Year	Project Name
2026	Challenges, Successes, and Sustainability of the 2019 Rural Maternity and Obstetrics Management Strategies (RMOMS) Programs The study provided valuable evidence into improving network-building strategies, enhancing maternal care services, optimizing network-building support, and fostering sustainable solutions that continue to serve rural maternal populations.  Topics:  Health Services, Healthcare Access, Maternal Health, Networking and collaboration, Telehealth, Women
2026	Changes in Medicare Fee-for-Services Health Care Expenditures in Rural and Urban Communities after Passage of the Affordable Care Act This project assessed changes in Medicare per-beneficiary spending across rural and urban counties from 2007 to 2020. It examined differences in rural versus urban per-beneficiary spending on hospital inpatient, hospital outpatient, physician, and post-acute care after the Affordable Care Act (ACA). Topics: Care management, Chronic diseases and conditions, Health services, Hospitals and clinics, Public health
2025	Rural-Urban Disparities in Mental Health Access and Quality in the United States The purpose of this project was to document the recent trends of mental health care access and quality in urban and rural communities. Topics: Healthcare access, Mental and behavioral health
2023	Assessing Cancer Care Coordination in Rural Health Clinics During a Pandemic This project aimed to understand how Rural Health Clinics perceived and implemented evidence-based cancer screening and treatment and related intervention strategies before and during the COVID-19 pandemic. Topics: Cancer, Coronavirus Disease 2019 (COVID-19), Rural Health Clinics (RHCs) Assessing Geographic Variability in Key Indicators of Water Quality and Air Quality: A Comparison of Urban vs. Rural Communities The purpose of this project was to compare air and water quality indicators across U.S. Census tracts specifically focusing on rural vs. urban differences. Topics: Environmental and agricultural health, Public health, Social determinants of health Examining Rural-Urban Differences in Availability of Hospital Cardiac Testing Services Between 2010-2020 This project will examine whether the availability of hospital-based cardiac testing services has changed over the past ten years in rural and urban counties and identify the characteristics of counties where service availability has changed. Topics: Care management, Chronic diseases and conditions, Health services, Hospitals and clinics, Public health
2022	Cancer Prevention and Control Activities in Rural Hospitals This project aimed to understand how rural hospitals perceive and implement evidence-based cancer screening and treatment and related intervention strategies. Topics: Cancer, Hospitals and clinics Impacts of Rural Hospital Closures on Community Health Outcomes and Access to Care This proposal examined the impact of rural hospital closures occurring between 2005-2017 across the nation on change in potential demand within safety-net healthcare systems as well as changes in all-cause and cause-specific mortality. Topic: Healthcare access Planning and Pilot Testing of Evidence-Based Cancer Prevention and Control Interventions with Rural Health Clinics This project leveraged growing collaborative efforts between the University of South Carolina Rural Health Research Center, South Carolina Office of Rural Health, South Carolina Primary Health Care Association, and Center for Rural and Primary Healthcare to assess and improve cancer prevention and control among rural South Carolina residents. Topics: Cancer, Rural Health Clinics (RHCs) Rural-Urban Differences in Child and Adolescent Mental Health pre and during the COVID-19 Pandemic This project examined rural-urban differences in the prevalence and severity of anxiety and depression among children and adolescents before and during the COVID-19 pandemic, as well as examined rural-urban differences in access to mental health care professionals and the receipt of care from a mental health professional before and during the COVID-19 pandemic. Topics: Children and adolescents, Health services, Mental and behavioral health
2021	Creating County Level Estimates of Childhood Obesity in the U.S.: A Spatial Multilevel Modeling Approach Using the 2016 National Survey of Children's Health, spatial multilevel models were constructed to estimate county level rates of childhood obesity in the U.S. Particular emphasis was placed on rural areas, for which direct estimates are often unavailable because of small sample sizes in population-based surveys. Topics: Children and adolescents, Obesity
2020	Rural Colon and Cervical Cancer Environmental Scan Detailed research was needed to provide a complex, textured picture of rural healthcare and the ways in which existing federally supported providers could provide adequate services across the continuum of cancer care from prevention through survivorship. Topic: Cancer
2019	Identification of High-Need Rural Counties Lacking an FQHC Presence Federally Qualified Health Centers (FQHCs) have been key safety net providers since the program was initiated. However, many rural communities lack this resource. Expanding on the index of relative rural deprivation developed by the University of South Carolina Rural Health Research Center, we identified high-need rural counties that currently are not served by an FQHC or similar provider. Topics: Critical Access Hospitals (CAHs), Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs) Identifying Obesogenic Communities in the U.S.: An Urban-Rural Comparison In this study, we created an obesogenic environment score for all U.S. counties and Census tracts, explored urban versus rural differences in obesogenic environment scores, and examined associations between obesogenic environments and childhood obesity overall and by level of rurality. Topics: Children and adolescents, Obesity Perceived Facilitators and Barriers to Rural Ambulatory Care Practice Among Registered Nurses Although a quarter of all registered nurses work in ambulatory care settings, little research has addressed the factors associated with their remaining in the profession and current job settings. The study surveyed a sample of rural and urban nurses to ascertain perceived facilitators and barriers to remaining in rural practice. Topics: Nurses and nurse practitioners, Workforce Promotion of Rural Health Research Center Attendance at Cancer-Related Meetings This project will promote attendance at cancer-related meetings by Rural Health Research Centers by facilitating the dissemination of information regarding important cancer meetings and handling the travel arrangements for Rural Health Research Center personnel. Topic: Cancer Rural Nursing Workforce: Current Educational Characteristics and Options for Improvement This project examined the current distribution of nurses, subset by educational attainment, across the rural U.S. using data from Census Public-Use Microdata files. Then surveyed approximately 750 registered nurse to bachelor of science in nursing (RN-to-BSN) educational programs across the U.S. identifying the proportion of programs offering rural content or facilitating rural placement. Topics: Nurses and nurse practitioners, Workforce
2018	Characteristics and Utilization Patterns of Rural Medicaid Recipients This study used the Medicaid Analytic Extract file to examine the characteristics of persons enrolled in Medicaid by type of eligibility. The study also examined overall utilization and total payments for this utilization. All estimates were subset by rurality and region. Topics: Medicaid and CHIP, Rural statistics and demographics For Amber "Waives" of Grain: The Impact of Medicaid Managed Care Waiver Programs on Care Choices in Rural America This project used a combination of systematic review of waiver content and structured interviews with key informants to assess the potential for rural disparities in access to care for Medicaid enrollees. Topic: Medicaid and CHIP
2017	Disparities in Access to Oral Health Care Among Rural Children: Current Status and Models for Innovation The ACA contains key provisions on addressing oral health disparities among vulnerable populations. This project will provide baseline information on trends in rural health and describe the experiences of four states taking innovative approaches to implementation of key ACA oral health provisions. Topics: Children and adolescents, Oral health Potential Impact of ESRD Payment Reform on Rural Dialysis Patients This study will estimate the potential implications of rural dialysis facility loss for rural patients. Specifically, we will identify low-volume dialysis facilities in rural areas, profile the patients they serve, and estimate the additional travel burden that these patients would experience if facilities close. Topics: Health services, Hospitals and clinics Trends in Rural Children's Health and Access to Care The past ten years have seen positive trends in the availability of health insurance coverage for children, coupled with worsening trends for poverty. This project will examine data from three iterations of the National Survey of Children' Health (2003, 2007, 2012) to see whether rural children have benefited equally from any improvements in health insurance, healthcare use, and health status. Topics: Children and adolescents, Private health insurance
2016	Colorectal Cancer Screening Bypass Behavior and Outcomes Studies have shown that increased distance to the closest endoscopy provider is associated with lower screening utilization among Medicare enrollees. The purpose of this study is to expand beyond the Medicare population to examine the travel behaviors of the entire population, comparing urban vs. rural residents in obtaining endoscopies for colorectal cancer screening. Topics: Cancer, Health promotion and disease prevention, Medicare Rural-Urban Differences in Anticipated Need for Aging-Related Assistance Among Pre-Retirement Age Adults We will use information from a nationally representative survey to ascertain how rural and urban adults aged 40-64 view their future and their plans for coping. Topic: Aging
2015	Post-Hospital Transitions in Care Among Dually-Eligible Medicare Beneficiaries This project will examine the hospitalization rates, post-discharge physician follow-up, and subsequent readmission rates among Medicare beneficiaries who are also enrolled in Medicaid. We will examine these dual-eligible beneficiaries by level of rurality to determine if residence is a significant factor in these rates. We will also control for co-morbidities, county characteristics, and other factors related to readmission rates. Topics: Diabetes, Hospitals and clinics, Medicare Role of Free Clinics in the Rural Safety Net This two-part study will combine a mapping project that documents the location of free clinics across the US with a telephone survey of the 21 state and 2 regional free clinic associations. Topics: Hospitals and clinics, Rural Health Clinics (RHCs) Rural Area Deprivation and Hospitalizations Among Children for Ambulatory Sensitive Conditions Rural areas with reduced social and economic resources may be particularly vulnerable to inadequate primary care for children. Topics: Children and adolescents, Hospitals and clinics
2014	Adequacy of Home Health Care Availability in Rural Counties This project will describe current distribution of HHC agencies, by ZIP Code and county of facility location and of service provision, across levels of rurality. Second, the project will estimate whether rural populations at risk for inadequate access to HHC, based on projected population need population / provider ratios. Topics: Aging, Home health Intensity of Service Provision for Medicare Beneficiaries Utilizing Home Health Services This study will assess whether Medicare beneficiaries in rural areas receive a lower intensity of home health (HH) services compared to their urban counterparts. Specifically, the study will examine (1) the distribution of levels of HH services for four conditions: joint (hip and knee) replacement, stroke, end-stage renal disease (ESRD), and diabetes; (2) the distribution of type of provider for each condition across the levels of rurality; and (3) the median charge and payment per beneficiary for these services across the levels of rurality. Topics: Chronic diseases and conditions, Diabetes, Home health, Medicare Profiling Health and Health Resource Availability in U.S. – Mexico Border Counties This project will augment a previous SCRHRC chartbook on Border health with additional information on health resources and health outcomes in US counties adjacent to Mexico.
2012	Analysis of State Dental Hygiene Practice Acts and Medicaid Policies for Children's Dental Care: Services Covered and Practitioners Reimbursed The purpose of this qualitative analysis will be to obtain a clear picture of the degree to which (1) state SCHIP and Medicaid programs are implementing waivers, or other programs, to improve access to dental care for vulnerable populations including children and pregnant women; and (2) dental hygienists impact the dental safety net for rural America. Topics: Children and adolescents, Maternal health, Medicaid and CHIP, Oral health Dialysis Availability in Rural America Working from Medicare Dialysis Compare files and the Standard Analysis File of the US Renal Data System, we will evaluate the current availability of dialysis services across rural America. We will examine general availability of services, service to population ratios, and patient outcome measures across levels of rurality. Topics: Chronic diseases and conditions, Diabetes, Medicare Rural HIV: Estimated Prevalence of Persons Living with HIV/AIDS (PLWHA) in Rural America This study will describe the prevalence of HIV/AIDS by county, or when county-level data are not available, by sub-state region or state, together with information on the availability of health services, including Ryan White Clinics. A sub-study will develop models identifying rural counties at highest risk for increases in the population of PLWHA. Topic: Chronic diseases and conditions
2010	Characteristics and Educational Needs of Rural Acute Care Hospital Boards of Directors Rural hospital boards face challenges in an environment of increasing legal and financial complexity. This study will characterize rural hospital Board of Directors' backgrounds, perceptions of board function, and perceived need of training and development. Topic: Hospitals and clinics
2009	Effect of Safety Net Providers on Ambulatory Care Sensitive Hospitalization Rates in Rural Counties This project will determine if the presence of a community health center or rural health clinic in a county reduces ambulatory care sensitive hospitalizations for children, working age adults, and older adults. Topics: Chronic diseases and conditions, Federally Qualified Health Centers (FQHCs), Health services, Poverty, Rural Health Clinics (RHCs)
2006	Rural Health Center Expansion and Recruitment Survey This collaborative project between WWAMI and the South Carolina Rural Health Research Centers examined and described the current staffing needs of rural health centers (RHCs), ascertained the staffing, recruitment, and retention issues that RHC CEOs regard as most critical; distinguished how issues differ between CEOs contemplating development of expansion sites versus those who are not; and described how these findings correlate with the literature and current national supply projections for the categories of health professions needed by the RHCs. Topics: Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), Workforce
2005	Effects of Alcohol Use on Educational Attainment and Employment in Rural Youth This study will examine the effects of alcohol use during the teen years on subsequent educational attainment and employment in a panel of rural residents. Topics: Children and adolescents, Substance use and treatment Mental Health Risk Factors, Unmet Needs and Provider Availability for Rural Children The study will examine the prevalence of subclinical problems in rural children, assess risk factors associated with problems in children, and assess the influence of local provider availability on healthcare provider contact. Topics: Children and adolescents, Health services, Mental and behavioral health
2003	Emergency Department Use by Medically Indigent Rural Residents Topics: Emergency medical services (EMS) and trauma, Hospitals and clinics, Uninsured and underinsured Estimated Mental Health Care Utilization and Costs in Rural Areas Topic: Mental and behavioral health Rural EMS Infrastructure Topics: Emergency medical services (EMS) and trauma, Frontier health
2002	Rural-Urban Comparison of Mental Health Care Treatment and Costs Topics: Healthcare financing, Mental and behavioral health