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      Characteristics of Hospitals Eligible for Rural Emergency Hospital Designation

      research-article
      , MD, MPH 1 , , , MD 1 , , MPH 1 , , MD, PhD 1
      JAMA Health Forum
      American Medical Association

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          Abstract

          This cross-sectional study compares the characteristics, finances, services, and challenges at hospitals that are eligible vs not eligible to become rural emergency hospitals.

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          Racial/Ethnic Health Disparities Among Rural Adults — United States, 2012–2015

          Problem/Condition Rural communities often have worse health outcomes, have less access to care, and are less diverse than urban communities. Much of the research on rural health disparities examines disparities between rural and urban communities, with fewer studies on disparities within rural communities. This report provides an overview of racial/ethnic health disparities for selected indicators in rural areas of the United States. Reporting Period 2012–2015. Description of System Self-reported data from the 2012–2015 Behavioral Risk Factor Surveillance System were pooled to evaluate racial/ethnic disparities in health, access to care, and health-related behaviors among rural residents in all 50 states and the District of Columbia. Using the National Center for Health Statistics 2013 Urban-Rural Classification Scheme for Counties to assess rurality, this analysis focused on adults living in noncore (rural) counties. Results Racial/ethnic minorities who lived in rural areas were younger (more often in the youngest age group) than non-Hispanic whites. Except for Asians and Native Hawaiians and other Pacific Islanders (combined in the analysis), more racial/ethnic minorities (compared with non-Hispanic whites) reported their health as fair or poor, that they had obesity, and that they were unable to see a physician in the past 12 months because of cost. All racial/ethnic minority populations were less likely than non-Hispanic whites to report having a personal health care provider. Non-Hispanic whites had the highest estimated prevalence of binge drinking in the past 30 days. Interpretation Although persons in rural communities often have worse health outcomes and less access to health care than those in urban communities, rural racial/ethnic minority populations have substantial health, access to care, and lifestyle challenges that can be overlooked when considering aggregated population data. This study revealed difficulties among non-Hispanic whites as well, primarily related to health-related risk behaviors. Across each population, the challenges vary. Public Health Action Stratifying data by different demographics, using community health needs assessments, and adopting and implementing the National Culturally and Linguistically Appropriate Services Standards can help rural communities identify disparities and develop effective initiatives to eliminate them, which aligns with a Healthy People 2020 overarching goal: achieving health equity.
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            Improving Health Among Rural Residents in the US

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              Author and article information

              Journal
              JAMA Health Forum
              JAMA Health Forum
              JAMA Health Forum
              American Medical Association
              2689-0186
              9 December 2022
              December 2022
              9 December 2022
              : 3
              : 12
              : e224613
              Affiliations
              [1 ]Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
              Author notes
              Article Information
              Accepted for Publication: October 18, 2022.
              Published: December 9, 2022. doi:10.1001/jamahealthforum.2022.4613
              Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2022 Chatterjee P et al. JAMA Health Forum.
              Corresponding Author: Paula Chatterjee, MD, MPH, University of Pennsylvania, 423 Guardian Dr, Room 1318, Philadelphia, PA 19104 ( pchat@ 123456pennmedicine.upenn.edu ).
              Author Contributions: Dr Chatterjee and Ms Huang had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
              Concept and design: Chatterjee, Navathe.
              Acquisition, analysis, or interpretation of data: Chatterjee, Klebanoff, Huang.
              Drafting of the manuscript: All authors.
              Critical revision of the manuscript for important intellectual content: Chatterjee, Huang, Navathe.
              Statistical analysis: All authors.
              Obtained funding: Chatterjee, Navathe.
              Administrative, technical, or material support: Klebanoff, Navathe.
              Supervision: Chatterjee, Navathe.
              Conflict of Interest Disclosures: Dr Chatterjee reported receiving grants from Laura & John Arnold Foundation outside the submitted work. Dr Navathe reported receiving grants from Hawaii Medical Service Association, Commonwealth Fund, Robert Wood Johnson Foundation, Donaghue Foundation, Pennsylvania Department of Health, US Department of Veterans Affairs, Ochsner Health System, United Healthcare, Blue Cross Blue Shield of North Carolina, Blue Shield of California, and Humana; receiving personal fees from Navvis Healthcare, NavaHealth, Yale New Haven Health System Center for Outcomes Research and Evaluation (CORE), Maine Health Accountable Care Organization, Singapore Ministry of Health, Elsevier Press, Medicare Payment Advisory Commission, Cleveland Clinic, Analysis Group, VBID Health, Advocate Physician Partners, Federal Trade Commission, Catholic Health Services of Long Island; receiving equity from Clarify Health; and being an unpaid board member for Integrated Services Inc outside the submitted work. No other disclosures were reported.
              Funding/Support: This study was funded by grant K23AG073512 from the National Institute on Aging (Dr Chatterjee), grant 1R01MD013859-01 from the National Institute on Minority Health and Health Disparities (Dr Navathe), and grant 1R01HS027595-01A1 from the Agency for Healthcare Research and Quality (Dr Navathe).
              Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
              Disclaimer: The views expressed herein are those of the authors and do not necessarily represent the views of the US government, the Department of Veterans Affairs, or the State of Pennsylvania.
              Article
              ald220037
              10.1001/jamahealthforum.2022.4613
              9856250
              36484999
              b144e6a2-acee-43da-b94e-268838344933
              Copyright 2022 Chatterjee P et al. JAMA Health Forum.

              This is an open access article distributed under the terms of the CC-BY License.

              History
              : 15 September 2022
              : 18 October 2022
              Categories
              Research
              Research
              Research Letter
              Online Only
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