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 & 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

Jeffery Talbert, PhD, Deputy Director

Professor, Biomedical Informatics

Dr. Talbert is a national leader in informatics research at the intersection of evidence-based policy and health care outcomes. He became the Deputy Director of the Center for Rural and Underserved Health Research in 2017. Appointed Director of the UK Institute for Biomedical Informatics in 2020, he also serves as Division Chief for Biomedical Informatics in the College of Medicine. For the Center for Clinical and Translational Science, he serves as an associate director as well as Director of the Biomedical Informatics Core. He also is the Co-Director of the Data Analytics Core for the Kentucky HEALing Communities project, and principal investigator for multiple projects with the Kentucky Cabinet for Health and Family Services working to develop data analytics and research capacity. Dr. Talbert received BS, MA, and PhD degrees from Texas A&M University. He has more than 25 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, 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, and other foundations and organizations.

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

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

Associate Professor, Family and Community Medicine

Dr. Peterson is Vice President 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

Chris Delcher, PhD

Director, Institute for Pharmaceutical Outcomes & Policy

Dr. Chris Delcher is an epidemiologist and Assistant Professor in the Department of Pharmacy Practice and Science, and the Director of the Institute for Pharmaceutical Outcomes & Policy at the University of Kentucky (https://pharmacy.uky.edu/research-0/research-centers/ipop). He received his master’s from the University of North Carolina's Gillings School of Global Public Health and his PhD from the University of Florida. In addition to his work with the Rural and Underserved Health Research Center funded by HRSA, Dr. Delcher’s current research is supported by the National Institute on Aging at NIH and the US Bureau of Justice Assistance. His research focuses on the epidemiology of prescription drug use from data obtained during medical and pharmacy encounters, understanding the intended and unintended consequences of drug policy and its effects on population health, and enhancing public health surveillance systems in high and low resource environments.

Research Interests
  • Drug policy
  • Epidemiology of prescription drug use
  • Public health surveillance systems
Awards
  • Swintosky Distinguished Lecturer, College of Pharmacy, University of Kentucky (2019)

Ahmed A. Arif, PhD, CPH, FACE

Associate Professor, Public Health Sciences
The University of North Carolina at Charlotte

Dr. Arif is an Associate Professor in the Department of Public Health Sciences within the College of Health and Human Services at the University of North Carolina in Charlotte. He is also an Adjunct Associate Professor in the Division of Epidemiology, Human Genetics and Environmental Sciences, within the School of Public Health at the University of Texas in Houston. Dr. Arif obtained his PhD in Epidemiology at the University of Texas at Houston and his MS in Biology at Western Kentucky University in Bowling Green. Prior to that, he graduated with an MBBS from Sind Medical College at the University of Karachi in Pakistan. As a co-author of 48 peer-reviewed articles, his research has been funded by NIH and CDC/NIOSH. His current research interests include studying respiratory health effects of environmental & occupational exposures in high-risk populations. Dr. Arif is working with the Rural and Underserved Health Research Center as a Principal Investigator for the Lung Diseases among Coal Miners project.

Research Interests
  • Epidemiology of asthma and occupational asthma
  • Occupational and environmental epidemiology
  • Chronic disease epidemiology
  • Population-based health surveys
  • Epidemiology of rate diseases
  • Health disparities

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

Associate Professor, Pharmacy Practice and Science

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)

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.

Hefei Wen, PhD

Assistant Professor, Division of Health Policy and Insurance Research, Department of Population Medicine
Harvard Medical School

Dr. Wen recently joined the Department of Population Medicine within the Division of Health Policy and Insurance Research at Harvard Medical School and Harvard Pilgrim Health Care Institute in Boston. Previously, she was an Assistant Professor in the University of Kentucky Department of Health Management and Policy 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 previous projects focused 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

Katie Youngen, MPH

Research Program Manager

Ms. Youngen comes to the Rural and Underserved Health Research Center with a background in health care marketing and communications working for organizations with underserved patients. She earned a Master of Public Health from the University of Kentucky with a concentration in Health Management and Policy. As a graduate student, she worked on research projects examining the effects of rural health interventions and local health departments’ activities in Appalachia. She also holds a BA from Butler University.

Al Cross, BA

Director of the Institute for Rural Journalism and Community Issues 

At the Institute for Rural Journalism and Community Issues, Al Cross helps rural news media define the public agenda in their communities and report on broader issues that have local impact but few local sources. The Institute is based in the University of Kentucky’s School of Journalism and Media, where Mr. Cross is an associate professor. He helped organize the Institute, which has academic partners at 25 universities in 17 states, and he became its director in 2004 after more than 26 years as a reporter at The Courier-Journal, the last 15½ as chief political writer. Mr. Cross writes a political column about twice a month for the Louisville newspaper, is an election-night commentator for the local PBS affiliate, KET, and is often quoted nationally on Kentucky politics.

Awards
  • Kentucky Journalism Hall of Fame (2010)
  • East Kentucky Leadership Foundation Media Award (2006)
  • Kentucky Psychological Association Media Award (2013)
  • James Madison First Amendment Award of the Scripps Howard First Amendment Center at UK (2015)
  • Pulitzer Prize won by The Courier-Journal staff for coverage of the nation’s deadliest bus and drunk-driving crash (1989, shared)
  • Investigative reporting award in the Southern Journalism Awards for a series on surface mining, including some of the first comprehensive stories on mountaintop-removal mining (1987, shared)
  • The Wells Key, the top honor of the Society of Professional Journalists, the nation’s oldest, broadest and largest journalism organization (2011)
  • National SPJ president (2001-2002)
  • Awards for his work from SPJ’s Louisville Chapter.

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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