Federal definitions of rurality and the impact on nursing research

In rural health research, the measurement of rural residence is commonly dichotomized as urban or rural, even though researchers encourage the use of more descriptive categories to capture rural diversity. Federal categorization schemes for operationalizing rural locations include United States Census Bureau definitions, Office of Management and Budget (OMB) classifications, and categorizations developed by the United States Department of Agriculture (USDA)--Rural-Urban Continuum Codes (RUCC), Urban Influence Codes (UIC), and Rural-Urban Commuting Areas. When categorizing states by rurality, the choice of the measure used influences which states are identified as most rural. We demonstrate this premise in a study of rural home healthcare.