ArticleJAMA network open2026
Community Resources and Hazards Across the Rural-Urban Continuum.
Article in JAMA network open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Assessing the Relationship Between Multidimensional Area-Level Indicators and Lupus Disease Activity in Children.Children (Basel, Switzerland) · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Importance: Rural-urban differences in health outcomes have worsened over time, yet the variation in exposure to social determinants of health (SDOH), which are key drivers of these outcomes, has not been adequately quantified. Objective: To explore variation in exposure to a sample of beneficial and adverse community-level SDOH across the rural-urban continuum. Design, Setting, and Participants: This cross-sectional study included all residential addresses in Maryland using GPS-Health (Geographic Patterns of SDOH), a 2025 statewide address-level dataset. Main Outcomes and Measures: The straight-line (great-arc) distance to the nearest resource (hospital, federally qualified health center [FQHC], pharmacy, Supplemental Nutrition Assistance Program [SNAP] retailer, civic center, and major roadway) or hazard (gun violence incident, eviction site, and Environmental Protection Agency [EPA]-designated site) was estimated. Addresses were categorized using Rural-Urban Commuting Area codes as urban (1-3), large rural (4-6), small rural (7-9), and isolated rural (10). Linear mixed-effects models estimated adjusted differences by rurality. Results: The study included 2 070 970 addresses: 1 933 793 urban addresses (93.4%), 86 270 large-rural addresses (4.2%), 17 594 small-rural addresses (0.8%), and 33 313 isolated-rural addresses (1.6%). Adults aged 65 years and older were most prevalent in large-rural areas (30.8%), disability was more prevalent in small-rural areas (17.9%), and both were more common in isolated-rural than urban areas (older adults: 27.7% vs 17.1%; disability: 15.6% vs 11.6%). Compared with urban addresses in an adjusted model, isolated-rural addresses were farther from hospitals (estimated difference, 4.22 [95% CI, 3.32 to 5.13] miles), pharmacies (estimated difference, 2.16 [95% CI, 1.54 to 2.80] miles), SNAP retailers (estimated difference, 1.15 [95% CI, 0.83 to 1.47] miles), and civic centers (estimated difference, 1.09 [95% CI, 0.67 to 1.50] miles). FQHCs were closest to large-rural addresses (estimated difference, -2.13 [95% CI, -2.50 to -1.76] miles). Urban addresses were closest to hazards. Conclusions and Relevance: In this cross-sectional study of all residential addresses in Maryland, distance from health-promoting resources increased with rurality, with isolated-rural areas farthest, despite a higher representation of populations with greater health care needs. Our findings support examining rurality as a continuum rather than a dichotomy to better characterize health outcomes and SDOH variation and to inform place-specific interventions.
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