Chronic Disease in Rural America – Resources

Are HHC Scores a Reliable Health Status Indicator Across Rural and Urban Areas?
Examines differences in Centers for Medicare & Medicaid Services Hierarchical Condition Category (HCC) risk scores between rural and urban Medicare Fee-for-Service (FFS) beneficiaries and analyzes which factors drive observed differences. Features statistics with breakdowns by urban, large rural, small rural, and isolated rural areas for 4 chronic conditions in 2019-2020.
Author(s): Craig D. Holden, Alana Knudson, Marilyn Klug, Samantha Augenbraun, Shena Popat
Date: 04/2025
Sponsoring organization: ETSU/NORC Rural Health Research Center
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Two Modeling Strategies in Analyzing Clustered Time-to-Event Data: The Strong Heart Family Study
Examines the use of the shared frailty and marginal Cox proportional hazards models to study associations between leukocyte telomere length and time-to-incident stroke among 4,635 American Indian study participants from tribal communities in Arizona, Oklahoma, North Dakota, and South Dakota. Discusses effective use of data models for population genetic studies.
Author(s): Heather Willmott, Caroline Gochanour, Kai Ding, et al.
Citation: Preventing Chronic Disease, 22, 240387
Date: 03/2025
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Public Health Research and Program Strategies for Diabetes Prevention and Management

Editorial describing diabetes prevention and management efforts and policy since 1975. Discusses disparities in diabetes prevalence including rural residence. Highlights current and future work in diabetes prevention and management.

Author(s): Shelly-Ann Bowen, Arsham Alamian, Stephen Onufrak
Citation: Preventing Chronic Disease, 22
Date: 03/2025
Sponsoring organization: Centers for Disease Control and Prevention
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Disparities in Cardiovascular Disease Prevalence by Race and Ethnicity, Socioeconomic Status, Urbanicity, and Social Determinants of Health Among Medicare Beneficiaries With Diabetes
Examines demographic disparities in cardiovascular disease prevalence among people with diabetes, utilizing 2015–2019 Medicare Current Beneficiary Survey data. Includes sociodemographic data, including rural-urban comparisons, on crude and adjusted prevalence of myocardial infarction, stroke, and heart failure.
Author(s): Xilin Zhou, Joohyun Park, Deborah B. Rolka, et al.
Citation: Preventing Chronic Disease, 22, 240270
Date: 03/2025
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Screening and Referral Programs for Diabetes and Cardiovascular Disease: Can Community Pharmacists Bridge the Care Gap?
Examines the community-based valued-driven care initiative (CVCI) in community pharmacies to evaluate its effectiveness related to screening and referral (S&R) to treat cardiovascular disease (CVD) and diabetes mellitus (DM). Analyzes patient demographics and success rates of CVD and DM S&R in 6 community pharmacies, with both rural and urban locations represented.
Author(s): Melanie Livet, Amber Watson, Shweta Pathak, et al.
Citation: Exploratory Research in Clinical and Social Pharmacy, 17, 100539
Date: 03/2025
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Rural–Urban Disparities in State-Level Diabetes Prevalence Among US Adults, 2021
Analyzes diabetes disparities among rural and urban populations in 41 states in the U.S. Utilizes 2021 Behavioral Risk Factor Surveillance System data to examine rural versus urban disparities and odds ratios (OR) for diabetes in different states.
Author(s): Olga Khavjou, Zohra Tayebali, Pyone Cho, Kristopher Myers, Ping Zhang
Citation: Preventing Chronic Disease, 21
Date: 01/2025
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Drive Time to Care and Retention in HIV Care: Rural–Urban Differences Among Medicaid Enrollees in the United States South
Presents a study on the role geography plays in HIV care retention and maintenance. Draws data from Medicaid enrollees in 13 southern states including the District of Columbia and compares patient drive times to care in rural and urban areas. Breaks down data by county social determinants of health, healthcare supply, and HIV prevalence, as well as patient characteristics.
Author(s): April D. Kimmel, Rose S. Bono, Zhongzhe Pan, et al.
Citation: Journal of Rural Health, 41(1), e12877
Date: 2025
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National Plan to Address Alzheimer's Disease: 2024 Update
Action plan outlining 6 goals for the U.S. Department of Health and Human Services to address the challenges facing people with Alzheimer's disease and Alzheimer's disease-related dementias (AD/ADRD) and their families and to minimize the burden of AD/ADRD. Includes action items related to AD/ADRD treatment and care quality, public awareness and engagement, data tracking, and collaboration to support underserved populations, including rural and tribal communities.
Date: 12/2024
Sponsoring organization: U.S. Department of Health and Human Services
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Identifying Best Practices for Improving the Evaluation and Management of Stroke in Rural Lower-Resourced Settings: A Scientific Statement From the American Heart Association
Discusses the value of quality improvement and expanded stroke service availability in underserved rural and remote settings. Identifies disparities in stroke care access and patient outcomes, and provides strategies related to policy, investment, training, and inter-organizational cooperation which address challenges in prehospital, inpatient, and postacute care, thrombolysis and ED care, patient transfers, and thrombectomy.
Author(s): Kori S. Zachrison, Kaiz S. Asif, Sherita Chapman, et al.
Citation: Stroke
Date: 12/2024
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QuickStats: Age-Adjusted Percentage of Adults Aged ≥18 Years with Diagnosed Chronic Obstructive Pulmonary Disease, by Urbanization Level — United States, 2023
Bar chart showing adult COPD rates for large metropolitan, small and medium metropolitan, and nonmetro areas.
Citation: MMWR (Morbidity and Mortality Weekly Report), 773(46), 1067
Date: 11/2024
Sponsoring organization: Centers for Disease Control and Prevention
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