A HRSA study of 8,509 mother-newborn pairs from the Boston Birth Cohort found that 5.3 percent of the babies had in-utero opioid exposure, leading to higher risks of fetal growth restriction and preterm birth.

Among preschool-aged children, opioid exposure was associated with increased risks of lack of expected physiological development and conduct disorder/emotional disturbance. In school-aged children, opioid exposure was associated with a higher risk of attention-deficit/hyperactivity disorder.

Read the abstract.

Learn how HRSA is addressing the opioid crisis

In 2011, The Pew Center on the States, a division of The Pew Charitable Trusts, released a report that graded states’ ability to serve insured and soon-to-be insured children and compared results to 2010 grades. In 2018, Pennsylvania completed their own report card to monitor for any changes and improvements. Pennsylvania has made updates and met additional benchmarks.  Click here to view the report card.

A new rural policy brief is available from the RUPRI Center for Rural Health Policy Analysis authored by Abigail R. Barker, PhD; Timothy D. McBride, PhD; Keith J. Mueller, PhD

The Patient Protection and Affordable Care Act of 2010 established Health Insurance Marketplaces (HIMs) as a mechanism to improve the functioning of existing individual insurance markets. However, to be successful, this model requires the presence of at least a handful of insurers from which beneficiaries in each local market can choose. Over the first five years of HIMs, rural counties have often struggled to attract sufficient numbers of HIM insurers. In this project, county-level data were combined from HIM plan availability files, Medicare Advantage (MA) availability and enrollment files, and Federal Employees Health Benefits Program (FEHBP) availability and enrollment files. We calculated the Herfindahl Index, which is a measure of competition in a given market, for MA and FEHBP markets for each county in 2013-16.

We found that, within a given population density category, the number of HIM insurers was positively correlated with the prior level of FEHBP market competition in a county. Note, also, that market competition was generally higher as population density increased. In 2017, the pattern continued to hold, with those counties that still attracted several insurers (rather than just one or two) averaging the lowest prior-year FEHBP Herfindahl index. We found that many of the population measures were in fact significant in their own right, including population density, total population, primary care providers per capita, and rural status of the county. Furthermore, even when controlling for these measures, prior FEHBP market concentration (low competition) was a significant predictor of low insurer participation in HIMs. In addition, from 2014 to 2017, the magnitude of the effect increased.

Click to download a copy: Insurer Participation in Rural Health Insurance Marketplaces: Are Some Markets Intrinsically More Competitive Than Others?

Cost-Sharing as a Barrier to Accessing Care at FQHCs and RHCs for Rural Medicare Beneficiaries.  Cost is often a significant barrier to accessing care for the rural Medicare population, so having a better understanding of the variations in cost-sharing per claim (deductibles and coinsurance amounts) at various types of safety-net facilities is important. The purpose of this study from the North Carolina Rural Health Research and Policy Analysis Center is to investigate cost as a barrier to accessing care at Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) for the rural Medicare population.

Measuring Access to Care in National Surveys: Implications for Rural Health.  In order to assess the efficacy of healthcare in meeting the needs of the population and to ensure access to timely, appropriate care, it is important to have nationally representative measures of access and barriers to healthcare. Given the unique healthcare context in rural settings, it is also important to understand whether, and how, access is measured in ways that are salient for rural populations. This brief from the University of Minnesota Rural Health Research Center reviews access measures included in major national surveys and presents implications for rural research on access to care.

Suicidal Thoughts, Plans, and Attempts by Non-Metropolitan and Metropolitan Residence. Using 2010-2016 data from the National Survey on Drug Use and Health, researchers from the Rural and Underserved Health Research Center found that the overall mean prevalence of suicidal thoughts among adults was significantly higher for non-metropolitan and small metropolitan counties.  This page on the Rural Health Research Gateway contains links to additional research on illicit drug and opioid use disorders in rural areas.

Trends in Meeting Physical Activity Guidelines Among Urban and Rural Dwelling Adults.  In its latest Morbidity and Mortality and Weekly Report, the Centers for Disease Control and Prevention finds that the prevalence for physical activity remains low, especially for some rural subgroups with high incidences of chronic diseases.  The report recommends incorporating culturally appropriate strategies into local, evidence-based programs might help communities build on recent progress.

SAMHSA Behavioral Health Barometer.  In this newly-released report, the Substance Abuse and Mental Health Services Administration (SAMSHA) provides a broad overview of behavioral health in metropolitan and nonmetropolitan areas of the U.S. with an emphasis on illicit drug, alcohol, and tobacco use, as well as the estimated percentage of people living with serious mental illness. The report includes a special focus on the misuse of prescription pain relievers, heroin use, and medication-assisted therapy (MAT) for opioid addiction.   Significant rural-metropolitan differences found include past-month cigarette use among teenagers (2.8 percent urban vs. 5.1 percent rural) and past-year serious mental illness among adults aged 18 or older (4.4 percent urban vs. 5.2 percent rural).

Binge Drinking and Prescription Opioid Misuse.  Research published in the American Journal of Prescription Medicine examined the relationship between alcohol and drug use and found that prevalence of prescription opioid misuse was similar among nondrinkers, but was 3.5 times higher among binge drinkers (Binge drinking refers to consuming four or more drinks within a couple of hours).  The research measured differences by race, gender, income and rural-urban location. Among the findings: binge drinkers in rural areas have a higher prevalence of prescription opioid misuse than binge drinkers in urban areas.

New data are available from the U.S. Census Bureau which provide estimates of the July 1, 2018 population for the nation, states, and counties by age, sex, race, and Hispanic origin. The latest brief from the Pennsylvania State Data Center highlights statewide trends in Pennsylvania’s changing population. As of 2018, Pennsylvania’s fastest growing populations include the population age 65 and over, the Hispanic or Latino population, and the non-Hispanic Asian population. Click here to read more.