The Maine Rural Health Research Center released its Ambulance Desert Chartbook. This chartbook analyzes 42 states in 2021-2022 and identifies places and people that are more than 25 minutes from an ambulance station, also called an ambulance desert. The report found that out of 4.5 million people living in an ambulance desert, 2.3 million (52%) were in rural counties. The reports also found that 84% of rural counties are an ambulance desert.

The Centers for Medicare & Medicaid Services’ Office of Minority Health (CMS OMH) released a report detailing the quality of care received by people enrolled in Medicare Advantage (MA).

The Disparities in Health Care in Medicare Advantage Associated with Dual Eligibility or Eligibility for a Low-Income Subsidy and Disability report presents summary information on the performance of Medicare Advantage plans on specific measures of quality of health care reported in 2021, which corresponds to care received in 2020. Specifically, this report compares the quality of care for four groups of Medicare Advantage enrollees that are defined based on the combination of two characteristics: (1) dual eligibility for Medicare and Medicaid or eligibility for a Part D Low-Income Subsidy (LIS) and (2) disability.

Overall, the report showed that people who were dually eligible for Medicare and Medicaid or eligible for the Low-Income Subsidy received worse clinical care than those who were not. The largest differences between the two groups were in the areas of Follow-up After Hospital Stay for Mental Illness (within 30 days of discharge), Avoiding Potentially Harmful Drug-Disease Interactions in Elderly Patients with Dementia, and Avoiding Potentially Harmful Drug-Disease Interactions in Elderly Patients with a History of Falls. Disparities by dual eligibility status/Low-Income Subsidy eligibility status were least common among Hispanic individuals and most common among White individuals. The report also shows more pronounced disparities in clinical care for dually eligible/Low-Income Subsidy eligible individuals in urban areas as compared to rural areas.

This report is based on an analysis of data from the Healthcare Effectiveness Data and Information Set (HEDIS). HEDIS collects information from medical records and administrative data on the technical quality of care that Medicare Advantage enrollees receive for a variety of medical issues, including diabetes, cardiovascular disease, and chronic lung disease.

Health care professionals, organizations, researchers, and hospital leaders can utilize this report along with other CMS tools and resources to help raise awareness of health disparities, develop health care interventions for Medicare Advantage enrollees who are dually eligible for Medicare and Medicaid/Low- Income Subsidy eligible and those with disabilities, and implement quality improvement efforts that improve health equity.

Help CMS to advance equity by sharing this report and our resources on prevention and health equity initiatives. Also, sign up for our listserv or visit https://go.cms.gov/omh for more information.

The Centers for Medicare & Medicaid Services’ Office of Minority Health (CMS OMH) released a report detailing the quality of care received by people enrolled in Medicare Advantage (MA).

The Disparities in Health Care in Medicare Advantage Associated with Dual Eligibility or Eligibility for a Low-Income Subsidy and Disability report presents summary information on the performance of Medicare Advantage plans on specific measures of quality of health care reported in 2021, which corresponds to care received in 2020. Specifically, this report compares the quality of care for four groups of Medicare Advantage enrollees that are defined based on the combination of two characteristics: (1) dual eligibility for Medicare and Medicaid or eligibility for a Part D Low-Income Subsidy (LIS) and (2) disability.

Overall, the report showed that people who were dually eligible for Medicare and Medicaid or eligible for the Low-Income Subsidy received worse clinical care than those who were not. The largest differences between the two groups were in the areas of Follow-up After Hospital Stay for Mental Illness (within 30 days of discharge), Avoiding Potentially Harmful Drug-Disease Interactions in Elderly Patients with Dementia, and Avoiding Potentially Harmful Drug-Disease Interactions in Elderly Patients with a History of Falls. Disparities by dual eligibility status/Low-Income Subsidy eligibility status were least common among Hispanic individuals and most common among White individuals. The report also shows more pronounced disparities in clinical care for dually eligible/Low-Income Subsidy eligible individuals in urban areas as compared to rural areas.

This report is based on an analysis of data from the Healthcare Effectiveness Data and Information Set (HEDIS). HEDIS collects information from medical records and administrative data on the technical quality of care that Medicare Advantage enrollees receive for a variety of medical issues, including diabetes, cardiovascular disease, and chronic lung disease.

Health care professionals, organizations, researchers, and hospital leaders can utilize this report along with other CMS tools and resources to help raise awareness of health disparities, develop health care interventions for Medicare Advantage enrollees who are dually eligible for Medicare and Medicaid/Low- Income Subsidy eligible and those with disabilities, and implement quality improvement efforts that improve health equity.

Help CMS to advance equity by sharing this report and our resources on prevention and health equity initiatives. Also, sign up for our listserv or visit https://go.cms.gov/omh for more information.

 The Government Accountability Office (GAO) released a report titled, “Why Health Care is Harder to Access in Rural America.” The report found many rural residents face several challenges, including fewer health care providers, longer travel distances to get to health care, fewer transportation options, and less broadband internet. The report recommends that federal agencies learn more about the needs of rural residents and address the gaps in information regarding the healthcare needs of people living in rural areas. Join NRHA in fighting for rural health.

Ground-breaking study provides national and state-level estimates of the economic burden of health disparities by race and ethnicity and educational levels.

New research shows that the economic burden of health disparities in the United States remains unacceptably high. The study, funded by the National Institute on Minority Health and Health Disparities (NIMHD), part of the National Institutes of Health,  revealed that in 2018, racial and ethnic health disparities cost the U.S. economy $451 billion, a 41% increase from the previous estimate of $320 billion in 2014. The study also finds that the total burden of education-related health disparities for persons with less than a college degree in 2018 reached $978 billion, about two times greater than the annual growth rate of the U.S. economy in 2018.

The findings from this study by researchers from NIMHD; Tulane University School of Public Health and Tropical Medicine, New Orleans; Johns Hopkins Bloomberg School of Public Health, Baltimore; Uniformed Services University, Bethesda, Maryland; TALV Corp, Owings Mills, Maryland; and the National Urban League were published in JAMA.

This study is the first to estimate the total economic burden of health disparities for five racial and ethnic minority groups nationally and for all 50 states and the District of Columbia using a health equity approach. The health equity approach set aspirational health goals that all populations can strive for derived from the Healthy People 2030 goals. It establishes a single standard that can be applied to the nation and each state, and for all racial, ethnic, and education groups. It is also the first study to estimate the economic burden of health disparities by educational levels as a marker of socioeconomic status.

“The exorbitant cost of health disparities is diminishing U.S. economic potential. We have a clear call to action to address social and structural factors that negatively impact not only population health, but also economic growth,” said NIMHD Director Eliseo J. Pérez-Stable, M.D.

Read more.

Today, the U.S. Census Bureau released the Vintage 2022 population estimates for metropolitan and micropolitan statistical areas and local governmental units, including incorporated places, minor civil divisions, and consolidated cities. They also released housing unit estimates for the nation, states and counties. Learn more and access the data here.

We’ve created a brief focused on the population change in Pennsylvania municipalities that visualizes changes between 2020 and 2022.

Read more on our Research Briefs page or click here to go straight to the brief.

Although data on the prevalence of current asthma among adults and children are available at national, regional, and state levels, such data are limited at the substate level (eg, urban–rural classification and county).

We examined the prevalence of current asthma in adults and children across 6 levels of urban–rural classification in each state. We estimated current asthma prevalence among adults for urban–rural categories in the 50 states and the District of Columbia and among children for urban–rural categories in 27 states by analyzing 2016-2018 Behavioral Risk Factor Surveillance System survey data. We used the 2013 National Center for Health Statistics 6-level urban–rural classification scheme to define urban–rural status of counties.

During 2016-2018, the current asthma prevalence among US adults in medium metropolitan (9.5%), small metropolitan (9.5%), micropolitan (10.0%), and noncore (9.6%) areas was higher than the asthma prevalence in large central metropolitan (8.6%) and large fringe metropolitan (8.7%) areas. Current asthma prevalence in adults differed significantly among the 6 levels of urban–rural categories in 19 states. In addition, the prevalence of current asthma in adults was significantly higher in the Northeast (9.9%) than in the South (8.7%) and the West (8.8%). The current asthma prevalence in children differed significantly by urban–rural categories in 7 of 27 states. For these 7 states, the prevalence of asthma in children was higher in large central metropolitan areas than in micropolitan or noncore areas, except for Oregon, in which the prevalence in the large central metropolitan area was the lowest.

Knowledge about county-level current asthma prevalence in adults and children may aid state and local policy makers and public health officers in establishing effective asthma control programs and targeted resource allocation.

Citation: Qin, Xiaoting, Cynthia A. Pate, and Hatice S. Zahran. “Adult asthma prevalence and trend analysis by urban–rural status across sociodemographic characteristics—United States, 2012-20.” Journal of Allergy and Clinical Immunology: Global 2, no. 2 (2023): 100085.

  During the COVID-19 PHE, states could receive enhanced federal payments for halting Medicaid disenrollments, also known as the Medicaid continuous enrollment provision. As of April 1, 2023, states are resuming operations to redetermine Medicaid eligibility for all enrollees.  The Kaiser Family Foundation (KFF) created a tracker to monitor changes in Medicaid enrollment during this unwinding period.  It presents the most recent Medicaid enrollment data available for each state as well as any unwinding data on monthly renewals, disenrollments, and other measures that may be available for a state.

Among other findings, the Government Accountability Office (GAO) reports that the number of midwives and midwifery students has increased; in 2021, midwives attended 12 percent of births in the U.S.  Access is still a concern, however. Students may have trouble with the cost of education and a limited number of training opportunities, while insurance coverage is spotty – leaving some people interested in having a midwife unable to afford one.  Recent data show that, in 2019, more than 30 percent of rural counties had no obstetric clinicians of any type.  The GAO reported on this shortage last year, with data supporting an increase in Medicaid reimbursement to close the gap in maternity care for rural areas.