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
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
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
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
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
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.
2018 Detailed Population Estimates Released
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.
Report: Pennsylvania employment strong, but job growth leaves regions, industries behind
UNIVERSITY PARK, Pa. — With the U.S. economy on track for potentially the longest expansion on record after the Great Recession of 2008-09, employment in Pennsylvania overall is strong. But the rosy statewide job numbers can mask persistent decline in various industries and regions across the state, according to economists in Penn State’s College of Agricultural Sciences.
Their conclusions are reflected in a report newly released by Penn State’s Center for Economic and Community Development, titled “Pennsylvania: Bust to Boom? Great Recession to Recovery & Beyond.” Through the liberal use of graphics, the report illustrates job growth and decline statewide and in five regions and 20 major industry sectors.
“While the Pennsylvania economy as a whole shows strength, it’s important to look at the distribution across the state,” said co-author Theodore Alter, professor of agricultural, environmental, and regional economics and the center’s co-director. “There’s a diversity of impact, and looking at the aggregate doesn’t give the correct picture.”
The report’s findings mirror those of two companion reports on the geography of employment and population shifts — released by the center in 2018 and earlier this year, respectively — that showed a significant contrast between southeastern Pennsylvania, which enjoyed mainly job and population growth from 2000 to 2017, and the rest of the state, with primarily declines.
The trends woven through this trilogy of reports suggest the existence of “two Pennsylvanians,” noted co-author Theodore Fuller, development economist in the Department of Agricultural Economics, Sociology and Education.
“Employment change in Pennsylvania’s five regions over the 10 years [2008-2018] covered in this report ranged from solid growth in southeastern Pennsylvania to widespread decline in western counties, and a mix of growth and decline in central, northern and northeastern Pennsylvania,” Fuller said. “This pattern was most stark during the recession and recovery but continued into the post-recovery growth years of 2015 to 2018.”
As an example, he pointed out that the 15 counties designated as southeastern Pennsylvania gained 133,000 jobs from 2015 to 2018, with 80,000 of that increase coming in the five-county Philadelphia metropolitan statistical area. In contrast, the 19-county western region gained only 3,000 jobs. While employment increased by 16,000 in the seven-county Pittsburgh MSA during this period, the other western counties combined lost a net of 13,000 jobs.
Fuller added that two major industrial developments underway that soon could bolster job creation and stimulate the economy of western Pennsylvania are construction by Royal Dutch Shell of a natural gas “cracker” plant in Beaver County — expected to be operational in the early 2020s — and a $1 billion investment by U.S. Steel to upgrade its Mon Valley Works by 2022.
In addition to regional changes in employment, there were winners and losers among industries, the report showed. Manufacturing and retail trade were in the top three industries in total employment in 2018, but they lost, by far, the most jobs among the 20 major sectors between 2008 and 2018. Manufacturing employment fell by nearly 80,000 and retail trade jobs declined by more than 28,000 over the 10-year period. Other industries with significant job losses were wholesale trade and educational services.
On the other hand, the state’s largest employment sector, health care and social services, gained more than 165,000 jobs during 2008-2018. In 2018, almost one in five Pennsylvanians was employed in this sector. Other growth industries included accommodation and food services, transportation and warehousing, and professional and technical services.
Pennsylvania’s top employment sector, health care and social services, gained 165,000 jobs in the 10-year period ending in 2018, but the largest number of those jobs were categorized as low-wage positions.
However, employment change doesn’t tell the whole story, the researchers said. Examining the average weekly wages of the jobs gained and lost provides additional insight. For instance, of all the jobs added in health care and social services between 2008 and 2018, by far the largest number were categorized as low-wage positions.
Across all the sectors analyzed, the greatest growth was in low-wage jobs, and the greatest losses came in middle-wage jobs, fueled by the decline in manufacturing employment. “Since 2008, we’ve seen a hollowing out of that middle-wage area,” Alter said. “And that suggests widening inequality, which could have profound implications for Pennsylvania’s economy going forward.”
The report is available on the Center for Economic and Community Development website.
Other contributors to this report were undergraduate research associates Raymond Hoy, Nolan Martino and Tessa Sontheimer; and Cristy Halerz Schmidt, applied research educator, Center for Economic and Community Development, Penn State. The U.S. Department of Agriculture’s National Institute of Food and Agriculture supported this work.
New Resource: Management Methodologies and Value-Based Strategies: An Overview for Rural Health Care Leaders
The Rural Health Value team has released a new resource outlining eight commonly used change management methodologies that are rural-relevant. It is intended as a guide to help rural health care leaders identify which approach(es) might be most useful to them and their organizations.
Management Methodologies and Value-Based Strategies: An Overview for Rural Health Care Leaders – Offers rural health leaders an overview of eight commonly used management methodologies to help guide change, plus additional resources and references for further exploration. (June 2019)
Top resources on the Rural Health Value website:
- Value-Based Care Assessment – Assess capacity and capabilities to deliver value-based care. Receive an eight category readiness report.
- Physician Engagement – Score current engagement and build effective relationships to create a shared vision for a successful future.
- Board and Community Engagement – Hold value-based care discussions as part of strategic planning and performance measurement.
- Social Determinants of Health – Learn and encourage rural leaders/care teams to address issues to improve their community’s health.
Contact information:
Keith J. Mueller, Ph.D.
Co-Principal Investigator
Unmet Need for Personal Care Assistance Among Rural and Urban Older Adults
Unmet Need for Personal Care Assistance Among Rural and Urban Older Adults. Despite differences in health, health services, economic, and demographic characteristics, little is known about whether rural and urban areas differ in unmet need for personal care for older adults with functional limitations. This brief from the University of Minnesota Rural Health Research Center addresses that gap by analyzing rural-urban differences in unmet need for help across 11 activities