AzCRH Studies & Reports
- Arizona Critical Access Hospitals: Community Health Needs (March 2022)
- Rurality is Associated with Increased Drive Times to Opioid Treatment Programs in Arizona (May 2021)
- The Arizona Behavioral Health Workforce (Nov. 2020)
- Arizona Workforce Report: Obstetrician-Gynecologist Physicians and Certified Nurse Midwives (Jan. 2020)
- Rural Availability of the Obstetrician & Gynecologist and Certified Nurse Midwife Workforce (Jan. 2020)
- Maternal Health Begins Where Moms Live, Learn, and Work (Oct. 2019)
- Arizona Primary Care Physician Workforce Report (Oct. 2019)
- Creating an Arizona Health Workforce Data System
- 2016 Arizona Statewide Emergency Medical Services Needs Assessment (ASENA)
- Arizona County Health Insurance Coverage Profiles - 2017
- AzCRH 2015 Supply and Demand Study of Arizona Health Practitioners and Professionals
- AzCRH 2015 Safety Net Health Care in Arizona Report
- AzCRH 2015 Arizona Pharmacist Supply and Demand Report
- Rural Behavioral Health Review
- Rural Health Plan 2005-2007
- National Community Health Advisor Study
- Arizona Rural Health Workforce Study
- Four U.S. Border States' Community Health Worker Training Needs Assessment
- Pima County Women's Health Review
- Socioeconomic Impact of Mandated Health Coverage for Telemedicine
- Building Partnerships to Leverage Available USDA Resources for Rural Providers
- Arizona Community Leader Focus Group Report
- MEZCOPH Collaborations at the U.S.-Mexico Border (2010-2012)
- MEZCOPH Rural Health Professions Program Annual Report (2012)
- The Supply of Physician Assistants, Nurse Practitioners, and Certified Nurse Midwives in Arizona (June 2014)
Rurality is Associated with Increased Drive Times to Opioid Treatment Programs in Arizona
Medication-Assisted Treatment (MAT) is considered an effective treatment for Opioid Use Disorder (OUD). Historically, MAT was only available at Opioid Treatment Programs (OTPs), which limited MAT availability and posed a barrier to access, especially for rural residents. Since 2002, the DEA has allowed waived physicians to prescribe OUD medication from office-based locations. The analysis compares drive times to OTPs with FQHCs to explore how MAT availability at primary care Federally Qualified Health Centers (FQHCs) in Arizona may increase rural access. We found that in urban centers, drive times are essentially the same (about 10 minutes) to reach OTPs and FQHCs. In remote, rural areas, it takes twice as long to reach an OTP (86 minutes) vs. an FQHC (44 minutes). We also found that MAT provision at FQHC locations could increase access to care in rural areas by reducing drive-time barriers.
The Arizona Behavioral Health Workforce Report is intended to inform Arizona health workforce policies to support a well-distributed and accessible behavioral health workforce. It has two aims: (1) describe behavioral health and access to behavioral healthcare in Arizona, and (2) use workforce data to describe rural and non-rural differences in the distribution of Arizona behavioral healthcare providers. Mental health and substance use disorders contribute to disease burden in the US and are among the leading causes of death. Prevention, early identification, screening, and access to high-quality treatment are public health priorities. Arizona meets just 40% of its current mental health care workforce needs and ranks 47th in in terms of behavioral health workforce availability. There are disparities in workforce across urban and rural areas in Arizona. The behavioral health workforce as measured by provider per 100,000 population ratio is four to five percent higher than the percent of the population living in urban areas than in rural areas for all professions except substance abuse counselors. Psychiatrists mostly practice in urban areas (96.7%), also exceeding the percent of the population living in urban areas (92%) by almost five percent.
A high-quality maternal health care system relies in part on the right number of well-trained women’s health providers in the right locations (Rayburn, 2017; U.S. Department of Health and Human Services, Health Resources and Services Administration, 2016). According to national estimates, Arizona and other states are anticipated to experience an ob-gyn shortage (U.S. Department of Health and Human Services, Health Resources and Services Administration, 2016). Using licensure data, we found that there are geographic disparities in the distribution of ob-gyn physicians across Arizona. The ratio of ob-gyns per 10 000 women in urban areas is 2.1, compared to 1.5 in large rural city/towns and 1.1 in small rural towns. There are no practicing ob-gyn physicians in isolated small rural towns. This geographic distribution is mirrored in the CNM workforce, which similarly favors urban over rural areas.
Women’s and maternal health begins where women live, learn and work. Access to timely and high-quality women’s health and primary care services is also an essential component of a supporting maternal health. According to the March of Dimes, Greenlee and La Paz counties are maternal care deserts and Cochise, Gila, Graham, and Santa Cruz counties have limited access to maternal care. Women in rural Arizona face barriers to maternal health care including a lower ratio of Ob-gyn providers per population. In general, women in rural areas have additional barriers like longer drive-times and fewer facilities offering obstetric services.
Women’s and maternal health begins where women live, learn and work. Access to timely and high-quality women’s health and primary care services is also an essential component of a supporting maternal health. According to the March of Dimes, Greenlee and La Paz counties are maternal care deserts and Cochise, Graham Pinal, and Santa Cruz counties have limited access to maternal care. Women in rural Arizona face barriers to maternal health care including a lower ratio of Ob-gyn providers per population. In general, women in rural areas have additional barriers like longer drive-times and fewer facilities offering obstetric services.
The Association of American Medical Colleges (AAMC) publishes an annual snapshot of the physician workforce by state using American Medical Association (AMA) Physician Masterfile data. This report aims to provide data on the distribution of the physician workforce and the differences in the distribution of physicians by training location and specialty. This data can assist in efforts to ensure that Arizona develops programs and policies that build a health care system that addresses the needs of all communities.
Creating an Arizona Health Workforce Data System
To assure ready access to high quality health care for all Arizonans, timely, unbiased, accurate health professions data can help inform policy, legislative, and regulatory interventions. The Health Services Resources Administration (HRSA) recommends that states routinely collect health workforce data at the time of licensing and renewal using standard minimum data sets (MDS) to more accurately capture clinical full time equivalent capacity and ability to meet demand across the state. North Carolina has an health care workforce data collecting and reporting system that could serve as a model for Arizona.
Emergency Medical Services (EMS) is an institution and product of public health, health care, and public safety that is chopped and scattered across multiple jurisdictional deployment methodologies throughout Arizona. To fully-asses the EMS needs of the state, those jurisdictions are considered as a whole; for it is the whole that makes a system, and a system is what truly impacts patient outcomes. Evaluating the "whole" is the genesis and driver of the 2016 Arizona Statewide EMS Needs Assessment (ASENA).
The primary objective of ASENA is to establish a current "snap-shot" of EMS in the state while simultaneously identifying needs and/or areas that can be targeted for further analysis and/or improvement as part of Population Health Management and Emergency Medical Services Integration under the AZ Flex Grant funded by the U.S. Health Resources and Services Administration (HRSA). In addition, the secondary objective of ASENA is to compare and contrast this current "snap-shot" with data obtained in a more narrow needs assessment conducted in 2001, allowing comparison of changes in Arizona's critical access EMS system over 15 years. » Learn more/download PDF
The Arizona Center for Rural Health (AzCRH) has created Arizona County Health Insurance Coverage Profiles to provide timely public health data to inform policymakers, stakeholders, health providers, and the public. Profiles include data about current health insurance coverage and other public health data including national, state and county level data. In addition, AzCRH posted an overview of the U.S. health system, and implications of health reform deliberations at the state and federal levels relating to legislation, regulation, program implementation and evaluation. The overview will be updated as new information becomes available.
The Women’s Health Review was initiated to identify health issues and concerns that are specific to women who live in Pima County and/or Tucson with a particular interest in sexual and reproductive health needs.
This report provides background information on telemedicine, its effectiveness and applications with an analysis of the expected impact of mandated telemedicine health coverage on telemedicine in Arizona.
On behalf of the National Organization of State Offices of Rural Health, an in person community leader focus group was organized as a pre-session to the annual 2012 Arizona statewide rural health conference.
Mel and Enid Zuckerman College of Public Health Collaborations at the U.S.-Mexico Border (2010-2012)
One of the strongest areas of focus of the University of Arizona’s Mel and Enid Zuckerman College of Public Health is our collaboration with communities to strengthen the public health infrastructure in the U.S.-Mexico border region. This report highlights the numerous partnerships and collaborations in the region.
The overall goal of the Rural Health Professions Program is to increase the numbers of public health students who practice in rural and underserved communities in the state of Arizona. This report covers the program activities in 2012.
As the Patient Protection and Affordable Care Act (ACA) coverage provisions are progressing, demand for health care is growing. This report estimates the supply of physician assistants (PAs), nurse practitioners (NPs), and certified nurse midwives (CNMs) as crucial components of the state’s health provider capacity. The study used licensing board data, training and graduation numbers from PA and NP colleges, and interviews with providers. The study calculates Arizona’s provider to population ratio, compares it to the national average, reports the number of PA, NP, and CNM providers attending Arizona schools by specialty and primary care, and estimates the number needed in Arizona to meet national benchmarks.