Adolescent Birth Rates and Rural–Urban Differences by Levels of Deprivation and Health Professional Shortage Areas in the United States, 2017–2018

2021 ◽  
Vol 111 (1) ◽  
pp. 136-144
Author(s):  
Sylvester O. Orimaye ◽  
Nathan Hale ◽  
Edward Leinaar ◽  
Michael G. Smith ◽  
Amal Khoury

Objectives. To examine the differences in adolescent birth rates by deprivation and Health Professional Shortage Areas (HPSAs) in rural and urban counties of the United States in 2017 and 2018. Methods. We analyzed available data on birth rates for females aged 15 to 19 years in the United States using the restricted-use natality files from the National Center for Health Statistics, American Community Survey 5-year population estimates, and the Area Health Resources Files. Results. Rural counties had an additional 7.8 births per 1000 females aged 15 to 19 years (b = 7.84; 95% confidence interval [CI] = 7.13, 8.55) compared with urban counties. Counties with the highest deprivation had an additional 23.1 births per 1000 females aged 15 to 19 years (b = 23.12; 95% CI = 22.30, 23.93), compared with less deprived counties. Rural counties with whole shortage designation had an additional 8.3 births per 1000 females aged 15 to 19 years (b = 8.27; 95% CI = 6.86, 9.67) compared with their urban counterparts. Conclusions. Rural communities across deprivation and HPSA categories showed disproportionately high adolescent birth rates. Future research should examine the extent to which contraceptive access differs among deprived and HPSA-designated rural communities and the impact of policies that may create barriers for rural communities.

2021 ◽  
Author(s):  
Michael Butzner ◽  
Yendelela Cuffee

BACKGROUND In rural communities, there are gaps in describing the design and effectiveness of technology interventions for treating diseases and addressing determinants of health. OBJECTIVE The aim of this study is to evaluate literature on current applications, therapeutic areas, and outcomes of telehealth interventions in rural communities in the United States. METHODS A narrative review of studies published on PubMed from January 2017 to December 2020 was conducted. Key search terms included telehealth, telemedicine, rural, and outcomes. RESULTS Among 15 included studies, 9 studies analyzed telehealth interventions in patients, 3 in health care professionals, and 3 in both patients and health care professionals. The included studies reported positive outcomes and experiences of telehealth use in rural populations including acceptability and increased satisfaction; they also noted that technology is convenient and efficient. Other notable benefits included decreased direct and indirect costs to the patient (travel cost and time) and health care service provider (staffing), lower onsite health care resource utilization, improved physician recruitment and retention, improved access to care, and increased education and training of patients and health care professionals. CONCLUSIONS Telehealth models were associated with positive outcomes for patients and health care professionals, suggesting these models are feasible and can be effective. Future telehealth interventions and studies examining these programs are warranted, especially in rural communities, and future research should evaluate the impact of increased telehealth use as a result of the COVID-19 pandemic.


10.2196/29575 ◽  
2021 ◽  
Vol 23 (8) ◽  
pp. e29575
Author(s):  
Michael Butzner ◽  
Yendelela Cuffee

Background In rural communities, there are gaps in describing the design and effectiveness of technology interventions for treating diseases and addressing determinants of health. Objective The aim of this study is to evaluate literature on current applications, therapeutic areas, and outcomes of telehealth interventions in rural communities in the United States. Methods A narrative review of studies published on PubMed from January 2017 to December 2020 was conducted. Key search terms included telehealth, telemedicine, rural, and outcomes. Results Among 15 included studies, 9 studies analyzed telehealth interventions in patients, 3 in health care professionals, and 3 in both patients and health care professionals. The included studies reported positive outcomes and experiences of telehealth use in rural populations including acceptability and increased satisfaction; they also noted that technology is convenient and efficient. Other notable benefits included decreased direct and indirect costs to the patient (travel cost and time) and health care service provider (staffing), lower onsite health care resource utilization, improved physician recruitment and retention, improved access to care, and increased education and training of patients and health care professionals. Conclusions Telehealth models were associated with positive outcomes for patients and health care professionals, suggesting these models are feasible and can be effective. Future telehealth interventions and studies examining these programs are warranted, especially in rural communities, and future research should evaluate the impact of increased telehealth use as a result of the COVID-19 pandemic.


2020 ◽  
Vol 110 (7) ◽  
pp. 1006-1008
Author(s):  
Lauren Lizewski ◽  
Grace Flaherty ◽  
Parke Wilde ◽  
Ross Brownson ◽  
Claire Wang ◽  
...  

Objectives. To assess stakeholder perceptions of the impact and feasibility of 21 national, state, and local nutrition policies for cancer prevention across 5 domains in the United States. Methods. We conducted an online survey from October through December 2018. Participants were invited to take the survey via direct e-mail contact or an organizational e-newsletter. Results. Federal or state Medicare/Medicaid coverage of nutrition counseling and federal or state subsidies on fruits, vegetables, and whole grains for participants in the Supplemental Nutrition Assistance Program were the policies rated as having the highest perceived impact and feasibility. Overall, the 170 respondents rated policy impact higher than policy feasibility. Polices at the federal or state level had a higher perceived impact, whereas local policies had higher perceived feasibility. Conclusions. Our findings might guide future research and advocacy that can ultimately motivate and target policy actions to reduce cancer burdens and disparities in the United States.


2018 ◽  
Vol 78 (1) ◽  
pp. 118-154 ◽  
Author(s):  
Joshua Lewis

From 1930 to 1960 rural communities, mainly in the U.S. South and Southwest, gained access to electricity. In addition to lights, the benefits included easier clothes washing, refrigeration, and pumped water. This article uses differences in the timing of electricity access across rural counties to study the effects on infant mortality and fertility. Rural electrification led to substantial reductions in infant mortality but had little effect on women's fertility. The increase in electricity access between 1930 and 1960 can account for 15 to 19 percent of the decline in rural infant mortality during this period.


2009 ◽  
Vol 84 (5) ◽  
pp. 436-445 ◽  
Author(s):  
Wayne N. Burton ◽  
Stephen H. Landy ◽  
Kristen E. Downs ◽  
M. Chris Runken

Author(s):  
Wendy Coduti

Mental health (MH) and disability management (DM) businesses and DM professionals are proficient at addressing employee physical health, yet promoting employee MH is often ignored. Individuals claiming long-term disability (LTD), 85% identified MH conditions as their primary disability (Carls et al., 2012). Mental health LTD expenses are often higher due to longer recovery and challenges in return to work (Salkever, Goldman, Purushothaman, & Shinogle, 2000). Financial burdens of depression, anxiety, and emotional disorders are among the greatest of any disease condition in the workforce (Johnston et al., 2009). Globally, a fifth to a quarter of employees go to work everyday with a mental illness (Lorenzo-Romanella, 2011). Health care research has shown the impact of mental illness on work performance, however many employers and researchers are unaware of the value quality MH care has on employees and costs (Langlieb, & Kahn, 2005). The American Psychological Association (APA) identified five categories of workplace practices that promote psychological health in employees including: employee involvement; work-life balance; employee growth and development; health and safety; and employee recognition (APA, 2014). Organizational benefits of the five elements include: improved quality, performance and productivity; reduced absenteeism, presenteeism and turnover; fewer accidents and injuries; improved ability to attract and retain quality employees; improved customer service and satisfaction; and lower healthcare costs (APA, 2014). The presenters will discuss employer costs of MH claims and how psychologically healthy workplaces align with successful DM programs, decreasing MH claims and costs. Opportunities for future research include the United States Affordable Care Act (ACA) and its impact on MH (Mechanic, 2012) through provisions that encourage employers to adopt health promotion programs (Goetzel et al., 2012) and opportunities for research including comparisons of multinational employers regarding MH costs in countries with single payer systems, and in those without (United States), (Tanner, 2013).


Author(s):  
William Garriott

AbstractIn the United States, state-based efforts to curtail the spread of methamphetamine (“meth”) have targeted domestic producers through heightened regulation of precursor chemicals used in the clandestine meth-production process. This article examines the impact of these efforts on the exercise of police power in a rural community affected by methamphetamine. As the author shows, the targeting of local meth production has incorporated residents of rural communities into the policing process by variously encouraging and requiring them to adopt a new way of perceiving the local landscape, centred around methamphetamine. Under the new legislation, previously benign objects such as cold medicine, batteries, and drain cleaner have been re-signified as objects with criminal potential that residents of rural communities are called upon to police. This has led to the expansion of police power within and beyond the formal domains of law enforcement. Through the targeting of local production, civic volunteers, pharmacists, retail clerks, natural resource officers, and others have been drawn into the policing of the meth problem. This reveals a key dynamic in the localization of police power: as police power is localized, the local is reimagined in terms of police power.


2017 ◽  
Vol 16 (3) ◽  
pp. 244-251 ◽  
Author(s):  
Ariela Schachter ◽  
Max Besbris

The recent settlement of immigrant populations into a wider range of geographies and communities across the United States raises new questions about the dynamics of residential segregation and complicates assumptions about how neighborhoods change—or don't—and why. While multiple theories attempt to explain the relationship between race/ethnicity, immigration, and neighborhood change, sociological examinations have been limited by the lack of systematic and frequently collected data. That is, the residential churn of neighborhoods, particularly in the market for rental housing where racial/ethnic minorities and immigrants predominate, often outpaces analysts’ ability to gather cross–neighborhood and cross–city data. In this essay we describe how online sources can help answer questions about race/ethnicity, immigration, and neighborhoods by providing large amounts of readily updatable data. An array of platforms designed to provide homeseekers with information about their housing options can also be used by sociologists for making claims about neighborhood change across multiple geographies. We review recent research that uses online data and describe an ongoing study by the authors that examines trends in the settlement patterns of immigrants and the rental housing market across the 50 largest MSAs in the United States. Online data sources can more accurately capture immigration and neighborhood processes, yielding better theories about the impact of immigration on neighborhood change.


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