Major Depression, Treatment Receipt, and Treatment Sources among Non-Metropolitan and Metropolitan Adults

Overview of Key Findings 7.8% of non-metropolitan (weighted number of persons=2,755,020) and 7.1% of metropolitan (weighted number of persons=14,868,655) adults had past year major depression. Treatment receipt (seeing a health professional or using prescription medication for depressive feelings) was similar among non-metropolitan (68.0%) and metropolitan (64.6%) adults. A closer examination of the type and source of treatment revealed the following: Rates of seeing a health professional were similar among non-metropolitan (60.8%) and metropolitan (58.4%) adults, but rates of using prescription medication for depressive feelings were higher among non-metropolitan (58.2%) than metropolitan (48.6%) adults. Rates of visiting a general practice/family doctor were higher among non-metropolitan (43.7%) than metropolitan (34.5%) adults

Suicidal Thoughts, Plans, and Attempts by Non-Metropolitan and Metropolitan Residence

Key Findings Mean prevalence rates for suicidal thoughts, plans, and attempts were significantly higher (P \u3c .05) among residents of non-metropolitan than large metropolitan counties. The adjusted odds of suicidal thoughts, plans, and attempts did not improve significantly from 2010 to 2016 among residents of any county type. The study findings suggest that suicide prevention interventions should be further targeted toward non-metropolitan counties. However, new interventions may need to be specifically developed to meet the unique needs of residents in non-metropolitan counties

Ethics and Economics of the COVID-19 Pandemic in the United States

The Covid-19 experience provides a natural experiment in personal and social ethics. Difficult decisions are routinely made to optimize lives and livelihoods. This commentary provides background and insight into the ethical and economic foundations underpinning dilemmas of this historic pandemic

Health and Health Care in Kentucky: Variations by Region and Metro/Micro/Rural Status

Health policy makers and health system managers frequently make decisions to allocate and organize resources according to differences in unmet needs across geographic areas. This report describes, compares, and contrasts key health, health behavior, and health care access indicators by region and metropolitan status in Kentucky

Perceived Treatment Need and Utilization for Illicit Drug and Opioid Use Disorders in Non-Metropolitan Areas

The policy brief provides nationally representative estimates of perceived treatment need and utilization for illicit drug and prescription pain reliever use disorders among non-metropolitan and metropolitan adults ages 18-64

Serious Mental Illness and Mental Health Treatment Utilization among Adults Residing in Non-Metropolitan and Metropolitan Counties

Key Findings The past year prevalence of serious mental illness (SMI) was significantly higher among non-metropolitan than metropolitan (5.90% vs. 5.18%, P \u3c .03) adults. Only 67.58% of non-metropolitan and 64.29% of metropolitan adults with SMI received any mental health (MH) treatment in the past year. Additional analyses revealed the following non-metropolitan/metropolitan treatment differences: A higher percentage of non-metropolitan than metropolitan adults with SMI received only medication for MH treatment (24.50% vs. 18.53%, P \u3c .02). A higher percentage of metropolitan than non-metropolitan adults with SMI received inpatient, outpatient, and medication (5.42% vs. 2.63%, P \u3c .02). A significantly higher percentage of non-metropolitan than metropolitan adults with SMI reported that they did not seek mental health treatment because they had no transportation or treatment was inconvenient (11.57% vs. 6.87%, P \u3c .03)

Illicit Drug and Opioid Use Disorders among Non-Metropolitan Residents

Illicit drug use disorder rates are similar across metropolitan and non-metropolitan areas and did not decline from 2011-2013 to 2014-2015 despite the implementation of major substance use treatment policies over this time period

Availability of Buprenorphine Treatment in Kentucky

Drug overdose and substance use treatment admissions data indicate that opioid use is problematic in Kentucky, but little information exists about the geographic availability of buprenorphine treatment across the state. Furthermore, there is even less information about the characteristics of the physicians prescribing buprenorphine. This report describes the availability of buprenorphine treatment in Kentucky

Partial Psychiatric Hospitalization Program Availability in Non-Metropolitan and Metropolitan Hospitals Nationally

Overview of Key Findings Partial psychiatric hospitalization programs (PPHPs) are intended to reduce or avoid inpatient stays by allowing patients to reside at home while receiving intensive psychiatric services in outpatient settings. A significantly smaller proportion of non-metropolitan than metropolitan hospitals offer PPHPs. 11.4% of non-metropolitan compared to 38.7% of metropolitan hospitals offer PPHPs. Regardless of location, hospitals that offer PPHPs have higher patient volumes and more beds than hospitals that offer PPHPs through affiliated providers or do not offer PPHPs at all

Increased Rates of Death from Unintentional Injury among Non-Hispanic White, American Indian/Alaska Native, and Non-Metropolitan Communities

Overview of Key Findings Living in a nonmetropolitan area is associated with an increase in the age-adjusted death rate from unintentional injuries, from 46.2 in metropolitan areas to 59.2 in nonmetropolitan areas in 2018, with all races/ethnicity groups affected except for non-Hispanic Black. The ratio of unintentional injury deaths in nonmetropolitan areas, compared to metropolitan areas, was 1.28 overall, ranging from 1.05 to 1.56 depending on race and ethnicity. American Indians and Alaska Natives have the highest rate of living in nonmetropolitan areas (39.5%), and this group has the greatest increase in death from unintentional injury associated with living in a nonmetropolitan setting (from 67.7 to 105.3 per 100,000). There is no association between urbanization and race/ethnicity on the rate of emergency department visits for nonfatal unintentional injuries