The Health Resources and Services Administration (HRSA) recently released the latest projections for the national supply, demand, and distribution of health care workers. Use the Workforce Projections Dashboard to explore supply and demand trends by occupation, state, year, and more. Additionally, check out Health Workforce Projections for an overview of projections for different groups of workers, such as nurses and physicians, and details on our programs that seek to address future shortages.

All communities rely on physical spaces that are vital to the well-being of their citizens, such as grocery stores, recreational facilities and pharmacies. But what happens when these places are lost, especially in rural areas where no alternatives exist?

Two new studies led by researchers in Penn State’s College of Agricultural Sciences and College of Health and Human Development — one published in the journal Wellbeing, Space and Society and the other in the Journal of Rural Health — analyzed the experiences of residents in one such rural Pennsylvania community after the closure of several of these essential places.

Closures included a grocery store, bank, hardware store, church, primary care clinic, pharmacy and two restaurants — some due to population loss and some as the result of the pandemic.

Both studies found that the loss of these spaces had well-being and social impacts. For example, the loss of the area’s only grocery store severely limited access to healthy food and decreased opportunities for social connection. Additionally, the loss of the area’s sole pharmacy and health care facility resulted in impacts on health, such as delays in seeking care and an over-reliance on local emergency medical services.

Kristina Brant, co-author on both papers and assistant professor of rural sociology, said the findings help showcase why the closures of community institutions — especially in rural areas — matter, and could help policymakers and practitioners find ways to improve and sustain well-being for these communities.

“While some people may be able to travel to the next town over to access services, this isn’t possible for everyone, so these closures could perpetuate inequalities between residents,” Brant said. “By documenting how communities are impacted by these closures, we can better show why helping communities preserve their institutions is important, while also considering strategies to help communities adapt and pivot when they do lose essential community institutions.”

In recent years, the researchers said, there has been population loss across much of rural America. Between 2010 and 2020, two-thirds of rural counties saw a decrease in their populations. And when populations decrease, community institutions can be threatened — it can be difficult to sustain businesses and organizations amid a declining number of community members.

Danielle Rhubart, first author of the paper in Wellbeing, Space and Society and assistant teaching professor of biobehavioral health, said it’s important to consider how a loss of these institutions can impact the community members who stay.

“A lot of the focus in previous research has been on the importance of these places in urban settings,” said Rhubart, who also co-authored the paper in the Journal of Rural Health. “We were interested in how the loss of these community institutions impacts rural community health and well-being.”

For both studies, the researchers interviewed 26 local residents. Questions were broad and open-ended, including ones about perceptions of the interviewees’ community. While the studies were limited to one area, the researchers said their findings could represent similar experiences in other rural locations across the United States.

In the paper led by Rhubart, the researchers examined how community members were affected by the loss of spaces not related to health care, such as grocery stores. In the paper in the Journal of Rural Health — led by Hazel Velasco Palacios, a doctoral student in rural sociology and in women’s, gender, and sexuality studies — the team explored how people were impacted by the loss of the area’s only health care institution.

“While we were interested in the closures in their community, we did not lead with this, choosing instead to ask questions such as ‘What are some of the challenges that you think the town and the people who live here are facing?’” Brant said. “The fact that so many respondents answered this question by talking about the closures signaled to us how these closures were top of their list of concerns.”

They found that following the loss of the area’s only clinic and pharmacy, community members reported having to travel farther for basic health care needs, which added stress to their lives. People also reported becoming increasingly dependent on others to get care — for example, needing to rely on neighbors or friends for rides.

Velasco Palacios said while this reliance on social networks demonstrates the self-resilience of the community, it also posed challenges.

“In cases where networks were not robust or relationships became strained, some residents struggled to access reliable care,” she said. “This dual nature of social networks — both a critical lifeline and a potential vulnerability — adds nuance to our understanding of how rural communities adapt to the loss of essential services.”

Residents also reported that this restricted access led to people being more likely to delay seeking care, to call on emergency medical services and to ration medication to make it last longer, suggesting that the loss of local health care institutions could contribute to negative health outcomes.

But the researchers found that the loss of places not obviously linked to health — such as grocery stores and banks — also has the potential to impact health and well-being. Because these spaces are often multifunctional and the only one of their kind in the area, Brant said, losing these places may be especially impactful in rural areas.

“For example, the loss of the town’s only grocery store limited people’s access to fresh food and also their access to social connection,” she said. “Because it was one of the few central institutions in the community, it operated as a community hub.”

The loss of certain places, such as the area’s pharmacy and health care facility, especially impacted more vulnerable groups, the researchers said. These groups included older adults, people with disabilities and working-class families, who reported delays in accessing care and the loss of trusted care providers.

While both studies illustrated how impactful the loss of these community institutions were to residents, the researchers said future work could continue to explore the loss of essential spaces across other varied, more diverse rural landscapes.

Jennifer Kowalkowski, assistant professor of nursing, and Jorden Jackson, graduate student in rural sociology and demography, were also co-authors on the studies.

The U.S. Department of Agriculture’s National Institute of Food and Agriculture and Penn State’s Social Science Research Institute helped support this research.

Authors from the Geisinger Commonwealth School of Medicine recently published a study, “Pediatric Traumatic Dental Injuries in Rural Pennsylvania: a 9-Year Retrospective Review.” The study included reviewing health records of 268 pediatric dental patients ages 6 months to 17 years who presented at the emergency department at Geisinger Medical center between July 2010 and July 2019 with traumatic dental injuries (TDIs). The results showed that TDIs were more common in male patients and were most likely to present during summer months. The most common injuries occurred outdoors and were caused by sporting activities.

Click here to read the study.

The U.S. Preventive Services Task Force (USPSTF) released the “14th Annual Report to Congress on High-Priority Evidence Gaps for Clinical Preventive Services.” This annual report reflects on preventive recommendations and calls attention to high-priority research gaps related to promoting health across the lifespan. The report also highlights research gaps in underserved populations and high-risk groups.

Click here to read the report.

The 2019-2023 American Community Survey (ACS) 5-Year Estimates have been released, providing updated demographic and socio-economic data for Pennsylvania’s counties and municipalities. The report highlights a 4.7% increase in owner-occupied housing units, rising home values, and changes in housing costs for both renters and homeowners.

For a look at these trends and their impact on counties across Pennsylvania, explore the full report.

Affordable rental housing paves the way to stable jobs, education, and other opportunities. The Rental Housing Affordability Data Explorer provides estimates on the availability of affordable rental housing at different income levels in Delaware, New Jersey, and Pennsylvania, at both the state and regional levels.

Updated with data through 2022, the tool also includes information on:

• the percentage of households who spend over 30 percent and over 50 percent of their income on rent.
• the availability of affordable units for low- and moderate-income renters
• the age and structure types of the low-cost rental housing stock
• federally subsidized rental housing programs and their expiration status.

The data explorer sheds light on trends in rental affordability and can inform state, regional, and county strategies to address challenges in affordability and preserve the existing low-cost rental stock.

Start exploring now.

In case you missed it, the CDC released its inaugural Rural Public Health Strategic Plan in September. Our work with many of you helped us to develop a strategy to ensure rural health needs are considered in all our programs and initiatives. We are committed to using the best research and data available to develop and disseminate tailored resources and build and improve rural public health activities.

Here are some examples of CDC’s rural work and recent successes you can share with your networks:

Electronic Case Reporting (eCR). eCR is the automated, real-time exchange of case report information between electronic health records and public health agencies. This information exchange is vital for public health facilities that treat under-resourced communities like critical access hospitals (CAHs). CAHs are rural hospitals with 25 or fewer acute care inpatient beds that are typically located more than 35 miles from another hospital. The number of CAHs using eCR increased 368% between 2022 and 2024. Click here to learn more about this successful onboarding of CAHs.

Population Level Analysis and Community Estimates (PLACES). PLACES is a free CDC web tool that expands access to data for rural communities, delivering hyper-local model-based data for the entire U.S. population at 4 levels of geography. The latest release included estimates for seven new nonmedical factors for health including transportation barriers, food insecurity, and lack of social and emotional support.

Insight Net. Through CDC investments, a team at Clemson University is collaborating with Clemson Rural Health, South Carolina’s Department of Public Health, and two large health systems to integrate respiratory disease trend data with information about available medical resources and community needs. Analysis and modeling using these data elements helps the state and health systems direct resources like mobile health clinics to high-risk rural communities. This tool has the potential to reduce thousands of preventable hospitalizations and deaths, drastically increase the number of high-risk patients served, and could be applied in other rural communities once evaluated.

High Obesity Program (HOP). CDC’s HOP investments in states, universities, territories, and tribes reach rural populations with proven interventions and innovative projects. HOP is a 5-year cooperative agreement to fund 16 land-grant universities to work with community extension services to improve access to healthier foods and safe places for physical activity where 40% or more of adults have obesity. From 2018 to 2023, all HOP recipients worked with rural counties. Overall, their work reached more than 338,000 people through improved access to safe places for physical activity and over 116,000 people through improved guidelines for healthier eating.

To learn more about CDC’s rural health work, visit us online at www.cdc.gov/rural-health and contact us at ruralhealth@cdc.gov.

The number of uninsured children in Pennsylvania remains stable following last year’s unwinding of the Medicaid continuous coverage provision, but no progress has been made, according to our 2024 State of Children’s Health report. The report provides the first look at the impact of resuming Medicaid renewals following a three-year federal hiatus during the COVID-19 public health emergency.

Between 2022 and 2023, the rate of Pennsylvania children without health insurance remained steady at 5.2%. However, steady rates do not mean progress. Too many children live in Pennsylvania without access to health insurance. The number of Pennsylvania children under age 19 without health insurance increased slightly from 145,000 to 147,000 from one year ago.

According to the report, factors such as age, race and ethnicity, and poverty level impact children’s access to health insurance. Demographic highlights include:

• Children under 6 are more likely to be uninsured (5.6%) than school age children (5.1%).
• Uninsured rates improved for American Indian and Alaska Native children and White children. Uninsured rates worsened for Asian children, Black children, Hispanic children, and children of multiple races.
• Children in lower-income families are more likely to be uninsured, and approximately 6.8% of PA children are financially eligible for Medicaid but not enrolled.

Accompanying fact sheets for each of the 67 counties show the local uninsured rate, race and ethnicity profiles, and public health insurance enrollment data.

The report finds that Medicaid, CHIP and Pennie™ remain significant sources of coverage with approximately 47% of Pennsylvania children relying on those programs’ health plans to meet their health care needs. A growing concern is that the Pennie™ “no wrong door” policy may not be working as intended since more than half of children enrolled through Pennie™ appear financially eligible for Medicaid or subsidized CHIP programs.

While the Medicaid unwinding process did not cause significant disruptions to children’s coverage in 2023, we will know next year if there were disruptions in 2024 as the process wrapped up in June.

Approximately 8 out of 10 children with renewals completed within Medicaid unwinding maintained public coverage. However, procedural disenrollments occurred too often with 42% of children disenrolled due to administrative reasons, not eligibility. To counter this trend, the report recommends that the state improve its poor track record of using automated “ex parte” renewals instead of enrollees submitting renewal applications.

The report also recommends strengthening the state’s continuous eligibility (CE) policy and supports DHS’ plan to provide continuous eligibility to children from birth until age 6. In a big win for kids, DHS has received federal approval last week of its plan to provide Medicaid continuous coverage for Pennsylvania’s youngest children, which is expected to start in January.

To help ensure no child is disconnected from care and to keep down costs for families and the state, the report recommends that Pennsylvania:

• Strengthen automated renewals
• Provide continuous coverage to young children
• Improve PA’s ‘no wrong door’ policy