New Rural Health Research Publications: Impact of Community Voice and Rethinking "Rural"

4 days ago | Jasmine Souers | @jasminesouers

The Mayo Clinic Center for Clinical and Translational Science Rural Health Research (RHR) Core works alongside people who know rural life best to make research meaningful and improve health for everyone in rural communities. By partnering with our Midwest Rural Health Research (MWRHR) Community Advisory Board (CAB) members, researchers, and RHR Core Faculty, the people involved in community-engaged research aim to ensure that studies reflect real needs and find ways technology can contribute to improved health outcomes in rural communities.

The impact of community voices in rural health research

When it comes to improving healthcare in rural communities, listening matters. in collaboration with several MWRHR CAB members, Tabetha Brockman, assistant professor of psychology in the Department of Psychiatry and Psychology at Mayo Clinic and program manager for CCaTS Rural Health Research Core, recently published a paper in the Journal of Clinical and Translational Science that shows just how powerful community input can be in shaping research that truly meets local needs.

Why this matters

About 66% of Mayo Clinic Health System patients live in rural areas across Minnesota, Wisconsin, and Iowa—compared to only 16% of the U.S. population overall. Rural communities face unique challenges, from fewer healthcare options to digital connectivity issues. The MWRHR CAB was created in 2023 to incorporate community voices into the research process.

First year strides

In the first year of the CAB’s establishment, 13 researchers presented their projects to the CAB, and the feedback was transformative. In fact, every researcher surveyed said CAB input influenced multiple parts of their work, especially study design, early planning, and implementation.

Here are some real-world examples of impact:

Better recruitment strategies: CAB members suggested creative ways to reach participants—through schools, churches, and local organizations— researchers hadn’t considered.

Improved study tools: Interview questions were revised based on CAB feedback, making them more relevant and respectful.

Smarter communication: CAB members recommended alternative outreach methods, such as email, to connect with potential participants.
Grant writing support: Researchers found CAB insights invaluable for proposals, especially around community engagement and dissemination plans.

One researcher summed it up perfectly: “This was so very valuable for me! CAB members helped me think about recruitment avenues I hadn't considered. This has proven incredibly fruitful and useful!”

Looking ahead

The study highlights that CAB input is most influential early in the research process, but there’s room to grow—especially in areas like data analysis. Involving community voices even before data is collected can lead to more meaningful, population-centered results.

The takeaway

Community Advisory Boards aren’t just a nice idea—they’re a gamechanger. They help researchers design studies that reflect real-world needs and ensure rural communities have a seat at the table.

CAB members also emphasized building relationships and trust—meeting people where they are and showing commitment to the community. This advice is shaping not just individual studies but the overall approach to rural health research.

Rethinking the definition of ‘rural’ health

When discussing differences in health outcomes for rural communities, a common challenge is a shared definition of “rural.” A recent commentary, Redefining Rurality: Adopting an Identity-Based and Community-Engaged Approach to Defining Rural Cancer Disparities, published in JNCI: Journal of the National Cancer Institute challenges the way we’ve been defining rural communities—and why that matters for cancer care and beyond.

Why this matters

Rural health disparities in the U.S. remain poorly understood. One reason? Current definitions of “rurality” rely heavily on geography and census data, which can miss the real story. These classifications often ignore the cultural diversity, intersectional identities, and lived experiences of rural residents. And when definitions fall short, so do solutions.

What the researchers propose

Researchers Trevor Kauer, Ph.D., Courtny Franco, Ph.D., Janice Krieger, Ph.D., and colleagues, argue for a more holistic approach—one that combines community-based participatory research (CBPR) with identity-based frameworks. Instead of just mapping zip codes, this approach asks:

How do people self-identify as rural?

What social determinants of health shape their lives?

What local knowledge can guide better interventions?

As one panelist at the 2024 Transforming Community and Rural Healthcare conference put it: “Nothing about us, without us, is for us.” In other words, rural communities must have a voice in defining what rural means.

Why the old system falls short

Geophysical and census-based metrics are convenient—but they can misrepresent rural populations and even perpetuate disparities in cancer care access, outcomes, and policy. Treating rural communities as a monolith ignores differences in culture, resources, and identity.

A new way forward

The commentary calls for integrating traditional rural-urban index systems with community-engaged, identity-based approaches. This shift would allow researchers and policymakers to design interventions that reflect the real needs of dynamic rural communities, rather than one-size-fits-all solutions.

The takeaway

Defining rurality isn’t just an academic exercise—it’s a critical step toward equity in cancer care and other health services. By centering rural voices and embracing complexity, we can build policies and programs that truly serve these communities.

Your voice matters: get involved

Rural communities have been underrepresented in healthcare research. Input from people who grew up, live or work in small towns, farming communities, or remote areas helps research teams understand rural life, revealing unique strengths and challenges that shape these communities. Insights are used to improve translational research at all phases and lead to better outcomes in the community. So, who can share input?

Anyone who identifies as rural because of first-hand experience growing up, living or working in a small town, farm country, frontier setting, reservation or other remote community.

Community members from Mayo Clinic Health System areas (southern Minnesota, western Wisconsin, and northern Iowa) – these are considered rural for purposes of the Rural Health Research Core.

Patients from other healthcare systems can still participate in community-engaged research with the Rural Health Research Core.

Rural is defined in various ways for specific grants and funding sources therefore the criteria can change. In the United States, there are three federal agencies that provide commonly used definitions of rural:

Want to check if your address is considered rural? The Am I rural? tool from the Rural Health Information Hub is a resource to determine if your address is considered rural.

To find out more about how you can get involved, email RuralHealthCore@mayo.edu.