{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T11:02:42Z","timestamp":1781262162056,"version":"3.54.1"},"reference-count":0,"publisher":"Project MUSE","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["hpu"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:p xml:lang=\"en\">Abstract: Few studies have examined whether the variation of health care infrastructure and workforce had potential impacts on COVID-19 mortality in rural counties. Linking national datasets, we stratified 1,548 rural and 1,148 urban U.S. counties using 2021 COVID-19 median mortality rates (19.5 vs. 14.0 per 10,000 population, respectively) as a cut-point for high and low mortality to compare sociodemographics, vaccination status, access to health centers and hospitals, and health care workforce supply between and within rural and urban counties. High-mortality (compared with low-mortality) rural counties had a higher percentage of residents who were older, Black and\/or Hispanic, less educated, in poverty, and uninsured. Among all county groupings, high-mortality rural counties had the lowest percentage of residents with a complete COVID-19 vaccination series, were least likely to have a hospital or virtual patient services, and had the fewest hospital-based personnel and population-adjusted advanced-practice registered nurses. Rural communities experiencing these health care gaps require targeted health policy and resources.<\/jats:p>","DOI":"10.1353\/hpu.2026.a992140","type":"journal-article","created":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T10:46:17Z","timestamp":1781261177000},"page":"733-749","source":"Crossref","is-referenced-by-count":0,"title":["Variation in Health Care Resources in Rural and Urban Counties Associated with Differences in COVID-19 Mortality"],"prefix":"10.1353","volume":"37","author":[{"given":"Shahida","family":"Shahrir","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arati","family":"Dahal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davis G.","family":"Patterson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bianca K.","family":"Frogner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"147","container-title":["Journal of Health Care for the Poor and Underserved"],"original-title":[],"language":"en","deposited":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T10:46:23Z","timestamp":1781261183000},"score":1,"resource":{"primary":{"URL":"https:\/\/muse.jhu.edu\/article\/992140"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":0,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,5]]}},"URL":"https:\/\/doi.org\/10.1353\/hpu.2026.a992140","relation":{},"ISSN":["1548-6869"],"issn-type":[{"value":"1548-6869","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]}}}