (RHRCs) program is so important. It is the only federal research program dedicated to producing policy-relevant research on rural health. The RHRCs works in consultation with the Federal Office of Rural Health Policy to conduct policy-oriented research on rural health services essential to understanding the challenges in rural communities and how those communities are, or may be, impacted by government policy in the areas of access to healthcare, health insurance, and population health. 

The Rural Health Research Gateway is a website created to provide easy access to RHRC projects, summaries of research in progress, and to support the dissemination of research results and policy-oriented information for use by rural stakeholders and decision-makers. As we observe National Rural Health Day on November 15, here is a sample of the rural-specific studies and policy briefs published by the RHRCs in 2018:

Rural and Underserved Health Research Center

Rural/Urban Disparities in Pneumococcal Vaccine Service Delivery Among the Fee-for-Service Medicare Population
This Policy Brief, published in February of 2018, used 2014 data to study access to pneumonia vaccine among the Medicare population. The study found a significant disparity in pneumococcal vaccine service delivery to fee-for-service Medicare beneficiaries. In addition, although primary care providers delivered the majority of pneumococcal vaccines to this population, pharmacy providers delivered a significantly greater proportion of vaccines in rural versus urban counties.

University of Minnesota Rural Health Research Center

Association Between Loss of Hospital-Based Obstetric Services and Birth Outcomes in Rural Counties in the United States
This University of Minnesota Rural Health Research Center study, published in the Journal of the American Medical Association in March 2018, examined whether the loss of obstetric services in hospitals in rural U.S. counties led to changes in childbirth outcomes or locations. The findings showed that, in rural counties not adjacent to urban areas, loss of hospital-based obstetric services was associated with increases in out-of-hospital and preterm births.

North Carolina Rural Health Research Center

Geographic Variation in Uncompensated Care Between Rural and Urban Hospitals
This policy brief published in June of 2018 looked at healthcare coverage from a geographic perspective. The researchers found that rural residents are less likely than urban residents to have healthcare coverage through their employer, are more likely to be low-income, and oftentimes are unable to afford coverage on their own. This often means higher rates of uncompensated care in hospitals that serve rural residents, compared to urban hospitals.

RUPRI Center for Rural Health Policy Analysis

Update: Independently Owned Pharmacy Closures in Rural America, 2003-2018
This policy brief, published in July of 2018, reviewed rural pharmacies and updated previous findings on the continued decline in the number of independently owned rural pharmacies since the implementation of Medicare Part D. Pharmacies play an important role in health service delivery to rural populations and this study found 630 rural communities that had at least one retail (independent, chain, or franchise) pharmacy in March 2003 had no retail pharmacy in March 2018.

WWAMI Rural Health Research Center

Prescribing Practices of Rural Physicians Waivered to Prescribe Buprenorphine

In June 2018, a WWAMI study found that over half of the physicians with a DEA 30-patient waiver to prescribe buprenorphine for patients with opioid use disorder were not treating any patients.

Maine Rural Health Research Center

Residential Settings and Healthcare Use of the Rural "Oldest-Old" Medicare Population
This policy brief published in March 2018 used Medicare Current Beneficiary Survey data to profile rural/urban Medicare beneficiaries ages 85 and older. Researchers found that rural adults in this age group are more likely to be disabled and live alone in the community or in nursing homes and less likely to live in assisted living facilities. The findings highlighted the rural needs for community-based services.

Southwest Rural Health Research Center

Diabetes-Related Hospital Mortality in Rural America: A Significant Cause for Concern Policy Brief
Also in March 2018, this center investigated reports that diabetes prevalence is higher in rural areas than in urban areas. The rural South had the highest average diabetes-related hospital mortality rates. In addition to the South, researchers found that mortality rates also among the highest rural areas of the Midwest compared to other areas in both regions.

For more on these and other research from the Rural Health Research Centers, please go to the following link. To learn more about the importance of rural health research, why rural health issues are unique, and more, view the videos found here.