Rural Health

NORC partners with rural communities to build on strengths and improve health outcomes.

Rural communities are foundational to the health and well-being of our country. Rural areas are the source of much of our food, drinking water, energy production, and outdoor recreation. One in five Americans—including a disproportionate share of Veterans and active-duty service members—lives in a rural community. And those communities are notably diverse: one in four rural Americans is a person of color. All of this makes the study of health in rural America essential for all of us.

Rural health research examines health outcomes, health care delivery, and public health infrastructure in communities outside metropolitan areas. It addresses both the distinct challenges rural populations face—including geographic isolation, workforce shortages, and hospital closures—and the strengths and assets that rural communities bring to improving health and well-being.

Rural communities are not monolithic. They include agricultural regions, former mining and manufacturing towns, tribal lands, and border communities—each with unique demographics, economies, and health needs. Effective rural health research and policy leverages community strengths while addressing structural barriers to care.

For more than three decades, NORC’s Walsh Center for Rural Health Analysis has partnered with federal agencies, states, and rural communities to generate evidence that supports healthier rural populations.

Explore the Walsh Center

Key Rural Health Issues

Rural health research addresses a wide range of interconnected issues that affect the health and well-being of rural populations. These topics reflect both longstanding challenges and emerging priorities in rural health policy and practice.

Rural Hospital Sustainability

Rural hospitals face unique financial pressures, with more than 150 closures since 2010. Research examines payment models, service line optimization, and policy interventions to maintain access to hospital care in rural areas.

Health Workforce Shortages

Rural areas experience persistent shortages of physicians, nurses, behavioral health providers, and other clinicians. Workforce research explores recruitment, retention, training pipelines, and scope-of-practice policies.

Behavioral Health & Substance Use

Rural communities face elevated rates of mental health conditions, suicide, and substance use disorders, often with limited local treatment options. Research addresses service delivery models, telehealth, and recovery ecosystems.

Telehealth & Digital Health

Technology can expand access to care in rural areas, but adoption depends on broadband availability, reimbursement policy, and integration into existing care systems. Research examines what works and for whom.

Rural Health Care Delivery Models

Innovative payment and delivery models—including global budgets, accountable care organizations, and value-based arrangements—are being tested and adapted for rural settings.

Emergency Medical Services

Many rural areas rely on volunteer EMS and face long transport times. Research addresses EMS workforce, financing, and integration with hospitals and trauma systems.

Maternal & Child Health

Rural communities have experienced a wave of obstetric unit closures, contributing to higher maternal mortality rates. Research examines access to prenatal care, delivery services, and postpartum support.

Social Drivers of Health

Factors like housing, transportation, food access, and economic opportunity shape health outcomes. Research in rural settings examines how these drivers interact with health care access and utilization.

Aging in Rural Communities

Rural areas have older populations on average, creating demand for services including chronic disease management, long-term care, and support for family caregivers.

Tribal & Indigenous Health

American Indian and Alaska Native populations in rural areas face distinct health challenges and navigate both Indian Health Service and rural health systems.

NORC’s Work in Rural Health

We generate evidence that helps rural communities build stronger, more sustainable health systems.

NORC has studied rural health since publishing its first rural study in 1952. Today, our Walsh Center for Rural Health Analysis leads a portfolio of research, evaluation, and technical assistance projects that inform federal policy, support state initiatives, and help rural communities strengthen their health systems.

NORC supports rural health research and practice through:

Policy analysis and program evaluation for federal and state agencies
Development of data tools and indices to track rural health trends
Technical assistance for states implementing payment reform and delivery system transformation

Mixed-methods research combining quantitative analysis with community engagement
Expertise in Medicare, Medicaid, and commercial payment policies affecting rural providers

The Walsh Center for Rural Health Analysis is NORC’s dedicated center for rural health research, policy analysis, and technical assistance. With more than 30 years of experience, the Walsh Center partners with federal agencies, states, and rural communities to generate evidence that supports healthier rural populations.

Visit the Walsh Center