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Arnold School of Public Health

Current Federal Office of Rural Health Policy (FORHP) Projects

This project will aim to understand how Rural Health Clinics perceive and implement evidence-based cancer screening and treatment and related intervention strategies before and during the COVID-19 pandemic.

Lead Researcher: Jan M. Eberth, PhD

Anticipated Completion Date: August 2021

In both rural and urban areas, prior research has documented shortages of key healthcare facilities in areas where a significant proportion of the population identify as African American, American Indian/Alaska Native, Hispanic, or as a member of another historically disadvantaged minority (HDM) group. This analysis will compare the likelihood that selected healthcare infrastructure elements, including hospitals, primary care services, long-term care, behavioral health services, and home health, are available within rural and urban ZIP Code Tabulation Areas that contain versus do not contain a high proportion of HDM residents.

Lead Researcher: Jan M. Eberth, PhD

Anticipated Completion Date: August 2021

This project aims to understand how rural hospitals implement evidence-based cancer screening and treatment and related intervention strategies. We will identify what types of cancer screening are offered in rural hospitals, their diagnostic and treatment referral processes, and the extent to which surgery, radiation, and chemotherapy services are provided on-site or through affiliated ambulatory/outpatient surgery centers.


Lead Researcher: Peiyin Hung, PhD

Anticipated Completion Date: June 2021

Using the 2016 National Survey of Children's Health, spatial multilevel models will be constructed to estimate county-and Census tract-level rates of childhood obesity in the US. Particular emphasis will be placed on rural areas, for which direct estimates are often unavailable because of small sample sizes in population-based surveys. 

Lead Researcher: Jan M. Eberth, PhD

Anticipated Completion Date: May 2021

Using a novel integration of spatial analysis, multi-level modeling, and difference-in-difference tests, we propose to 1) investigate whether safety-net providers were more likely to defray the demand for services due to their proximity to hospitals that closed and 2) quantify the impact of hospital closures on rural mortality rates. The proposal aims to fill gaps in prior work by providing national estimates of impacts of hospital closures for rural populations due to changes to potential demand for services as well as in changes in health outcomes. Our study findings will provide new information on the cascading effect of increasing transportation times, social and economic conditions, and reduced access to healthcare providers on population health outcomes within rural communities.

Lead Researcher: Nathaniel Bell, PhD

Anticipated Completion Date: September 2021

This project will leverage growing collaborative efforts between the Rural and Minority Health Research Center (RMHRC), SC Office of Rural Health, SC Primary Health Care Association, and SC Center for Rural and Primary Healthcare to assess and improve cancer prevention and control among rural SC residents. The project will involve three phases: (1) planning and adapting; (2) pilot testing; and (3) evaluation focused on increasing use of evidence-based (EB) strategies to increase colorectal and/or cervical cancer screening and initiation of timely, appropriate follow-up care as applicable, among patients served at Rural Health Clinics (RHCs) in South Carolina. Throughout the project period, we will use a flexible, iterative, and adaptive approach to ensure our efforts maximize existing statewide efforts

Lead Researcher: Jan M. Eberth, PhD

Anticipated Completion Date: December 2021 


Adverse childhood experiences (ACEs) are events of abuse, neglect, and household dysfunction that occur between birth and 17 years of age. Multiple studies have established the association between ACEs and risky behaviors and poor physical and mental health outcomes in childhood and beyond. Rural and minority children often have higher rates of ACE exposure than their peers. Yet previous results on ACEs and rurality have shown mixed results due to differences in: 1) geographic coverage of studied datasets, 2) measurement of ACEs, and 3) sampling methodologies. Furthermore, examinations of intra-rural differences in ACEs among racial/ethnic groups, particularly among American Indian/Alaska Native populations, have been limited. The findings from this study will inform and improve prevention and intervention efforts for rural children in the U.S.

This project's aims include 1) ascertaining whether ACE and positive childhood experiences (PCE) exposure differs between rural and urban children by type and by count and whether rural exposures differ across U.S. census regions (Northeast, Midwest, South, West); 2) quantifying racial/ethnic disparities in ACE and PCE exposure across rural communities overall and across U.S. census regions; and 3) documenting the proportion of children with ACEs who lack PCE exposure and whether this differs across levels of rurality

Lead Researcher: Elizabeth Crouch, PhD

Anticipated Completion Date: August 2021

Challenge the conventional. Create the exceptional. No Limits.