Research Reports

Rural America is often at a significant disadvantage in accessing quality and affordable healthcare. Rural hospitals remain vulnerable to closure due to broad environmental and health industry forces. Rural health organizations have increasingly aligned with larger healthcare systems to offset operational and financial risks. The question remains as to how these healthcare alliances impact the community health capacity of rural Pennsylvania. Rural community health leaders believed that the benefits of forming alliances better leverage scarce resources and outweighed the associated costs. Overall the outcomes of affiliations are positive. In most cases, these alliances minimized the rural hospitals' operational and financial risks and increased investment in rural hospitals and their associated services.

The rapid increase in Marcellus Shale development over the past decade has raised concerns about the potential impacts of drilling and related development on public health, including health insurance coverage, demand for health care services, and health outcome indicators among populations who live in communities with substantial development. Accordingly, this report presents results from analyses that examined health insurance coverage, health care utilization, and health outcomes and changes in those indicators since substantial well development began in 2006. Although suggestive, this report is intended to be exploratory and not conclusive. Despite its descriptive approach, the findings from this report should provide a foundation for increased surveillance and additional research.