ArticleThe Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association2025
A novel approach to incorporate frontier areas into urban-rural geographic classifications: Integrated Metropolitan-to-Frontier Area Codes.
Article in The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Cancer Risk Factors, Screening, and Neighborhood Socioeconomic Deprivation Across the U.S. Urban-to-Frontier Continuum.Journal of the National Cancer Institute. Monographs · 2026Article
- The digital divide in adoption and advanced use of electronic health records among US hospitals: rural versus urban disparities from 2008 to 2023.Journal of the American Medical Informatics Association : JAMIA · 2026Article
- A novel approach to incorporate frontier areas into urban-rural geographic classifications: Integrated Metropolitan-to-Frontier Area Codes.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
purposeTo develop an urban-rural-frontier classification that integrates urbanicity and geographic remoteness and captures nuances in population and land area distributions invisible in traditional coding schemes, thereby providing a framework to measure health outcomes and access to care across the full urban-to-frontier continuum.
methodsWe created tract-level Integrated Metropolitan-to-Frontier Area Codes (tIMFAC) by combining the US Department of Agriculture's Economic Research Service's Frontier and Remote Area (FAR) codes with Rural-Urban Commuting Area (RUCA) codes, classifying tracts as metropolitan, micropolitan, frontier-micropolitan, small town/rural, and frontier-small town/rural. We compared population and land area distributions and median distances to health care facility types by RUCA, FAR, and tIMFAC, and summarized distances to health care facilities across tIMFAC by Census regions.
findingstIMFAC metropolitan, micropolitan, and small town/rural categories had higher population densities (312, 74, and 27/m
conclusiontIMFAC provides a policy-relevant approach to identifying health differences across the urban-to-frontier continuum, supporting efforts to better understand and address unique rural and frontier health challenges.
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Registered trials
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