The Maine Rural Health Research Center focuses on barriers to health access for rural residents and related topics, including insurance coverage, Medicaid, behavioral health, long term services & supports, and challenges faced by rural providers (rural health clinics & critical access hospitals) in delivering and sustaining services. For over 20 years, the Maine Rural Health Research Center’s research agenda has focused on some of the most intractable health access problems facing rural residents, especially those with mental health and substance abuse issues and those facing financial barriers due to lack of insurance and under-insurance. That body of research has helped reveal the effects of policy and health system organization and financing on rural health access. The Center is committed to enhancing policy making and improving the access, delivery and financing of rural health services by effectively linking its research to the policy development process through appropriate dissemination strategies.

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2010

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Impact of Employment Transitions on Health Insurance Coverage of Rural Residents, Nathaniel J. Anderson MS, MPH; Erika C. Ziller PhD; Melanie M. Race MS; and Andrew F. Coburn PhD

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Racial, socioeconomic, and rural-urban disparities in obesity-related bariatric surgery, Amy E. Wallace, Yinong Young-Xu, David Hartley PhD, and William B. Weeks

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Rural America: A look beyond the images, John A. Gale MS

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Are Rural Health Clinics Part of the Rural Safety Net?, David Hartley PhD, MHA; John A. Gale MS; Al Leighton BA; and Stuart Bratesman MPP

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Mental Health Services in Rural Jails [Policy Brief], Melanie M. Race MS; Anush Yousefian Hansen MS,MA; David Lambert PhD; and David Hartley PhD, MHA

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Safety Net Activities of Independent Rural Health Clinics, David Hartley PhD, MHA; John A. Gale MS; Al Leighton BA; and Stuart Bratesman MPP

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Mental Health Services in Rural Jails [Working Paper], Melanie M. Race MS; Anush Yousefian Hansen MS,MA; David Lambert PhD; and David Hartley PhD, MHA

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Access to rural mental health services: Service use and out-of-pocket costs, Erika C. Ziller PhD; Nathaniel J. Anderson MS, MPH; and Andrew F. Coburn PhD

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Characteristics of Inpatient Psychiatric Units in Small Rural Hospitals, David Hartley PhD, MHA; Stephanie L. Loux MS; David Lambert PhD; John A. Gale MS; and Anush Yousefian Hansen MS, MA

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Encouraging Rural Health Clinics to Provide Mental Health Services: What are the options?, John A. Gale MS; Stephanie L. Loux MS; Barbara Shaw JD; and David Hartley PhD, MHA

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The Provision of Mental Health Services by Rural Health Clinics, John A. Gale MS; Stephanie L. Loux MS; Barbara Shaw JD; and David Hartley PhD, MHA

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The Role of State Flex Programs in Supporting Quality Improvement in CAHs (Policy Brief #16), Andrew F. Coburn PhD; John A. Gale MS; Mark Richards BA; and Anush Yousefian Hansen MS,MA

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Monitoring the Community Benefits of CAHs: A Review of the Data (Briefing Paper #24), John A. Gale MS, Melanie M. Race MS, and Andrew F. Coburn PhD

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Community Benefit Activities of CAHs, Non-Metropolitan Hospitals, and Metropolitan Hospitals, 2007, Melanie Race MS, John A. Gale MS, and Andrew F. Coburn PhD

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State Initiatives Funded by the Medicare Rural Hospital Flexibility Grant Program (Policy Brief #3), Melanie Race MS, John A. Gale MS, and Andrew F. Coburn PhD

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Monitoring the Community Benefits of CAHs: A Review of the Data (Policy Brief #13), Melanie M. Race MS, John Gale MS, and Andrew F. Coburn PhD

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Models for Quality Improvement in CAHs: The Role of State Flex Programs (Briefing Paper #25), Andrew F. Coburn PhD; John A. Gale MS; Mark Richards BA; Anush Yousefian Hansen MS, MA; and Melanie Race MS

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Development of the Rural Active Living Assessment Tools: Measuring rural environments, Anush Yousefian Hansen MS, MA; Erin Hennessey MPH; M. Renee Umstattd PhD; Christina Economos PhD; Jeffrey S. Hallam PhD; Raymond R. Hyatt PhD; and David Hartley PhD, MHA

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The Cost of Defensive Medicine in the United States, J. William Thomas PhD, Erika C. Ziller PhD, and Deborah Thayer MBA

2009

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Availability, Characteristics, and Role of Detoxification Services in Rural Areas, Jennifer D. Lenardson MHS, Melanie M. Race MS, and John A. Gale MS

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A community benefit reporting toolkit for critical access hospitals, John A. Gale MS and Melanie Race MS

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Health Insurance Profile Indicates Need to Expand Coverage in Rural Areas, Jennifer D. Lenardson MHS; Erika C. Ziller PhD; Andrew F. Coburn PhD; and Nathaniel J. Anderson MS, MPH

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Maine Barriers to Integration Study: The view from Maine on the barriers to integrated care and recommendations for moving forward, John A. Gale MS and David Lambert PhD

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Profile of rural health insurance coverage: A chartbook, Jennifer D. Lenardson MHS, Erika C. Ziller PhD, and Andrew F. Coburn PhD

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Active Living for Rural Youth: Addressing Physical Inactivity in Rural Communities, Anush Yousefian Hansen MS, MA; Erika C. Ziller PhD; Jon Swartz BA; and David Hartley PhD, MHA

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An Environmental Assessment Instrument for Rural Communities: Development of the Rural Active Living Assessment (RALA) Tools, Anush Yousefian Hansen MS, MA

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Rural-urban differences in health care access vary across measures, Erika C. Ziller PhD and Jennifer D. Lenardson MHS

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Private health insurance in rural areas: Challenges and opportunities, Erika C. Ziller PhD and Andrew F. Coburn PhD

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Policy Issues Affecting Maine’s Hospitals, John A. Gale MS and Jennifer D. Lenardson MHS

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Rural coverage gaps decline following public health insurance expansions, Erika C. Ziller PhD and Andrew F. Coburn PhD

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Mental Health and Substance Abuse in Maine: Building a community-based system, David Lambert PhD and John A. Gale MS

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Rural children don't receive the mental health care they need, David Lambert PhD, Erika C. Ziller PhD, and Jennifer D. Lenardson MHS

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The 2009 Report to the Secretary: Rural Health and Human Services Issues, National Advisory Committee on Rural Health and Human Services

2008

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The Underinsured in Rural America: The Root of the Problem and Possible Solutions, Andrew F. Coburn PhD and Erika C. Ziller PhD

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Use of mental health services by rural children, David Lambert PhD, Erika C. Ziller PhD, and Jennifer D. Lenardson MHS

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Substance abuse by youth and young adults in rural America, David Lambert PhD; John A. Gale MS; and David Hartley PhD, MHA

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Developing Indicators to Document the Community Impact of CAHs (Policy Brief #7), John A. Gale MS, Jennifer D. Lenardson MHS, Andrew F. Coburn PhD, and Melanie M. Race MS

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Rural-urban Differences in Work Patterns Among Adults with Depressive Symptoms, Lisa Morris PhD; Stephenie L. Loux MS; Erika C. Ziller PhD; and David Hartley PhD, MHA

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The Community Benefit and Impact of CAHs: the Results of the 2007 CAH Survey (Policy Brief #6), Stephanie L. Loux MS, Andrew F. Coburn PhD, John A. Gale MS, and Jennifer D. Lenardson MHS

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The Community Benefit and Impact of CAHs: Results of the 2007 CAH Survey (Briefing Paper #19), Stephanie L. Loux MS, Andrew F. Coburn PhD, John A. Gale, and Jennifer D. Lenardson MHS

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Distribution of Substance Abuse Treatment Facilities Across the Rural-Urban Continuum [Policy Brief], Jennifer D. Lenardson MHS and John A. Gale MS

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Uninsured Rural Families, Erika C. Ziller PhD; Andrew F. Coburn PhD; Nathaniel J. Anderson MS, MPH; and Stephanie L. Loux MS

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Employment of Advanced-practice Psychiatric Nurses to Stem Rural Mental Health Workforce Shortages, Nancy P. Hanrahan PhD, RN and David Hartley PhD, MHA

2007

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Distribution of Substance Abuse Treatment Facilities Across the Rural-Urban Continuum [Working Paper], John A. Gale MS and Jennifer D. Lenardson MHS

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Rural Families More Likely to be Uninsured and Have Different Sources of Coverage, Erika C. Ziller PhD; Andrew F. Coburn PhD; Nathaniel J. Anderson MS, MPH; and Stephanie L. Loux MS

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Substance abuse among rural youth: A little meth and a lot of booze, David Hartley PhD, MHA

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The Community Impact of CAHs (Policy Brief #2), John A. Gale MS; Andrew F. Coburn PhD; Victoria Freeman DrPH; Walter Gregg MA, MPH; and Rebecca Slifkin PhD

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Choosing Rural Definitions: Implications for Health Policy, Andrew F. Coburn PhD; A. Clinton MacKinney MD, MS; Timothy D. McBride PhD; Keith J. Mueller PhD; Rebecca T. Slifkin PhD; and Mary K. Wakefield PhD, RN

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Use of Critical Access Hospital Emergency Rooms by Patients with Mental Health Symptoms, David Hartley PhD, MHA; Erika C. Ziller PhD; Stephenie L. Loux MS; John A. Gale MS; David Lambert PhD; and Anush Yousefian Hansen MS, MA

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Exploring the Community Impact of CAHs (Briefing Paper #14), John A. Gale MS; Andrew F. Coburn PhD; Victoria Freeman DrPH; Walter Gregg MA, MPH; and Rebecca Slifkin PhD