What Is Rural? Challenges and Implications of Definitions that Inadequately Encompass Rural People and Places.

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Publication Date



Rural, MRHRC, Access to care; Behavioral Health; Emergency departments; Health disparities; Health policy; Hospital closures; Populations; Public health; Rural health care

Publication Title

Health affairs (Project Hope)


Monitoring and improving rural health is challenging because of varied and conflicting concepts of just what rural means. Federal, state, and local agencies and data resources use different definitions, which may lead to confusion and inequity in the distribution of resources depending on the definition used. This article highlights how inconsistent definitions of rural may lead to measurement bias in research, the interpretation of research outcomes, and differential eligibility for rural-focused grants and other funding. We conclude by making specific recommendations on how policy makers and researchers could use these definitions more appropriately, along with definitions we propose, to better serve rural residents. We also describe concepts that may improve the definition of and frame the concept of rurality. [Journal abstract]


©2019 Project HOPE—The People-to-People Health Foundation, Inc.