Sheps Center research improves health care in rural areas
The North Carolina Rural Health Research Program and others are leading rural health innovation in western North Carolina.
Carolina’s Cecil G. Sheps Center for Health Services Research is an invaluable resource for hospital administrators, government officials and others looking for data-driven information to guide health care decisions.
Rural health is a particularly important issue in North Carolina, where the mortality rate for rural residents is 13% higher than that of urban residents — a gap that has doubled since 2000, said Mark Holmes, director of the Sheps Center and its North Carolina Rural Health Research Program. He is also a professor at the UNC Gillings School of Global Public Health.
“Over the next few years, states will be leading and looking for innovative approaches to address rural health,” Holmes said. “North Carolina has a strong history of rural health innovation. And so we’re excited to be a part of that.”
The N.C. Rural Health Research Program gets most funding for its projects from the U.S. Department of Health and Human Services Federal Office of Rural Health Policy.
The program specializes in policy research and advises both government officials and hospitals, nationally as well as in regions like western North Carolina. “It’s a real partnership.” Holmes said. “We want to make sure that our research goes beyond getting published, but is actionable and used by the state, local communities, and the hospitals.”
For example, one research project looked to identify how one Appalachian community exhibited 10% lower rates of obesity, diabetes, and mortality from heart disease and cancer than similar Appalachian counties. A site visit to the community in Madison County found that contributing factors included a strong focus on primary care, cross-sector collaboration, a commitment to outreach and promoting health as a shared value. These site visits, as part of a larger project, led to the Appalachian Regional Commission developing a series of issue briefs and recommendations for communities in addressing key public health challenges in the area such as obesity, opioid misuse, and tobacco use.
Here are some of the ways Sheps Center research supports rural health care innovation in North Carolina:
Erin Fraher is co-director of the program on health workforce research and policy at the Sheps Center as well as a professor in the UNC School of Medicine’s family medicine department. State and federal policy makers use her research on the training, regulation and payment of the nation’s health workforce as they address workforce shortages, particularly in rural and underserved communities. One of her studies examined rural residency planning and development programs and identified places where future rural residency programs could be developed. Because people tend to locate near where they were trained, this helps increase the number of physicians in rural areas.
Emily Hawes, a researcher at the Sheps Center and professor of family medicine in the medical school, leads an $11 million initiative to strengthen physician and dental training programs funded by the federal Health Resources and Services Administration. Residents in these programs not only provide care in areas with shortages of physicians and dentists; they are also more likely to stay in the area or a similar setting to establish their practice.
Sheps Center senior research fellow and medical school professor, now spends much of her time in Asheville, where she is the chair for research at the Mountain Area Health Education Center. In that role, she leads the development and implementation of research strategy and vision for UNC Health Sciences at MAHEC, developing teams of researchers that span Chapel Hill and Asheville while also engaging MAHEC’s many community partners. Halladay is also co-director of the North Carolina Network Consortium Practice Based Research Network, a collection of medical practices dedicated to researching better ways to deliver primary care health services.
Kristin Reiter is a research fellow at the Sheps Center and Humana Distinguished Professor and chair of the health policy and management department at UNC Gillings School of Global Public Health. Dr. Reiter leads a team at UNC that provides financial analysis to Critical Access Hospitals at no cost. There are more than 1,300 CAHs in the U.S. and 20 in North Carolina. Reiter and colleagues developed a web-based data tool to make it easier for CAHs to benchmark hospital performance.
