Thursday, April 3, 2025
4/3/2025
Rural Health Research Grant Program Cooperative Agreement - Residents of the rural US experience multiple health inequities and health care access barriers, making them a priority population for many federal programs. Rural residents--particularly underserved populations: low income, persons with disabilities, sexual and gender minorities, and members of minoritized racial and ethnic groups--report poorer health and higher chronic illness rates than people in urban areas. A 2024 Centers for Disease Control and Prevention analysis found that rural communities experience higher mortality rates from the five leading causes of death; from 2010-2022, the disparity widened for four of the causes. Health care access is a crucial component of health equity, yet rural residents receive fewer provider visits and preventive screenings than urban residents. There are fewer primary and specialty care providers in rural areas, which creates access gaps, particularly for those with limited transportation. Rural residents are more likely to defer necessary health care due to cost and have higher uninsured and underinsured rates, while rural communities struggle to provide adequate mental health and substance use treatment despite unprecedented levels of need. 4.5 million (disproportionately rural) US residents live in ambulance deserts. The COVID-19 public health emergency (PHE) strained rural public health and health care systems with capacity impacts we have yet to realize. Recent policy changes, such as Minimum Staffing Standards for Nursing Homes, seek to assure quality but may be unfeasible for rural facilities given workforce gaps. The post-PHE Medicaid “unwinding” is increasing US uninsured rates, but the rural impact is unclear. Despite these challenges, many rural communities demonstrate exceptional resilience and innovation to serve residents. Health care financing and delivery reforms, including proposals to reimagine the rural health system, hold potential for reducing rural inequities. Telehealth policy shifts and service expansions during the PHE increased use, and efforts to further expand these services may improve access for a range of needs, particularly behavioral health. States are experimenting with new models of rural health care delivery and payment, including community health worker programs, free-standing emergency departments, mobile integrated health, and global budgets. However, knowledge gaps may hamper the full benefit for rural communities. For example, changing payment- and delivery-system models raise questions about rural participation, impacts on access/quality, and policy and program changes necessary to make these models function optimally. To reduce knowledge gaps and advance information about effective rural innovations, the proposed Northeast Rural Health Research Center (NeRHRC) will leverage expertise from the University of Vermont (UVM) and University of Southern Maine (USM) in a new consortium RHRC program. Co-Principal Investigators Ziller and Jonk have a 7-year collaborative leadership history and a combined 40+ years’ rural health research experience. Many of UVM’s multiple institutes and centers have rural-relevant missions, including the UVM Health Network, an integrated health system serving more than 1 million people in Vermont and upstate New York. The Maine Rural Health Research Center at USM has a 32-year history of research on access to rural health services. Building on these resources, the NeRHRC’s four-year research agenda focuses on rural health care access, with emphases on public health insurance, emergency medical services, behavioral health, healthy aging, and policy strategies to support rural health care providers. In the first year, we propose projects related to: rural Medicaid coverage, rural aging resources, Rural Health Clinic payment reform participation and emergency mental health among rural youth. Our research and dissemination strategies offer a targeted approach to addressing contemporary rural health policies and programs.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).