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2022

Assessment and Analysis of Housing Quality and Policies in Rural Pennsylvania

September 29, 2022  | Health Care and Human Services

The purpose of this study was to assess housing quality and related policies and programs in rural Pennsylvania. The research goals and objectives focused on four areas: gaining a quantitative understanding of housing quality for rural Pennsylvania communities; understanding barriers faced by rural residents in securing loans to address home improvement; understanding municipal policy and implementation regarding housing maintenance codes; and developing policy considerations that address the key issues regarding housing quality in rural Pennsylvania.

Executive Summary

Tags:  housing quality index , sub-quality housing , rural housing , property maintenance codes , housing finance programs

Coroner/Medical Examiner Services in Pennsylvania

August 02, 2022  | Health Care and Human Services

This research provides information about Pennsylvania coroner/medical examiners (C/MEs) and their offices. It examined office caseloads, funding, facilities, forensic capacity, vehicles and equipment, and staffing and training resources. It also assessed how the opioid epidemic and the COVID-19 pandemic affected county C/ME offices.

Executive Summary

Tags:  coroner , medical examiner , opiods , covid-19

Access to Maternity and Obstetric Care in Rural Pennsylvania

April 22, 2022  | Health Care and Human Services

This study examined access to maternity care in rural Pennsylvania. Maternity care (also known as obstetric care) can be defined as health care services delivered to women during pregnancy, childbirth, and the postpartum. Access to maternity care is defined as the availability of birthing facilities (hospitals or birth centers) and practitioners (physicians and midwives) providing these health services.

Executive Summary

Tags:  maternity care , maternal care , children

Access to Mental Health Services in Rural Pennsylvania

January 24, 2022  | Health Care and Human Services

This research assessed the demand for mental health services in rural Pennsylvania with a focus on youth and the elderly. It identified challenges these populations face in accessing mental health care to provide options for improving and expanding mental health care services for underserved rural Pennsylvanians.

Executive Summary

Tags:  mental health , youth , elderly

2021

Recruitment and Retention Issues for Counselors in Rural Pennsylvania Substance Use Disorder Treatment Programs

October 11, 2021  | Health Care and Human Services

Recruiting high-quality counselors is a major problem for rural substance use disorder (SUD) treatment programs. Treatment program directors linked recruitment problems to low salaries, the rural location of the treatment facility, and the lack of adequate training in the SUD field. Emotional exhaustion was the strongest predictor of intent to quit. Low job satisfaction, poor management communication, and a high percentage of clients on medication-assisted treatment were also related to the intent to quit. 

Executive Summary

Tags:  mental health , counseling services , treatment , substance use disorder

Suicide Trends and Prevention in Rural Pennsylvania Counties and Schools

June 19, 2021  | Health Care and Human Services

This study examined the overall trends in suicide across Pennsylvania from 1990 to 2018, the suicide prevention programs currently used by counties, and the programs that are used in K - 12 school districts. Suicide rates have been increasing over the last decade. In 2018, the suicide rate in rural counties was 25 percent higher than in urban counties. Higher numbers of handgun sales, lower levels of education, lower incomes, larger populations over age 65, and higher unemployment correlate with higher rural suicide rates. 

Executive Summary

Tags:  mental health , suicide

2020

Availability of Hospice in Rural Pennsylvania (2020)

May 12, 2020  | Health Care and Human Services

Hospice represents a specific form of palliative care that is typically delivered within the last six months of life. There is a strong evidence base that demonstrates the benefits that hospice has on quality of life and cost of care at the patients' end of life. Despite the reported benefits, hospice remains underused, with substantial geographic variation in hospice availability and use rates. Assuming similar patterns of hospice use, the research found that there will be significant increases in future hospice demand, based on projections of an aging population in rural Pennsylvania counties. Interviews with stakeholders - namely hospice care providers in rural Pennsylvania - validated hospice availability and use concerns related to travel time, and lack of choice for patients and families. They also highlighted issues related to using electronic health records in areas with poor internet or cell service. 

Executive Summary

Tags:  hospice , palliative care , aging population

Evaluation of Senior Community Centers in Rural and Urban Pennsylvania (2020)

March 05, 2020  | Health Care and Human Services

With the growing senior population in Pennsylvania, the research examined challenges and opportunities that senior community centers face. Specifically, the research created an inventory of Pennsylvania's rural and urban senior community center (SCC) locations, including the type of services provided and activities available. Attendance and program participation were analyzed as well as accessibility issues, means of transportation to/from the center, and relevant demographic characteristics. Participants accessed a wide variety of programs, including congregate meals, health, and wellness programs, group recreational programs, and at a few centers, personal care services. The research identified important policy considerations for the Pennsylvania Department of Aging that could help enhance and further support senior community centers across the entire state. 

Executive Summary

Tags:  senior centers

Child Sexual Abuse and Exploitation in Pennsylvania (2020)

January 08, 2020  | Health Care and Human Services

Research was conducted to understand the characteristics of Commercial Sexual Exploitation of Children (CSEC), and how it is identified and investigated by CYS caseworkers. The research identified challenges in multiple steps of the CYS process, from the initial screening of child abuse reports to the actions of the State Commonwealth Court. Recommendations were made and are intended to improve the quality of the child welfare system in Pennsylvania. The recommendations focus on strategies that can support and enhance child protection work statewide. Pennsylvania's statutory requirement for expungement of CYS cases dispositioned as "unfounded", "invalid," or "screened-out" without an investigation, can create numerous barriers to CYS's ability to keep children safe. The researchers identified high variability in the rate at which reports were screened out across counties, potentially resulting in disparate access to protective services depending on one's address. 

Executive Summary

Tags:  child sexual abuse , child exploitation

2019

Oral Health Status of Low-Income Children in Pennsylvania: A Rural-Urban Comparison (2019)

November 20, 2019  | Health Care and Human Services

The overall goal of the research study was to develop recommendations for public policy to improve the oral health status of low-income children residing in rural Pennsylvania. Specifically, the research, conducted in 2018-2019, analyzed: (1) the oral health component of the Medical Assistance (MA) program for children in Pennsylvania, (2) the Children's Health Insurance Program (CHIP), (3) a variety of additional oral health programs and services, (4) the school oral health program, (5) the supply and geographic distribution of dentists in Pennsylvania, and (6) the overall oral health care delivery system for low-income children in rural Pennslyvania. 

Executive Summary

Tags:  low-income , children , oral health

Analysis of Obesity Rates for School Children n Pennsylvania (2019)

June 19, 2019  | Health Care and Human Services

The U.S. Department of Health considers about one-third of children and adolescents aged 6 to 19 to be overweight or obese. In particular, the Pennsylvania Department of Health defines childhood obesity for persons aged 2-19 years as a Body Mass Index (BMI) at or above the 95th percentile. The BMI-for-age is a useful measure because it allows one to compare obesity rates of similar cohorts across different states, or across different counties in a particular state. Previous research conducted by the Center for Rural Pennsylvania (2005) indicated that rural areas have higher obesity rates. From an economic standpoint, there are private and social costs associated with obesity. Crucial private costs of obesity are lower productivity, income inequality, and higher healthcare costs. Research in nutrition economics and health economics found that childhood obesity has a negative impact on academic performance and leads to lower self-esteem, and exposes students to bullying and hidden bias among peers and teachers.

Executive Summary

Tags:  children , obesity

The Availability of Medication-Assisted Treatment for Opioid Addiction in Pennsylvania (2019)

March 06, 2019  | Health Care and Human Services

This study assessed the barriers and opportunities that exist in expanding Medication-Assisted Treatment (MAT) services in Pennsylvania. MAT includes the use of methadone, buprenorphine, Suboxone, naloxone, and naltrexone in residential, behavioral, or outpatient programs, hospitals, and jails and prisons to help individuals suffering from opioid addiction to overcome withdrawal symptoms, cravings, and potential overdose. The research found that those who seek emergency care and long-term treatment for opioids and who live in rural areas of Pennsylvania have limited access to care. Other barriers to accessing MAT services are lack of childcare and housing, lack of transportation, limited private insurance coverage, and limited funding for MAT services. Combating heroin and opioid use disorders requires an "all-in" commitment. It should continue to enforce laws and regulations enacted to provide coverage for mental health services for patients suffering from addiction and direct additional state and federal funding to support MAT services throughout Pennsylvania. 

Executive Summary

Tags:  opioid , addiction

2018

Comparing Rural and Urban Drug Use and Violence in the Pennsylvania Youth Survey (2018)

July 16, 2018  | Health Care and Human Services

Understanding youth drug use and violent behavior is an important step in reducing drug use and violence in Pennsylvania. Rural and urban areas may have different rates of drug use and violence and thus require different types of interventions. In terms of alcohol and illicit drug use, the results indicated little overall differences between urban and rural students. However, the analysis only examined the number of prevention programs in a school district and the data did not include details about individual programs operating in schools. Further research could attempt to get more school-specific details about the programs that operated in those schools.

Executive Summary

Tags:  addiction , violence , youth

2017

Examination of Community Health Workers in Rural Pennsylvania (2017)

November 16, 2017  | Health Care and Human Services

Community health workers (CHWs) play a vital role in the health care delivery system of rural Pennsylvania counties. Currently, the role of CHWs is not well defined. Efforts toward certification and training programs are evident throughout Pennsylvania, yet they lack consistency. The research gathered information on CHWs through surveys, focus groups, and interviews. Results found that CHWs are used in a variety of agencies and contexts in rural Pennsylvania, with duties ranging from working with the elderly to working with infants and children. It was evident from the research that low pay, high turnover, and lack of adequate funding were significant issues for many agencies. In addition, many agencies experienced large caseloads and lacked consistent CHWs certification and training. A variety of educational backgrounds and training further complicates the consistency of CHW roles. The researchers found that decisions on certification and training need to be made by the state legislature and the state Departments of Health and Human Services. 

Executive Summary

Tags:  home health care , health workers , health care , community health workers

Exploring Healthcare Alliances in Rural Pennsylvania (2017)

September 10, 2017  | Health Care and Human Services

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.

Tags:  healthcare

2016

Domestic Violence Cases in Rural Pennsylvania Magisterial Courts: Practices, Effectiveness, and Consequences (2016)

September 19, 2016  | Health Care and Human Services

This research examined domestic violence (DV) cases brought before Magisterial Courts in rural Pennsylvania and the manner in which these courts commonly handle DV cases. The research used semi-structured interviews with Magisterial Court judges and secondary court data.

Tags:  pennsylvania courts , magisterial courts , intimate partner violence , domestic violence , justice

Analysis of Domestic Violence Services in Rural Pennsylvania (2016)

September 17, 2016  | Health Care and Human Services

This research analyzed domestic violence services and potential barriers to those services in Pennsylvania, particularly in rural counties. The study tracked shelter characteristics and needs, typical client characteristics and needs, shelter services, community partnerships, and coalition building to identify and analyze any barriers to the effective delivery of domestic violence services in rural counties. In general, the research found that shelters in rural counties face unique challenges in helping victims of domestic violence such as critical resource gaps, availability of public transportation, and transitional housing. Rural shelters rely heavily on their community partners, such as faith groups and local business, for resources such as hotel stay, medical stays, and other day-to day needs. 

Tags:  domestic violence , services

2015

Heroin: Combating this Growing Epidemic in PA - Findings Compiled from Statewide Hearings on Addiction Treatment and Recovery Services (2015)

December 17, 2015  | Health Care and Human Services

This report summarizes the testimony presented at the Center for Rural Pennsylvania's second round of statewide public hearings in July and August 2015. The hearings took a closer look at heroin and opioid addiction, specifically treatment and recovery services in Pennsylvania. These hearings were held July 21 at Saint Vincent College in Latrobe, July 29 at The Commonwealth Medical College in Scranton, and August 18 at the Yorktowne Hotel in York.

Tags:  treatment and recovery , addiction , opioids , heroin , crisis

Assessing Career Dissatisfaction and Plans to Leave Patient Care Among the Rural Pennsylvania Health Workforce (2015)

May 11, 2015  | Health Care and Human Services

This research analyzed survey data for four health workforces in Pennsylvania, namely physicians, physician assistants, dentists, and dental hygienists, to identify any rural/urban differences in the workforce makeup, career satisfaction, and plans to leave patient care. The research used the 2012-2013 Pennsylvania Health Workforce Surveys for the analysis. The surveys collect a variety of information on health care workers, including their age, gender, educational background, employment, and job satisfaction levels.

Tags:  patient care , health care work , career satisfaction , health workers

2014

Comparison of Cancer Incidence and Mortality for Rural vs. Urban Counties, Rural Appalachian Counties and Rural U.S. Counties (2014)

July 13, 2014  | Health Care and Human Services

This research set out to find if there were any significant differences in cancer incidence and mortality in rural Pennsylvania counties as compared to urban Pennsylvania counties, rural Appalachian counties, and rural U.S. counties.

Tags:  rural cancer incidence , appalachia

Telehealth in Rural Pennsylvania (2014)

January 14, 2014  | Health Care and Human Services

Telehealth, which is the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, and public health and health administration, has been proposed as a possible solution to meeting these challenges. This research, conducted in 2012 and 2013, set out to describe how and to what extend telehealth is being implemented in rural Pennsylvania.

Tags:  rural health care , public health , telehealth

2013

Home and Community-Based Alternatives to Nursing Home Care (2013)

November 17, 2013  | Health Care and Human Services

This research determined the scope and magnitude of home and community-based care alternatives to nursing homes currently available in rural Pennsylvania and the current need for rural home and community-based care alternatives to nursing homes among specific constituent groups.

Tags:  rural health care , home health care , community health care , nursing care

2006

2004

2003

Analysis of the Children's Health Insurance Program in Rural Pennsylvania

January 01, 2003  | Health Care and Human Services

Studies on Rural Elderly Care

January 01, 2003  | Health Care and Human Services

2002

1998

Introducing the Center's new journal, Rural Policy: The Research Bulletin of the Center for Rural Pennsylvania.