Rural Health
Resources by Topic: Rural-urban differences
Worker Displacement in Appalachia: Using Detailed Industry and Firm Data to Link the Displaced Worker Supplement to Appalachia
Examines worker displacement and its impact in the Appalachian region of the United States. Includes a literature review as well as demographic, employment, and county-level characteristics and experiences of displaced workers. Provides comparisons of metro versus nonmetro areas and discusses health and well-being impacts of displacement.
Author(s): Erin Kenney, Teresa M. Lynch
Date: 06/2025
Sponsoring organization: Appalachian Regional Commission
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Examines worker displacement and its impact in the Appalachian region of the United States. Includes a literature review as well as demographic, employment, and county-level characteristics and experiences of displaced workers. Provides comparisons of metro versus nonmetro areas and discusses health and well-being impacts of displacement.
Author(s): Erin Kenney, Teresa M. Lynch
Date: 06/2025
Sponsoring organization: Appalachian Regional Commission
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The Appalachian Region: A Data Overview from the 2019-2023 American Community Survey Chartbook
State- and county-level information on population, age, household characteristics, housing occupancy, education, labor force, employment, transportation, income, health insurance coverage, disability, and veteran status, for the 13 Appalachian states. Features statistics with breakdowns by 5 levels of population density. Includes data explorer options for Appalachian categories such as population and age, education, income and poverty, computer and broadband access, rural Appalachia versus rural America, and employment and commuting.
Additional links: Full Report
Author(s): Sara Srygley, Nurfadila Khairunnisa, Diana Elliott
Date: 06/2025
Sponsoring organizations: Appalachian Regional Commission, Population Reference Bureau
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State- and county-level information on population, age, household characteristics, housing occupancy, education, labor force, employment, transportation, income, health insurance coverage, disability, and veteran status, for the 13 Appalachian states. Features statistics with breakdowns by 5 levels of population density. Includes data explorer options for Appalachian categories such as population and age, education, income and poverty, computer and broadband access, rural Appalachia versus rural America, and employment and commuting.
Additional links: Full Report
Author(s): Sara Srygley, Nurfadila Khairunnisa, Diana Elliott
Date: 06/2025
Sponsoring organizations: Appalachian Regional Commission, Population Reference Bureau
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Inpatient Psychiatric Unit Availability Within US Short-Term, Acute-Care Hospitals, 2011-2023
Examines the availability of inpatient psychiatric units (IPUs) and the impact of COVID-19 on short-term psychiatric care in hospitals. Utilizes 2011-2023 Centers for Medicaid & Medicare Services (CMS) data to examine changes in IPU availability according to rural versus urban location.
Author(s): Zoe Lindenfeld, Colleen M. McCullough, Ji Eun Chang, et al.
Citation: JAMA Network Open, 8(6)
Date: 06/2025
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Examines the availability of inpatient psychiatric units (IPUs) and the impact of COVID-19 on short-term psychiatric care in hospitals. Utilizes 2011-2023 Centers for Medicaid & Medicare Services (CMS) data to examine changes in IPU availability according to rural versus urban location.
Author(s): Zoe Lindenfeld, Colleen M. McCullough, Ji Eun Chang, et al.
Citation: JAMA Network Open, 8(6)
Date: 06/2025
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The Workforce Outcomes of Physicians Completing Residency Training in North Carolina in 2017, 2018, and 2019
Analyzes the number and percent of residency and fellowship program graduates who completed training in 2017, 2018, and 2019 who were in practice in North Carolina and in rural areas 5 years after residency or fellowship graduation. Also examines the number and percent of physicians who completed residency training in North Carolina who were in practice in North Carolina 5 years after training for 7 high need specialties.
Author(s): Evan Galloway, Brianna Lombardi, Erin P. Fraher
Date: 06/2025
Sponsoring organization: The Cecil G. Sheps Center for Health Services Research
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Analyzes the number and percent of residency and fellowship program graduates who completed training in 2017, 2018, and 2019 who were in practice in North Carolina and in rural areas 5 years after residency or fellowship graduation. Also examines the number and percent of physicians who completed residency training in North Carolina who were in practice in North Carolina 5 years after training for 7 high need specialties.
Author(s): Evan Galloway, Brianna Lombardi, Erin P. Fraher
Date: 06/2025
Sponsoring organization: The Cecil G. Sheps Center for Health Services Research
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Affordable Care Act Enrollment in Texas after Rating Area Adjustments
Provides a brief overview of how Texas changed its approach to Affordable Care Act (ACA) rating areas for rural counties in 2023. Examines the association between the ACA rating area change and health plan enrollment, plan selection, and premiums from 2022 to 2024. Compares findings by urban and rural county status.
Author(s): Elena Andreyeva, Daniel Marthey, Simon F. Haeder, Benjamin Ukert
Citation: The American Journal of Managed Care, 31(6), e147-e152
Date: 06/2025
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Provides a brief overview of how Texas changed its approach to Affordable Care Act (ACA) rating areas for rural counties in 2023. Examines the association between the ACA rating area change and health plan enrollment, plan selection, and premiums from 2022 to 2024. Compares findings by urban and rural county status.
Author(s): Elena Andreyeva, Daniel Marthey, Simon F. Haeder, Benjamin Ukert
Citation: The American Journal of Managed Care, 31(6), e147-e152
Date: 06/2025
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2023 Quality Payment Program Experience Report
Reports on the clinician experience for those participating in the Quality Payment Program in 2023. Presents data on Merit-based Incentive Payment System (MIPS) eligibility and participation rates for clinicians in small practices and rural areas, mean and median final scores for 2023 and 2025 payment adjustments, and payment adjustment trends from 2021 through 2023.
Date: 06/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Reports on the clinician experience for those participating in the Quality Payment Program in 2023. Presents data on Merit-based Incentive Payment System (MIPS) eligibility and participation rates for clinicians in small practices and rural areas, mean and median final scores for 2023 and 2025 payment adjustments, and payment adjustment trends from 2021 through 2023.
Date: 06/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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The Impact of High Hospital Fixed-Cost Ratios on Rural Populations
Explores how rurality relates to hospital cost structures as categorized by Urban Influence Codes (UICs). Describes the characteristics of hospitals at different fixed-to-total-cost ratio levels, the demographics associated with hospitals at different ratio levels, and the share of nonmetropolitan hospitals that have Critical Access Hospital (CAH) or Low-Volume Hospital (LVH) designations. Discusses how findings could be used to refine hospital payment policies.
Author(s): Abigail Barker, Eliot Jost, Timothy McBride, Keith Mueller
Date: 06/2025
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Explores how rurality relates to hospital cost structures as categorized by Urban Influence Codes (UICs). Describes the characteristics of hospitals at different fixed-to-total-cost ratio levels, the demographics associated with hospitals at different ratio levels, and the share of nonmetropolitan hospitals that have Critical Access Hospital (CAH) or Low-Volume Hospital (LVH) designations. Discusses how findings could be used to refine hospital payment policies.
Author(s): Abigail Barker, Eliot Jost, Timothy McBride, Keith Mueller
Date: 06/2025
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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5 Key Facts About Medicaid Coverage for People Living in Rural Areas
Provides an overview of Medicaid coverage in rural areas. Includes rural versus urban comparisons of Medicaid coverage, enrollee age, enrollee diagnosed chronic conditions, state-by-state data of Medicaid enrollees by degree of rurality, and more.
Author(s): Rhiannon Euhus, Sammy Cervantes, Alice Burns, Robin Rudowitz
Date: 06/2025
Sponsoring organization: KFF
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Provides an overview of Medicaid coverage in rural areas. Includes rural versus urban comparisons of Medicaid coverage, enrollee age, enrollee diagnosed chronic conditions, state-by-state data of Medicaid enrollees by degree of rurality, and more.
Author(s): Rhiannon Euhus, Sammy Cervantes, Alice Burns, Robin Rudowitz
Date: 06/2025
Sponsoring organization: KFF
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Assessing Temporal Changes in Spatially-Varying Disparities in Tobacco Retailer Density across Ohio
Examines how tobacco retailer density (TRD) across Ohio contributes to disparities in tobacco use. Utilizes 2017-2022 geocoded data on TBD, with breakdowns according to census tract sociodemographic characteristics and urban, suburban, or rural neighborhood type.
Author(s): Rui Qiang, Peter F. Craigmile, Wendy Hyde, Abby Shores, Megan E. Roberts
Citation: Ohio Journal of Public Health, 7(2)
Date: 06/2025
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Examines how tobacco retailer density (TRD) across Ohio contributes to disparities in tobacco use. Utilizes 2017-2022 geocoded data on TBD, with breakdowns according to census tract sociodemographic characteristics and urban, suburban, or rural neighborhood type.
Author(s): Rui Qiang, Peter F. Craigmile, Wendy Hyde, Abby Shores, Megan E. Roberts
Citation: Ohio Journal of Public Health, 7(2)
Date: 06/2025
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Rural-Suburban-Urban Differences in Caregiving in the Northeast U.S. Region
Analyzes characteristics of caregiving experiences in the Northeast according to rural, suburban, or urban geography. Focuses on percentage of people who have provided caregiving, as well as their income, weekly care expenses, use of social safety net programs, desire to participate in the workforce, and demographic profile.
Author(s): Elena Pojman, Florence Becot
Date: 06/2025
Sponsoring organizations: North Central Regional Center for Rural Development, Northeast Regional Center for Rural Development, PennState
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Analyzes characteristics of caregiving experiences in the Northeast according to rural, suburban, or urban geography. Focuses on percentage of people who have provided caregiving, as well as their income, weekly care expenses, use of social safety net programs, desire to participate in the workforce, and demographic profile.
Author(s): Elena Pojman, Florence Becot
Date: 06/2025
Sponsoring organizations: North Central Regional Center for Rural Development, Northeast Regional Center for Rural Development, PennState
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