Purpose: Access to health care supports both individual and population health. Ample research demonstrates access barriers faced by rural residents and people with disabilities; however, less research has examined access barriers for rural residents by disability status or explored differences across multiple types of access barriers. This brief report addresses this gap by examining 11 financial and nonfinancial barriers to accessing health care among rural adults by disability status. Methods: Using nationally representative data from the 2022 National Health Interview Survey and focusing on rural adults (n = 4,703), we conducted bivariate and multivariate logistic regression analyses comparing 11 separate access barriers by disability status and generated adjusted predicted probabilities of experiencing these barriers, controlling for sociodemographic characteristics. Findings: Overall, compared to those without disabilities, rural people with disabilities had significantly higher adjusted predicted probabilities of 8 of the 11 access barriers. These include delaying multiple types of care due to cost, not being able to afford prescriptions, and delaying care due to facility hours, insurance acceptance, transportation, and travel time. Rural people with disabilities were, however, more likely than their nondisabled counterparts to report having a usual place for care. Conclusions: Rural individuals with disabilities face more barriers to care than their peers without disabilities, including delaying care, which can potentially worsen health outcomes. Our findings provide important information for policymakers to improve access to care at the intersection of rurality and disability.

Purpose: Social/emotional support can help to buffer the health and financial impacts of health care costs. However, little research examines differences in social/emotional support as it relates to health care affordability, and even less examines these issues by rurality despite rural/urban differences in health and health care access. This study addresses these gaps by examining differences in social/emotional support and health care affordability issues among rural and urban adults.Methods: Using weighted data from the 2020 and 2021 National Health Interview Survey (n = 44,987), we examined differences in three health care affordability issues: worry about medical bills, problems paying medical bills, and inability to pay medical bills. We conducted bivariate and multivariate logistic regression analyses comparing these issues by rurality, social/emotional support, and other sociodemographic and health characteristics, generating adjusted odds ratios and predicted probabilities of these issues.Findings: Rural residents were more likely to report problems paying and inability to pay medical bills (13.0% vs. 10.2%, p < 0.001; 8.2% vs 6.2%, p < 0.001). Sociodemographic and health covariates were differentially associated with adjusted odds of health care affordability issues, while low social/emotional support was associated with higher adjusted odds and adjusted predicted probabilities of all three health care affordability issues in both rural and urban areas.Conclusions: Low social/emotional support is associated with higher odds and predicted probabilities of all health care affordability issues regardless of rurality. Future policy aimed at reducing medical debt in rural areas should consider the beneficial impacts of social/emotional support.

Rural and urban areas differ in terms of age structure, health outcomes, and access to resources, but there is limited research on rural-urban differences in elder mistreatment. This study addresses that gap. We used data from Round 3 of the National Social Life, Health & Aging Project (NSHAP) survey ( n = 2,333) to examine rural-urban differences in rates of 11 indicators of elder mistreatment, overall and by individual indicators. We conducted logistic regression models and generated predicted probabilities adjusting for sociodemographic and social well-being characteristics. Elder mistreatment was less common among rural than urban older adults (adjusted predicted probability 41.5% vs. 49.5%, P < 0.01). Rates were also higher for urban older adults for nearly every individual indicator of mistreatment. Rates of elder mistreatment were high (>40%) for both rural and urban older adults, but urban older adults faced a greater risk, requiring attention to urban risk and rural resilience.

Shorter leukocyte telomere length (LTL) is an aging biomarker and risk factor for aging‐related diseases, including abdominal aortic aneurysm (AAA). This study aimed to identify plasma proteins causally associated with LTL and investigate their roles in linking LTL to AAA. A proteomics analysis was conducted for LTL and a polygenic risk score (PRS) for LTL using 4955 plasma proteins by SomaScan in self‐identified White participants ( N = 7587–8055) from the Atherosclerosis Risk in Communities (ARIC) study. Replications were evaluated in self‐identified Black participants ( N = 1668–2094) from ARIC and White participants ( N = 2333–2431) from the Cardiovascular Health Study (CHS). Mendelian randomization (MR) analysis assessed causality between LTL and proteins. Survival and mediation analyses explored protein‐mediated associations between LTL and AAA risk. In ARIC White participants, 15 unique proteins were identified for LTL or LTL PRS. Three LTL‐associated proteins (MZB1, PLOD3, COL28A1) replicated in ARIC Black participants, and six (TNFRSF17, MZB1, CHL1, GDF15, THPO and PLOD3) in CHS White participants. Three proteins associated with LTL PRS (THPO, GP1Bα, PEAR1) replicated in CHS White participants. MR analysis supported causal associations between LTL and five proteins (KDR, TNFRSF17, GDF15, ST3GAL6, CHL1) with all except GDF15 being novel to LTL. LTL was associated with AAA risk (HR = 0.873, 95% CI: 0.803–0.950), with GDF15 mediating 12.4% of this association ( p = 0.028). We identified five proteins causally influenced by LTL and highlighted GDF15 as a mediator linking LTL to AAA risk, offering novel insights into aging biology and AAA pathogenesis.