Diabetes Care and Outcomes: Disparities Across Rural America
Abstract
We examined differences in receipt of diabetes care and selected outcomes between rural and urban persons living with diabetes, using nationally representative data from the 2006 Behavioral Risk Factor Surveillance System (BRFSS). "Rural" was defined as living in a non-metropolitan county. Diabetes care variables were physician visit, HbA1c testing, foot examination, and dilated eye examination. Outcome variables were presence of foot sores and diabetic retinopathy. Analysis was limited to persons 18 and older self-reporting a diagnosis of diabetes (n = 29,501). A lower proportion of rural than urban persons with diabetes reported a dilated eye examination (69.1 vs. 72.4%; P = 0.005) or a foot examination in the past year (70.6 vs. 73.7%; P = 0.016). Conversely, a greater proportion of rural than urban persons reported diabetic retinopathy (25.8 vs. 22.0%; P = 0.007) and having a foot sore taking more than four weeks to heal (13.2 vs. 11.2%; P = 0.036). Rural residence was not associated with receipt of services after individual characteristics were taken into account in adjusted analysis, but remained associated with an increased risk for retinopathy (OR = 1.20, 95% CI = 1.02-1.42). Participation in Diabetes Self-Management Education (DSME) was positively associated with all measures of diabetes care included in the study. Availability of specialty services and travel considerations could explain some of these differences.
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The majority of the 34 million people with diabetes in the US have a DED screening care gap, due to a lack of access, and education around the need for a diabetic eye exam.
“the majority of the 34 million people with diabetes in the US have a DED screening care gap, due to a lack of access, and education around the need for a diabetic eye exam3,4.”
From Autonomous artificial intelligence increases screening and follow-up for diabetic retinopathy in youth: the ACCESS randomized control trial (2024) · cites this paper as [4]
Cites
Revisiting the Behavioral Model and Access to Medical Care: Does it Matter?
Andersen, R. M. (1995) · Journal of Health and Social Behavior · doi:10.2307/2137284 · Cited by 9,831 · see citing works
Standards of Medical Care in Diabetes
Power, D. V. (2006) · Diabetes Care · doi:10.2337/diacare.29.02.06.dc05-1593 · Cited by 8,672 · see citing works
Improving Primary Care for Patients With Chronic Illness: The Chronic Care Model, Part 2
Bodenheimer, T., Wagner, E. H., & Grumbach, K. (2002) · JAMA · doi:10.1001/jama.288.15.1909 · Cited by 2,413 · see citing works
(2005) · JAMA · doi:10.1001/jama.294.19.2423-c · Cited by 2,325 · see citing works
Effectiveness of Self-Management Training in Type 2 Diabetes
Norris, S. L., Engelgau, M. M., & Venkat Narayan, K. M. (2001) · Diabetes Care · doi:10.2337/diacare.24.3.561 · Cited by 1,846 · see citing works
Lifetime risk for diabetes mellitus in the United States
Narayan, K. M. V. (2003) · JAMA · doi:10.1001/jama.290.14.1884 · Cited by 1,515 · see citing works
Standards of Medical Care in Diabetes—2008
Dora, J. M., Kramer, C. K., & Canani, L. H. S. (2008) · Diabetes Care · doi:10.2337/dc08-0109 · Cited by 1,413 · see citing works
Standards of Medical Care in Diabetes—2008
American Diabetes Association (2008) · Diabetes Care · doi:10.2337/dc08-s012 · Cited by 1,377 · see citing works
Improvements in Diabetes Processes of Care and Intermediate Outcomes: United States, 1988–2002
SAADDINE, J. B., Cadwell, B. L., Gregg, E. W., Engelgau, M. M., Vinicor, F., Imperatore, G., & Narayan, K. M. V. (2006) · Annals of Internal Medicine · doi:10.7326/0003-4819-144-7-200604040-00005 · Cited by 561 · see citing works
Probst, J. C., Laditka, S. B., Wang, J., & Johnson, A. O. (2007) · BMC Health Services Research · doi:10.1186/1472-6963-7-40 · Cited by 291 · see citing works
Self-citationImpact of a Program to Improve Adherence to Diabetes Guidelines by Primary Care Physicians
Kirkman, M. S., Williams, S. R., Caffrey, H., & Marrero, D. G. (2002) · Diabetes Care · doi:10.2337/diacare.25.11.1946 · Cited by 213 · see citing works
Chin, M. H., Cook, S., Drum, M. L., Jin, L., Guillen, M., Humikowski, C. A., Koppert, J., Harrison, J. F., Lippold, S. A., & Schaefer, C. T. (2004) · Diabetes Care · doi:10.2337/diacare.27.1.2 · Cited by 209 · see citing works
Siminerio, L. M., Piatt, G., & Zgibor, J. C. (2005) · The Science of Diabetes Self-Management and Care · doi:10.1177/0145721705275325 · Cited by 206 · see citing works
Mainous, A. G., Koopman, R. J., Gill, J. M., Baker, R., & Pearson, W. S. (2004) · American Journal of Public Health · doi:10.2105/ajph.94.1.66 · Cited by 145 · see citing works
Race, Rural Residence, and Control of Diabetes and Hypertension
Mainous, A. G. (2004) · The Annals of Family Medicine · doi:10.1370/afm.119 · Cited by 141 · see citing works
Quality of diabetes care in community health centers
Chin, M. H., Auerbach, S. B., Cook, S., Harrison, J. F., Koppert, J., Jin, L., Thiel, F., Karrison, T. G., Harrand, A. G., Schaefer, C. T., et al. (2000) · American Journal of Public Health · doi:10.2105/ajph.90.3.431 · Cited by 139 · see citing works
Adherence to American Diabetes Association Standards of Care by Rural Health Care Providers
Coon, P. J., & Zulkowski, K. M. (2002) · Diabetes Care · doi:10.2337/diacare.25.12.2224 · Cited by 108 · see citing works
Pathman, D. E., Ricketts, T. C., & Konrad, T. R. (2005) · Health Services Research · doi:10.1111/j.1475-6773.2005.00454.x · Cited by 90 · see citing works
Rural-urban differences in visits to primary care physicians.
Probst, J. C., Moore, C. G., Baxley, E. G., & Lammie, J. J. (2002) · PubMed · Cited by 73 · see citing works
Self-citationQuality of diabetes care among low-income patients in North Carolina
Bell, R. A., CAMACHO, F. T., Goonan, K. L., Duren‐Winfield, V., Anderson, R. T., KONEN, J. C., & Goff, D. C. (2001) · American Journal of Preventive Medicine · doi:10.1016/s0749-3797(01)00328-2 · Cited by 73 · see citing works
A Comparison of Diabetes Care in Rural and Urban Medical Clinics in Alabama
Andrus, M. R., Kelley, K. W., Murphey, L. M., & Herndon, K. C. (2003) · Journal of Community Health · doi:10.1023/b:johe.0000007443.96138.03 · Cited by 70 · see citing works
Strine, T. W., Okoro, C. A., Chapman, D. P., Beckles, G. L., Balluz, L. S., & Mokdad, A. H. (2004) · Preventive Medicine · doi:10.1016/j.ypmed.2004.10.009 · Cited by 68 · see citing works
Matza, L. S., Rousculp, M. D., Malley, K. G., Boye, K. S., & Oglesby, A. K. (2008) · Health and Quality of Life Outcomes · doi:10.1186/1477-7525-6-95 · Cited by 58 · see citing works
Racial and ethnic differences in diabetes care and health care use and costs.
Lee, J. A., Liu, C., & Sales, A. E. (2006) · Europe PMC (PubMed Central) · Cited by 36 · see citing works
Sloan, F. A., Grossman, D. S., & Lee, P. P. (2009) · Ophthalmology · doi:10.1016/j.ophtha.2009.03.010 · Cited by 33 · see citing works
Balamurugan, A., Rivera, M. D., Jack, L., Allen, K. A., & Morris, S. L. (2006) · Europe PMC (PubMed Central) · Cited by 33 · see citing works
Balamurugan, A., Hall-Barrow, J., Blevins, M., Brech, D., Phillips, M., Holley, E., & Bittle, K. (2009) · The diabetes educator · doi:10.1177/0145721708326988 · Cited by 30 · see citing works
Barriers Associated With the Delivery of Medicare-Reimbursed Diabetes Self-management Education
Powell, M. P., Glover, S. H., Probst, J. C., & Laditka, S. B. (2005) · The Science of Diabetes Self-Management and Care · doi:10.1177/0145721705283039 · Cited by 29 · see citing works
Self-citationZuWallack, R., Hashim, A., McCuskerl, C., Nonnandin, E., Benoit-Connors, M. L., & Lahiri, B. (2006) · Chronic Respiratory Disease · doi:10.1191/1479972306cd096oa · Cited by 23 · see citing works
The State of Diabetes Care Provided to Medicare Beneficiaries Living in Rural America
Weingarten, J. P., Brittman, S., Hu, W., Przybyszewski, C., Hammond, J. M., & Fitzgerald, D. (2006) · The Journal of Rural Health · doi:10.1111/j.1748-0361.2006.00057.x · Cited by 22 · see citing works
Evaluating progress toward Healthy People 2010 national diabetes objectives.
Mukhtar, Q., Jack, L., Martin, M. “., Murphy, D. L., & Rivera, M. D. (2006) · PubMed Central · Cited by 21 · see citing works
Rural Health Clinics and Diabetes‐Related Primary Care for Medicaid Beneficiaries in Oregon
Kirkbride, K., & Wallace, N. (2009) · The Journal of Rural Health · doi:10.1111/j.1748-0361.2009.00226.x · Cited by 18 · see citing works
A field-based approach to support improved diabetes care in rural states.
Johnson, E. A., Webb, W. L., McDowall, J. M., Chasson, L. L., Oser, C. S., Grandpre, J. R., Marasinghe, M. I., Butcher, M. K., O’Leary, E. M., Harwell, T. S., et al. (2005) · PubMed Central · Cited by 18 · see citing works
Improving Access to Quality Diabetes Education in a Rural State
Butcher, M. K., Gilman, J., Meszaros, J. F., Bjorsness, D. K., Madison, M., McDowall, J. M., Oser, C. S., Johnson, E. A., Harwell, T. S., Helgerson, S. D., et al. (2006) · The Science of Diabetes Self-Management and Care · doi:10.1177/0145721706296029 · Cited by 17 · see citing works
Phillips, M. M. (2004) · Europe PMC (PubMed Central) · Cited by 11 · see citing works
Peer Reviewed: Evaluating Progress Toward Healthy People 2010 National Diabetes Objectives
Mukhtar, Q., Jack, L., Martin, M. “., Rivera, M. D., & Murphy, D. L. (2006) · Preventing Chronic Disease · Cited by 6 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Disparities in Vision Health and Eye Care
Elam, A. R., Tseng, V. L., Rodriguez, T. M., Mike, E. V., Warren, A., Coleman, A. L., Aguwa, U. T., Alabiad, C. R., Briceño, C. A., Capó, H., et al. (2022) · Ophthalmology · doi:10.1016/j.ophtha.2022.07.010 · Cited by 226 · see citing works
Socioeconomic inequalities and type 2 diabetes complications: A systematic review
Tatulashvili, S., Fagherazzi, G., Dow, C., Cohen, R., Fosse‐Edorh, S., & Bihan, H. (2019) · Diabetes & Metabolism · doi:10.1016/j.diabet.2019.11.001 · Cited by 196 · see citing works
Johnston, K. J., Wen, H., & Maddox, K. E. J. (2019) · Health Affairs · doi:10.1377/hlthaff.2019.00838 · Cited by 187 · see citing works
Burden and management of type 2 diabetes in rural United States
Dugani, S. B., Mielke, M. M., & Vella, A. (2021) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3410 · Cited by 151 · see citing works
Wolf, R. M., Channa, R., Liu, T. Y. A., Zehra, A., Bromberger, L., Patel, D., Ananthakrishnan, A., Brown, E. A., Prichett, L., Lehmann, H. P., et al. (2024) · Nature Communications · doi:10.1038/s41467-023-44676-z · Cited by 116 · see citing works
Solomon, S. D., Shoge, R. Y., Ervin, A., Contreras, M., Harewood, J., Aguwa, U. T., & Olivier, M. M. G. (2022) · Ophthalmology · doi:10.1016/j.ophtha.2022.07.012 · Cited by 110 · see citing works
Liu, Y., Zupan, N. J., Shiyanbola, O. O., Swearingen, R., Carlson, J. N., Jacobson, N. A., Mahoney, J., Klein, R., Bjelland, T. D., & Smith, M. A. (2018) · PLoS ONE · doi:10.1371/journal.pone.0206742 · Cited by 103 · see citing works
Fathy, C., Patel, S., Sternberg, P., & Kohanim, S. (2016) · Seminars in Ophthalmology · doi:10.3109/08820538.2016.1154170 · Cited by 106 · see citing works
Disparities in Adult Vision Health in the United States
Zambelli-Weiner, A., Crews, J. E., & Friedman, D. S. (2012) · American Journal of Ophthalmology · doi:10.1016/j.ajo.2012.03.018 · Cited by 97 · see citing works
Diabetes Self-Management Education Programs in Nonmetropolitan Counties — United States, 2016
Rutledge, S., Masalovich, S. E., Blacher, R. J., & SAUNDERS, M. M. (2017) · MMWR Surveillance Summaries · doi:10.15585/mmwr.ss6610a1 · Cited by 90 · see citing works
Cummings, D. M., Lutes, L. D., Littlewood, K., Solar, C. A., Carraway, M., Kirian, K., Patil, S. P., Adams, A. D., Ciszewski, S., Edwards, S., et al. (2019) · Diabetes Care · doi:10.2337/dc18-1841 · Cited by 69 · see citing works
Flood, D., Geldsetzer, P., Agoudavi, K., Aryal, K. K., Brant, L. C. C., Brian, G. R., Dorobanţu, M., Farzadfar, F., Fronea, O. F. G., Gurung, M. S., et al. (2022) · Diabetes Care · doi:10.2337/dc21-2342 · Cited by 64 · see citing works
Lepard, M. G., Joseph, A. L., Agne, A. A., & Cherrington, A. L. (2015) · Current Diabetes Reports · doi:10.1007/s11892-015-0608-3 · Cited by 62 · see citing works
Dolar-Szczasny, J., Barańska, A., & Ręjdak, R. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12093161 · Cited by 61 · see citing works
McLendon, S. F. (2017) · Diabetes Spectrum · doi:10.2337/ds16-0004 · Cited by 57 · see citing works
“The prevalence of diabetes is 17% higher in adults living in rural areas than in the population as a whole (6).”
BackgroundAvailability and Affordability of Essential Medicines: Implications for Global Diabetes Treatment
Beran, D., Ewen, M. A., Lipska, K. J., Hirsch, I. B., & Yudkin, J. S. (2018) · Current Diabetes Reports · doi:10.1007/s11892-018-1019-z · Cited by 54 · see citing works
Dugani, S. B., Wood‐Wentz, C. M., Mielke, M. M., Bailey, K. R., & Vella, A. V. (2022) · JAMA Network Open · doi:10.1001/jamanetworkopen.2022.32318 · Cited by 51 · see citing works
Towne, S. D., Bolin, J. N., Ferdinand, A. O., Nicklett, E. J., Smith, M. L., & Ory, M. G. (2017) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph14050464 · Cited by 50 · see citing works
Foss, R. M., Fischer, K., Lampman, M. A., Laabs, S. B., Halasy, M. P., Allen, S. V., Garrison, G. M., Sobolik, G. J., Bernard, M., Sosso, J. L., et al. (2023) · The Annals of Family Medicine · doi:10.1370/afm.2962 · Cited by 47 · see citing works
Andreae, S. J., Andreae, L. J., Richman, J., Cherrington, A., & Safford, M. M. (2020) · The Annals of Family Medicine · doi:10.1370/afm.2469 · Cited by 47 · see citing works
Tseng, W. H., Stevenson, T. R., Canter, R. J., Chen, S. L., Khatri, V. P., Bold, R. J., & Martinez, S. R. (2010) · Plastic & Reconstructive Surgery · doi:10.1097/prs.0b013e3181f444bc · Cited by 45 · see citing works
Méndez, I., Lundeen, E. A., SAUNDERS, M. M., Williams, A., SAADDINE, J. B., & Albright, A. L. (2022) · The Science of Diabetes Self-Management and Care · doi:10.1177/26350106211065378 · Cited by 43 · see citing works
Patel, D., Ananthakrishnan, A., Lin, T., Channa, R., Liu, T. Y. A., & Wolf, R. M. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11237120 · Cited by 43 · see citing works
Racial/Ethnic, Regional, and Rural/Urban Differences in Receipt of Diabetes Education
Brown-Guion, S. Y., Youngerman, S. M., Hernandez-Tejada, M., Dismuke, C., & Egede, L. (2013) · The diabetes educator · doi:10.1177/0145721713480002 · Cited by 42 · see citing works
Lutes, L. D., Cummings, D. M., Littlewood, K., DiNatale, E., & Hambidge, B. (2017) · Obesity · doi:10.1002/oby.21883 · Cited by 42 · see citing works
Differences in U.S. Rural-Urban Trends in Diabetes ABCS, 1999–2018
Mercado, C. I., Bullard, K. M., Gregg, E. W., Ali, M. K., Saydah, S., & Imperatore, G. (2021) · Diabetes Care · doi:10.2337/dc20-0097 · Cited by 45 · see citing works
Higher hospitalization and mortality rates among SARS‐CoV‐2‐infected persons in rural America
Anzalone, A. J., Horswell, R. L., Hendricks, B. M., Chu, S. T., Hillegass, W. B., Beasley, W. H., Harper, J. R., Kimble, W., Rosen, C. J., Miele, L., et al. (2022) · The Journal of Rural Health · doi:10.1111/jrh.12689 · Cited by 41 · see citing works
Issa, R., Nazir, S., Minhas, A. M. K., Lang, J. J., Ariss, R. W., Kayani, W. T., Khalid, M. U., Sperling, L. S., Shapiro, M. D., Jneid, H. M., et al. (2023) · Vascular Medicine · doi:10.1177/1358863x221140151 · Cited by 36 · see citing works
Impact of Longitudinal Virtual Primary Care on Diabetes Quality of Care
Lu, A. D., Gunzburger, E. C., Glorioso, T. J., Smith, W. B., Kenney, R. R., Whooley, M. A., & Ho, P. M. (2021) · Journal of General Internal Medicine · doi:10.1007/s11606-020-06547-x · Cited by 35 · see citing works
Glenn, L. E., Nichols, M. G., Enriquez, M., & Jenkins, C. M. (2019) · Public Health Nursing · doi:10.1111/phn.12693 · Cited by 34 · see citing works
Low, L. L., Tong, S. F., & Low, W. Y. (2016) · PLoS ONE · doi:10.1371/journal.pone.0147127 · Cited by 34 · see citing works
Kobe, E. A., Lewinski, A. A., Jeffreys, A. S., Smith, V. A., Coffman, C. J., Danus, S. M., Sidoli, E., Greck, B. D., HORNE, L. C., Saxon, D. R., et al. (2022) · Journal of General Internal Medicine · doi:10.1007/s11606-021-07281-8 · Cited by 36 · see citing works
Access to Transportation and Health Care Visits for Medicaid Enrollees With Diabetes
Thomas, L. V., Wedel, K. R., & Christopher, J. E. (2017) · The Journal of Rural Health · doi:10.1111/jrh.12239 · Cited by 32 · see citing works
Chen, C. C., Chen, L.-W., & Cheng, S. (2017) · Public Health · doi:10.1016/j.puhe.2017.06.009 · Cited by 30 · see citing works
Geographic Access Disparities to Clinical Trials in Diabetic Eye Disease in the United States
Soares, R. R., Parikh, D. A., Shields, C. N., Peck, T. J., Gopal, A. D., Sharpe, J. E., & Yonekawa, Y. (2020) · Ophthalmology Retina · doi:10.1016/j.oret.2020.12.006 · Cited by 30 · see citing works
Perceived Benefits and Barriers of a Community-Based Diabetes Prevention and Management Program
Shawley-Brzoska, S., & Misra, R. (2018) · Journal of Clinical Medicine · doi:10.3390/jcm7030058 · Cited by 26 · see citing works
Sullivan, J., Jett, B. P., Cradick, M., & Zuber, J. K. (2016) · Annals of Pharmacotherapy · doi:10.1177/1060028016663564 · Cited by 25 · see citing works
Johnston, K. J., Wen, H., Kotwal, A., & Maddox, K. E. J. (2021) · Journal of General Internal Medicine · doi:10.1007/s11606-020-06532-4 · Cited by 25 · see citing works
Fitzgerald, T. L., Lea, C. S., Brinkley, J., & Zervos, E. E. (2014) · Rural and Remote Health · doi:10.22605/rrh2668 · Cited by 25 · see citing works
Cancer in rural America: Improving access to clinical trials and quality of oncologic care
Unger, J. M., McAneny, B. L., & Osarogiagbon, R. U. (2025) · CA A Cancer Journal for Clinicians · doi:10.3322/caac.70006 · Cited by 28 · see citing works
Modernizing Diabetes Care Quality Measures
Jiang, D. H., O’Connor, P. J., Huguet, N., Golden, S. H., & McCoy, R. G. (2022) · Health Affairs · doi:10.1377/hlthaff.2022.00233 · Cited by 23 · see citing works
Disparities in Acute and Chronic Complications of Diabetes Along the U.S. Rural-Urban Continuum
Steiger, K. G., Herrin, J. S., SWARNA, K. S., Davis, E. M., & McCoy, R. G. (2024) · Diabetes Care · doi:10.2337/dc23-1552 · Cited by 21 · see citing works
Schaefer, S. L., Dualeh, S. H. A., Kunnath, N. J., Scott, J. W., & Ibrahim, A. M. (2024) · Health Affairs · doi:10.1377/hlthaff.2023.00843 · Cited by 21 · see citing works
Rural–urban disparities in use of post-lumpectomy radiation
Martinez, S. R., Shah, D. R., Tseng, W. H., Canter, R. J., & Bold, R. J. (2012) · Medical Oncology · doi:10.1007/s12032-012-0266-0 · Cited by 21 · see citing works
Strom, J. L., Lynch, C. P., & Egede, L. E. (2011) · The Science of Diabetes Self-Management and Care · doi:10.1177/0145721710394875 · Cited by 21 · see citing works
Tilden, D. R., French, B. C., Datye, K. A., & Jaser, S. S. (2023) · Diabetes Care · doi:10.2337/dc23-1564 · Cited by 19 · see citing works
Martinez, S. R., Shah, D. R., Maverakis, E. M., & Yang, A. D. (2012) · Journal of Surgical Oncology · doi:10.1002/jso.23169 · Cited by 16 · see citing works
Social adaptability index predicts overall mortality in patients with diabetes
Goldfarb‐Rumyantzev, A. S., Rout, P., Sandhu, G. S., Barenbaum, A. L., Patibandla, B. K., Narra, A., Chawla, V., & Williams, M. E. (2012) · Journal of Diabetes and its Complications · doi:10.1016/j.jdiacomp.2011.12.002 · Cited by 15 · see citing works
Luo, H., Bell, R. A., Winterbauer, N. L., Xu, L., Zeng, X., Wu, Q., Rafferty, A. P., & Watson, A. (2020) · Journal of Public Health Management and Practice · doi:10.1097/phh.0000000000001226 · Cited by 15 · see citing works
Luo, H., Basu, R., Bell, R. A., Rafferty, A. P., Zeng, X., Qu, H., & Dove, C. (2021) · The Journal of Rural Health · doi:10.1111/jrh.12588 · Cited by 15 · see citing works
Brennan, M. B., Tan, T., Schechter, M. C., & Fayfman, M. (2023) · Seminars in Vascular Surgery · doi:10.1053/j.semvascsurg.2023.01.002 · Cited by 15 · see citing works
Rural-Urban Differences in Hospital and Patient-Reported Outcomes Following Total Hip Arthroplasty
Lachance, A. D., Call, C. M., Radford, Z. J., Stoddard, H. L., Sturgeon, C. M., Babikian, G. M., Rana, A. J., & McGrory, B. J. (2023) · Arthroplasty Today · doi:10.1016/j.artd.2023.101190 · Cited by 14 · see citing works
Effects of between visit physician-patient communication on Diabetes Recognition Program scores
Bredfeldt, C. E., Compton-Phillips, A. L., & Snyder, M. H. (2011) · International Journal for Quality in Health Care · doi:10.1093/intqhc/mzr061 · Cited by 14 · see citing works
Diabetic education in rural areas
Maez, L., Erickson, L., & Naumuk, L. (2014) · Rural and Remote Health · doi:10.22605/rrh2742 · Cited by 14 · see citing works
Al-Wagdi, B. E., & Al‐Hanawi, M. K. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1326675 · Cited by 12 · see citing works
Bennett, K. J., Probst, J. C., Iyer, M., & Glover, S. H. (2012) · Rural and Remote Health · doi:10.22605/rrh2097 · Cited by 12 · see citing works
Self-citationFactors Influencing Latino Participation in Community-Based Diabetes Education
Francis, S. L., Noteman, A., & Litchfield, R. E. (2014) · Journal of Extension · doi:10.34068/joe.52.05.29 · Cited by 12 · see citing works
Carr, D. H., Kappagoda, M., Boseman, L. A., Cloud, L. K., & Croom, B. (2020) · Journal of Public Health Management and Practice · doi:10.1097/phh.0000000000001109 · Cited by 12 · see citing works
Wiznia, D. H., Jimenez, R. L., & Harrington, M. A. (2021) · Journal of the American Academy of Orthopaedic Surgeons · doi:10.5435/jaaos-d-21-00425 · Cited by 11 · see citing works
Robinson, S. A., Netherton, D., Zocchi, M. S., Purington, C., Ash, A. S., & Shimada, S. L. (2021) · JMIR Diabetes · doi:10.2196/32320 · Cited by 10 · see citing works
Soares, R. R., Gopal, A. D., Parikh, D. A., Shields, C. N., PATEL, S. N., Hinkle, J. W., Sharpe, J. E., Ho, A. C., Regillo, C. D., Haller, J. A., et al. (2021) · American Journal of Ophthalmology · doi:10.1016/j.ajo.2021.04.001 · Cited by 11 · see citing works
(2013) · Europe PMC (PubMed Central) · Cited by 11 · see citing works
Physical Activity Among Rural Men: Barriers and Preferences
Gallagher, J. B., Bayman, E. O., Cadmus‐Bertram, L., Jenkins, N. D. M., Pearlman, A. M., Whitaker, K. M., & Carr, L. J. (2023) · Preventing Chronic Disease · doi:10.5888/pcd20.230046 · Cited by 10 · see citing works
Burmeister, J., Pham, M. N., Bohler, F., & North, C. (2025) · Annals of Medicine · doi:10.1080/07853890.2025.2522323 · Cited by 9 · see citing works
Effectiveness of diabetes education interventions in rural America: a systematic review
Jarvandi, S., Roberson, P. N. E., Greig, J. A., Upendram, S., & Grion, J. (2022) · Health Education Research · doi:10.1093/her/cyac039 · Cited by 9 · see citing works
Tejada-Tayabas, L. M., & Ríos-Lugo, M. J. (2014) · Health · doi:10.4236/health.2014.615233 · Cited by 9 · see citing works
Lim, H. T., & Choi, K. S. (2012) · Journal of the Korean Ophthalmological Society · doi:10.3341/jkos.2012.53.4.516 · Cited by 9 · see citing works
Harry, M. L., Saman, D. M., Allen, C. I., Ohnsorg, K. A., Sperl‐Hillen, J. M., O’Connor, P. J., Ziegenfuss, J. Y., Dehmer, S. P., Bianco, J. A., & DESAI, J. R. (2018) · Clinical Diabetes · doi:10.2337/cd17-0116 · Cited by 8 · see citing works
Rafie, Hosig, Wenzel, Borowski, Jiles, K. A., & Schlenker (2021) · Rural and Remote Health · doi:10.22605/rrh6620 · Cited by 8 · see citing works
Chafe, R., Albrechtsons, D., Hagerty, D., & Newhook, L. A. (2015) · BMC Research Notes · doi:10.1186/s13104-015-1358-7 · Cited by 8 · see citing works
Health disparities and inequalities in prevalence of diabetes in the Kingdom of Saudi Arabia
Al‐Hanawi, M. K. (2024) · International Journal for Equity in Health · doi:10.1186/s12939-024-02265-6 · Cited by 7 · see citing works
The forgotten - overcoming challenges in diabetes care for marginalized populations
Martinez-Cruz, M., Namasingh, N., Alexopoulos, A., Batch, B. C., Crowley, M. J., & Bosworth, H. B. (2025) · Expert Review of Endocrinology & Metabolism · doi:10.1080/17446651.2025.2526200 · Cited by 7 · see citing works
Diaz, A. T., Lock, L. J., Molfenter, T. D., Mahoney, J., Boss, D., Bjelland, T. D., & Liu, Y. (2021) · Implementation Science Communications · doi:10.1186/s43058-021-00175-0 · Cited by 6 · see citing works
Navigating Unserved Areas: A Comprehensive Review of Medical Deserts
Costa, D., Ielapi, N., & Serra, R. (2026) · Standards · doi:10.3390/standards6010006 · Cited by 7 · see citing works
Geo-Stratified Analysis of Associations Between Socio-Economic Factors and Diabetes Risk
Redmond, M. L., Bimali, M., Ablah, E. A., Mayes, P., & Dugan, K. (2022) · Kansas Journal of Medicine · doi:10.17161/kjm.vol15.15799 · Cited by 6 · see citing works
Bryan, J. M., Bryar, P. J., & Mirza, R. G. (2023) · Telemedicine Journal and e-Health · doi:10.1089/tmj.2022.0357 · Cited by 6 · see citing works
Klobucar, T. F., Hibbs, R., Jans, P., & Adams, M. R. (2012) · Professional Case Management · doi:10.1097/ncm.0b013e31823ba3cb · Cited by 6 · see citing works
Hadden, K. B., Arnold, C. L., Curtis, L. M., Davis, T. C., Gan, J. M., Hur, S. I., McSweeney, J. C., Mikesell, B. L., & Wolf, M. S. (2020) · Contemporary Clinical Trials Communications · doi:10.1016/j.conctc.2020.100550 · Cited by 6 · see citing works
Dorali, P., Shahmoradi, Z., Weng, C. Y., & Lee, T. (2023) · Ophthalmology Retina · doi:10.1016/j.oret.2023.01.001 · Cited by 6 · see citing works
Healthcare Use and Expenditures in Rural Survivors of Hospitalization for Sepsis*
Stinehart, K. R., Hyer, J. M., Joshi, S., & Brummel, N. E. (2024) · Critical Care Medicine · doi:10.1097/ccm.0000000000006397 · Cited by 5 · see citing works
Haskins, C., McDowell, B. D., Carnahan, R. M., Fiedorowicz, J. G., Wallace, R. B., Smith, B. J., & Chrischilles, E. A. (2020) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2020.110294 · Cited by 5 · see citing works
Naik, A. G., Staab, E. M., Li, J., Siddiqui, S., Wan, W., Schaefer, C. T., Campbell, A., Quinn, M. T., & Baig, A. A. (2022) · Journal of Evaluation in Clinical Practice · doi:10.1111/jep.13746 · Cited by 4 · see citing works
Latinos Living Well—A Diabetes Education Program for Rural-Residing Latinos
Keane, M., & Francis, S. L. (2018) · Journal of Extension · doi:10.34068/joe.56.04.15 · Cited by 5 · see citing works
Design of a Rural Diabetes Self-Directed Care Program
Rugh, D. (2011) · Social Work in Health Care · doi:10.1080/00981389.2011.597496 · Cited by 5 · see citing works
Nasir, M. M., Farhan, S. H., Mushahid, H., Shah, S., Shuja, M. H., Khan, A. B., Ali, S. H., Farhan, S. A., Hassan, A., Ahmed, J., et al. (2025) · Endocrinology Diabetes & Metabolism · doi:10.1002/edm2.70065 · Cited by 4 · see citing works
Geographic variation in diabetic retinopathy screening within the Veterans Health Administration
Davis, M. L., Snider, M. J. E., Hunt, K. J., Medunjanin, D., Neelon, B., & Maa, A. Y. (2023) · Primary care diabetes · doi:10.1016/j.pcd.2023.06.004 · Cited by 4 · see citing works
Rural-Urban Disparities in the Uptake of New Diabetes Medications
Zhu, B., Dong, D., Luo, J., & Glied, S. (2024) · Diabetes Spectrum · doi:10.2337/ds23-0075 · Cited by 4 · see citing works
Zaman, M., Zajner, C., Xie, J. S., Patil, N. S., Moayad, L., Popovic, M. M., Kertes, P. J., Muni, R. H., & Kohly, R. P. (2024) · American Journal of Ophthalmology · doi:10.1016/j.ajo.2024.11.008 · Cited by 4 · see citing works
Okere, A. N., Li, T. Y., Theran, C. A., Nyasani, E., & Ali, A. A. (2025) · Computers in Biology and Medicine · doi:10.1016/j.compbiomed.2025.109824 · Cited by 4 · see citing works
Emmert, R., Thompson, M., Smith, D., Marlar, R., McPherson, K., Demla, S., & Hartwell, M. L. (2024) · Ophthalmic Epidemiology · doi:10.1080/09286586.2024.2434247 · Cited by 4 · see citing works
Hadden, K. B., Arnold, C. L., Curtis, L. M., Gan, J. M., Hur, S. I., Kwasny, M., McSweeney, J. C., Prince, L. Y., Wolf, M. S., & Davis, T. C. (2018) · Contemporary Clinical Trials · doi:10.1016/j.cct.2018.09.007 · Cited by 4 · see citing works
Effect of Stanford Youth Diabetes Coaches' Program on Youth and Adults in Diverse Communities
Patil, S. J., Tallon, E. M., Wang, Y., Nayyar, M., Hodges, K., Phad, A., Rodriguez, E., & Gefter, L. (2022) · Family & Community Health · doi:10.1097/fch.0000000000000323 · Cited by 4 · see citing works
Lock, L. J., Channa, R., Brennan, M. B., Cao, Y., & Liu, Y. (2022) · BMJ Open Diabetes Research & Care · doi:10.1136/bmjdrc-2022-003174 · Cited by 4 · see citing works
County Rurality and Incidence and Prevalence of Diagnosed Diabetes in the United States
Dugani, S. B., Lahr, B. D., Xie, H. W., Mielke, M. M., Bailey, K. R., & Vella, A. V. (2024) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2023.11.022 · Cited by 3 · see citing works
Huff, T., Gibson, D., & O'Connor, M. I. (2022) · Journal of the American Academy of Orthopaedic Surgeons · doi:10.5435/jaaos-d-21-00911 · Cited by 3 · see citing works
Implementation of a Teleophthalmology Screening Program for Diabetic Retinopathy in New York City
Capellàn, P., Dillon, A. B., Rodriguez, G., Chua, J., Mahrous, M. A., Kovacs, K. D., Tassel, S. H. V., D’Amico, D. J., Kiss, S., & Orlin, A. (2023) · Journal of VitreoRetinal Diseases · doi:10.1177/24741264231208253 · Cited by 3 · see citing works
Carcone, A. I., Holtz, B., Reardon, M., Vesey, D., Ellis, D. A., & Parks, M. (2024) · JMIR Formative Research · doi:10.2196/55650 · Cited by 2 · see citing works
Patterns of Complementary Therapy Use for Symptom Management for Older Rural Adults With Diabetes
Bell, R. A., Quandt, S. A., Grzywacz, J. G., Neiberg, R. H., Altizer, K. P., Lang, W., & Arcury, T. A. (2012) · Journal of Evidence-Based Complementary & Alternative Medicine · doi:10.1177/2156587212463070 · Cited by 3 · see citing works
Bhagra, S., Ducharme‐Smith, A., Juntunen, M. B., Liedl, C. P., Golembiewski, E. H., Sundt, W. J. S., Krpata, T. S., Lampman, M. A., Espinoza, A. L., & McCoy, R. R. (2025) · PLoS ONE · doi:10.1371/journal.pone.0322177 · Cited by 3 · see citing works
Identifying priority and bright spot areas for improving diabetes care: a geospatial approach
Topmiller, M., Mallow, P. J., Shaak, K., & Kieber-Emmons, A. M. (2021) · Family Medicine and Community Health · doi:10.1136/fmch-2021-001259 · Cited by 3 · see citing works
- Authors
- Hale, N. L., Bennett, K. J., & Probst, J. C.
- Affiliations
- University of South Carolina (US)
- Corresponding author
- Hale, Nathan L.
- Venue
- Journal of Community Health
- Published
- 2010-04-14
- Volume
- 35
- Issue
- 4
- Pages
- 365-374
- ISSN
- 0094-5145 (ISSN-L)
- 1573-3610
- OpenAlex
- W1982328152
- Cited by
- 132
- References
- 36
- Citations by year
- 2026: 3 · 2025: 15 · 2024: 13 · 2023: 12 · 2022: 17 · 2021: 13 · 2020: 8 · 2019: 7 · 2018: 7 · 2017: 8 · 2016: 6 · 2015: 3 · 2014: 4 · 2013: 2 · 2012: 10
- FWCI
- 3.87
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of Community Health (publishedVersion)
- PubMed (publishedVersion)
- Scholar Commons (University of South Carolina) (submittedVersion)
- Funders
- Health Resources and Services Administration
- U.S. Public Health Service (U1CRH03711)
- Office of Rural Health
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetic Foot Ulcer Assessment and Management
- Keywords
- diabetes management, urban-rural differences, rural health, diabetes self-management education, diabetic retinopathy, foot ulcer, HbA1c testing, dilated eye examination, foot examination, travel barriers, nonmetropolitan counties
- MeSH terms
- Adolescent, Adult, Aged, Cross-Sectional Studies, Diabetes Mellitus, Female, Humans, Male, Middle Aged, Rural Health, United States, Urban Health, Outcome Assessment, Health Care, Rural Health Services, Urban Health Services, Behavioral Risk Factor Surveillance System, Healthcare Disparities, Young Adult
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