Rural and Urban Pharmacy Presence – Pharmacy Deserts

Date: August 22, 2022

Rural and Urban Pharmacy Presence – Pharmacy Deserts

The purpose of this brief is to examine the availability of community pharmacies and their provided services in rural areas of the U.S. The brief also provides a deeper analysis of counties with no retail pharmacies (i.e., pharmacy deserts) based on metropolitan/nonmetropolitan locations.

In 2021, there were 138 counties with no retail pharmacy, including 101 noncore, 15 micropolitan, and 22 metropolitan counties. By most measures, the proportion of the population considered vulnerable, including nonwhite, uninsured, unemployed, and income below the federal poverty level, is higher in noncore counties with no retail pharmacies than in other counties with no retail pharmacies. Further, the percent of population aged 65 and older and the percent aged 85 and older are higher in noncore and micropolitan counties with no pharmacy than in metropolitan counties.

Despite the possibility of using telepharmacy to improve access to health services in medically underserved regions, only around half of U.S. states have passed legislation authorizing telepharmacy.

Contact Information:

Keith J. Mueller, PhD
RUPRI Center for Rural Health Policy Analysis
Phone: 319.384.3832
keith-mueller@uiowa.edu

Additional Resources of Interest:

Increased Rates of Death from Unintentional Injury Among non-Hispanic White, American Indian/Alaska Native, and Nonmetropolitan Communities

Date: July 25, 2022

Increased Rates of Death from Unintentional Injury Among non-Hispanic White, American Indian/Alaska Native, and Nonmetropolitan Communities

Unintentional injury is the third leading cause of death in the U.S., with an age-adjusted death rate of 48.0 per 100,000 in 2018. The National Hospital Ambulatory Medical Care Survey public use datafile for 2018 was used to generate estimates of nonfatal unintentional injury rates.

Key Findings

  • Visits to the emergency department (ED) for unintentional injuries in 2018 were similar in metropolitan and nonmetropolitan areas.
  • The rate of deaths from unintentional injuries in 2018 was higher in nonmetropolitan areas, compared to metropolitan areas, for all racial/ethnic groups except non-Hispanic Black.
  • Living in a nonmetropolitan area was associated with the largest increase in deaths for those who are American Indian or Alaska Native.
  • Residents of nonmetropolitan areas are more likely than those living in metropolitan areas to suffer a fatal unintentional injury, though there was no difference in the rates of nonfatal unintentional injury ED visits.

Contact Information:

Jeffery Talbert, PhD
Rural and Underserved Health Research Center
Phone: 859.323.7141
jeff.talbert@uky.edu

Additional Resources of Interest:

Nursing Homes in Rural America: A Chartbook

Date: July 14, 2022

A new chartbook is available from the Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis:

Nursing Homes in Rural America: A Chartbook

Hari Sharma; Lili Xu; Fred Ullrich; Clint MacKinney; Keith J. Mueller

Closure of nursing homes and hospitals with swing beds in recent years has changed the availability of post-acute and long-term care services in rural areas. This study examines the availability of post-acute and long-term care services as well as characteristics of residents and nursing homes in noncore, micropolitan, and metropolitan counties.

Please click here to read the brief.

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RUPRI Center for Rural Health Policy Analysis
University of Iowa
College of Public Health
Department of Health Management and Policy
145 Riverside Drive, N200 – CPHB
Iowa City, IA 52242
Phone: (319) 384-3832
Fax: (319) 384-4371

Web site: www.public-health.uiowa.edu/rupri

Follow us on Twitter! @RUPRIhealth

Nursing Homes in Rural America: A Chartbook

Date: July 8, 2022

Nursing Homes in Rural America: A Chartbook

In this chartbook, the Rural Health Research & Policy Centers document nursing home availability at the county level and identify counties without nursing homes. The Rural Health Research & Policy Centers also evaluate the supply of nursing home beds per 1,000 population aged 65 and older. In addition, the Rural Health Research & Policy Centers identify county-level nursing home availability for counties with and without hospitals with swing beds. Finally, the Rural Health Research & Policy Centers describe the resident and nursing home characteristics including occupancy levels, payer mix, demographics, and health care needs. The Rural Health Research & Policy Centers summarize data for the noncore, micropolitan, and metropolitan counties.

Key Findings

  • A lower proportion of noncore counties have nursing home post-acute care and long-term care services. Even the inclusion of hospitals with swing beds does not eliminate the differences in access to post-acute care and long-term care services between noncore counties and metro/micropolitan counties.
  • Many noncore counties have a higher number of nursing home beds per 1,000 population aged 65 and older, particularly in the Midwest. However, differences in the beds per 1,000 population aged 65 and older between noncore counties and metropolitan counties vary by states/regions.
  • Residents of nursing homes in noncore counties are less likely to have functional limitations but are more likely to have behavioral/mental health needs.

Contact Information:

Hari Sharma, PhD
RUPRI Center for Rural Health Policy Analysis
Phone: 319.384.4368
hari-sharma@uiowa.edu

Additional Resources of Interest:

Self-Rated Health Among Gay, Lesbian, and Bisexual Adults: Rural/Urban Differences

Date: July 6, 2022

Self-Rated Health Among Gay, Lesbian, and Bisexual Adults: Rural/Urban Differences

This study examines the intersections of sexual orientation, geographic context, and race/ethnicity and their associations with self-rated health. The Rural Health Research & Policy Centers leveraged three nationally representative and population-based datasets in this brief; the National Health Interview Survey (NHIS), the Behavioral Risk Factor Surveillance System (BRFSS), and the Health Information National Trends Survey.

Key Findings

  • Two national datasets (NHIS and BRFSS) revealed statistically significant differences in self-rated health between rural lesbian, gay, and bisexual (LGB) respondents and heterosexual respondents, with LGB respondents more likely to report fair or poor self-rated health.
  • In multivariable models adjusting for age, sex, race, ethnicity, educational attainment, and income, LGB rural adults had lower likelihood of excellent/very good/good self-rated health, compared with heterosexual rural adults in both the NHIS and the BRFSS datasets.
  • Among rural adults, there were differences in self-rated health by race and ethnicity and sexual orientation.

Contact Information:

Carrie Henning-Smith, PhD, MPH, MSW
University of Minnesota Rural Health Research Center
Phone: 612.626.4512
henn0329@umn.edu

Additional Resources of Interest:

Anxiety, Depression, and Access to Mental Health Care by Sexual Orientation and Rurality

Date: June 30, 2022

Anxiety, Depression, and Access to Mental Health Care by Sexual Orientation and Rurality

The purpose of this policy brief is to illustrate the differences in two of the most common mental health disorders (anxiety and depression) and in access to mental health care by sexual orientation and rurality.

Key Findings

  • Rural lesbian, gay, and bisexual (LGB) adults reported the highest rates of depression and anxiety disorder diagnosis, as well as the highest levels of depressed feelings, compared with urban LGB adults and rural and urban heterosexual adults.
  • Urban LGB adults reported the most barriers to accessing health care.
  • Both rural and urban LGB adults were more likely to have delayed mental health care in the past 12 months because of cost, compared with their heterosexual counterparts.

Contact Information:

Carrie Henning-Smith, PhD, MPH, MSW
University of Minnesota Rural Health Research Center
Phone: 612.626.4512
henn0329@umn.edu

Additional Resources of Interest:

New Case Studies on LGBTQ+ Health in Rural Areas

Date: June 30, 2022

Small-Town Pride Celebrations Supporting Social Connectedness & Well-Being for LGBTQ+ Rural ResidentsFeelings of social connectedness and belonging vary by sexual orientation and gender identity. For example, lesbian, gay, and bisexual (LGB) adults report lower social cohesion in their neighborhoods, which may be perpetuated by discrimination and homophobia from members of their community. In addition, recent research found that rural LGB adults reported the lowest levels of having their social and emotional needs met, compared with urban LGB adults, urban heterosexual adults, and rural heterosexual adults. This case series highlights examples of two small-town Pride celebrations that contribute to social connectedness and belonging for rural lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) community members.

Rural Community Organizations Building Inclusive Environments for LGBTQ+ ResidentsCommunity organizations play a key role in providing services and programming in rural communities. This case study series highlights examples of rural community organizations providing LGBTQ+ welcoming and inclusive programming and services from different regions across the U.S.

Improving Access to LGBTQIA+-Friendly Care in Rural AreasLesbian, gay, bisexual, transgender, queer/questioning, and asexual/agender (LGBTQIA+) individuals face many barriers to accessing health care, including lack of health insurance, a shortage of health care providers that are skilled in treating LGBTQIA+ patients, as well as stigma and discrimination in health care settings. This case study series features two organizations that are working toward improving health care for rural LGBTQIA+ patients.

Contact Information:

Mariana Story Tuttle, MPH
University of Minnesota Rural Health Research Center
Phone: 612.626.8401
tuttl090@umn.edu

Additional Resources of Interest:

Social and Emotional Support during the COVID-19 Pandemic by Sexual Orientation and Rurality

Date: June 22, 2022

Social and Emotional Support during the COVID-19 Pandemic by Sexual Orientation and Rurality

Rural residents face distinct risks for social isolation and loneliness, as do lesbian, gay, and bisexual (LGB) adults. This policy brief examines nationally representative data on social and emotional supports during the COVID-19 pandemic by rurality and sexual orientation.

Key Findings

  • Rural LGB adults reported the lowest levels of having their social and emotional needs met.
  • Approximately 32.7% of rural LGB adults said those needs were always met (versus 55.7% of rural heterosexual adults).
  • Rural LGB adults also reported the greatest decrease in social and emotional support during the COVID-19 pandemic, with 23.5% saying they had less support than they had a year ago.

Contact Information:

Mariana Story Tuttle, MPH
University of Minnesota Rural Health Research Center
Phone: 612.626.8401
tuttl090@umn.edu

Additional Resources of Interest: