This study assesses how, among behavioral health clinicians working in rural safety net practices, the amount of exposure to care in rural underserved communities received during training relates to confidence in skills important in their work settings, successes in jobs and communities, and anticipated retention.  The summary provides a quick overview of the study published in the Journal of Rural Health.

View the Study Summary here.

About PRISM

PRISM is a collaborative of State Primary Care Offices, Offices of Rural Health, Area Health Education Centers and other organizations that have partnered to collect data to identify and document outcomes to enhance the retention of clinicians.  Through its design, this collaborative approach builds shared interest, cooperation and group wisdom in best practices to promote retention among the states.

PRISM provides a standardized and state-of-the-art way for states to gather real-time data from clinicians as they serve in States’ and the National Health Service Corps’ (NHSC) loan repayment, scholarship and other incentive programs.  This retention data gathering system routinely surveys clinicians as they serve in these public programs to provide quality, consistent, real-time, convenient and ongoing data to inform the management and retention of clinicians in service programs.

PRISM is a complex, longitudinal data gathering system that incorporates the data collection, analysis and dissemination expertise of the Cecil G. Sheps Center for Health Services Research.  State offices can easily enter, track and manage retention questionnaires.

PRISM training and technical assistance is provided by 3RNET, supported through a contract with the National Rural Health Association with funds from the US Health Resources and Services Administration (HRSA). State collaborative members pay an annual fee to support enhancements to PRISM.

For more information contact Jackie Fannell

 

The updated Consumer Credit Explorer offers an easy way to visualize trends in U.S. consumer debt at the national, state, and even regional level. What’s new? The go-to resource from the Federal Reserve Bank of Philadelphia has been enhanced with data through Q4 2023. You can also now compare trends in up to two U.S. regions, up to two debt or credit characteristics, and up to two borrower or neighborhood demographics at once.

The tool allows you to see overall debt and types of debt, broken down by borrower age or credit score type, neighborhood income level or majority race/ethnicity, and much more, providing a unique view into household financial well-being.

See the new Consumer Credit Explorer and learn more.

Researchers at the North Carolina Rural Health Research and Policy Analysis used a recent revision of the Financial Distress Index (FDI) model to describe the relative risk of experiencing financial distress for rural hospitals and selected urban hospitals. Among the findings: over 60 percent of hospitals at highest relative risk of financial distress are in seven states:  Texas, Oklahoma, Tennessee, Alabama, Kansas, Mississippi, and Georgia.

Among findings from the Maine Rural Health Research Center: rural adults aged 18-64 are more likely than their urban counterparts to visit the emergency department in a given year; socio-demographics associated with higher rates of non-urgent ED use by rural residents include younger age, fair or poor mental and physical health, low income, public insurance coverage, and lower access to primary care.

New Data from the CDC on Preventable Premature Death. The new study from the Centers for Disease Control and Prevention (CDC) is an extension of an earlier CDC study, which showed a higher percentage of early death from the five leading causes in rural counties compared with urban counties during 2010-2017.  More recent data show that the rural-urban gap in all-cause mortality continues to widen.  In 1999, the death rate in rural areas was 7 percent higher than in urban areas; by 2019, it was 20 percent higher.  View CDC’s rural health website and  Rural Public Health At-a-Glance to find out what CDC is doing to improve the health and well-being of rural communities.

The Federal Reserve Bank of Philadelphia launched new data on the Anchor Economy Dashboard. You can now explore anchor institution economic impacts and reliance measures for the years 2004 and 2019 for all 524 U.S. regions.

In the coming weeks, they are releasing an accompanying research brief that delves deeper into the change in anchor institution reliance in the United States between 2004 and 2019. The brief will be posted to  their website and discussed at the upcoming 2024 Anchor Economy Conference in Philadelphia on May 15–16.

If you have any questions on the dashboard or this new data set, please feel free to get in touch Deborah Diamond at deborah.diamond@phil.frb.org.

The 2018 CHRONIC Care Act influenced the growth rate in MA plan enrollment by allowing plans to offer more options extending the types of benefits available to MA beneficiaries. The Act gave MA plans the flexibility to offer new supplemental benefits to address enrollees’ broader health and social needs. Now, in addition to traditional primarily health-related benefits, MA plans can offer expanded health-related benefits (e.g., in-home support services, therapeutic massage, caregiver support, home-based palliative care, and adult day health services) and special supplemental benefits for the chronically ill (SSBCI) such as food and produce, meals, transportation, and pest control.

MA plans providing any supplemental benefit were less commonly offered in noncore counties (87.2 percent of plans), followed by micropolitan counties (94.6 percent) and metropolitan counties (97.6 percent) in 2022. But only 10 to 20 percent of plans offered expanded supplemental benefits or SSBCI across all three geographies. Plans with traditional primarily health-related supplemental benefits most frequently included vision (97.6 percent), hearing (95.2 percent), fitness (94.6 percent), and dental services (93.6 percent). Significantly fewer plans offered expanded supplemental benefits and SSBCI that address beneficiaries’ broader health and social needs. Declining availability of all supplemental benefit types was seen as geography shifted from metropolitan to noncore counties.

Read the full report here.

Authors:  Edmer Lazaro, DPT, MSHCA; Dan M. Shane, PhD; Fred Ullrich, BA; Keith Mueller, PhD

The COVID-19 public health emergency (PHE) led to a dramatic increase in telehealth use owing to relaxed policies to facilitate healthcare access, but early studies demonstrated variability in telehealth utilization patterns across demographic groups. COVID-19 disproportionately affected communities of color and the socially disadvantaged, highlighting existing disparities in access and quality of care in the U.S. health system.  In early 2023, an RTRC research team conducted a systematic review to summarize available evidence from early in the COVID-19 pandemic and concluded that most available evidence showed that telehealth did not reduce disparities in access to health care during the PHE. In December 2023, the prior systematic review was updated with contemporary data using the same search strategy and methods.

Of the 523 references in our updated search, 32 met final inclusion criteria for the study. Most studies were retrospective cohort studies using before-after methodology, and telehealth utilization was the most common study outcome. Compared to the initial search, more of the papers included in this search focused on total health care utilization (instead of telehealth-only utilization), but overall, conclusions were similar. Telehealth utilization, in aggregate, increased more slowly among disadvantaged groups, such as older, more rural, Black, and economically disadvantaged populations than in less disadvantaged populations over the course of the PHE.

Please click here to read the brief.

A new study released in the CDC’s Morbidity and Mortality Weekly Report (MMWR) shows the gap in preventable premature mortality (or early death) between rural and urban America is growing wider. People living in rural areas are at a higher risk of dying early from one of the five leading causes of death when the death could have been prevented compared to people living in urban areas.  A video on premature and preventable deaths is available here.

This report is an extension of the 2019 CDC study, which showed the percentage of preventable early deaths from the five leading causes was higher in rural counties compared with urban counties during 2010–2017. It extends the study period by including mortality data for additional years (2018-2022), expanding the analysis from 2010 to 2022. Below are some of the main findings, and a brief data visualization of the report is available here.

Cancer 

• The percentage of preventable early cancer deaths among all premature deaths declined from 21% in 2010 to 0.3% in 2022. Regardless of metropolitan status, all county categories experienced declines.
• However, declines in urban areas were larger than those in rural areas, which widened the rural-urban disparities in early cancer deaths.
• Differences in tobacco use and less access to lung cancer screening facilities may explain some of this gap.

Unintentional injury

• The percentage of preventable early deaths from unintentional injury increased from 2010 through 2019 (39% to 54%), followed by a steep increase from 2019 to 2021 and a slight decrease through June 2022 to 64%.
• Increases in the percentage of preventable early deaths from unintentional injury during 2010-2022 were statistically significant for all rural-urban county categories except micropolitan (rural counties with small towns, population of 10,000 to 50,000 person).
• Percentages were higher in rural areas than in urban areas, but the gap narrowed.
• The worsening and expanding drug overdose epidemic, increases in motor vehicle traffic fatalities, and increases in falls drive the growth in early deaths from unintentional injury.

Stroke

• The percentage of preventable early deaths from stroke declined slightly from 2010 through 2019 (32% to 26%), followed by an increase to 34% through June 2022.
• Each rural-urban county category experienced steep increases from 2019 to June 2022, except for the most rural counties, which experienced a slight decrease from 2021 to June 2022; rural counties had the highest percentage from January to June 2022 (42% in micropolitan counties and 41% in noncore counties).
• Increases in 2020 and 2021 were likely associated with COVID-19-related conditions that contributed to risk-associated increased heart disease and stroke mortality, such as delayed or avoided emergency care treatment.
• The highest percentages of preventable early deaths from stroke in 2022 were in southern states.

These findings can help guide local public health interventions to reduce risks of early death, while also highlighting the need to understand and address underlying social, environmental, and structural inequities contributing to disparities in preventable early deaths between rural and urban areas.

Access the full report and share this information with your network using our partner toolkit. This resource contains social media messages, graphics, and newsletter text you can use to help bring awareness of these findings and the need for more multi-sector approaches and focused interventions across the U.S. to reduce early death from the five leading causes. View CDC’s rural health website and  Rural Public Health At-a-Glance to find out what CDC is doing to improve the health and well-being of rural communities.

For as long as statistics about opioid overdose deaths have been collected in the United States, white individuals have been much more likely to die than Black individuals of the same age. With the rapidly increasing rate of fentanyl overdoses in the late 2010s, that trend began to reverse — by the start of the COVID-19 pandemic in 2020, more Black Americans began to die of opioid overdoses and from drug overdoses of any kind, according to researchers at Penn State.

New research from the Penn State College of Health and Human Development examined racial and regional differences in overdose fatalities from 2012-21, capturing the periods preceding and during the COVID-19 pandemic. In most of the nation, the researchers found that younger Black individuals died of overdose at lower rates than their white counterparts, but older Black individuals — especially men in Midwestern cities — became several times more likely to die of drug overdose than their white counterparts as the COVID-19 pandemic emerged.

The study was published in The American Journal on Addictions.

Read more.