The Journal of Rural Health Impact Factor & Information

Publisher: American Rural Health Association; National Rural Health Care Association (U.S.), Wiley

Journal description

The Journal of Rural Health, a quarterly journal published by the NRHA, offers a variety of original research relevant and important to rural health. Some examples include evaluations, case studies, and analyses related to health status and behavior, as well as to health work force, policy and access issues. Quantitative, qualitative and mixed methods studies are welcome. Highest priority is given to manuscripts that reflect scholarly quality, demonstrate methodological rigor, and emphasize practical implications. The journal also publishes articles with an international rural health perspective, commentaries, book reviews and letters.

Current impact factor: 1.77

Impact Factor Rankings

2015 Impact Factor Available summer 2015
2013 / 2014 Impact Factor 1.771
2012 Impact Factor 1.444
2011 Impact Factor 1.429
2010 Impact Factor 1.41
2009 Impact Factor 1.105
2008 Impact Factor 1.05
2007 Impact Factor 1.108
2006 Impact Factor 1.038
2005 Impact Factor 0.866
2004 Impact Factor 0.673
2003 Impact Factor 0.537
2002 Impact Factor 0.782

Impact factor over time

Impact factor
Year

Additional details

5-year impact 1.68
Cited half-life 6.40
Immediacy index 0.25
Eigenfactor 0.00
Article influence 0.50
Website Journal of Rural Health, The website
Other titles The Journal of rural health, JRH
ISSN 0890-765X
OCLC 12020952
Material type Periodical, Internet resource
Document type Journal / Magazine / Newspaper, Internet Resource

Publisher details

Wiley

  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author cannot archive a post-print version
  • Restrictions
    • 12 months embargo
  • Conditions
    • Some journals have separate policies, please check with each journal directly
    • On author's personal website, institutional repositories, arXiv, AgEcon, PhilPapers, PubMed Central, RePEc or Social Science Research Network
    • Author's pre-print may not be updated with Publisher's Version/PDF
    • Author's pre-print must acknowledge acceptance for publication
    • On a non-profit server
    • Publisher's version/PDF cannot be used
    • Publisher source must be acknowledged with citation
    • Must link to publisher version with set statement (see policy)
    • If OnlineOpen is available, BBSRC, EPSRC, MRC, NERC and STFC authors, may self-archive after 12 months
    • If OnlineOpen is available, AHRC and ESRC authors, may self-archive after 24 months
    • Publisher last contacted on 07/08/2014
    • This policy is an exception to the default policies of 'Wiley'
  • Classification
    ​ yellow

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: As part of the Patient Protection and Affordable Care Act (Affordable Care Act) of 2010, 2 new opportunities for health care coverage were established for many uninsured individuals beginning on January 1, 2014. The first opportunity was through Medicaid expansion where states had the opportunity to expand Medicaid coverage to individuals with household incomes up to 133% of the federal poverty level. The second opportunity was through the establishment of Health Insurance Marketplaces where individuals could purchase private health plans and potentially qualify for financial assistance in paying for their plans. The Office of Rural Health Policy (ORHP) provided supplemental grant awards to help stimulate Affordable Care Act outreach and education efforts in rural communities that were being served by the Rural Health Care Services Outreach (Outreach) Grant Program. As a result, Outreach grantees enrolled 9,300 rural Americans during the initial Open Enrollment period. Valuable outreach and enrollment lessons were learned from rural communities based on discussions with the Outreach grantees who received the supplemental funding. These lessons will help rural communities prepare for the next Open Enrollment period. © 2014 National Rural Health Association.
    The Journal of Rural Health 12/2014; 31(1). DOI:10.1111/jrh.12100
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    ABSTRACT: PurposeLittle is known about access to care for hematological cancer patients. This study explored patient experiences of barriers to accessing care and associated financial and social impacts of the disease. Metropolitan versus nonmetropolitan experiences were compared. MethodsA state‐based Australian cancer registry identified adult survivors of hematological cancers (including lymphoma, leukemia and myeloma) diagnosed in the previous 3 years. Survivors were mailed a self‐report pen and paper survey. FindingsOf the 732 eligible survivors, 268 (37%) completed a survey. Forty percent of participants reported at least one locational barrier which limited access to care. Only 2% reported cancer‐related expenses had restricted their treatment choices. Almost two‐thirds (64%) reported at least one financial or social impact on their daily lives related to cancer. The most frequently reported impacts were the need to take time off work (44%) and difficulty paying bills (21%). Survivors living in a nonmetropolitan location had 17 times the odds of reporting locational or financial barriers compared with those in metropolitan areas. Preferred potential solutions to alleviate the financial and social impacts of the disease were: free parking for tests or treatment (37%), free medications or treatments (29%), and being able to get treatment in their local region (20%). Conclusions Providing more equitable access to care for hematological cancer patients in Australia requires addressing distances traveled to attend treatment and their associated financial and social impacts on nonmetropolitan patients. Greater flexibility in service delivery is also needed for patients still in the workforce.
    The Journal of Rural Health 08/2013; 29(s1). DOI:10.1111/jrh.12020
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    ABSTRACT: PurposeTo explore the perceived barriers, resources, and training needs of rural primary care providers in relation to implementing the American Medical Association Expert Committee recommendations for assessment, treatment, and prevention of childhood obesity.Methods In‐depth interviews were conducted with 13 rural primary care providers in Oregon. Transcribed interviews were thematically coded.ResultsBarriers to addressing childhood obesity fell into 5 categories: barriers related to the practice (time constraints, lack of reimbursement, few opportunities to detect obesity), the clinician (limited knowledge), the family/patient (family lifestyle and lack of parent motivation to change, low family income and lack of health insurance, sensitivity of the issue), the community (lack of pediatric subspecialists and multidisciplinary/tertiary care services, few community resources), and the broader sociocultural environment (sociocultural influences, high prevalence of childhood obesity). There were very few clinic and community resources to assist clinicians in addressing weight issues. Clinicians had received little previous training relevant to childhood obesity, and they expressed an interest in several topics.Conclusions Rural primary care providers face extensive barriers in relation to implementing recommended practices for assessment, treatment, and prevention of childhood obesity. Particularly problematic is the lack of local and regional resources. Employing nurses to provide case management and behavior counseling, group visits, and telehealth and other technological communications are strategies that could improve the management of childhood obesity in rural primary care settings.
    The Journal of Rural Health 08/2013; 29. DOI:10.1111/jrh.12006
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    ABSTRACT: PurposeTo examine whether there is a difference in the likelihood that a general dentist practices in a rural location based on individual characteristics, including dental school attended, birth state, practice arrangement, sex, and age.Methods All private practice, general dentists in Iowa were included in this study. Data were extracted from the year 2010 version of the Iowa Dentist Tracking System, which monitors practice patterns of active dentists. Rurality of primary office location, categorized using Rural‐Urban Commuting Area codes, served as the outcome variable. Chi‐square tests and multivariable logistic regression were used to explain associations between rural practice location and dentist characteristics.FindingsFifteen percent of the state's population resided in isolated small rural towns, but only 8% of general dentists practiced here. Approximately 17% of dentists in isolated small rural towns were age 40 or younger, compared to 32% of dentists in urban areas. Among male dentists, those who were born in Iowa (P = .002) were older (P = .020), and graduated from dental schools other than the University of Iowa (P = .009) were more likely to practice in rural areas than were their counterparts. Conversely, among female dentists, solo practice (P = .016) was the only variable significantly associated with rural practice location.Conclusions The dentist workforce in rural areas of Iowa is dominated by older males who were born in Iowa. As this generation retires and increasing numbers of women enter the profession, state policy makers and planners will need to monitor changing trends in the rural workforce.
    The Journal of Rural Health 08/2013; 29(Suppl 1):89-95. DOI:10.1111/jrh.12004
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    ABSTRACT: PurposeObservation care is used to evaluate patients prior to admission or discharge. Often beneficial, such care also imposes greater financial liability on Medicare beneficiaries. While the use of observation care has increased recently, critical access hospitals (CAHs) face different policies than prospective payment (PPS) hospitals, which may influence their observation care use.Methods We used 100% Medicare inpatient and outpatient claims files and enrollment data for years 2007 to 2009, and the 2007 American Hospital Association data to compare trends in the likelihood, prevalence and duration of observation stays between CAHs and PPS hospitals in metro and non‐metro areas among fee‐for‐service Medicare beneficiaries over age 65.FindingsWhile PPS hospitals are more likely to provide any observation care, the 3‐year increase in the proportion of CAHs providing any observation care is approximately 5 times as great as the increase among PPS hospitals. Among hospitals providing any observation care in 2007, the prevalence at CAHs was 35.7% higher than at non‐metro PPS hospitals and 72.8% higher than at metro PPS hospitals. By 2009, these respective figures had increased to 63.1% and 111%. Average stay duration increased more slowly for CAHs than for PPS hospitals.Conclusions These data suggest that a growing proportion of CAHs are providing observation care and that CAHs provide relatively more observation care than PPS hospitals, but they have shorter average stays. This may have important financial implications for Medicare beneficiaries.
    The Journal of Rural Health 08/2013; 29. DOI:10.1111/jrh.12007
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    ABSTRACT: PurposeWith its population rapidly aging, China needs prompt action to facilitate the middle‐aged and senior citizens' utilization of health care. The New Rural Cooperative Medical Scheme (NCMS), a health care reform initiative started in 2003, is currently China's primary insurance program for the rural population.Methods With a 2‐province pilot sample (Gansu, the poorest province, and Zhejiang, one of the richest) of people over age 45 from the China Health and Retirement Longitudinal Study (CHARLS), this paper used logistic regressions to examine the association between the coverage of New Rural Cooperative Medical Scheme and the underutilization of medical care.FindingsAmong those who had a need to visit a health care provider during the previous month, people covered by NCMS were more likely to underutilize outpatient care than the uninsured (Odds Ratio = 5.610, 2.035‐15.466). As for those who had a need to be hospitalized in the past year, the association between NCMS coverage and the underutilization of inpatient care was not statistically significant (Odds Ratio = 1.907, 0.335‐10.862). Low total household expenditure per capita, living in the inland province of Gansu, and being an urban resident were also associated with underutilizing outpatient care.Conclusion Further research is needed to understand the negative association between NCMS coverage and outpatient care utilization.
    The Journal of Rural Health 08/2013; 29(s1). DOI:10.1111/jrh.12013
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    ABSTRACT: PurposeThis study investigates health disparities for adults residing in a mountaintop coal mining area of Appalachian Kentucky. Mountaintop mining areas are characterized by severe economic disadvantage and by mining‐related environmental hazards. MethodsA community‐based participatory research study was implemented to collect information from residents on health conditions and symptoms for themselves and other household members in a rural mountaintop mining area compared to a rural nonmining area of eastern Kentucky. A door‐to‐door health interview collected data from 952 adults. Data were analyzed using prevalence rate ratio models. FindingsAdjusting for covariates, significantly poorer health conditions were observed in the mountaintop mining community on: self‐rated health status, illness symptoms across multiple organ systems, lifetime and current asthma, chronic obstructive pulmonary disease, and hypertension. Respondents in mountaintop mining communities were also significantly more likely to report that household members had experienced serious illness, or had died from cancer in the past 5 years. Significant differences were not observed for self‐reported cancer, angina, or stroke, although differences in cardiovascular symptoms and household cancer were reported. Conclusions Efforts to reduce longstanding health problems in Appalachia must focus on mountaintop mining portions of the region, and should seek to eliminate socioeconomic and environmental disparities.
    The Journal of Rural Health 08/2013; 29. DOI:10.1111/jrh.12016
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    ABSTRACT: Background Booster seats reduce mortality and morbidity for young children in car crashes, but use is low, particularly in rural areas. This study targeted rural communities in 4 states using a community sports-based approach. Objective The Strike Out Child Passenger Injury (Strike Out) intervention incorporated education about booster seat use in children ages 4-7 years within instructional baseball programs. We tested the effectiveness of Strike Out in increasing correct restraint use among participating children. Methods Twenty communities with similar demographics from 4 states participated in a nonrandomized, controlled trial. Surveys of restraint use were conducted before and after baseball season. Intervention communities received tailored education and parents had direct consultation on booster seat use. Control communities received only brochures. ResultsOne thousand fourteen preintervention observation surveys for children ages 4-7 years (Intervention Group [I]: N = 511, Control [C]: N = 503) and 761 postintervention surveys (I: N = 409, C: N = 352) were obtained. For 3 of 4 states, the intervention resulted in increases in recommended child restraint use (Alabama +15.5%, Arkansas +16.1%, Illinois +11.0%). Communities in 1 state (Indiana) did not have a positive response (-9.2%). Overall, unadjusted restraint use increased 10.2% in intervention and 1.7% in control communities (P = .02). After adjustment for each state in the study, booster seat use was increased in intervention communities (Cochran-Mantel-Haenszel odds ratio 1.56, 95% confidence interval [1.16-2.10]). ConclusionsA tailored intervention using baseball programs increased appropriate restraint use among targeted rural children overall and in 3 of 4 states studied. Such interventions hold promise for expansion into other sports and populations.
    The Journal of Rural Health 08/2013; 29(s1):S70-S78. DOI:10.1111/jrh.12000
  • The Journal of Rural Health 01/2012; 28(1). DOI:10.1111/j.1748-0361.2010.00337.x
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    ABSTRACT: Purpose: To determine the association between sleep duration and depressive symptoms in a rural setting. Methods: We conducted a cross-sectional study using data from Wave 3 of the Walk the Ozarks to Wellness Project including 12 rural communities in Missouri, Arkansas, and Tennessee (N = 1,204). Sleep duration was defined based on average weeknight and weekend hours per day: short (<7), optimal (7-8), and long (>8). The primary outcome was self-reported elevated depressive symptoms. Multivariable logistic regression was used to estimate adjusted prevalence odds ratios (aPOR) and 95% confidence intervals (95% CI). Findings: Elevated depressive symptoms were common in this rural population (17%). Depressive symptoms were more prevalent among subjects with short (26.1%) and long (24%) sleep duration compared to those with optimal (11.8%) sleep duration. After adjusting for age, gender, race, education, employment status, income, and BMI, short sleep duration was associated with increased odds of elevated depressive symptoms (aPOR = 2.12, 95% CI: 1.49, 3.01), compared to optimal sleep duration. Conversely, the association between long sleep duration and depressive symptoms was not statistically significant after covariate adjustment. Similar findings were observed when we excluded individuals with insomnia symptoms for analysis. Conclusions: This study suggests that short sleep duration (<7 hours per night) and depressive symptoms are common among rural populations. Short sleep duration is positively associated with elevated depressive symptoms. The economic and health care burden of depression may be more overwhelming among rural populations, necessitating the need to target modifiable behaviors such as sleep habits to improve mental health.
    The Journal of Rural Health 10/2011;
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    ABSTRACT: Low salaries and difficult work conditions are perceived as a major barrier to the recruitment of primary care physicians to rural settings. To examine rural-urban differences in physician work effort, physician characteristics, and practice characteristics, and to determine whether, after adjusting for any observed differences, rural primary care physicians' incomes were lower than those of urban primary care physicians. Using survey data from actively practicing office-based general practitioners (1,157), family physicians (1,378), general internists (2,811), or pediatricians (1,752) who responded to the American Medical Association's annual survey of physicians between 1992 and 2002, we used linear regression modeling to determine the association between practicing in a rural (nonmetropolitan) or urban (standard metropolitan statistical area) setting and physicians' annual incomes after controlling for specialty, work effort, provider characteristics, and practice characteristics. Rural primary care physicians' unadjusted annual incomes were similar to their urban counterparts, but they tended to work longer hours, complete more patient visits, and have a much greater proportion of Medicaid patients. After adjusting for work effort, physician characteristics, and practice characteristics, primary care physicians who practiced in rural settings made $9,585 (5%) less than their urban counterparts (95% confidence intervals: -$14,569, -$4,602, P < .001). In particular, rural practicing general internists and pediatricians experienced lower incomes than did their urban counterparts. Addressing rural physicians' lower incomes, longer work hours, and greater dependence on Medicaid reimbursement may improve the ability to ensure that an adequate supply of primary care physicians practice in rural settings.
    The Journal of Rural Health 03/2008; 24(2):161-70. DOI:10.1111/j.1748-0361.2008.00153.x
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    ABSTRACT: Few studies have examined hospitalization patterns among the uninsured, especially from the perspective of rural and urban differences. To examine whether the patterns of uninsured hospitalizations differ in rural and urban hospitals and to identify the most prevalent and costly diagnoses among uninsured hospitalizations. We conducted a cross-sectional analysis of the Healthcare Cost and Utilization Project's National Inpatient Sample representing a total of 37,804,021 hospital discharges, with 4.9% of them generated by uninsured persons in 2002. We compared demographic and clinical characteristics and the proportion of frequent and costly diagnoses by rural and urban hospitals. We used multiple logistic regression models to examine the relationship between preventable conditions and rural and urban hospitals among uninsured hospitalizations. Uninsured persons discharged from rural hospitals were more likely than their urban counterparts to be working-age adults (82% vs 79%) and to reside in a ZIP code area with a median household income of less than $35,000 per year (56% vs 26%). Rural uninsured hospitalizations were more likely to be for preventable conditions than were urban uninsured hospitalizations (P < .001). The proportion of total hospital charges related to preventable hospitalizations was 15.5% in rural hospitals versus 10.0% in urban hospitals. The patterns of uninsured hospitalizations in rural and urban hospitals were different in many ways. Providing adequate access to primary care could result in potential savings related to preventable hospitalizations for the uninsured, especially for rural hospitals.
    The Journal of Rural Health 03/2008; 24(2):194-202. DOI:10.1111/j.1748-0361.2008.00158.x
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    ABSTRACT: Medicare beneficiaries incur 27%-30% of lifetime charges in the last year of life; most charges occur in the last quarter. Factors associated with high end-of-life Medicare charges include less advanced age, non-white race, absence of advance directive, and urban residence. We analyzed Medicare hospital charges in the last year of life for nursing home residents with severe cognitive impairment, focusing on rural-urban differences. The study population consisted of 3,703 nursing home residents (1,882 rural, 1,821 urban) in Minnesota and Texas who died in 2000-2001. Data on Medicare hospital charges were obtained from 1998-2001 Centers for Medicare and Medicaid Services MedPAR files. During the last year of life, unadjusted charges averaged $12,448 for rural subjects; $31,780 for urban. The charges were distributed across the last 4 quarters similarly for the 2 populations, with 15%-20% of charges incurred in each of the first 3 quarters, and 47% (rural) and 52% (urban) in the last quarter. At the individual level, a higher percentage of hospital charges were incurred in the last 90 days by urban than by rural residents (P < .001). A larger proportion of urban (43%) than rural (37%) residents were hospitalized in the final quarter. The charges for hospitalized residents (N = 1,994) were distributed similarly to those of the entire study population. Medicare hospital charges during the last year of life were lower for rural nursing home residents with cognitive impairment than for their urban counterparts. Charges tend to be more concentrated in the last 90 days of life for urban residents.
    The Journal of Rural Health 03/2008; 24(2):154-60. DOI:10.1111/j.1748-0361.2008.00152.x
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    ABSTRACT: Context: Obesity is a chronic disease of epidemic proportions in the United States. Primary care providers are critical to timely diagnosis and treatment of obesity, and need better tools to deliver effective obesity care. To conduct a pilot randomized trial of a chronic care model (CCM) program for obesity care in rural Kansas primary care. We enrolled 107 participants to a 6-month, 2-armed, randomized trial comparing a CCM for obesity with usual care. The primary outcome was weight change at 90 days. The usual care arm received educational weight loss materials and outcome assessments at day 0, 90, and 180. The active arm received the same elements as the usual care arm plus a multicomponent obesity CCM. The Day 90 mean +/- SD weight change for the active arm (n = 34) and control arm (n = 33), respectively, was -4.5 +/- 7.7 pounds and -2.4 +/- 8.1 pounds (P = .27 for difference). The Day 180 mean +/- SD weight change for the active (n = 27) and control (n = 27) arms, respectively, was -9.4 +/- 10.3 pounds and -2.1 +/- 10.7 pounds (P = .01 for difference). There was no significant change in physical activity, or fruit and vegetable intake at day 90 or day 180. Improving the recognition and treatment of obesity in primary care settings is a critical initiative. Rural populations suffer disproportionately with obesity, and better methods of delivering obesity care are needed for this population. Further research is needed to establish the effectiveness of a CCM approach for obesity care.
    The Journal of Rural Health 02/2008; 24(2):125-32. DOI:10.1111/j.1748-0361.2008.00148.x
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    ABSTRACT: A 3-year pilot program to expand the role of nurse practitioners (NPs) in the Washington State workers' compensation system was implemented in 2004 (SHB 1691), amid concern about disparities in access to health care for injured workers in rural areas. SHB 1691 authorized NPs to independently perform most functions of an attending physician. The aims of this study were to (1) describe the contribution by NPs to Washington's workers' compensation provider workforce, (2) evaluate change in provider availability attributable to SHB 1691, and (3) evaluate the effect of SHB 1691 on timely accident report filing. Administrative data were used to evaluate this natural experiment, using a pre-post design with primary care physicians (PCPs) as a nonequivalent comparison group. NPs served injured workers with characteristics similar to those served by PCPs, but 22.0% of NPs were rural, compared with 17.3% of PCPs. Of claimants with NPs as their attending provider, 53.3% were injured in a rural county, compared with 24.7% for those with PCP attending providers. The number of NPs participating in the workers' compensation system rose after SHB 1691 implementation, more so in rural areas. SHB 1691 implementation was associated with a 16 percentage point improvement in timely accident report filing by NPs in both rural and urban areas. Authorizing NPs to function as attending providers for injured workers may improve provider availability (especially in rural areas) and timely accident report filing, which in turn may improve worker outcomes and system costs.
    The Journal of Rural Health 02/2008; 24(2):171-8. DOI:10.1111/j.1748-0361.2008.00154.x
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    ABSTRACT: The Balanced Budget Act (BBA) of 1997 and other recent policies have led to reduced Medicare funding for home health agencies (HHAs) and visits per beneficiary. We examine the staffing characteristics of stable Medicare-certified HHAs across rural and urban counties from 1996 to 2002, a period encompassing the changes associated with the BBA and related policies. Data were drawn from Medicare Provider of Service files and the Area Resource File. The unit of analysis was the 3,126 counties in the United States, grouped into 5 categories: metropolitan, nonmetropolitan adjacent, and 3 nonmetropolitan nonadjacent groups identified by largest town size. Only relatively stable HHAs were included. We generated summary HHA staff statistics for each county group and year. All staff categories, other than therapists, declined from 1997 to 2002 across the metropolitan and nonmetropolitan county groupings. There were substantial population-adjusted decreases in stable HHA-based home health aides in all counties, including remote counties. The limited presence of stable HHA staff in certain nonmetropolitan county types has been exacerbated since implementation of the BBA, especially in the most rural counties. The loss of aides in more rural counties may limit the availability of home-based long-term care in these locations, where the need for long-term care is considerable. Future research should examine the degree to which the presence of HHA staff influences actual access and whether other paid and unpaid sources of care substitute for Medicare home health care in counties with limited supplies of HHA staff.
    The Journal of Rural Health 02/2008; 24(1):12-23. DOI:10.1111/j.1748-0361.2008.00132.x