The Rural and Underserved Health Research Center

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Why focus on health research among the rural and underserved?

Research that is focused on metropolitan areas often doesn't translate into the realities of health care in rural areas. Unlike the majority of research in rural health, we seek to study the nexus of rurality and poverty. Much of rural America is impoverished relative to metropolitan areas and especially to suburban areas.

Within several Census regions are areas that have been designated as being especially underserved, including the predominantly white Appalachian region spanning the South, Midwest, and Northeast; the predominantly African American Mississippi Delta region in the South; and heavily Hispanic regions of Texas and the West. To date, very little research has focused on rural health and health services in these and other impoverished areas of the U.S., despite the fact that health care organizations and providers delivering care in these areas frequently have fewer resources, which further inhibits their abilities to maintain access and deliver services in an efficient manner.

What do we do?

Research conducted at the Center will expand the breadth of knowledge available about the organization, coordination, strategizing, and efficiency of health services and policies in impoverished and underserved rural communities.

Our specific aims are to
  • Advance understanding of effective means of organizing health services, facilitating access, and improving population health in rural America, especially in areas with low median household incomes, high poverty and unemployment rates, and low educational levels.
  • Disseminate research findings to inform health policy makers, health system managers, and providers about how to better organize and deliver health services, with the ultimate goal of reducing inequities in care and improving population health in rural communities.

Where are we located?

We're part of the University of Kentucky (UK) in Lexington and represent a multidisciplinary collaboration among Kentucky health researchers and experts. The Center brings together a team of rural health services and policy experts from UK's Colleges of Public Health, Medicine, Pharmacy, and Agriculture. We are also working with the American Board of Family Medicine, which is headquartered in Lexington.


Leadership and Administration

Tyrone F. Borders, PhD, Director

Foundation for a Healthy Kentucky Endowed Chair in Rural Health Policy
Professor, Health Management and Policy

Dr. Borders is a Foundation for a Healthy Kentucky Endowed Chair in Rural Health Policy and Co-Director of the UK Institute for Rural Health Policy. He is a leading expert on rural health services research and policy in the U.S. and serves as Editor of the Journal of Rural Health, the nation's only scholarly journal focused on rural health policy issues. Dr. Borders is also a member of the National Advisory Committee on Rural Health and Human Services, which makes recommendations on rural policy to the ORHP and directly to the U.S. Secretary of HHS.

He earned a PhD in Health Administration/Health Services Research, MA in Health Administration, and MS in Epidemiology from the University of Iowa and a BA in Psychology from the University of Kansas. Dr. Borders is an accomplished rural health services researcher with >50 published articles in this area. He has received funding as PI from the NIH (NIAAA and NIDA), RWJF, and AHRQ to investigate rural health and health services.

Research Interests
  • Access to substance use treatment
  • Epidemiology of substance use
  • Consumer assessments of care
Awards
  • Honorary Kentucky Colonel
  • Excellence in Writing Award, University of Kentucky Department of Rhetoric and Writing
  • Faculty Research Award, University of Arkansas for Medical Sciences

Brady Reynolds, PhD, Deputy Director

Foundation for a Healthy Kentucky Endowed Chair in Rural Health Policy
Associate Professor, Behavioral Science

Dr. Reynolds is a Foundation for a Healthy Kentucky Endowed Chair in Rural Health Policy at UK and an Associate Professor in the Department of Behavioral Science in the College of Medicine. He has considerable expertise in tobacco treatment approaches appropriate for rural adolescent and pregnant smokers. Dr. Reynolds has been awarded several NIH-funded research grants to develop and evaluate these cessation programs, which have been featured in the Rural Health Information Hub (RHIhub). Dr. Reynolds also developed the UK Appalachian Health Research Center, which facilitates a community-level approach to policy and health-related research in rural Appalachia.

Research Interests
  • Treatment development and evaluation for rural adolescent smokers
  • Mindfulness training to improve treatment outcomes for adolescent smokers
  • The role of impulsive behavior in addiction

Julia Cecil, MBA, MA, Assistant Director

Ms. Cecil has 20 years of professional editing, writing, and research experience in both academic and corporate environments. She has served as Managing Editor of the Journal of Rural Health for approximately 7 years, is experienced in technical writing for rural health audiences, and has assisted in the management of a large research project. Ms. Cecil earned an MBA from Indiana University and an MA in Anthropology from the University of North Carolina-Chapel Hill.


Faculty & Staff

Lars E. Peterson, MD, PhD

Dr. Peterson is Director of Research at the American Board of Family Medicine and an Associate Professor of Family and Community Medicine at UK. He earned his MD and PhD in Health Services Research from Case Western Reserve University and is certified by the American Board of Family Medicine. He has expertise in health services research, access to health care in rural areas, primary care, quality of care, scope of practice, and multilevel modeling. Dr. Peterson's knowledge of rural family medicine and HSR directly pertains to the Center's focus on improving our understanding of access to primary care in impoverished and underserved areas where family medicine doctors are frequently the only physician providers.

Research Interests
  • Quality of care
  • Scope of practice
  • Measuring primary care
  • Rural health
  • Physician continuing medical education and professional development
Awards
  • New Investigator Award, North American Primary Care Research Group
  • Best Research Paper, "More Comprehensive Care Among Family Physicians Is Associated with Lower Costs and Fewer Hospitalizations," Society of Teachers of Family Medicine
  • Rural Health Student Leadership Award, National Rural Health Association
  • LaVonne Straub Memorial Student Research Paper Award, "Multilevel Analysis of Rural-Urban Contextual Associations with Self-Reported Mental Health Status," National Rural Health Association

Alison F. Davis, PhD

Dr. Davis is Professor in the UK Department of Agriculture Economics and Executive Director of the Community & Economic Development Initiative of Kentucky. She earned a PhD in Economics from North Carolina State University. Her rural health research program consists of educating community leaders and health care professionals about the economic impact of health care, implementing community health needs assessment programs, identifying markets for new health enterprises, and developing rural health networks to promote accessibility and quality health care for all rural communities.

Jeffery Talbert, PhD

Dr. Talbert is Professor in the Department of Pharmacy Practice and Science, Director of the Institute for Pharmaceutical Outcomes and Policy, and Associate Director of the UK Center for Clinical and Translational Science. He received BS, MA, and PhD degrees from Texas A&M University. He has 20 years of experience in health research focused on the intersection of policy decisions and health outcomes, including serving as a research fellow for the U.S. Congress and as a faculty member in Public Policy, Public Health, and Pharmacy. Dr. Talbert's current research projects are supported by grants from the NIH, HRSA, the Kentucky Cabinet for Health and Family Services, the Foundation for a Healthy Kentucky, and other foundations and organizations.

Research Interests
  • Medicaid policy
  • Public health informatics
  • Pharmaceutical outcomes

Patricia (Trish) Rippetoe Freeman, RPh, PhD, FAPhA

Dr. Freeman holds several positions in the College of Pharmacy at the University of Kentucky, including Director of the Center for the Advancement of Pharmacy Practice (CAPP); Clinical Associate Professor in the Pharmacy Practice and Science Department; and Faculty Associate in the Institute for Pharmaceutical Outcomes and Policy (IPOP). She is President of the Kentucky Pharmacists Association, 2016. She received a bachelor of pharmacy degree and a PhD degree from the University of Kentucky, and completed postdoctoral fellowships at the University of Vermont College of Medicine and the UK College of Medicine.

Research Interests
  • Pharmaceutical policy & public health, including outcomes associated with policy aimed at curbing the abuse and diversion of medications
  • The role of the pharmacist as a public health provider
Awards
  • Pharmacy Leadership Award, National Community Pharmacists Association (2016)
  • Cardinal Health Generation Rx Award, Kentucky Pharmacists Association (2016)
  • Fellow, American Pharmacists Association (2016)
  • Good Government Pharmacist of the Year, American Pharmacists Association (2012)

Hefei Wen, PhD

Dr. Wen joined the UK Department of Health Management and Policy as Assistant Professor after earning her doctorate at Emory University. She has a broad background in health economics and the U.S. health care system, with specific expertise in behavioral health policy and drug control policy. She is committed to leverage economic thinking and econometric methods to inform the U.S. health care and public safety regime. Dr. Wen's current projects focus on the implications of the ACA insurance expansion for access to addiction treatment and mental health care, as well as the impact of opioid regulation and marijuana liberalization on substance use behavior.

Research Interests
  • Health insurance & access to care
  • Addiction treatment
  • Opioid regulation
  • Marijuana liberalization

Rick Ingram, DrPH

Dr. Ingram is an Assistant Professor of Health Management and Policy at UK. He completed his DrPH at UK and also holds an MEd from the University of Virginia and a BA from the University of Cincinnati. His research focuses on public health system performance and structure, including the impact of variations in structure on health outcomes and practice-based research in public health.

Aric Schadler, MS, Statistician

Mr. Schadler is currently a Data Scientist Manager/Statistician in the UK College of Pharmacy. He is working with Dr. Talbert and Dr. Freeman, leading the analysis of immunization outcomes. He has 14 years of experience working with researchers, including 6 years dedicated to health care research. His research emphasis is in the field of multivariate statistics. As a UK HealthCare statistician, he has worked with physicians and nursing on early identification and prediction of sepsis using vitals collected in the electronic medical record, assisting in trending outcomes affecting patient care.

Research Interests
  • Multivariate Statistics
  • Disease Prediction
  • Lean Processes
Awards
  • Outstanding Teaching Award, University of Kentucky, Department of Statistics (2003)
  • UK Make a Difference Gold Award (2011)

SuZanne Troske, MS, Research Associate

Ms. Troske is a Research Associate with the Community & Economic Development Initiative of Kentucky (CEDIK). She is working with Dr. Davis on the project studying the effect of hospital closures on emergency services in rural areas, including data collection and statistical analysis. She joined CEDIK after more than 25 years of working with economists and policy makers in areas such as K-12 education, prescription drug policy, and tax legislation. She earned an MS in Economics from Florida State University.

Bo Fang, PhD, MS, Research Assistant

Bo Fang is the Research Assistant of Lars Peterson, the Director of Research at the American Board of Family Medicine. He earned his PhD in biology from the Chinese Academy of Sciences and his MS in biostatistics from the State University of New York at Albany. Mr. Fang is working with Dr. Peterson on improving our understanding of access to primary care in impoverished and underserved areas. He has expertise in statistical analyses and SAS programming, and his techniques in other fields such as geocoding are also helpful to the Center.


How are we funded?

Our primary funding source is the Federal Office of Rural Health Policy (FORHP). Part of the Health Resources and Services Administration, FORHP coordinates activities related to rural health care within the U.S. Department of Health and Human Services.

For more information about all the Rural Health Research Centers funded by FORHP, visit RuralHealthResearch.org

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