@janprobst.bsky.social

@janprobst

Jan Probst ~ 40 years health services research, mostly into rural issues Guardian of Sam the rural health advoCATe. Bibliography:

1359 Siguiendo2313 Seguidores1097 Publicaciones

Bluesky

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@janprobst.bsky.social@janprobst· Jul 13

Local. From downtown Boston. Riiiggght.

@janprobst.bsky.social@janprobst· Jul 7

Rural counties had higher proportionate drops in ACA Marketplace coverage (about -12%), per Sarah Melotte at @dailyyonder.bsky.social. Urban counties ranged from -6% in the suburbs thru -11% in small metro counties. Grimly shared by Sam the rural health advoCATe. #PowerOfRuralCats

Map of US states, showing drops ranging from -25% in Arizona to =3% in Texas.

@janprobst.bsky.social@janprobst· May 17

Holy Pete. Sam’s guardian checks cites on papers she *reviews,* much less actually coauthors.

Picture of aTabby cat in the sun, mouth open in horror.

@janprobst.bsky.social@janprobst· Apr 28

Sam the rural health advoCATe is proud to to share that South Carolina's own Joni Nelson, PhD will receive the National Rural Health Association's Volunteer of the Year award for 2026. 🏆 Sharing a picture of Dr. Nelson at NRHA (can't remember year). #PowerOfRuralCats

@janprobst.bsky.social@janprobst· Apr 27

Respectfully, sticking to my position that information asymmetry precludes effective markets in healthcare; it should be handled as a regulated utility.

“The elusive character of information asymmetry precludes effective a commodity suggests that it departs considerably from the usual marketability assumptions about markets.
That risk and uncertainty are, in fact, the most significant elements in medical care hardly needs argument. I will hold that virtually all the special features of this industry, in fact, stem from the prevalence of uncertainty.”

@janprobst.bsky.social@janprobst· Apr 14

Sometimes it feels hard to focus on rural health research, or any public health research, when one is unsure that anyone is listening or that any policy changes will be made, muses Sam the rural health advoCATe. Even gorgeous whiskers might not be enough. #PowerOfRuralCats

Closeup of a grey tabby cat with his head pensively resting on his cat tree. Gorgeous white whiskers.

@janprobst.bsky.social@janprobst· Apr 9

Sam the rural health advoCATe shares a new graphic depiction of health care shortages, from the Northeast Rural Health Research Center at the University of Maine. Ambulance gaps make other gaps even worse. #PowerOfRuralCats storymaps.arcgis.com/stories/57e4...

Ambulance Deserts (ADs) and Health Care Deserts (HCDs)
Across 41 states in 2020-2021, 4.5m people live in ADs. In rural areas, 3.7m live in ADs, 2.7m live in HCDs and 1.5m live in AD & HCDs.

@janprobst.bsky.social@janprobst· Mar 28

Someone out there needs a little green frog.

Picture of a small green frog with a white racing stripe.

@janprobst.bsky.social@janprobst· Feb 27

Image: a path next to cleqr mountain lake. The sky is deep blue with a few fluffy clouds. Clouds and the mountain forests are reflected in the lake. #RMNP

@janprobst.bsky.social@janprobst· Feb 15

Angrily shared by Sam the rural health advoCATe. While lip service is given to finding a replacement, most ZCTAs in this service area had no or only 1 provider back in 2020. Yet another slice of rural care taken away. #PowerOfRuralCats www.beckershospitalreview.com/finance/trin...

Map of the US at the ZCTA level, indicating the number of facilities reporting that they serve patients in that ZIP Code. Note that large area of North Dakota and Montana are served by a single provider or no provider at all.
Source: 5. Probst JC, Yell N, Benavidez G, Hung P, Crouch E. Benefits for some: are rural hospice gaps ethical? Poster presentation, National Rural Health Association Annual Meeting, May 2023.

@janprobst.bsky.social@janprobst· Feb 5

Sam's guardian received the note below from a reporter with whom guardian had been working on a rural story. Sam the rural health advoCATe is hissed. Not the first to note this, but: When he is tired of a toy, Sam ignores it; he doesn't destroy it. #PowerOfRuralCats

Unfortunately, I was part of the Washington Post's layoffs yesterday. I know I was speaking with some of you for stories. I was hoping to follow up with many more of you.

@janprobst.bsky.social@janprobst· Jan 28

Altho it's not on their web site, sighs Sam the rural health advoCate, Preventing Chronic Disease has a new call for papers on rural health. Share your solutions! #PowerOfRuralCats

Improving Rural Health: Solutions for Persistent Rural Public Health Challenges

Public health challenges have been documented in rural geographic areas and remain barriers to delivering public health, clinical, and allied health services to communities in these areas. These challenges include limited health care access, excessive tobacco use in economically poor counties, limited physical activities, and high prevalences of behavioral and mental health conditions and chronic diseases. PCD welcomes manuscripts that will help advance the discourse on public health solutions to persistent conditions that exacerbate poor health outcomes in rural settings. Example topics include

Community–clinical linkages to improve population health in rural settings.
Community engagement efforts to improve child and adolescent health.
Community engagement approaches to address chronic disease prevention.
Community health workers to address access to care in rural settings.
Opportunities and challenges for rural local health departments to improve population health in rural settings.
Submission Due Date: Monday, June 15, 2026

@janprobst.bsky.social@janprobst· Jan 22

Fungi and lichens in a decaying log of a forest floor.

@janprobst.bsky.social@janprobst· Jan 19

Timeline cleanse.

Little brown lizard with cute little toes on a bright yellow flower.

@janprobst.bsky.social@janprobst· Jan 17

@janprobst.bsky.social@janprobst· Jan 16

Sam the rural health advoCATe shares Mark Holmes' (Sheps Center) analysis of state Rural Health Transformation proposals. 25 state proposals include CME on nutrition. This is astonishingly cynical given the absence of both providers and stores in rural. (sources in comments) #PowerOfRuralCats

RHTP state policy actions:
25 states Nutrition CME
25 states Presidential Fitness Test
21 states SNAP Waiver
19 states Interstate compacts
11 states Scope of practices
7 states CON regulations

Map showing percent of persons in rural counties who are low income and have limited access to a grocery store (≥ 10 miles).

Map showing the proportion of residents of rural counties who both receive SNAP and have low access to grocery stores.

Map of the US highlighting the Health Professional Shortage Areas (HPSAs) primary care scores for each county in the US. 63% of primary care HSPAs are rural.

@janprobst.bsky.social@janprobst· Jan 15

Of note, a different SC legislator asked for a light sentence, so May could spend time with his children while they are young.

@janprobst.bsky.social@janprobst· Jan 5

National Bird Day.

Image of a small bird, black wings head and beak, white chest, looking back over its shoulder while perched on a pole.

@janprobst.bsky.social@janprobst· Jan 2

Sam the rural health advoCATe posts his hope for a good year for rural America. One in which equity replaces urbanism and good things happen for rural people. #PowerOfRuralCats

A two lane road stretches from the foreground to the distance, with hills on the left and sunny grazing land in the center/right.

@janprobst.bsky.social@janprobst· Dec 25

Sam’s guardian received this from a former mentee this morning. Guardian has the *best* formers, full stop.

@janprobst.bsky.social@janprobst· Dec 20

Student accomplishment:

Paper entitled “the impact of rural hospital closures and mergers of health system ecologies: a scoping review” is noted to be among the top 1% of article views by the journal Medical Care Research and Review.

@janprobst.bsky.social@janprobst· Dec 9

Sam the rural health advoCATe welcomes this restatement of the problems facing rural. This is a good time for all rural cats to be alert regarding possible loss of health care facilities, and social safety nets that promote health, in rural America. #PowerOfRuralCats

Face of a grey tabby cat, looking alarmed

@janprobst.bsky.social@janprobst· Dec 8

WaPo has an excellent article outlining the effects of H-1B fees for rural. Couldn’t get it to share, apologies Sam the rural health advoCATe. Maybe the author can help. @davidovalle.bsky.social @whitneyzahnd.bsky.social #PowerOfRuralCats

Headline: the new H-1B visa fee is upending health care in rural America.

@janprobst.bsky.social@janprobst· Dec 7

Sam the rural health advoCATe totally understands about cats ignoring complex survey design ... and adds that he is also freaked by people who can't define rural adequately.

Picture of a tabby cat, sitting up but with one paw held over his face.

@janprobst.bsky.social@janprobst· Dec 5

Rural micropolitan counties have towns. These towns in no way match what most folks think of as "urban," while they meet certain Census definitions. The picture below contrasts screen grabs from a town in a rural county and Rockville, MD.

The picture on the left shows a single level small store with a pickup next to it and 3-story building in the background. The picture on the right shows a very large building of approximately 10 stories, with a taller (20 story) building in the background.

@janprobst.bsky.social@janprobst· Dec 4

Timeline cleanse. Sam the rural health advoCATe takes music practice very seriously.

@janprobst.bsky.social@janprobst· Dec 1

@janprobst.bsky.social@janprobst· Nov 27

Sam the rural health advoCATe loves veterans and loves analyses that include rurality. However, the definitions documented in this study appear incorrect (screenshot). RUCAs 1.0 - 3.0 are urban, per ERS/USDA. #PowerOfRuralCats jamanetwork.com/journals/jam...

Census tracts with rural-urban commuting codes of 1.0 or 1.1 are characterized as urban. …tracts coded 10.0 are highly rural

@janprobst.bsky.social@janprobst· Nov 24

Yep,

Picture of a grey tabby cat looking downcast.

@janprobst.bsky.social@janprobst· Nov 18

Sam the rural health advoCATe is cheering these new Rural Health Fellows! Remember to offer a toast to each of them on National Rural Health Day, this Thursday, November 20. @ruralhealth.bsky.social #PowerOfRuralCats www.ruralhealth.us/blogs/2025/1...