Project Summary This project seeks to harness big data in electronic health records to study the impact of increasing access to telemedicine on the health and wellbeing of rural caregivers. Life in rural communities comes with additional barriers to daily activities. Family members may travel hours to make weekly or monthly purchases from big box super stores. Travel time eats away at time for other activities, both paid work and family related. Farm- related family work is often time- and labor-intensive, budgets are often stretched, and household production activities usually require more time. Rural families have less access to restaurants, food preparation programs, food delivery services, and the like. They are less likely to outsource household production tasks like cooking, cleaning, washing clothes, growing food, childcare, and elder care. The compilation of this reality puts disproportionate stress on caregivers in rural communities. Rural caregivers, predominantly women, are vulnerable to exhaustion, increased health issues related to stress, and missing their own preventative care screenings due to the increased burden of care within their households. This was especially true during COVID-19. Using data from the Northeast and Southern regions of the country, the project develops a proof of concept for a future R01 grant to study the dynamics of increasing telemedicine in rural communities in the Midwest. The focus of this project is to document increased access to telemedicine and other remote healthcare options for caregivers during COVID-19 and its effect on the health and wellbeing of caretakers in rural communities. Technological advancements of the past half century have accelerated the use of big data methods to understand major health, economic, and social trends, and the project harnesses electronic health records from major health systems linked to the 2020 Census and American Community Survey (ACS) to analyze differential changes in health service take up and overall health and wellbeing of caregivers and related family members. The project will evaluate what public health policies that can effectively be implemented to support increased access in rural communities, and which types of telemedicine prove particularly helpful in enhancing and increasing the health and wellbeing of caregivers in rural communities.