Rural Inequality Research Articles

The impact of internet medical service on rural gender inequality in health opportunity: a cross-sectional study

BackgroundThe increasing popularity of Internet medical service may have alleviated the gender inequality in health opportunity faced by rural women. However, research to ascertain the association between Internet medical service and gender inequality in health opportunity is scarce. This study explored the impact of Internet medical service on gender inequality in health opportunity among rural women and the underlying mechanisms involved.MethodsA multistage stratified cross-sectional survey was conducted across six counties in three provinces in China, yielding 3,108 responses for a 97.13% response rate. The questionnaire was used to collect information on Internet healthcare use, health status, health behaviors, social activities and personal exercise, chronic disease status, and demographic and socio-economic characteristics of the participants. Based on Roemer's theory of equality of opportunity (EOP), we established a decomposition strategy for the fairness gap between genders, which we used for the measurement of the gender inequality in health opportunity Fixed effects models, propensity score matching (PSM), and least absolute shrinkage and selection operator (LASSO) regression were utilized to explore the impact of Internet medical service on rural gender inequality in health opportunity.ResultsOn average, rural women experienced a gender health fairness gap of 1.63. Internet medical service significantly mitigated this inequality (β = -0.0602, P = 0.0002), and this finding remained significant across propensity score matching (PSM) and LASSO regression analyses. Mechanistic analysis revealed that human capital positively moderates this effect (β = -0.0510, P < 0.01), while income (β = 0.0370, P < 0.001) and marital status (β = 0.2039, P < 0.001) have negative moderating effects.ConclusionsBy focusing on gender inequality in the digital era, this study highlights the mitigating role of Internet medical service on gender inequality in health opportunity in rural areas. This study proposes and validates the mechanisms through which Internet medical service alleviates gender inequality in health opportunity, suggesting that human capital amplifies this effect, while high personal income and marital status attenuate this effect. These findings contribute to understanding how the digital age can narrow gender health opportunity equality, providing support for future interventions aimed at promoting health equity and gender equality.

The Rural and Urban China Education Disparities

Abstract: In the last decades, education in China has significantly developed and the majority of Chinese young generations are literate. While the exponential growth in urban adult literacy is a testament to the success of the compulsory education system, it is crucial to acknowledge that rural education has been left behind and marginalized in China. This research delves into the urgent issue of rural education inequality in China. The paper thoroughly investigates the current education problems in rural regions and proposes a solution by adjusting faculty distribution and implementing a national central platform for artificial intelligence classrooms (AIC). These measures aim to address the pressing concern, optimize funding usage, and mitigate inequality in education resources to prevent the urban-rural gap from widening. It is important to note that while implementing these proposals is yet to be completed, this paper provides a theoretical examination of the existing issues. Based on the findings, the study proposes a theoretical AIC model for making a social change of education.

Inequality of rural residents’ income in China since the targeted poverty alleviation strategy: New trends, causes, and policy implications

Poverty and income inequality are problems faced by many countries including China. Since the implementation of Targeted Poverty Alleviation (TPA), absolute poverty has been eradicated, meanwhile, Chinese rural residents' income and inequality have experienced unprecedented new dynamics, but still, very few studies have focused on them. Hence, we attempt to examine the new trends in Chinese farmers' income inequality and to understand its causes during this period. We observe that China's urban-rural income ratio has been shrinking and the urban-rural inequality has been decreasing from 2014 to 2021. The reduction in the Theil index indicates a decrease in the regional inequality of farmers' income as well, and the decline in inter-regional inequality among eight economic zones contributes about 80% to increased equality. These new trends are caused by the fact that, with the TPA, the incomes of rural residents especially that in destitute areas, grew faster than that of urban residents and farmers in prosperous areas. The higher share of non-agricultural industry and agricultural mechanization level have significant positive impact on regional equality of farmers' income, while urban-rural dual structure has significant negative inhibitory effects. The lowest farmers' income and the highest inequality in the Northwest, and the slowest growth in the Northeast deserve more attention in rural Revitalization. From these findings, we propose four policy implications that would be applied to improve Chinese farmers' income equality, govern relative poverty, and achieve common prosperity in the post-poverty era.

Do climate adaptation programmes potentially exacerbate rural inequality? Identifying beneficiaries of a drought mitigation scheme in Maharashtra, India

ABSTRACT The adverse implications of climate change can exacerbate socially uneven distributions of vulnerability. Therefore, climate adaptation programs are maladaptive if benefits are captured by privileged social groups, contributing to heightened socio-economic inequality and leaving the plight of highly vulnerable population segments unaddressed. This paper examines this potential using the case of Birsa Munda Krishi Kranti Yojana, an irrigation subsidy program for Scheduled Tribe farmers administered by the Government of Maharashtra, India. We investigated this scheme in Talasari block, an impoverished rural sub-administrative area 135 km north of Mumbai. The research shows that benefits from the scheme tended to flow towards more well-off agricultural households, notwithstanding checks-and-balances within the program that sought to prioritise the needs of poorer farmers. In turn, these distributional effects contributed to intensified agrarian class stratification by providing more well-off farmers with enhanced capabilities to respond to climate stresses, shedding important conceptual insights into the interplay of climate change and government policy for class mobility within smallholder and tribal populations. The evidence from this paper highlights the imperative for inclusive agricultural development and raises questions about agricultural subsidy programs as policy levers to address climate adaptation.

Party Branch Embeddedness and Urban–Rural Environmental Inequality: Self-Regulation or Pollution Shelter?

With the deepening of environmental governance, the overall environmental quality of the region has been improved. However, internal environmental inequality, especially urban–rural environmental inequality, has continued to come to the fore. Nevertheless, there are still few studies on how to mitigate the increasing urban–rural environmental inequality. On the basis of examining the urban–rural environmental inequality in China’s environmental emission reduction investment dimension, this research verified the impact and mechanism of informal regulatory forces (grassroots party organizations) in alleviating urban–rural environmental inequality. In particular, based on an empirical analysis of data from the Chinese Private Enterprise Survey (CPES) 2006–2014, this study found that (1) investment in environmental management of polluting enterprises in rural areas is significantly lower than in urban areas, and the trend of urban–rural environmental inequality is intensifying; (2) urban–rural environmental inequality is more pronounced at the enterprise level in areas with larger enterprises and greater environmental enforcement and that urban-centered environmental regulatory policies continue to exacerbate urban–rural environmental inequality; and (3) the embeddedness of regional party organizations can narrow the gap between urban and rural environmental protection investment by private enterprises and alleviate urban–rural environmental inequality. The specific pathway is to improve rural enterprises’ social responsibility awareness and policy implementation. Based on the above findings, this paper argues that a gradual break with “urban-centered environmentalism” is the fundamental solution to urban–rural environmental inequality. However, in the current context of limited resources for formal environmental regulation, the power of informal environmental regulation can still mitigate these effects.

Farmland rental participation, livelihood capital, and rural income inequality: evidence from rural China

ABSTRACT Using data from the China Family Panel Studies through a national rural survey, we analysed the effects of farmland rental participation and five types of livelihood capital on rural household income. We considered different livelihood strategies and applied the sustainable livelihood framework. Additionally, we used a regression-based Shapley-value decomposition method to examine how farmland rental participation and livelihood capital contribute to the rural income gap. Additionally, we investigated whether farmland rental participation is beneficial in reducing rural income inequality. The results show that farmland rental participation can lead to income benefits for the vast majority of farmers. Furthermore, farmland rental participation is not a primary factor contributing to the rural income gap. Household physical, human, and financial capital emerge as the three factors significantly influencing the income gap. The quantile regression results indicate that providing reasonable guidance to the farmland rental market is beneficial for narrowing the rural income gap. Implementing proactive policies aimed at enhancing the human, financial, and social capital of farmers can theoretically contribute to narrowing the rural income inequality.

Stochastic dominance testing of poverty in Mozambique

AbstractNational assessments produced regularly from 1996/97 to 2019/20 provide standard estimates of the evolution of poverty in Mozambique. Stylised facts point to significant reduction in monetary and multidimensional poverty until 2014/15, even though characterised by persistent urban–rural and regional inequalities in several dimensions, followed by worsening deprivation during 2014/15–2019/20. In this paper, we rely on first-order dominance (FOD) methodology to check the robustness of standard poverty estimates while providing deeper insights into what happened in this poverty-stricken country. Our main findings include that the capital city, Maputo, and surrounding areas progressively came to dominate all other provinces in terms of well-being, and the provincial rankings from spatial FOD analysis are very stable over time. Rural areas, mainly those in the northern and central regions, are, with a few exceptions, always at the bottom of the ranking. Moreover, our FOD temporal analysis reveals that 2019/20 dominates, with a high degree of confidence, the results from earlier years, pointing to positive development over time, but with one important exception. The comparison between 2019/20 and 2014/15 is indeterminate, indicating that no significant advancement took place during this period. What stands out is the compelling need for concerted policy action to address the strong and persistent spatial gaps in welfare and poverty, including the capacity to respond effectively to external and internal shocks.

The future of AVS, dizziness, and vertigo in emergency departments Part iii: A tyranny of distance – the persistence of rural health inequity

The future of AVS, dizziness, and vertigo in emergency departments Part iii: A tyranny of distance – the persistence of rural health inequity In the third article of this five-part series, Dr Millie Nakatsuka discusses the impact of isolation on health equity and the medical decision-making for emergency presentations of acute vestibular syndrome (AVS). People in rural and remote areas bear a significantly higher burden of disease and have poorer health outcomes. They have greater socio-economic disadvantage with lower levels of educational attainment, lower rates of employment, lower income and exhibit more health risk factors with markedly increased rates of obesity, tobacco smoking and alcohol consumption.

Queensland Trauma Education (QTE): an innovative simulation program that addresses the needs and barriers of interprofessional trauma care education across a complex landscape.

Effective trauma care requires the rapid management of injuries. Rural and remote areas face inequity in trauma care due to time, distance and resource constraints, and experience higher morbidity and mortality rates than urban settings. A training needs analysis (TNA) conducted with stakeholders across Queensland, Australia, revealed a lack of contextual, accessible and interprofessional trauma education for clinicians. The Clinical Skills Development Service and Jamieson Trauma Institute developed the Queensland Trauma Education (QTE) program to address these concerns. QTE comprises a face-to-face training course and open access to online training resources created and reviewed by trauma experts. QTE also supports local training through a statewide simulation network and free access to simulation training equipment. The aim of this article is to review the QTE program and assess the benefits to clinicians in both the delivery of education and the provision of trauma care. To evaluate the QTE program, a desktop review was conducted. This included analyses of website data, course and website content, and facilitator, stakeholder, participant and user feedback. The data were evaluated using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework, and the program's alignment with the original TNA outcomes was assessed. The results showed that QTE aligns with the identified training needs. Specifically, QTE provides trauma education that is relevant, sustainable, employs best practice, is locally delivered, provides continuous support, is multidisciplinary, multi-platformed, physically accessible and accredited by the Australasian College for Emergency Medicine. The review also highlights how QTE has effectively been reaching its target population, improves knowledge and skills, has become widely adopted, and been implemented and maintained with relative success. The innovative QTE program addresses the previous deficits in trauma education and meets the needs identified in the TNA. The review also reveals further opportunities for continuous improvement and program sustainability.

Socioeconomic and residence-based inequalities in adolescent fertility in 39 African countries

IntroductionDespite the advancement in sexual and reproductive healthcare services and several public health measures aimed at controlling fertility rates, countries in sub-Saharan Africa (SSA) still experience higher adolescent fertility rates than other low-and middle-income countries. This study examined the disparities in adolescent fertility in 39 countries in SSA, focusing on socioeconomic and residence-based dimensions.MethodsThis study involved a secondary analysis of data obtained from 39 recent Demographic and Health Surveys conducted in SSA. The measures of difference (D), ratio (R), population attributable fraction (PAF), and population attributable risk (PAR) were estimated using the Health Equity Assessment Tool (HEAT) software version 3.1 developed by the World Health Organization. The measures: D, R, PAF, and PAR were used to examine the inequalities in adolescent fertility across the socioeconomic and residence-based dimensions.ResultsOut of the 39 countries included in the study, Guinea (D=27.70), Niger (D=27.50), Nigeria (D=23.90), and Côte d’Ivoire (D=23.60) exhibited the most significant residence-based inequalities in the rate of adolescent fertility, with the higher rate observed among adolescents in rural areas. Rwanda was the sole country that showed a slight inclination towards rural inequality in terms of the rate of adolescent fertility, with a value of D = -0.80. The burden of adolescent fertility was disproportionately higher among young women with low economic status across all the countries, exacerbating wealth-based inequities. The countries with the largest absolute discrepancies were Nigeria (D=44.70), Madagascar (D=41.10), Guinea (D=41.00), and Cameroon (D=40.20). We found significant disparities in educational attainment contributing to unequal inequalities in adolescent fertility, particularly among young women who lack access to formal education. Countries such as Madagascar (D=59.50), Chad (D=55.30), Cameroon (D=54.60), and Zimbabwe (D=50.30) had the most significant absolute disparities.ConclusionThis study revealed that young women residing in rural areas, those in households with low economic status and those with limited educational opportunities experience a disproportionately high burden of adolescent fertility across the 39 countries in SSA. The current findings offer valuable information to governmental entities at all levels regarding the need to ensure the provision of equitable, accessible, and dependable sexual and reproductive health services to the populace, particularly for young women. Therefore, the various stakeholders need to enhance the effectiveness of health policies and legislation pertaining to adolescent women living in rural areas, those from economically disadvantaged households, and those with limited or no access to formal education. Such interventions could potentially reduce adolescent fertility rates and mitigate the adverse maternal and child outcomes associated with high adolescent fertility in SSA.

Discussions of Cancer Survivorship Care Needs: Are There Rural versus Urban Inequities?

Rural cancer survivors may face greater challenges receiving survivorship care than urban cancer survivors. To test for rural versus urban inequities and identify other correlates of discussions about cancer survivorship care with healthcare professionals. Data are from the 2017 Medical Expenditure Panel Survey (MEPS), which included a cancer survivorship supplement. Adult survivors were asked if they discussed with a healthcare professional 5 components of survivorship care: need for follow-up services, lifestyle/health recommendations, emotional/social needs, long-term side effects, and a summary of treatments received. The Behavioral Model of Health Services guided the inclusion of predisposing, enabling, and need factors in ordered logit regression models of each survivorship care variable. A significantly lower proportion of rural than urban survivors (42% rural, 52% urban) discussed in detail the treatments they received, but this difference did not persist in the multivariable model. Although 69% of rural and 70% of urban ssurvivors discussed in detail their follow-up care needs, less than 50% of both rural and urban survivors discussed in detail other dimensions of survivorship care. Non-Hispanic Black race/ethnicity and time since treatment were associated with lower odds of discussing 3 or more dimensions of survivorship care. This study found only a single rural/urban difference in discussions about survivorship care. With the exception of discussions about the need for follow-up care, rates of discussing in detail other dimensions of survivorship care were low among rural and urban survivors alike.

New forms of employment: development of take-away delivery and urban–rural wage inequality

PurposeSince smartphones became ubiquitous, online grocery and food purchases through take-away delivery platforms have steadily increased in China. Nevertheless, whether the development of take-away delivery can ameliorate urban–rural wage inequality still requires further analysis. The purpose of this paper is to clarify whether this positive effect exists.Design/methodology/approachThis paper makes estimations based on city and individual levels combining the Chinese Household Income Project (CHIP) 2008, CHIP 2013, CHIP2018 survey data and the take-away delivery site data. At the city level, the Oaxaca-Blinder (O-B) decomposition method is employed to construct wage inequality index of urban and rural labors. At the individual level, this paper analyzes urban–rural wage differentials with high or low formal education level.FindingsThe rapid establishment of take-away delivery sites has resulted in an increase of 52.425 yuan on average in the annual wage of rural labors with low formal education level. When the cumulative number of sites increases by 1 unit, the annual wage inequality index decreases by 0.007 on average. Labors with the characteristics of rural household registration and low education can enjoy more dividends. Through inter-/within-industry decomposition, this paper elaborates formal education, age and cross-industry transfer as the main factors for the improvement of urban–rural wage inequality. Narrowing effect of wage differences between different groups in multiple sample slices also contributes to the mechanism analyses.Originality/valueTo the best of the author’s knowledge, this paper is the first to analyze the impact of take-away delivery development on the urban–rural wage inequality from the perspective of the establishment of take-away delivery sites. This empirical study will enrich the existing theoretical perspectives on urban–rural divide under the emergence of new forms of employment. The results indicate that new forms of employment represented by take-away delivery can not only promote economic growth, but also eliminate urban–rural inequality.

What Explains Inequalities in Telehealth Utilization Among North Carolina Medicaid Beneficiaries?

Background: Increased availability of telehealth can improve access to health care. However, there is evidence of persistent disparities in telehealth usage, as well as among people from minoritized racial and ethnic groups and rural residents. The objective of our work was to explore the degree to which disparities in telehealth use for behavioral health (BH) and musculoskeletal (MSK) related services during the COVID-19 pandemic are explained by observed beneficiary- and area-level characteristics. Methods: Using North Carolina Medicaid claims data of Medicaid beneficiaries with BH or MSK conditions, we apply nonlinear regression-based decomposition analysis-based models developed by Kitagawa, Oaxaca, and Blinder to determine which observed variables are associated with racial, ethnic, and rural inequalities in telehealth usage. Results: In the BH cohort, we found statistically significant differences in telehealth usage by race in the adult population, and by race, Hispanic ethnicity, and rurality in the pediatric population. In the MSK cohort, we found significant inequities by Hispanic ethnicity and rurality among adults, and by race and rurality among children. Inequalities in telehealth use between groups were small, ranging from 0.7 percentage points between urban and rural adults with MSK conditions to 3.8 percentage points between white adults and people of color among those with BH conditions. Overall, we found that racial and ethnic inequalities in telehealth use are not well explained by the observed variables in our data. Rural disparities in telehealth use are better explained by observed variables, particularly area-level broadband internet use. Conclusions: For inequalities between rural and urban residents, our analysis provides observational evidence that infrastructure such as broadband internet access is an important driver of differences in telehealth use. For racial and ethnic inequalities, the pathways may be more complex and difficult to measure, particularly when relying on administrative data sources in place of more detailed data on individual-level socioeconomic factors.

Does rural transformation affect rural income inequality? Insights from cross-district panel data analysis in Bangladesh

Rural transformation plays a crucial role in enhancing the income and employment prospects of the rural labor force. We investigate the effects of rural transformation on rural income inequality at the district level in Bangladesh using data from five years of nationally representative Household Income and Expenditure Surveys. The Gini coefficient is used to measure rural income inequality. In contrast, the share of high-value agricultural outputs and the share of rural non-farm employment are used as indicators of rural transformation. We find that rural income inequality is positively associated with the share of high-value agricultural outputs and the share of rural non-farm employment. The non-linear regression result shows an inverted U-shaped relationship between rural transformation and income inequality, which indicates that income inequality initially increases with rural transformation but decreases in the long run. Additionally, we find that rural income inequality is positively correlated with the proportion of household education expenditures, agricultural rental activity, and the share of remittances. This study also reveals that income inequality in rural areas of Bangladesh has a significant negative correlation with the government's social safety net program.

Rural entrepreneurship and inequality: exploring trends in emerging economies through the lens of Lebanon

Rural entrepreneurship and inequality: exploring trends in emerging economies through the lens of Lebanon

Malt Barley in Twentieth-Century Mexico: The Brewing Industry, Centralized Knowledge, and the Green Revolution

Abstract This article focuses on how Mexico’s brewers, backed by a collaboration of U.S. and Mexican agronomists and officials who together developed the foundations of the Green Revolution, facilitated the centralization of decision-making over new technologies of production in the malt barley industry in the mid-twentieth century. Brewers developed and enforced an extensive contract farming system dominated by a single company that gave them substantial control over the dissemination of new knowledge about seed varieties, but which created an opportunity for profit-seeking intermediaries to assume a primary role in mediating the transfer of these new technologies to small farmers. In doing so, they enabled the consolidation of a brewing triopoly that, while poised for global expansion by the 1980s, contributed to higher levels of rural inequality as it deployed Green Revolution technologies to serve large industry growth. This article therefore examines a key, though often underexplored dimension of the Green Revolution, in particular how urban industry captured new technologies aimed at ending food insecurity to serve mid-century industrialism.

WELFARE AND RURAL WELL-BEING IN POST MAO CHINA (1978-88): A DEBATE

During the first decade of reform (1978-88) there was an impressive economic growth, change in the output growth pattern, shift in the structure of employment, and rise in the income and consumption level of the peasants. The number of those in absolute poverty declined significantly, though rural income inequality, both regionally and intra regionally, even at the village level increased significantly. In this context the question arises: did the growth of income and output per head due to economic reforms accompany a similarly improved performance with regard to non -income indicators of well -being? Based on available literature on rural reforms in post Mao China, this paper examines the debate on the above question. This question assumes importance because China in the pre-reform period had brought remarkable improvements in living conditions including the expansion of life expectancy, reduction infant mortality and illiteracy even with the slow and low growth in per capita income. From the Nolan and Sen it emerges that while policy and institutional changes meant for raising economic growth as well as per capita income were remarkably successful, the same instruments, however, undermined the public provisioning of social goods and services and affected the length and quality of' life of peasants in poorer households for whom market medicated access to health services were proving increasingly difficult. But while the pre-reform Maoist period, had strong egalitarian distributive mechanism in place, the welfare standards and quality of services were too low.

Associations between digital literacy, health literacy, and digital health behaviors among rural residents: evidence from Zhejiang, China

ObjectiveWithin the digital society, the limited proficiency in digital health behaviors among rural residents has emerged as a significant factor intensifying health disparities between urban and rural areas. Addressing this issue, enhancing the digital literacy and health literacy of rural residents stands out as a crucial strategy. This study aims to investigate the relationship between digital literacy, health literacy, and the digital health behaviors of rural residents.MethodsInitially, we developed measurement instruments aimed at assessing the levels of digital literacy and health literacy among rural residents. Subsequently, leveraging micro survey data, we conducted assessments on the digital literacy and health literacy of 968 residents in five administrative villages in Zhejiang Province, China. Building upon this foundation, we employed Probit and Poisson models to empirically scrutinize the influence of digital literacy, health literacy, and their interaction on the manifestation of digital health behaviors within the rural population. This analysis was conducted from a dual perspective, evaluating the participation of digital health behaviors among rural residents and the diversity to which they participate in such behaviors.ResultsDigital literacy exhibited a notably positive influence on both the participation and diversity of digital health behaviors among rural residents. While health literacy did not emerge as a predictor for the occurrence of digital health behavior, it exerted a substantial positive impact on the diversity of digital health behaviors in the rural population. There were significant interaction effects between digital literacy and health literacy concerning the participation and diversity of digital health behaviors among rural residents. These findings remained robust even after implementing the instrumental variable method to address endogeneity issues. Furthermore, the outcomes of robust analysis and heterogeneity analysis further fortify the steadfastness of the aforementioned conclusions.ConclusionThe findings suggest that policymakers should implement targeted measures aimed at enhancing digital literacy and health literacy among rural residents. This approach is crucial for improving rural residents' access to digital health services, thereby mitigating urban–rural health inequality.

Addressing rural energy poverty and rural-urban energy access gap in developing countries: does international remittances matter?

ABSTRACT Alleviating rural energy poverty and inequality in rural-urban energy accessibility is a panacea for rural economic development. Researchers and policymakers have underscored the importance of remittances in socio-economic development; however, the role of remittances on rural energy poverty and disparity in rural-urban energy access remains under-researched area. This study, therefore, investigates whether remittances contribute to enhance rural energy poverty and rural-urban inequality in energy access in 135 developing countries from 2000–2020. Evidence from cross-sectional and endogeneity-corrected results supports that international remittance inflow substantially reduces rural poverty and rural-urban inequality in energy access. The results also indicate that the effect of remittance on rural energy poverty and rural-urban inequality in energy access depends on the state of countries’ financial development and GDP per capita, indicating that remittances alleviate rural energy poverty and inequality in rural-urban energy accessibility in countries with higher access to credit and per capita GDP. We documented that these findings differ across income groups. The policy implications are discussed.

165 Predicting Success: A Mixed Model of KL2 Trainee Profiles and Outcomes

OBJECTIVES/GOALS: Penn State CTSI supports KL2 career development awards for faculty seeking to become leaders in clinical and translational research. CTSAs can benefit from a better understanding of KL2 applicant profiles and trainee outcomes. Predictive modeling of KL2 records provides insights into institutional processes and continuous improvement goals. METHODS/STUDY POPULATION: Collecting KL2 application records at Penn State CTSI from 2017 to 2023, comprising both accepted and not accepted candidate profiles, this study used a generalized logistic mixed model with binomial distribution to understand the factors predictive of KL2 trainee acceptance, (n=47). The following factors were modeled as potentially predictive of scholars’ acceptance: Institution-specific Processes—Campus; Terminal Degree Type; College of Residency, Applicant Demographics and Portfolio—Minoritized or Protected Groups; Mean Application Score; Rurality Focus; Gender, and Outcomes—Post-Program h-index. RESULTS/ANTICIPATED RESULTS: Only Campus and Degree were significant factors predictive of trainee acceptance (r&lt;.0001), with a particular campus and the MD degree-designation both exerting selectional pressures on acceptance rates. Applicant demographics were not significant historical factors in selection despite the most recent trainee cohort comprised of all women. Similarly, while our CTSA focuses on rural inequality and accessibility, a research proposal focused on rurality was not a significant factor for acceptance. Notably, NIH-scaled application scores and post-program h-indices were not significant for accepted and non-accepted applicants. DISCUSSION/SIGNIFICANCE: The absence of applicant-focused selectional pressure is striking—Penn State CTSI does not significantly select for gender, URM, or URP status. Administration is now empowered to intentionally engage, recruit, and retain from our other affiliated campuses and colleges.