School Enrollment among Urban Non-Slum, Slum and Rural Children in Kenya: Is the Urban Advantage Eroding?

ERIC Educational Resources Information Center

Mugisha, Frederick

2006-01-01

For long now, the urban child has been considered to be more likely than his/her rural counterpart in being able to realize the dream of fully participating in school. This observation has mainly been attributed to what is commonly known as the "urban advantage." This "urban advantage" is associated with increased access to…

From the litter up and the sky down: Perspectives on urban forest structure and eco-hydrological processes (presentation)

EPA Science Inventory

The structure of the urban forest represents the complex product of local biophysical conditions, socio-economic milieu, people preferences and management with rare counterparts in rural forests. However, urban forest structure, as similarly observed in rural forests, affects key...

Prevalence of Obesity among Adults from Rural and Urban Areas of the United States: Findings from NHANES (2005-2008)

ERIC Educational Resources Information Center

Befort, Christie A.; Nazir, Niaman; Perri, Michael G.

2012-01-01

Purpose: Rural residents have higher rates of chronic diseases compared to their urban counterparts, and obesity may be a major contributor to this disparity. This study is the first analysis of obesity prevalence in rural and urban adults using body mass index classification with measured height and weight. In addition, demographic, diet, and…

The patterns of refractive errors among the school children of rural and urban settings in Nepal.

PubMed

Pokharel, A; Pokharel, P K; Das, H; Adhikari, S

2010-01-01

The uncorrected refractive error is an important cause of childhood blindness and visual impairment. To study the patterns of refractive errors among the urban and rural school going children of Nepal. A total of 440 school children of urban and rural schools within the age range of 7-15 years were selected for this study using multi-stage randomization technique. The overall prevalance of refractive error in school children was 19.8 %. The commonest refractive error among the students was myopia (59.8 %), followed by hypermetropia (31.0 %). The children of age group 12-15 years had the higher prevalence of myopia as compared to the younger counterparts (42.5 % vs 17.2 %). The prevalence of myopia was 15.5 % among the urban students as compared to 8.2 % among the rural ones (RR = 1.89, 95 % CI = 1.1-3.24). The hypermetropia was more common in urban students than in rural ones (6.4 %) vs 5.9 %, RR = 1.08 (95 % CI: 0.52-2.24). The prevalence of refractive error in the school children of Nepal is 19.8 %. The students from urban settings are more likely to have refractive error than their rural counterparts. © Nepal Ophthalmic Society.

Variation In Rural Health Information Technology Adoption And Use.

PubMed

Heisey-Grove, Dawn M

2016-02-01

While rural hospitals and physicians have adopted health information technology at the same, or greater, rates as their urban counterparts, meaningful-use attestation varies dramatically among rural providers. Also, rural providers are more likely to skip a year of declaring that they have met meaningful-use requirements, putting them at a financial disadvantage compared to urban providers. Project HOPE—The People-to-People Health Foundation, Inc.

Assessment of intake inadequacy and food sources of zinc of people in China.

PubMed

Ma, Guansheng; Li, Yanping; Jin, Ying; Du, Songming; Kok, Frans J; Yang, Xiaoguang

2007-08-01

To assess the intake inadequacy and food sources of zinc of people in China. Diets of 68 962 subjects aged 2-101 years (urban 21 103, rural 47,859) in the 2002 China National Nutrition and Health Survey were analysed. Dietary intake was assessed using 24-hour recall for three consecutive days. Zinc intake inadequacy was calculated based on values suggested by the World Health Organization. The median zinc intake ranged from 4.9 mg day- 1 (urban girls, 2-3 years) to 11.9 mg day-1 (rural males, 19+ years). The zinc density of urban residents (2-3 to 19+ years) was 5.0-5.3 mg day-1 (1000 kcal)-1, significantly higher than that of their rural counterparts (4.7-4.8 mg day-1 (1000 kcal)-1). Differences in food sources of zinc from cereal grains (27.4-45.1 vs. 51.6-63.2%) and animal foods (28.4-54.8 vs. 16.8-30.6%) were found between urban and rural residents. Zinc from vegetables and fruits (8.2-13.8 vs. 9.7-12.4%) and legumes (1.3-3.3 vs. 2.5-3.4%) was comparable between urban and rural residents. The proportion of zinc intake inadequacy ranged between 2.8% (urban females, 19+ years) and 29.4% (rural lactating women). Rural residents had higher proportions of zinc intake inadequacy than their urban counterparts. Significantly higher proportions of zinc inadequacy were found in the category of phytate/zinc molar ratio >15 for both rural and urban residents. About 20% of rural children are at risk of inadequate zinc intake, with phytate as a potential important inhibitor. Moreover, lactating women are also considered a vulnerable group.

Sexual behavior of in-school adolescents in Osun State, Southwest Nigeria: a comparative study.

PubMed

Sabageh, Adedayo O; Fatusi, Adesegun O; Sabageh, Donatus; Aluko, Joel A

2014-01-01

The sexual and reproductive health of adolescents is of utmost importance in many nations (especially in developing countries). Sexual behavior varies from location to location and the outcome (when negative) creates great concerns mainly due to the consequential impact on health and development. This study aimed at comparing sexual behavior of in-school adolescents in rural and urban areas of Osun state. A comparative cross sectional study was conducted. A total of 760 in-school adolescents were recruited using multistage sampling technique. Pre-tested questionnaires were administered after ethical considerations. Data were analysed and p-value was placed at 0.05. A total of 380 rural and 380 urban adolescents participated in this study with a mean age of 14.90 ± 2.44 and 14.34 ± 2.31 years, respectively. About one-fifth (20.1%) had experienced their first sex (66% of rural and 34% of urban). The mean age at first sex was 14.05 years ± 2.3 years (13.89 ± 2.3 years for rural and 14.37 ± 2.3 years for urban). Only 76 (49.7%) sexually experienced respondents had used condom in the past (45.5% of rural, 57.7% of urban). Half of the urban respondents used condom during their first sex while only a quarter of their rural counterparts had done so (p=0.003). Sexual behavior was commoner among the rural respondents than their urban counterpart. There is an urgent need for sexuality education especially among rural adolescents in the study area.

Health Careers Education for Rural Primary Schoolchildren

ERIC Educational Resources Information Center

Gorton, Susan M.

2011-01-01

International and national studies have reported that health professionals who grew up in a rural area are more likely to return to work in a rural area than their urban raised counterparts. The chronic severe shortage of health professionals in rural and remote Australia has meant inequitable health care for rural and remote communities and a…

Rural and urban park visits and park-based physical activity.

PubMed

Shores, Kindal A; West, Stephanie T

2010-01-01

A physical activity disparity exists between rural and urban residents. Community parks are resources for physical activity because they are publicly provided, available at a low cost, and accessible to most residents. We examine the use of and physical activity outcomes associated with rural and urban parks. Onsite observations were conducted using the System for Observing Play and Recreation in Communities (SOPARC) at four rural and four urban parks. Momentary sampling scans were conducted four times per day for seven days at each site. A total of 6,545 park visitors were observed. Both rural and urban park visitors were observed more often at larger parks with paved trails and attended most often on weekends. Rural park visits were more frequent than urban park visits but rural visits were less physically active. Although similarities were observed between rural and urban park visits, differences suggest that findings from park and physical activity studies in urban areas should not be considered representative of their rural counterparts. Given that the majority of existing park and physical activity research has been undertaken in urban settings, the need for complementary research in rural settings has been made evident through this presentation of baseline descriptive data.

The Changing Context of Rural America: A Call to Examine the Impact of Social Change on Mental Health and Mental Health Care.

PubMed

Carpenter-Song, Elizabeth; Snell-Rood, Claire

2017-05-01

Recent social changes and rising social inequality in the rural United States have affected the experience and meaning of mental illness and treatment seeking within rural communities. Rural Americans face serious mental health disparities, including higher rates of suicide and depression compared with residents of urban areas, and substance abuse rates in rural areas now equal those in urban areas. Despite these increased risks, people living in rural areas are less likely than their urban counterparts to seek or receive mental health services. This Open Forum calls for a research agenda supported by anthropological theory and methods to investigate the significance of this changed rural social context for mental health.

A Multi-Method Inquiry of the Practice and Context of Rural School Psychology

ERIC Educational Resources Information Center

Goforth, Anisa N.; Yosai, Erin R.; Brown, Jacqueline A.; Shindorf, Zachary R.

2017-01-01

This multi-method inquiry used (1) quantitative examination of context, characteristics, roles, and responsibilities of rural school psychologists compared to their suburban and urban counterparts and (2) qualitative examination of two focus groups of rural school psychologists. Results showed that rural school psychologists served more schools,…

Satisfaction with local exercise facility: a rural-urban comparison in China.

PubMed

Zheng, Jiakun; An, Ruopeng

2015-01-01

Rural-urban inequalities in China have been widening over the past few decades. Compared to their urban counterparts, rural residents may encounter various barriers to equal opportunities to effectively engage in physical activity. This study examines the rural-urban disparity in physical activity, proximity and satisfaction with local exercise facilities. An in-person survey was conducted in 29 counties of 10 Chinese provinces in 2012. Five thousand questionnaires were administered by trained staff with a completion rate of 82.1%. The complete sample includes 1661 rural and 2446 urban residents. Eight dichotomous outcome measures were used, pertaining to leisure-time physical activity engagement; proximity to the nearest exercise facility from home; satisfaction level with the quantity, variety, fee levels, opening hours, and daily management and services of nearby exercise facilities; and satisfaction level with the local public sports service system. Nearest-neighbor matching was performed to match rural residents with urban residents by observed individual sociodemographics, including gender, age, education level and residential province. Pearson's χ2 test was used to assess the difference in sociodemographics and outcome measures between rural and urban residents before and after matching. Before nearest-neighbor matching, the frequency distributions of age and education level are significantly different between rural and urban residents (both p<0.0001). After matching, the differences in the frequency distributions between rural and urban residents become statistically non-significant for all observed sociodemographics: gender (p=0.170), age (p=0.934), education level (p=0.244) and residential province (p=1.000). Compared to their matched urban counterparts, rural residents are 8.1% (p<0.0001) more likely to be physically inactive in their leisure time and 5.8% (p=0.005) less likely to live within 30-minute walking distance to the nearest exercise facility. Rural residents are 15.7%, 15.7%, 8.6%, 13.5% and 14.7% more likely to be unsatisfied with the quantity, variety, fee levels, opening hours, and daily management and services of nearby exercise facilities, and 16.1% more likely to be unsatisfied with the local public sports service system than matched urban residents (all p<0.0001). Substantial rural-urban disparities tend to be present in leisure-time physical activity, proximity to the nearest exercise facility, and satisfaction level with exercise facilities and the public sports service system. Policy interventions are warranted to improve the accessibility and affordability of local exercise facilities in rural areas as a way to promote physical activity among Chinese rural residents and reduce disparities.

Impact of Family Abuse on Running Away, Deviance, and Street Victimization among Homeless Rural and Urban Youth

ERIC Educational Resources Information Center

Thrane, Lisa E.; Hoyt, Danny R.; Whitbeck, Les B.; Yoder, Kevin A.

2006-01-01

Problem: Various demographic and familial risk factors have been linked to runaway behavior. To date, there has not been a systematic investigation of the impact of size of community on runaway behavior. This study will compare runaways from smaller cities and rural areas to their urban counterparts. Methods: A convenience sample of 602…

High School Biology Evolution Learning Experiences in a Rural Context: A Case of and for Cultural Border Crossing

ERIC Educational Resources Information Center

Borgerding, Lisa A.

2017-01-01

Although the concept of "rural" is difficult to define, rural science education provides the possibility for learning centered upon a strong connection to the local community. Rural American adolescents tend to be more religious than their urban counterparts and less accepting of evolution than their non-rural peers. Because the status…

Figuring It out on Their Own: How Rural Adult Online Students Negotiate Barriers to Learning Online

ERIC Educational Resources Information Center

Peich, Alysia

2017-01-01

The health of rural communities depends, in part, on the education level of rural adults. Economic vitality is impacted by degree completion, and the rate of degree completion by rural adults lags behind that of their urban and suburban counterparts. Low completion rates suggest that there are conditions for rural students that prevent them from…

Rural-urban disparity in knowledge and compliance with traffic signs among young commercial motorcyclists in selected local government areas in Oyo State, Nigeria.

PubMed

Olumide, Adesola O; Owoaje, Eme T

2017-06-01

This study compared knowledge and compliance with traffic signs among young commercial motorcyclists in rural and urban communities in Oyo state, Nigeria. Information on knowledge and compliance with 10 common traffic signs was obtained from 149 rural and 113 urban commercial motorcyclists aged 18-35 years. Aggregate knowledge scores were computed and categorized as good (≥5) and poor (<5) knowledge. Overall, 98.7% rural versus 61.1% urban motorcyclists had poor knowledge of traffic signs (p < 0.05). After controlling for age, level of education and years of commercial riding, motorcyclists in the rural areas were more likely to have poor knowledge of the traffic signs (OR = 58.15; 95% CI = 11.96-282.79). A higher proportion of rural than urban motorcyclists never obeyed any of the traffic signs. Young rural commercial motorcyclists' knowledge and compliance with the road signs was poorer than their urban counterparts. Interventions to improve the rural motorcyclists' knowledge and ultimately compliance with road signs are urgently required.

Motivation for Math in Rural Schools: Student and Teacher Perspectives

ERIC Educational Resources Information Center

Hardre, Patricia L.

2011-01-01

Rural schools, students, teachers, administrators, families and community leaders face unique challenges from those of their urban and suburban counterparts. This paper investigates motivation in rural secondary schools, with a particular focus on mathematics, from teacher and student perspectives. It integrates recent research on math learning…

Analyzing Rural Versus Urban Differences in Career Dissatisfaction and Plans to Leave Among Pennsylvanian Physicians.

PubMed

Vick, Brandon

2016-01-01

This study estimates whether physicians in rural Pennsylvania have higher odds of career dissatisfaction and plans to leave patient care in the next 6 years, compared to their urban counterparts. Rural-urban differences were estimated across specific subgroups of physicians (gender, race, and specialty) and with regard to specific sources of career dissatisfaction. The 2012 Pennsylvania Health Workforce Survey of Physicians allowed for analysis of 17,444 physicians younger than 55 years old actively practicing patient care. Multivariate, logistic regression was performed to estimate the associations with 2 outcome areas: career dissatisfaction and plans to leave patient care in the next 6 years. Controls included rural setting, age, sex, race, work hours, specialty, and practice characteristics. Over 12% of under-55 physicians are dissatisfied with their careers and over 18% report plans to leave patient care in the next 6 years. Rural physicians in Pennsylvania have 18.6% higher odds of reporting career dissatisfaction and 29.5% higher odds of leaving patient care in the next 6 years (P < .01 for each) versus their urban counterparts. Rates of dissatisfaction and potential attrition among younger physicians are not insignificant, with a stronger association with rural practice. Given the large number of rural health shortage areas, better understanding this association is important to health care providers and policy makers. Regression results suggest that higher rural odds are related more to physician work (i.e., stress, practice demands, and lack of autonomy) and family situations and less related to income concerns. © 2015 National Rural Health Association.

Women's health care: the experiences and behaviors of rural and urban lesbians in the USA.

PubMed

Barefoot, K Nikki; Warren, Jacob C; Smalley, K Bryant

2017-01-01

Previous research has consistently demonstrated that, in comparison to their cisgender heterosexual counterparts, lesbians face a multitude of women's healthcare-related disparities. However, very little research has been conducted that takes an intersectionality approach to examining the potential influences of rural-urban location on the health-related needs and experiences of lesbians. The purpose of this study was to quantitatively compare rural and urban lesbians' access to women's health care, experiences with women's healthcare providers (WHCPs), and preventive behavior using a large, diverse sample of lesbians from across the USA. A total of 895 (31.1% rural and 68.9% urban) lesbian-identified cisgender women (ie not transgender) from the USA participated in the current online study. As part of a larger parent study, participants were recruited from across the USA through email communication to lesbian, gay, bisexual, and transgender (LGBT)-focused organizations and online advertisements. Participants were asked to complete a series of questions related to their women's healthcare-related experiences and behaviors (ie access to care, experiences with WHCPs, and preventive behavior). A series of χ2 analyses were utilized in order to examine rural-urban differences across dependent variables. An examination of sexual risks revealed that relatively more rural lesbians reported at least one previous male sexual partner in comparison to the urban sample of lesbians (78.1% vs 69.1%, χ2(1, N=890)=7.56, p=0.006). A similarly low percentage of rural (42.4%) and urban (42.9%) lesbians reported that they have a WHCP that they see on a regular basis for preventive care. In terms of experiences with WHCP providers, relatively fewer rural lesbians indicated that their current WHCP had discussed/recommended the human papillomavirus (HPV) vaccination in comparison to urban lesbians (27.5% vs. 37.2%; χ2 (1, N=796)=7.24, p=0.007). No other rural-urban differences in experiences with WHCPs emerged - few rural and urban lesbians had been asked about their sexual orientation by their WHCP (38.8% and 45.0%, respectively), been provided with appropriate safe-sex education by their WHCP (21.4% and 25.3%), had their last HIV/sexually transmitted infection screening instigated by their WHCP (if applicable; 15.7% and 19.5%), and reported that their WHCP seems knowledgeable about lesbian health concerns (56.5% vs 54.6%). In terms of preventive behavior, significantly fewer rural lesbians aged 40 years or more had received a mammogram in the past 3 years (63.2% vs 83.2%; χ2(1, N=163)=8.36, p=0.004) when compared to their urban counterparts. No other significant rural-urban differences in preventive behaviors emerged. A similarly low percentage of rural and urban lesbians indicated that they have received the HPV vaccination (22.8% and 29.0%, respectively) and/or have had a HIV/STI screening (43.0% and 47.8%), Pap test (62.0% and 64.5%) or breast exam (59.2% and 62.8%), in the past 3 years. The current findings highlight that rural lesbians in the USA, in comparison to urban lesbians, may experience elevated health risks related to being more likely to have at least one previous male sexual partner, less likely to be recommended the HPV vaccination by a WHCP, and, for those 40 or older, less likely to receive routine mammogram screenings. Furthermore, rural lesbians appear to engage in similarly low rates of HPV vaccination and regular HIV/STI screenings, Pap tests, and clinical breast exams as their urban counterparts. Given the increased cervical and breast cancer risks associated with rural living, the current findings underscore the dire need for health promotion efforts aimed at increasing rural lesbians' engagement in routine pelvic and breast exams.

Building Special Education Teacher Capacity in Rural Schools: Impact of a Grow Your Own Program

ERIC Educational Resources Information Center

Sutton, Joe P.; Bausmith, Shirley C.; O'Connor, Dava M.; Pae, Holly A.; Payne, John R.

2014-01-01

Rural education has a legacy of unique challenges, with highest priority needs in the South. Chief among these challenges are the conditions of poverty associated with many rural districts and the education of students with disabilities. Compared with their urban and suburban counterparts, rural teachers experience higher rates of turnover, and…

Rural Residence and Prescription Medication Use by Community-Dwelling Older Adults: A Review of the Literature

ERIC Educational Resources Information Center

Grymonpre, Ruby E.; Hawranik, Pamela G.

2008-01-01

Context: Due to various barriers to health care access in the rural setting, there is concern that rural older adults might have lower access to prescribed medications than their urban counterparts. Purpose: To review published research reports to determine prevalence and mean medication use in rural, noninstitutionalized older adults and assess…

Leveraging Resources for Learning Improvement Agendas: The Role of Educational Service Agencies and Local Communities

ERIC Educational Resources Information Center

Henry, Wesley L. C.

2017-01-01

Rural America is rapidly becoming more diverse, yet rural communities remain different from their urban and suburban counterparts. Despite several decades of economic hardship in rural areas, rural schools are under researched by scholars and under prioritized by policymakers. Therefore, this study was designed to better understand how school and…

Disparity in Breast Cancer Late Stage at Diagnosis in Missouri: Does Rural Versus Urban Residence Matter?

PubMed

Williams, Faustine; Thompson, Emmanuel

2016-06-01

Despite the fact that black women have a lower incidence of breast cancer compared to white women, black women experience higher death rates than any other group. We examined the stage of breast cancer presentation by race and geographic region using population-based breast cancer incidence in all 115 counties in the state of Missouri. We used 2003-2008 breast cancer incidence data from Missouri Cancer Registry and Research Center. County of residence was categorized as urban or rural using the rural-urban continuum code. We computed the conditional proportion of stage at diagnosis by race and metropolitan status and also used Pearson's chi-squared test with Yates' continuity correction to determine statistical significance of association. Results of the study indicate that a greater proportion of black women (38.8 %) compared to white women (30.2 %) were diagnosed with more advanced breast metastasis. Our results further suggest that stage at diagnosis depended on county of residence or metropolitan status (p = .04). Women living in non-metropolitan counties were slightly more likely to have late-stage breast cancer than their metropolitan counterparts (32.0 vs 30.7 %). Overall, black women had 1.5-fold increased odds of late-stage breast cancer diagnosis compared to their white counterparts (OR = 1.50; 95 % CI, 1.39, 1.63; p < 0.0001). While the odds of late diagnosis among women living in non-metropolitan or rural counties was over 11 % higher compared with their metropolitan or urban counterpart. The current study corroborates previous findings that the risk of late-stage breast cancer diagnosis was higher among women residing in non-metropolitan rural counties.

Do Older Rural and Urban Veterans Experience Different Rates of Unplanned Readmission to VA and Non-VA Hospitals?

ERIC Educational Resources Information Center

Weeks, William B.; Lee, Richard E.; Wallace, Amy E.; West, Alan N.; Bagian, James P.

2009-01-01

Context: Unplanned readmission within 30 days of discharge is an indicator of hospital quality. Purpose: We wanted to determine whether older rural veterans who were enrolled in the VA had different rates of unplanned readmission to VA or non-VA hospitals than their urban counterparts. Methods: We used the combined VA/Medicare dataset to examine…

Exclusive breast-feeding is rarely practised in rural and urban Morogoro, Tanzania.

PubMed

Shirima, R; Greiner, T; Kylberg, E; Gebre-Medhin, M

2001-04-01

To investigate and compare feeding practices among infants of less than 7 months of age in a rural and an urban area in Tanzania. Cross-sectional, questionnaire-based interview of mothers and focus group discussions with extension workers and community leaders. Eleven villages in a rural district and 10 wards in an urban district in the Morogoro region, Tanzania, west of Dar es Salaam. Probability samples of mothers with infants of less than 7 months of age from each area). Exclusive breast-feeding was rarely practised in either the rural or urban areas investigated. However, the urban mothers initiated breast-feeding earlier, discarded colostrum less frequently, breast-fed exclusively for a longer period, gave breast milk as the first feed more often and delayed the introduction of solid foods for longer than their rural counterparts. The rural mothers, on the other hand, breast-fed their previous infants slightly longer than the urban mothers. The better performance of urban mothers could be partly due to sustained breast-feeding support in hospital settings and other campaigns which may not have reached the rural areas. In both the rural and urban areas more efforts are needed to encourage exclusive breast-feeding, to avoid premature complementation and, in the case of the urban areas, to protect extended breast-feeding.

Rural-urban differences in cancer care: results from the Lake Superior Rural Cancer Care Project.

PubMed

Elliott, Thomas E; Elliott, Barbara A; Renier, Colleen M; Haller, Irina V

2004-09-01

Past studies have shown significant differences between rural and urban cancer patients in many measures of cancer care. There is little recent information about this disparity, which generally has shown disadvantages in rural populations. This study reports the rural and urban differences in cancer care using data from the Lake Superior Rural Cancer Care Project. The study used a prospective, population-based design that included all incident cases of breast, colorectal, lung, and prostate cancers diagnosed in northeastern Minnesota, northwestern Wisconsin, and the western portion of Michigan's Upper Peninsula from 1992 to 1997. The outcome measures were 9 endpoints that represented state-of-the-art cancer care during the study. Rural cancer patients as compared with their urban counterparts were disadvantaged in proportion staged, stage at diagnosis, initial management procedures, post-treatment surveillance testing, and participation in cancer clinical trials. These findings are similar to previously published studies. Further research is needed to determine more clearly the barriers in rural cancer care and to find more effective strategies.

Rural Issues in Rehabilitation Service Delivery: A Goodwill Industries of America Study.

ERIC Educational Resources Information Center

Larsen, Carmen O.; Foley, Jeffrey C.

1992-01-01

This article uses survey data to describe some common elements among rural vocational rehabilitation programs and differentiate them from their urban counterparts. The survey of 173 Goodwill Industries centers brought 78 responses. Thirteen centers (17%) characterized themselves as entirely rural; 22 (28%) as nonrural, and 43 organizations said…

The Longitudinal Relationships between Rural Adolescents' Prosocial Behaviors and Young Adult Substance Use

ERIC Educational Resources Information Center

Carlo, Gustavo; Crockett, Lisa J.; Wilkinson, Jamie L.; Beal, Sarah J.

2011-01-01

While many adolescents and young adults experiment with substances (e.g., alcohol, cigarette smoking, marijuana), recent research suggests that rural youth and young adults may be more at risk for substance use than their urban counterparts. This study was designed to examine the longitudinal relationships between rural adolescents' prosocial…

Promoting Academic, Business, and Community Partnerships in Rural Areas.

ERIC Educational Resources Information Center

Morelli, Peg

Rural community colleges are faced with issues similar to their urban counterparts, but many challenges for rural schools are further exacerbated by limited resources, geographic isolation, and a static economy. This paper argues that the difference between success and failure can be the ability to create strong partnerships. Of the 15 colleges in…

[Medical Service Information Seeking Behaviors in Rural and Urban Patients in Sichuan Province].

PubMed

Zhang, Wen-Jie; Xue, Li; Chen, Rao; Duan, Zhan-Qi; Liu, Dan-Ping

2018-03-01

To understand how rural and urban patients seek medical service information in Sichuan province. A self-designed questionnaire was distributed randomly to patients who visited primary,secondary and tertiary health facilities in Chengdu,Yibin and Suining,collecting data in relation to their sources of medical service information,as well as the contents and credibility of the information. The major sources of medical service information came from friends,past experiences and television programs,which were consistent with the most desirable access channels. The urban patients were more likely to trust (5.3%) and use (10.6%) the Internet to obtain medical service information compared with their rural counterparts (3.4% and 5.5%,respectively, P <0.05). The most sought after information concerned about medical staff,reputation and price. The rural patients were more likely to be concerned about price (26.7%) than their urban counterparts (20.3%, P <0.05). The choices of patients were likely to be influenced by advices from family members,relatives and friends,and doctors and nurses. The patients had a higher level of trust in doctors and nurses than their relatives and friends,but lower than their family members. Patient choices are shaped by their medical service information seeking behaviors and advices from others. Targeted marketing strategies for urban and rural patients should be developed to channel patients to appropriate health facilities. Copyright© by Editorial Board of Journal of Sichuan University (Medical Science Edition).

Greek Children Living in Rural Areas Are Heavier but Fitter Compared to Their Urban Counterparts: A Comparative, Time-Series (1997-2008) Analysis

ERIC Educational Resources Information Center

Tambalis, Konstantinos D.; Panagiotakos, Demosthenes B.; Sidossis, Labros S.

2011-01-01

Purpose: To compare 12-year (1997-2008) trends in the distribution of Body Mass Index (BMI) status and physical fitness test performances among 8- to 9-year-old Greek children living in rural and urban areas. Methods: Population data derived from 11 national school-based health surveys conducted from 1997 to 2008. Anthropometric measurements and…

Rural Primary Care Providers' Perceptions of Their Role in the Breast Cancer Care Continuum

ERIC Educational Resources Information Center

Rayman, Kathleen M.; Edwards, Joellen

2010-01-01

Context: Rural women in the United States experience disparity in breast cancer diagnosis and treatment when compared to their urban counterparts. Given the 11% chance of lifetime occurrence of breast cancer for women overall, the continuum of breast cancer screening, diagnosis, treatment, and recovery are of legitimate concern to rural women and…

Disparities in health status between rural and urban adult males in Lower Silesia, Poland.

PubMed

Lipowicz, Anna

2015-01-01

Among the factors responsible for disparities in health status is place of residence. The aim of the study was to analyze differences in health status in 4142 adult males from villages and cities in Poland. Eleven biological parameters were used to assess the biological age. Among the better educated subjects, nine out of the eleven parameters were significantly worse in the rural subjects than in their urban counterparts. BMI, percent body fat, white blood cell count and blood glucose were higher, whereas respiratory and cardiovascular efficiency were lower. Only visual acuity was better in the rural subjects. For the poorly educated men, the pattern was generally similar, although the differences between the rural and urban subjects were smaller.

Impact of family abuse on running away, deviance, and street victimization among homeless rural and urban youth.

PubMed

Thrane, Lisa E; Hoyt, Danny R; Whitbeck, Les B; Yoder, Kevin A

2006-10-01

Various demographic and familial risk factors have been linked to runaway behavior. To date, there has not been a systematic investigation of the impact of size of community on runaway behavior. This study will compare runaways from smaller cities and rural areas to their urban counterparts. A convenience sample of 602 adolescents was interviewed between 1995 and August of 1996 in Missouri, Iowa, Nebraska, and Kansas, USA. Multiple regression was used to examine the association between gender, neglect, sexual abuse, physical abuse, geographic and family structure change, and community size of first runaway to predict age at first runaway, deviant subsistence strategies, and street victimization. Findings indicate that adolescents exposed to neglect (beta=-.20) and sexual abuse (beta=-.16) ran away sooner and were more likely to be victimized on the street. Rural adolescents who experienced higher levels of physical abuse relied more heavily on deviant subsistence strategies (beta=.15) and remained in abusive homes longer (beta=.15) than their similarly situated urban counterparts. Rural youth who have been subjected to elevated levels of familial abuse are at greater risk of deviant subsistence strategies, which increase the likelihood of street victimization.

Myocardial infarction in Québec rural and urban populations between 1995 and 1997.

PubMed

Loslier, Julie; Vanasse, Alain; Niyonsenga, Théophile; Courteau, Josiane; Orzanco, Gabriela; Hemiari, Abbas

2007-01-01

There is abundant evidence of health inequities between urban and rural populations. The purpose of this paper is to describe the socioeconomic characteristics of Québec urban and rural populations and the relation between rurality and incidence of myocardial infarction (MI), care management and outcomes. Socioeconomic data by census subdivisions were available from the 1996 Canadian census, representing 7,137,245 individuals. Data on patients with MI were taken from the provincial administrative health database (MED-ECHO), which is managed by the Ministry of Health and contains clinical and demographic information collected when patients are released from acute care hospitals in Québec. We included a total of 37,678 cases compiled over the 3 years of follow-up in the analyses. Residents of rural areas with low urban influence have higher MI incidence rates than all of the other populations in the study. In comparison with urban populations, their observed rural counterparts are at a disadvantage with regard to education, employment and income. Although angioplasty and coronary artery bypass graft surgery rates were higher in more urban areas, the survival rate was lower than in rural areas. This study revealed geographic heterogeneity of MI incidence, revascularization rates and survival rates among urban and rural populations.

Factors influencing Internet usage in older adults (65 years and above) living in rural and urban Sweden.

PubMed

Berner, Jessica; Rennemark, Mikael; Jogréus, Claes; Anderberg, Peter; Sköldunger, Anders; Wahlberg, Maria; Elmståhl, Sölve; Berglund, Johan

2015-09-01

Older adults living in rural and urban areas have shown to distinguish themselves in technology adoption; a clearer profile of their Internet use is important in order to provide better technological and health-care solutions. Older adults' Internet use was investigated across large to midsize cities and rural Sweden. The sample consisted of 7181 older adults ranging from 59 to 100 years old. Internet use was investigated with age, education, gender, household economy, cognition, living alone/or with someone and rural/urban living. Logistic regression was used. Those living in rural areas used the Internet less than their urban counterparts. Being younger and higher educated influenced Internet use; for older urban adults, these factors as well as living with someone and having good cognitive functioning were influential. Solutions are needed to avoid the exclusion of some older adults by a society that is today being shaped by the Internet. © The Author(s) 2014.

Health Indicators and Geographic Mobility among Young Rural-to-Urban Migrants in China.

PubMed

Li, Xiaoming; Stanton, Bonita; Chen, Xinguang; Hong, Yan; Fang, Xiaoyi; Lin, Danhua; Mao, Rong; Wang, Jin

2006-01-01

The process of rural-to-urban migration in China is accelerating with increased modernization and industrialization. To address the issues of health outcomes and geographic mobility among this population, data from 4,208 rural-to-urban migrants in two major metropolitans of China were analyzed. Results indicate that average duration of migration was 4.3 years, with younger migrants being more mobile than their older counterparts. After controlling for possible confounders, increases in mobility were associated with unstable living arrangements, substandard employment conditions, suboptimal health status, inferior health-seeking behaviour, elevated level of substance use, depressive symptoms and expression of dissatisfaction with life and work. The findings in the present study underscore the need for improved living and employment conditions and increased healthcare services available to rural-to-urban migratory population.

Parental encouragement of initiative-taking and adjustment in Chinese children from rural, urban, and urbanized families.

PubMed

Chen, Xinyin; Li, Dan

2012-12-01

Due to the requirements of the competitive, market-oriented urban society, parents in urban and urbanized families are more likely than parents in rural families to encourage initiative-taking in child rearing in China. The socialization experiences of children from different types of families may be related to their adjustment. This study examined parental socialization attitudes, social and school adjustment, and their relations in Chinese children from rural, urban, and urbanized families. Participants were elementary school students (N = 1,033; M age = 11 years) and their parents in China. Data were obtained from parental reports, peer evaluations, teacher ratings, and school records. A multivariate analysis of variance revealed that parents in urban and urbanized families had higher scores than parents in rural families on encouragement of initiative-taking. Urban children, particularly girls, were more sociable, obtained higher social status, and had fewer school problems than their rural counterparts. Children from urbanized families were different from rural children and similar to urban children in social and school adjustment. Moreover, multigroup invariance tests showed that parental encouragement of initiative-taking was associated more strongly with children's sociable-assertive behavior and social standing in the urban and urbanized groups than in the rural group. The results indicate that particular socialization attitudes may vary in their adaptive value in child development as a function of specific social and cultural requirements in changing societies. PsycINFO Database Record (c) 2012 APA, all rights reserved.

Rural-urban disparity in lung function parameters of Nigerian children: effects of socio-economic, nutritional and housing factors

PubMed Central

Kuti, Bankole Peter; Oladimeji, Oluwatoyin Ibukun; Kuti, Demilade Kehinde; Adeniyi, Adewuyi Temidayo; Adeniji, Emmanuel Oluwatosin; Osundare, Yetunde Justinah

2017-01-01

Introduction The effect of socio-demographic and nutritional factors on lung functions of African children is poorly studied. This study set out to determine the effects of these factors on lung functions of Nigerian school children. Methods Rural and urban secondary schools students in Ilesa, Nigeria were selected by multistage sampling. The socio-demographic, nutritional status as well as lung function parameters measured using incentive Spirometry (MIR Spirolab III srl, Italy) of the children were obtained and compared among the rural and urban children. Results A total of 250 children (128 rural and 122 urban) aged 9 to 17 years participated in the study over a 12 month period. Mean (SD) age was 12.6 (1.9) years and Male: Female 1:1.1. The urban children were heavier, taller and have larger lung volumes than their age and sex matched rural counterpart. Stunted rural males [Mean (SD) FVC 1.8 (0.3) L vs. 2.2 (0.6) L t-test = 2.360; p = 0.022], underweight females [Mean (SD) FVC 1.8 (0.4) L vs. 2.2 (0.6) L; t-test = 2.855; p = 0.006] and those exposed to unclean fuel [Mean (SD) FVC 2.1 (0.6) L vs. 2.4 (0.5) L; t-test = 2.079; p = 0.041] had significantly lower lung volumes compared to their counterparts without these conditions. Conclusion Undernutrition, low socio-economic class and use of unclean fuels adversely affect the lung functions of Nigerian children. Improved standard of living, use of clean fuel and adequate nutrition may ensure better lung health among these children. PMID:29629016

A case study of the counterpart technical support policy to improve rural health services in Beijing.

PubMed

Jian, Weiyan; Chan, Kit Yee; Tang, Shunv; Reidpath, Daniel D

2012-12-29

There is, globally, an often observed inequality in the health services available in urban and rural areas. One strategy to overcome the inequality is to require urban doctors to spend time in rural hospitals. This approach was adopted by the Beijing Municipality (population of 20.19 million) to improve rural health services, but the approach has never been systematically evaluated. Drawing upon 1.6 million cases from 24 participating hospitals in Beijing (13 urban and 11 rural hospitals) from before and after the implementation of the policy, changes in the rural-urban hospital performance gap were examined. Hospital performance was assessed using changes in six indices over-time: Diagnosis Related Groups quantity, case-mix index (CMI), cost expenditure index (CEI), time expenditure index (TEI), and mortality rates of low- and high-risk diseases. Significant reductions in rural-urban gaps were observed in DRGs quantity and mortality rates for both high- and low-risk diseases. These results signify improvements of rural hospitals in terms of medical safety, and capacity to treat emergency cases and more diverse illnesses. No changes in the rural-urban gap in CMI were observed. Post-implementation, cost and time efficiencies worsened for the rural hospitals but improved for urban hospitals, leading to a widening rural-urban gap in hospital efficiency. The strategy for reducing urban-rural gaps in health services adopted, by the Beijing Municipality shows some promise. Gains were not consistent, however, across all performance indicators, and further improvements will need to be tried and evaluated.

Comparative ruralism and 'opening new windows' on gentrification.

PubMed

Phillips, Martin; Smith, Darren P

2018-03-01

In response to the five commentaries on our paper 'Comparative approaches to gentrification: lessons from the rural', we open up more 'windows' on rural gentrification and its urban counterpart. First, we highlight the issues of metrocentricity and urbanormativity within gentrification studies, highlighting their employment by our commentators. Second, we consider the issue of displacement and its operation within rural space, as well as gentrification as a coping strategy for neoliberal existence and connections to more-than-human natures. Finally, we consider questions of scale, highlighting the need to avoid naturalistic conceptions of scale and arguing that attention could be paid to the role of material practices, symbolizations and lived experiences in producing scaled geographies of rural and urban gentrification.

Residential Spaces and Timing of First Sexual Intercourse Among Never-Married Youths in Nigeria.

PubMed

Amoyaw, Jonathan Anim; Luginaah, Isaac

2017-10-01

Youths in sub-Saharan Africa who initiate sex at an early age tend to be more vulnerable to HIV/AIDS and other sexually transmitted diseases because of the lack of accurate knowledge of preventive behaviors. Although sociocultural and economic factors associated with sexual initiation among youths have been studied extensively in Nigeria, little is known about the effect of place-based factors. Rural and urban disparities remain high in Nigeria, and these disparities are reinforced by stark regional inequalities between the north and south. Considering these underlying inequalities, we examined the extent to which rural and urban youths in northern and southern Nigeria differ with regard to the timing of sexual initiation using the 2013 Nigerian Demographic and Health Survey. Results from our event history analyses suggest that never-married male and female youths who lived in the urban north delayed their first sexual intercourse compared with their counterparts in the rural north, but those who lived in the rural south had their first sex earlier. Young males who lived in the urban south also experienced their first sex earlier than their counterparts in the rural north. Surprisingly, educated youths and those who had accurate knowledge about HIV/AIDS transmission experienced their first sex early. Clearly, the timing of sexual initiation among youths varies across different spatial and cultural contexts. Therefore, interventions aimed at discouraging early sexual initiation among young people in Nigeria may need to go beyond merely providing health information and services to addressing the livelihood needs of youths, especially those in rural settings.

Variations in Rural Hospital Costs: Effects of Market Concentration and Location

PubMed Central

Vogel, W. Bruce; Miller, Michael K.

1995-01-01

This article explores two neglected questions: (1) Does the relationship between hospital concentration and costs vary between urban and rural markets? and (2) Do hospital costs in non-metropolitan areas vary with rurality? Covariance model results using 1992 data reveal that: (1) Although metropolitan and urban markets exhibit a negative relationship between hospital average costs and market concentration, non-metropolitan and rural markets fail to exhibit any relationship between costs and concentration; and (2) among non-metropolitan hospitals, only hospitals located in single-hospital communities have lower costs than their counterparts in multiple-hospital communities, once other factors are held constant. PMID:10153476

Small Steps Make Meaningful Change in Transforming Urban Schools

ERIC Educational Resources Information Center

Miranda, Antoinette Halsell; Radliff, Kisha M.; Della Flora, Olympia A.

2018-01-01

Urban schools in the United States are generally viewed as having greater challenges than their suburban and rural counterparts. Most notably, they often have lower academic achievement and much of the educational reform movement has been aimed at urban schools in an attempt to close the achievement gap. Although much of the focus in recent years…

Developing a Learner-Centered Curriculum for a Rural Public Health Program

ERIC Educational Resources Information Center

Njoku, Anuli; Wakeel, Fathima; Reger, Michael; Jadhav, Emmanuel; Rowan, Julie

2017-01-01

Rural communities, compared with their urban counterparts, have higher rates of disease and adverse health conditions, fueling disparities in health outcomes. This encourages the need for effective curricula to engage students and enable them to address such disparate health outcomes as imminent health professionals. Incorporating learner-centered…

Physical Activity, Metabolic Syndrome, and Overweight in Rural Youth

ERIC Educational Resources Information Center

Moore, Justin B.; Davis, Catherine L.; Baxter, Suzanne Domel; Lewis, Richard D.; Yin, Zenong

2008-01-01

Background: Research suggests significant health differences between rural dwelling youth and their urban counterparts with relation to cardiovascular risk factors. This study was conducted to (1) determine relationships between physical activity and markers of metabolic syndrome, and (2) to explore factors relating to physical activity in a…

Violence in Rural, Suburban, and Urban Schools in Pennsylvania.

PubMed

Flynn, Kalen; McDonald, Catherine C; D'Alonzo, Bernadette A; Tam, Vicky; Wiebe, Douglas J

2018-01-01

School violence is a public health issue with direct and collateral consequences that has academic and social impacts for youth. School violence is often considered a uniquely urban problem, yet more research is needed to understand how violence in rural and suburban schools may be similar or different from urban counterparts. Using school violence data from a state with urban, suburban, and rural counties, we explored the landscape of school violence in Pennsylvania (PA) through mapping, descriptive statistics, and factor analysis. Results show school violence is not solely an urban problem. Schools in all county types and across grade levels deal with violence to varying degrees, and the majority of schools across county types experience low levels of violence. Types of violence experienced by PA schools loaded onto three factors, suggesting that targeted interventions may be better suited to addressing school violence.

Dynamism of household carbon emissions (HCEs) from rural and urban regions of northern and southern China.

PubMed

Maraseni, Tek Narayan; Qu, Jiansheng; Yue, Bian; Zeng, Jingjing; Maroulis, Jerry

2016-10-01

China contributes 23 % of global carbon emissions, of which 26 % originate from the household sector. Due to vast variations in both climatic conditions and the affordability and accessibility of fuels, household carbon emissions (HCEs) differ significantly across China. This study compares HCEs (per person) from urban and rural regions in northern China with their counterparts in southern China. Annual macroeconomic data for the study period 2005 to 2012 were obtained from Chinese government sources, whereas the direct HCEs for different types of fossil fuels were obtained using the IPCC reference approach, and indirect HCEs were calculated by input-output analysis. Results suggest that HCEs from urban areas are higher than those from rural areas. Regardless of the regions, there is a similarity in per person HCEs in urban areas, but the rural areas of northern China had significantly higher HCEs than those from southern China. The reasons for the similarity between urban areas and differences between rural areas and the percentage share of direct and indirect HCEs from different sources are discussed. Similarly, the reasons and solutions to why decarbonising policies are working in urban areas but not in rural areas are discussed.

Comparative Study of Lead Concentration in Feathers of Urban and Rural Passerines in Merida, Mexico.

PubMed

Nava-Diaz, Remedios; Hoogesteijn, Almira L; Erosa, Mercy Dzul; Febles, Jose L; Mendez-Gonzalez, Rosa M

2015-10-01

Lead is a commonly monitored heavy metal because of potential health effects on exposed organisms. We quantified lead in secondary feathers of two passerine bird species, clay-colored thrushes (Turdus grayi) and great-tailed grackles (Quiscalus mexicanus), from an urban and a rural site in the municipality of Merida, Yucatan. Urban lead concentration was significantly higher than its rural counterpart for both species (p < 0.05). In the urban site, lead concentration was similar in both species (p = 0.14). However, data from the rural site showed that lead concentration was significantly higher in thrush feathers (p < 0.05). Lead levels herein presented are among the lowest ever reported suggesting that either lead accumulation or absorption is limited. Finally, our data seem to support the hypothesis that species feeding ecology plays a major role in lead accumulation.

Malnutrition among women in sub-Saharan Africa: rural-urban disparity.

PubMed

Uthman, O A; Aremu, O

2008-01-01

Malnutrition is a serious public health problem, particularly in developing countries, linked to a substantial increase in the risk of mortality and morbidity. Women and young children are most often affected. Rural disadvantage is a known factor, but little attention has been paid to rural-urban disparity among women. To provide a reliable source of information for policy-makers, the current study used nationally representative data from 26 countries in sub-Saharan Africa to update knowledge about the prevalence malnutrition and its rural-urban disparities among women. The data sources were the demographic and health surveys of 26 countries conducted between 1995 and 2006. The methods included meta-analysis, meta-regression, sub-group and sensitivity. Overall, rural women were 68% more likely to be malnourished compared with their urban counterparts. In the meta-regression analysis, sub-region, sample size, and the year the study was conducted explained the observed heterogeneity. This meta-analysis provided usable data for women in sub-Saharan Africa. The magnitude of rural-urban malnutrition disparity revealed provides a baseline that will be of assistance to clinicians, researchers, and policy-makers in the detection, prevention and treatment of malnutrition among rural women.

Marriage outcome and relationship with urban versus rural context for individuals with psychosis in a population-based study in China.

PubMed

Yang, Lawrence H; Phillips, Michael R; Li, Xianyun; Yu, Gary; Zhang, Jingxuan; Shi, Qichang; Song, Zhiqiang; Ding, Zhijie; Pang, Shutao; Susser, Ezra

2015-10-01

While social integration among individuals with psychosis differs by social context, this has rarely been investigated across urban vs. rural settings. For individuals with psychosis, marriage may be a key component of social integration. This study aims to compare marriage outcomes for individuals with psychosis in urban vs. rural settings in China, where marriage has been almost universal among individuals without psychosis. In a large community-based study in four provinces representing 12% of China's population, we identified 393 individuals with psychosis (112 never treated). We used adjusted Poisson regression models to compare marriage status for those living in urban (n = 96) vs. rural (n = 297) contexts. While urban and rural residents had similar impairments due to symptoms, urban female residents were 2.72 times more likely to be unmarried than their rural counterparts (95% CI 1.19-6.22, p < 0.0176). Stratified analyses indicated that this marital disadvantage occurred primarily among urban females with an earlier age of onset. No differences were found among males. Our findings indicate that urban contexts impeded opportunities for marriage for female individuals with psychosis. These data suggest that urban women with earlier age of onset have difficulty in marrying which may be related to economic expectations of women in urban areas. Research examining contextual mechanisms that affect marriage may further understanding of social integration in China and other contexts.

Identification of differences between rural and urban safety cultures.

PubMed

Rakauskas, Michael E; Ward, Nicholas J; Gerberich, Susan G

2009-09-01

The prevailing risk of traffic fatalities is much larger in rural areas compared to urban areas. A number of explanations have been offered to explain this including road design, emergency medical service proximity, and human factors. This research explored the potential contribution of rural driver attitudes that may underlie the increased fatal crash risk in rural environments. This analysis examined differences between rural and urban drivers in terms of self-reported risk taking for driving behaviors associated with fatal crashes and attitudes toward safety interventions using a large-scale survey. The results suggested that rural drivers engage in riskier behavior, such as not wearing seatbelts, because they have lower perceptions of the risks associated with such behaviors. Results also suggested that vehicle type (e.g., pickup trucks versus passenger vehicles) may be related to seatbelt compliance and frequency of driving under the influence of alcohol. Rural drivers perceived the utility of government-sponsored traffic safety interventions to be lower than their urban counterparts. This study provides insights into the role of the human factor in rural fatal crashes and provides policy suggestions for developing safety interventions that are designed with respect to the psychosocial factors that define the rural culture.

Leading Remotely: Exploring the Experiences of Principals in Rural and Remote School Communities in Jamaica

ERIC Educational Resources Information Center

Miller, Paul

2015-01-01

School leadership is an exciting although challenging job. Principals of schools located in rural and remote communities, particular small schools, experience and encounter many challenges that their counterparts in suburban and urban areas do not experience. Concerns over staffing, the quality and availability of materials, facilities,…

Reducing Potentially Excess Deaths from the Five Leading Causes of Death in the Rural United States

PubMed

Garcia, Macarena C; Faul, Mark; Massetti, Greta; Thomas, Cheryll C; Hong, Yuling; Bauer, Ursula E; Iademarco, Michael F

2017-01-13

In 2014, the all-cause age-adjusted death rate in the United States reached a historic low of 724.6 per 100,000 population (1). However, mortality in rural (nonmetropolitan) areas of the United States has decreased at a much slower pace, resulting in a widening gap between rural mortality rates (830.5) and urban mortality rates (704.3) (1). During 1999–2014, annual age-adjusted death rates for the five leading causes of death in the United States (heart disease, cancer, unintentional injury, chronic lower respiratory disease (CLRD), and stroke) were higher in rural areas than in urban (metropolitan) areas (Figure 1). In most public health regions (Figure 2), the proportion of deaths among persons aged <80 years (U.S. average life expectancy) (2) from the five leading causes that were potentially excess deaths was higher in rural areas compared with urban areas (Figure 3). Several factors probably influence the rural-urban gap in potentially excess deaths from the five leading causes, many of which are associated with sociodemographic differences between rural and urban areas. Residents of rural areas in the United States tend to be older, poorer, and sicker than their urban counterparts (3). A higher proportion of the rural U.S. population reports limited physical activity because of chronic conditions than urban populations (4). Moreover, social circumstances and behaviors have an impact on mortality and potentially contribute to approximately half of the determining causes of potentially excess deaths (5).

Comparing the mental health of rural-to-urban migrant children and their counterparts in china: Protocol for a systematic review and meta-analysis.

PubMed

Zhang, Jun-Hua; Yan, Li-Xia; Yuan, Yang

2018-04-01

In recent years, the issue of migrant children with peasant parents working in cities has attracted widespread attention in recent years because of the sheer number and the benefits bundled in China's household. The focus has gradually extended from early education opportunities to all aspects of physical and mental development, especially the social adaptation and mental health of migrant children. The negative impact of environment changes on migrant children' mental health is very worrying for parents and the society. Some studies have found that immigrant children's mental health is significantly lower than their peers, but there are also studies that hold the opposite view. Thus, the mental health status of migrant children is still a controversial issue, which may have a certain relationship with the potential differences in the specific problems of mental health, regions, comparison objects, and researchers. The objective of this protocol is to investigate whether mental health and subdimensions differ between rural-to-urban migrant children and their counterparts living in China and examine study characteristics that might result in differences among studies. We will search PubMed, Embase, OVID, ERIC, Web of Science, and Chinese databases including CNKI, Chongqing VIP, and Wan Fang data from start to April 2018. Cross-sectional studies with a comparison of migrant children and their counterparts will be included. The primary outcome will be the mean and standard deviation of mental health and its sub-dimensions. Standardized mean difference is used as the main effect value. Subgroup analyses will be carried out by the location of studies and school type of. Sensitivity analyses will be conducted to assess the robustness of the findings. Analyses will be performed with RevMan and Stata software. This systematic review and meta-analysis will compare the mental health status of rural-to-urban migrant children and their counterparts living in China. The results of this systematic and meta-analysis will be helpful to get a more reliable understanding of the mental health of rural-to-urban migrant children and the reasons for the controversy on this issue.

HIV-positive pregnant women attending the prevention of mother-to-child transmission of HIV/AIDS (PMTCT) services in Ethiopia: economic productivity losses across urban-rural settings.

PubMed

Zegeye, Elias Asfaw; Mbonigaba, Josue; Kaye, Sylvia Blanche

2018-06-01

HIV/AIDS impacts significantly on pregnant women and on children in Ethiopia. This impact has a multiplier effect on household economies and on productivity losses, and is expected to vary across rural and urban settings. Applying the human capital approach to data collected from 131 respondents, this study estimated productivity losses per HIV-positive pregnant woman-infant pair across urban and rural health facilities in Ethiopia, which in turn were used to estimate the national productivity loss. The study found that the annual productivity loss per woman-infant pair was Ethiopian birr (ETB) 7,433 or United States dollar (US$) 378 and ETB 625 (US$ 32) in urban and rural settings, respectively. The mean patient days lost per year due to inpatient admission at hospitals/health centres was 11 in urban and 22 in rural health facilities. On average, urban home care-givers spent 20 (SD = 21) days annually providing home care services, while their rural counterparts spent 23 days (SD = 26). The productivity loss accounted for 16% and 7% of household income in urban and rural settings, respectively. These high and varying productivity losses require preventive interventions that are appropriate to each setting to ensure the welfare of women and children in Ethiopia.

Burden of anaemia in rural and urban jat women in haryana state, India.

PubMed

Maninder, Kaur; Kochar, G K

2009-09-01

A cross-sectional study was undertaken on 600 Jat women (rural=300, urban=300), aged 40 to 70 years from Haryana state in North India. The aim of the study was to determine the prevalence of anaemia and the dietary intake of rural and urban middle-aged (40-59 years) and older (60 and above) Jat women. The findings indicated that all the subjects exhibited a decline in the mean values of haemoglobin (Hb) concentration with advancement in age. The mean blood Hb concentration of urban middle-aged and older women was 10.1±1.3g/dl and 9.91.4g/dl respectively, which was higher than their rural counterparts at all age groups, although the differences were statistically non-significant (p>0.05). The overall prevalence of anaemia reached 88.7% (rural women= 91.3%, urban women =86%). Daily dietary intake of rural and urban subjects was below the recommended dietary allowances. Physical performance of both groups of the women showed a decline with a decrease in Hb concentration. A significant and positive correlation of Hb status was observed with grip strength and vital capacity while a negative association was witnessed with blood pressure and pulse rate in both the rural and urban women. Anaemia among these women may be attributed to inadequate dietary intake, illiteracy, and poor access to health services.

Managing rapid urbanization in the third world: some aspects of policy.

PubMed

Hope, K R

1989-01-01

A priority task for developing countries is the formulation of national urbanization policies that: 1) foster the full development of national resources; 2) promote cohesion among regions, especially where there are striking inequities in per capita output; 3) prevent or correct the overconcentration of economic activity in a few urban centers; and 4) create a more efficient, equitable management of growth within cities. Although urban households tend to be served better by the health and educational sectors than their rural counterparts, the urban poor are denied these benefits in the absence of special programs to ensure universal access. The urban poor are further denied access to the benefits of urban centers through a transportation policy that is oriented more toward roads and cars than public transit systems. Of major concern are the overcrowded squatter settlements that have developed in response to massive rural-urban migration. Since the landlessness, joblessness, and demoralization in rural areas and the consequent urban influx are at the root of the urban crisis in the Third World, integrated rural development is essential to retain substantial new additions to the urban labor force in rural areas. Land reform is the single strategy with the greatest potential to improve the quality of life of the landless poor and small holders. Other needs include programs of labor-intensive rural public works to provide supplementary income-earning opportunities and improve the rural infrastructure and more widespread participation of the rural poor in the development process. Increasingly sophisticated administrative and financing systems will be required to carry out a national urbanization policy, and current politicized bureaucracies must be replaced by a reliance on technically skilled professional administrators.

Rural Active Living: A Call to Action.

PubMed

Umstattd Meyer, M Renée; Moore, Justin B; Abildso, Christiaan; Edwards, Michael B; Gamble, Abigail; Baskin, Monica L

2016-01-01

Rural residents are less physically active than their urban counterparts and disproportionately affected by chronic diseases and conditions associated with insufficient activity. While the ecological model has been successful in promoting and translating active living research in urban settings, relatively little research has been conducted in rural settings. The resulting research gap prohibits a comprehensive understanding and application of solutions for active living in rural America. Therefore, the purpose of this article was to assess the evidence base for an ecological model of active living for rural populations and outline key scientific gaps that inhibit the development and application of solutions. Specifically, we reexamined the 4 domains conceptualized by the model and suggest that there is a dearth of research specific to rural communities across all areas of the framework. Considering the limited rural-specific efforts, we propose areas that need addressing to mobilize rural active living researchers and practitioners into action.

Rural Active Living: A Call to Action

PubMed Central

Meyer, M. Renée Umstattd; Moore, Justin B.; Abildso, Christiaan; Edwards, Michael B.; Gamble, Abigail; Baskin, Monica L.

2015-01-01

Rural residents are less physically active than their urban counterparts and disproportionately affected by chronic diseases and conditions associated with insufficient activity. While the ecological model has been successful in promoting and translating active living research in urban settings, relatively little research has been conducted in rural settings. The resulting research gap prohibits a comprehensive understanding and application of solutions for active living in rural America. Therefore, the purpose of this paper was to assess the evidence-base for an ecological model of active living for rural populations and outline key scientific gaps that inhibit the development and application of solutions. Specifically, we reexamined the four domains conceptualized by the model and suggest there is a dearth of research specific to rural communities across all areas of the framework. Considering the limited rural-specific efforts, we propose areas that need addressing in order to mobilize rural active living researchers and practitioners into action. PMID:26327514

Cognitive Appraisals of Specialty Mental Health Services and Their Relation to Mental Health Service Utilization in the Rural Population

ERIC Educational Resources Information Center

Deen, Tisha L.; Bridges, Ana J.; McGahan, Tara C.; Andrews, Arthur R., III

2012-01-01

Purpose: Rural individuals utilize specialty mental health services (eg, psychiatrists, psychologists, counselors, and social workers) at lower rates than their urban counterparts. This study explores whether cognitive appraisals (ie, individual perceptions of need for services, outcome expectancies, and value of a positive therapeutic outcome) of…

Obesity risk in rural, urban and rural-to-urban migrants: prospective results of the PERU MIGRANT study.

PubMed

Carrillo-Larco, R M; Bernabé-Ortiz, A; Pillay, T D; Gilman, R H; Sanchez, J F; Poterico, J A; Quispe, R; Smeeth, L; Miranda, J J

2016-01-01

Although migration and urbanization have been linked with higher obesity rates, especially in low-resource settings, prospective information about the magnitude of these effects is lacking. We estimated the risk of obesity and central obesity among rural subjects, rural-to-urban migrants and urban subjects. Prospective data from the PERU MIGRANT Study were analyzed. Baseline data were collected in 2007-2008 and participants re-contacted in 2012-2013. At follow-up, outcomes were obesity and central obesity measured by body mass index and waist circumference. At baseline, the primary exposure was demographic group: rural, rural-to-urban migrant and urban. Other exposures included an assets index and educational attainment. Cumulative incidence, incidence ratio (IR) and 95% confidence intervals (95% CI) for obesity and central obesity were estimated with Poisson regression models. At baseline, mean age (±s.d.) was 47.9 (±12.0) years, and 53.0% were females. Rural subjects comprised 20.2% of the total sample, whereas 59.7% were rural-to-urban migrants and 20.1% were urban dwellers. A total of 3598 and 2174 person-years were analyzed for obesity and central obesity outcomes, respectively. At baseline, the prevalence of obesity and central obesity was 20.0 and 52.5%. In multivariable models, migrant and urban groups had an 8- to 9.5-fold higher IR of obesity compared with the rural group (IR migrants=8.19, 95% CI=2.72-24.67; IR urban=9.51, 95% CI=2.74-33.01). For central obesity, there was a higher IR only among the migrant group (IR=1.95; 95% CI=1.22-3.13). Assets index was associated with a higher IR of central obesity (IR top versus bottom tertile 1.45, 95% CI=1.03-2.06). Peruvian urban individuals and rural-to-urban migrants show a higher incidence of obesity compared with their rural counterparts. Given the ongoing urbanization occurring in middle-income countries, the rapid development of increased obesity risk by rural-to-urban migrants suggests that measures to reduce obesity should be a priority for this group.

Are urban children really healthier? Evidence from 47 developing countries.

PubMed

Van de Poel, Ellen; O'Donnell, Owen; Van Doorslaer, Eddy

2007-11-01

On average, child health outcomes are better in urban than in rural areas of developing countries. Understanding the nature and the causes of this rural-urban disparity is essential in contemplating the health consequences of the rapid urbanization taking place throughout the developing world and in targeting resources appropriately to raise population health. Using micro-data on child health taken from the most recent Demographic and Health Surveys for 47 developing countries, the purpose of this paper is threefold. First, we document the magnitude of rural-urban disparities in child nutritional status and under-5 mortality across all 47 developing countries. Second, we adjust these disparities for differences in population characteristics across urban and rural settings. Third, we examine rural-urban differences in the degree of socioeconomic inequality in these health outcomes. The results demonstrate that there are considerable rural-urban differences in mean child health outcomes in the entire developing world. The rural-urban gap in stunting does not entirely mirror the gap in under-5 mortality. The most striking difference between the two is in the Latin American and Caribbean region, where the gap in growth stunting is more than 1.5 times higher than that in mortality. On average, the rural-urban risk ratios of stunting and under-5 mortality fall by, respectively, 53% and 59% after controlling for household wealth. Controlling thereafter for socio-demographic factors reduces the risk ratios by another 22% and 25%. We confirm earlier findings of higher socioeconomic inequality in stunting in urban areas and demonstrate that this also holds for under-5 mortality. In a considerable number of countries, the urban poor actually have higher rates of stunting and mortality than their rural counterparts. The findings imply that there is a need for programs that target the urban poor, and that this is becoming more necessary as the size of the urban population grows.

Long-Term Trends in Black and White Mortality in the Rural United States: Evidence of a Race-Specific Rural Mortality Penalty.

PubMed

James, Wesley; Cossman, Jeralynn S

2017-01-01

The rural mortality penalty-growing disparities in rural-urban macro-level mortality rates-has persisted in the United States since the mid 1980s. Substantial intrarural differences exist: rural places of modest population size, close to urban areas, experience a greater mortality burden than the most rural locales. This research builds on recent findings by examining whether a race-specific rural mortality penalty exists; that is, are some rural areas more detrimental to black and/or white mortality than others? Using data from the Compressed Mortality File from 1968 to 2012, we calculate annual age-adjusted, race-specific mortality rates for all rural-urban regions designated by the Rural-Urban Continuum Codes. Indicators for population, socioeconomic status, and health infrastructure, as a proxy for access to care, are used as predictors of race-specific mortality in multivariable regression models. Three important results emerge from this analysis: (1) there is a substantial mortality disadvantage for both black and white rural Americans, (2) the most advantageous regions of mortality for blacks exhibit higher mortality than the most disadvantageous regions for whites, and (3) access to health care is a much stronger predictor of white mortality than black mortality. The rural mortality penalty is evident in race-specific mortality trends over time, with an added disadvantage in black mortality. The rate of mortality improvement for rural blacks and whites lags behind their same-race, urban counterparts, creating a diverging gap in race-specific mortality trends in rural America. © 2016 National Rural Health Association.

The Rural – Urban Divide: Health Services Utilization Among Older Mexicans in Mexico

PubMed Central

Salinas, Jennifer J.; Al Snih, Soham; Markides, Kyriakos; Ray, Laura A.; Angel, Ronald J.

2010-01-01

Context Mexico Purpose Using the health care service utilization model as a framework, this paper will analyze the differences in health care service use among older Mexicans living in urban and rural areas in Mexico. Methods The Mexican Health and Aging Survey (MHAS) data were used to test the applicability of Andersen’s “model of health services” of predisposing (ie, age, sex, etc.), enabling (education, insurance coverage, etc.) and need factors (diabetes, hypertension, etc.) to predict ever being in the hospital and physician visits in the past year by place of residence (urban, rural, semi-rural). Findings Results showed that older Mexicans living in the most rural areas (populations of 2500 or fewer) were significantly less likely to have been hospitalized in the previous year and visited the physician less often (P < .0001) than their urban counterparts. The significant difference in hospitalization between rural and urban residing older Mexicans was largely accounted for by having health care coverage. Certain need factors such as diabetes, previous heart attack, hypertension, depression, and functional limitations predicted frequency of physician visits and hospitalization, but they did not explain variations between rural and urban older Mexicans. Conclusions Not having insurance coverage was associated with a lower likelihood of spending an overnight visit in the hospital and visiting a physician for older Mexicans. This lower utilization may be due to barriers to access rather than better health. PMID:21029168

Mortality and nursing home placement of dementia patients in rural and urban areas: a cohort study from the Swedish Dementia Registry.

PubMed

Roheger, Mandy; Zupanic, Eva; Kåreholt, Ingemar; Religa, Dorota; Kalbe, Elke; Eriksdotter, Maria; Garcia-Ptacek, Sara

2018-04-14

Life in rural and urban areas differs in regard to social support and health care. Our aim was to examine the association between nursing home placement and survival of patients with dementia living in urban vs. rural areas. We performed a longitudinal cohort study of patients with dementia at time of diagnosis (n = 58 154) and at first follow-up (n = 21 522) including patients registered from 2007 through 2014 in the Swedish Dementia Registry (SveDem). Descriptive statistics are shown. Odds ratios with 95% CI are presented for nursing home placement and hazard ratios for survival analysis. In age- and sex-adjusted analyses, patients living in urban areas were more likely to be in nursing homes at the time of dementia diagnosis than patients in rural areas (1.49, 95% CI: 1.29-1.73). However, there were no differences in rural vs urban areas in either survival after dementia diagnosis (urban: 0.99, 0.95-1.04, intermediate: 1.00, 0.96-1.04), or nursing home placement at first follow-up (urban: 1.00, 0.88-1.13; intermediate: 0.95, 0.85-1.06). Persons with dementia living in rural areas are less likely to live in a nursing home than their urban counterparts at the time of dementia diagnosis, but these differences disappear by the time of first follow-up. Differences in access to nursing homes between urban and rural settings could explain these findings. Results should be considered in the future healthcare decisions to ensure equality of health care across rural and urban areas. © 2018 The Authors. Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of Nordic College of Caring Science.

Blood pressure trends and hypertension among rural and urban Jat women of Haryana, India.

PubMed

Kaur, Maninder

2012-03-01

Hypertension is an important public health problem and the major causes of cardiovascular morbidity and mortality among aged and elderly population in India. The present study is an attempt to assess age related trends of blood pressure and prevalence of hypertension in rural and urban women as well as correlation of blood pressure with obesity indicators (WC, BMI, and WHR). Data for present cross-sectional study were collected by purposive sampling method from six hundred Jat women (300 rural and 300 urban), aged 40 to 70 years. Karl Pearson's correlation coefficient (r) was employed to find the relationship between blood pressure and obesity indicators. The results revealed an age associated increase in mean values of systolic and diastolic blood pressure in rural and urban women. Urban women showed significantly higher overall mean value of systolic (mm of Hg) (133.93 vs. 130.79, p < 0.001), diastolic blood pressure (mm of Hg) (84.34 vs. 82.81, p < 0.01) and pulse rate (81.72 +/- 6.27 vs. 80.94 +/- 9.06, p > 0.05) as compared to rural women. The overall prevalence of hypertension was found to be 9% in rural and 26.66% in urban women as per JNC VII criteria. Increased prominence of hypertension among urban Jat women may be attributed to their modern lifestyle having more stress, less manual work and faulty dietary habits. There was a very low awareness of hypertension in the rural subjects (37%) than their urban (72%) counterparts. Rural and urban women revealed a positive and significant association of systolic blood pressure with body mass index, whereas only urban women displayed positive correlation of waist circumference with systolic (r = 0.183**) and diastolic (r = 0.151**) blood pressure.

A case study of the counterpart technical support policy to improve rural health services in Beijing

PubMed Central

2012-01-01

Background There is, globally, an often observed inequality in the health services available in urban and rural areas. One strategy to overcome the inequality is to require urban doctors to spend time in rural hospitals. This approach was adopted by the Beijing Municipality (population of 20.19 million) to improve rural health services, but the approach has never been systematically evaluated. Methods Drawing upon 1.6 million cases from 24 participating hospitals in Beijing (13 urban and 11 rural hospitals) from before and after the implementation of the policy, changes in the rural–urban hospital performance gap were examined. Hospital performance was assessed using changes in six indices over-time: Diagnosis Related Groups quantity, case-mix index (CMI), cost expenditure index (CEI), time expenditure index (TEI), and mortality rates of low- and high-risk diseases. Results Significant reductions in rural–urban gaps were observed in DRGs quantity and mortality rates for both high- and low-risk diseases. These results signify improvements of rural hospitals in terms of medical safety, and capacity to treat emergency cases and more diverse illnesses. No changes in the rural–urban gap in CMI were observed. Post-implementation, cost and time efficiencies worsened for the rural hospitals but improved for urban hospitals, leading to a widening rural–urban gap in hospital efficiency. Conclusions The strategy for reducing urban–rural gaps in health services adopted, by the Beijing Municipality shows some promise. Gains were not consistent, however, across all performance indicators, and further improvements will need to be tried and evaluated. PMID:23272703

Place-based differences in the commission of recurrent animal cruelty.

PubMed

Tallichet, Suzanne E; Hensley, Christopher; Evans, Rhea A

2012-12-01

Despite the recent surge in research linking animal and human acts of violence, relatively few studies have been conducted examining animal cruelty itself. Although several researchers have begun to identify some of the correlates of animal cruelty, few have attempted to understand how differences in the backgrounds of rural and urban residents have led to their abuse of animals. Using survey data from 180 inmates, this study examines how demographic characteristics, exposure to animal cruelty in childhood, and the target animal's relationship with the abuser have contributed to the frequency of acts of animal cruelty in urban- and rural-based settings. Unlike their urban counterparts, rural respondents who engaged in recurrent animal cruelty were more likely to have witnessed family members and/or friends abuse an animal. Moreover, rural respondents who engaged in recurrent animal cruelty abused pet and stray animals, whereas recurrent animal abusers who grew up in urban areas tended to abuse pets only. These findings suggest possible place-based differences in the etiology of recurrent animal cruelty.

Comparative ruralism and ‘opening new windows’ on gentrification

PubMed Central

Phillips, Martin; Smith, Darren P

2018-01-01

In response to the five commentaries on our paper ‘Comparative approaches to gentrification: lessons from the rural’, we open up more ‘windows’ on rural gentrification and its urban counterpart. First, we highlight the issues of metrocentricity and urbanormativity within gentrification studies, highlighting their employment by our commentators. Second, we consider the issue of displacement and its operation within rural space, as well as gentrification as a coping strategy for neoliberal existence and connections to more-than-human natures. Finally, we consider questions of scale, highlighting the need to avoid naturalistic conceptions of scale and arguing that attention could be paid to the role of material practices, symbolizations and lived experiences in producing scaled geographies of rural and urban gentrification. PMID:29657709

Are winds in cities always slower than in the countryside? Modelling the Urban Wind Island Effect

NASA Astrophysics Data System (ADS)

Droste, Arjan; Steeneveld, Gert-Jan

2017-04-01

Though the Urban Heat Island has been extensively studied, relatively little has been documented about differences in wind between the city as a whole and the countryside. Urban winds are difficult to capture in both observations and modelling, due to the complex urban canyon and neighbourhood geometry. This study uses a straightforward mixed-layer model (Tennekes & Driedonks, 1981) to investigate the contrast between the diurnal cycle of wind in the urban and the rural environment. The model contains one urban and one rural column, to identify differences in wind patterns between city and countryside under equal geostrophic forcing. The model has been evaluated against rural observations from the 213 m. Cabauw tower (the Netherlands), and the urban observations from the BUBBLE campaign (Basel, Rotach et al., 2005). The influence of the urban fabric on the wind is investigated by varying the surface underneath the column model using the 10 urban Local Climate Zones, thereby altering building height, fraction of impervious surface, and initial boundary-layer depth. First results show that for high initial urban boundary-layer depths compared to the rural boundary-layer depth, the urban column can be much windier than its rural counterpart: i.e. the urban Wind Island Effect. The effect appears to be most prominent in the morning and the late afternoon (up to 1 m/s), for Local Climate Zones with lower buildings (3 or 7). BUBBLE observations confirm the timing of the Wind Island Effect, though with weaker magnitude.

Frontline staff motivation levels and health care quality in rural and urban primary health facilities: a baseline study in the Greater Accra and Western regions of Ghana.

PubMed

Alhassan, Robert Kaba; Nketiah-Amponsah, Edward

2016-12-01

The population of Ghana is increasingly becoming urbanized with about 70 % of the estimated 26.9 million people living in urban and peri-urban areas. Nonetheless, eight out of the ten regions in Ghana remain predominantly rural where only 32.1 % of the national health sector workforce works. Doctor-patient ratio in a predominantly rural region is about 1:18,257 compared to 1:4,099 in an urban region. These rural-urban inequities significantly account for the inability of Ghana to attain the health related Millennium Development Goals (MDGs) before the end of 2015. To ascertain whether or not rural-urban differences exist in health worker motivation levels and quality of health care in health facilities accredited by the National Health Insurance Authority in Ghana. This is a baseline quantitative study conducted in 2012 among 324 health workers in 64 accredited clinics located in 9 rural and 7 urban districts in Ghana. Ordered logistic regression was performed to determine the relationship between facility geographic location (rural/urban) and staff motivation levels, and quality health care standards. Quality health care and patient safety standards were averagely low in the sampled health facilities. Even though health workers in rural facilities were more de-motivated by poor availability of resources and drugs than their counterparts in urban facilities (p < 0.05), quality of health care and patient safety standards were relatively better in rural facilities. For Ghana to attain the newly formulated sustainable development goals on health, there is the need for health authorities to address the existing rural-urban imbalances in health worker motivation and quality health care standards in primary healthcare facilities. Future studies should compare staff motivation levels and quality standards in accredited and non-accredited health facilities since the current study was limited to health facilities accredited by the National Health Insurance Authority.

Geographically pervasive effects of urban noise on frequency and syllable rate of songs and calls in silvereyes (Zosterops lateralis).

PubMed

Potvin, Dominique A; Parris, Kirsten M; Mulder, Raoul A

2011-08-22

Recent studies in the Northern Hemisphere have shown that songbirds living in noisy urban environments sing at higher frequencies than their rural counterparts. However, several aspects of this phenomenon remain poorly understood. These include the geographical scale over which such patterns occur (most studies have compared local populations), and whether they involve phenotypic plasticity or microevolutionary change. We conducted a field study of silvereye (Zosterops lateralis) vocalizations over more than 1 million km(2) of urban and rural south-eastern Australia, and compared possible effects of urban noise on songs (which are learned) and contact calls (which are innate). Across 14 paired urban and rural populations, silvereyes consistently sang both songs and contact calls at higher frequencies in urban environments. Syllable rate (syllables per second) decreased in urban environments, consistent with the hypothesis that reflective structures degrade song and encourage longer intervals between syllables. This comprehensive study is, to our knowledge, the first to demonstrate varied adaptations of urban bird vocalizations over a vast geographical area, and to provide insight into the mechanism responsible for these changes.

Causes and Disparities in Death Rates Among Urban American Indian and Alaska Native Populations, 1999-2009.

PubMed

Jacobs-Wingo, Jasmine L; Espey, David K; Groom, Amy V; Phillips, Leslie E; Haverkamp, Donald S; Stanley, Sandte L

2016-05-01

To characterize the leading causes of death for the urban American Indian/Alaska Native (AI/AN) population and compare with urban White and rural AI/AN populations. We linked Indian Health Service patient registration records with the National Death Index to reduce racial misclassification in death certificate data. We calculated age-adjusted urban AI/AN death rates for the period 1999-2009 and compared those with corresponding urban White and rural AI/AN death rates. The top-5 leading causes of death among urban AI/AN persons were heart disease, cancer, unintentional injury, diabetes, and chronic liver disease and cirrhosis. Compared with urban White persons, urban AI/AN persons experienced significantly higher death rates for all top-5 leading causes. The largest disparities were for diabetes and chronic liver disease and cirrhosis. In general, urban and rural AI/AN persons had the same leading causes of death, although urban AI/AN persons had lower death rates for most conditions. Urban AI/AN persons experience significant disparities in death rates compared with their White counterparts. Public health and clinical interventions should target urban AI/AN persons to address behaviors and conditions contributing to health disparities.

Perceptions of Shale Gas Development: Differences in Urban and Rural Communities

NASA Astrophysics Data System (ADS)

Melby, G.; Grubert, E.; Brandt, A. R.

2016-12-01

Shale gas development in Pennsylvania has been shown to have a large impact on nearby rural communities, but almost no research has been done on how development of the Marcellus Shale affects urban residents in neighboring cities. The goal of this project is to examine how the social and environmental priorities of urban and rural communities differ and to determine how well informed urban residents are on shale gas development. An anonymous web survey was used to survey 250 residents of Pennsylvania's largest cities on topics like how respondents prioritize different environmental and social factors and how well informed they feel about shale gas development. The results of this survey were compared to findings of previous surveys on rural communities located near energy development. In terms of environmental priorities, urban residents are more concerned about climate change and air pollution than rural residents. Both urban and rural respondents agreed that healthcare and education were their top social concerns, but urban respondents also prioritized housing and employment. Most urban respondents said that they were unfamiliar with shale gas development, although many were still concerned about what its environmental impacts might be. We also found that our results displayed two well known demographic trends: first, Democrats are far more likely to self identify as environmentalists than those who vote Republican, and second, that people of color are far less likely to identify as environmentalists than white respondents. As a result, there are disproportionately fewer self-identifying environmentalists in urban and largely Democrat-leaning areas with racially diverse populations. Our data displayed known trends in urban populations as well as new information on how urban residents differ from their rural counterparts in their views on shale gas development and their broader social and environmental priorities.

Should I Stay or Should I Go? Perceived Barriers to Pursuing a University Education for Persons in Rural Areas

ERIC Educational Resources Information Center

Friesen, Laura; Purc-Stephenson, R. J.

2016-01-01

A university education can provide an individual with greater employment options, higher income potential, and improved health and quality of life, yet young persons from rural areas remain less likely to attend university than their urban counterparts. This study explores the perceived personal, social, and cultural factors that might create…

Rural/urban mortality differences in England and Wales and the effect of deprivation adjustment.

PubMed

Gartner, Andrea; Farewell, Daniel; Roach, Paul; Dunstan, Frank

2011-05-01

Perceptions that rural populations are inevitably healthier and live longer than urban populations are increasingly being challenged. But very few publications have investigated the extent to which these putative differences can be explained by variation in area composition. Existing publications have tended to use conventional deprivation measures, often thought to mask rural deprivation by favourable averages. Further, they have typically been based on large and variably-sized geographical units, or confined to studies of a single region or cause of death. This study examines differences in mortality between rural and urban areas in the entire population of England and Wales for 2002-2004. It uses the most up-to-date small geographical units of similar size and homogeneity of population together with the recently-introduced Rural and Urban Area Classification, and adjusts for five different deprivation measures (including modern composite indices). The causes of death investigated were all-cause mortality, cancer, lung cancer, respiratory disease, circulatory disease, suicide and accidents. Particular points of focus for the study were the potential for interaction between deprivation and rurality, and the importance of choice of deprivation measure in quantifying the relationships between mortality, rurality and deprivation. Choice of deprivation measure was not found to alter the substantive conclusions of any analysis, and little evidence for differential effects of deprivation in rural and urban areas was uncovered. Differences between rural and urban areas in all-cause, circulatory disease and cancer mortality could largely be accounted for by adjusting for deprivation. For these causes of death, therefore, rural populations were not found to be inherently healthier than their urban counterparts. However, substantial residual differences between rural and urban areas were found in comparisons of mortality from lung cancer and respiratory disease, mortality being lower in rural areas. Stronger relationships between rurality and mortality were found in 'village and dispersed' settlements. Copyright © 2011 Elsevier Ltd. All rights reserved.

A Comparison of Particulate Matter from Biomass-Burning Rural and Non-Biomass-Burning Urban Households in Northeastern China

PubMed Central

Jiang, Ruoting; Bell, Michelle L.

2008-01-01

Background Biomass fuel is the primary source of domestic fuel in much of rural China. Previous studies have not characterized particle exposure through time–activity diaries or personal monitoring in mainland China. Objectives In this study we characterized indoor and personal particle exposure in six households in northeastern China (three urban, three rural) and explored differences by location, cooking status, activity, and fuel type. Rural homes used biomass. Urban homes used a combination of electricity and natural gas. Methods Stationary monitors measured hourly indoor particulate matter (PM) with an aerodynamic diameter ≤ 10 μm (PM10) for rural and urban kitchens, urban sitting rooms, and outdoors. Personal monitors for PM with an aerodynamic diameter ≤ 2.5 μm (PM2.5) were employed for 10 participants. Time–activity patterns in 30-min intervals were recorded by researchers for each participant. Results Stationary monitoring results indicate that rural kitchen PM10 levels are three times higher than those in urban kitchens during cooking. PM10 was 6.1 times higher during cooking periods than during noncooking periods for rural kitchens. Personal PM2.5 levels for rural cooks were 2.8–3.6 times higher than for all other participant categories. The highest PM2.5 exposures occurred during cooking periods for urban and rural cooks. However, rural cooks had 5.4 times higher PM2.5 levels during cooking than did urban cooks. Rural cooks spent 2.5 times more hours per day cooking than did their urban counterparts. Conclusions These findings indicate that biomass burning for cooking contributes substantially to indoor particulate levels and that this exposure is particularly elevated for cooks. Second-by-second personal PM2.5 exposures revealed differences in exposures by population group and strong temporal heterogeneity that would be obscured by aggregate metrics. PMID:18629313

A comparison of particulate matter from biomass-burning rural and non-biomass-burning urban households in northeastern China.

PubMed

Jiang, Ruoting; Bell, Michelle L

2008-07-01

Biomass fuel is the primary source of domestic fuel in much of rural China. Previous studies have not characterized particle exposure through time-activity diaries or personal monitoring in mainland China. In this study we characterized indoor and personal particle exposure in six households in northeastern China (three urban, three rural) and explored differences by location, cooking status, activity, and fuel type. Rural homes used biomass. Urban homes used a combination of electricity and natural gas. Stationary monitors measured hourly indoor particulate matter (PM) with an aerodynamic diameter < or = 10 microm (PM10) for rural and urban kitchens, urban sitting rooms, and outdoors. Personal monitors for PM with an aerodynamic diameter < or = 2.5 microm (PM2.5) were employed for 10 participants. Time-activity patterns in 30-min intervals were recorded by researchers for each participant. Stationary monitoring results indicate that rural kitchen PM10 levels are three times higher than those in urban kitchens during cooking. PM10 was 6.1 times higher during cooking periods than during noncooking periods for rural kitchens. Personal PM2.5 levels for rural cooks were 2.8-3.6 times higher than for all other participant categories. The highest PM2.5 exposures occurred during cooking periods for urban and rural cooks. However, rural cooks had 5.4 times higher PM2.5 levels during cooking than did urban cooks. Rural cooks spent 2.5 times more hours per day cooking than did their urban counterparts. These findings indicate that biomass burning for cooking contributes substantially to indoor particulate levels and that this exposure is particularly elevated for cooks. Second-by-second personal PM2.5 exposures revealed differences in exposures by population group and strong temporal heterogeneity that would be obscured by aggregate metrics.

Urban vs Rural Residence and the Prevalence of Depression and Mood Disorder Among African American Women and Non-Hispanic White Women

PubMed Central

Weaver, Addie; Himle, Joseph A.; Taylor, Robert Joseph; Matusko, Niki N.; Abelson, Jamie M.

2015-01-01

IMPORTANCE There is a paucity of research among African Americans and rural residents. Little is known about the association between urbanicity and depression or about the interaction of urbanicity, race/ethnicity, and sex on depression and mood disorder prevalence. OBJECTIVE To examine the interaction of urbanicity and race/ethnicity on lifetime and 12-month major depressive disorder (MDD) and mood disorder prevalence for African American women and non-Hispanic white women. DESIGN, SETTING, AND PARTICIPANTS The US National Survey of American Life data were used to examine the interaction of urbanicity and race/ethnicity on lifetime and 12-month diagnoses of DSM-IV MDD and mood disorder among female respondents, who included noninstitutionalized African American, Caribbean black, and non-Hispanic white women in the United States between February 2001 and June 2003. Participants included 1462 African American women and 341 non-Hispanic white women recruited from the South because all suburban and rural National Survey of American Life respondents resided in this region. Bivariate multiple logistic regression and adjusted prevalence analyses were performed. Urban, suburban, or rural location (assessed via Rural-Urban Continuum Codes), self-reported race/ethnicity, and sociodemographic factors (age, education, household income, and marital status) were included in the analysis. MAIN OUTCOMES AND MEASURES Lifetime and 12-month MDD and mood disorder assessed via the World Mental Health Composite International Diagnostic Interview. RESULTS Compared with urban African American women, rural African American women had a significantly lower odds of meeting criteria for lifetime (odds ratio [OR], 0.39; 95% CI, 0.23–0.65) and 12-month (OR, 0.29; 95% CI, 0.18–0.46) MDD and for lifetime (F = 0.46; 95% CI, 0.29–0.73) and 12-month (F = 0.42; 95% CI, 0.26–0.66) mood disorder. However, the interaction of urbanicity and race/ethnicity suggested that rural non-Hispanic white women had a significantly higher odds of meeting criteria for lifetime (OR, 2.76; 95% CI, 1.22–6.24) and 12-month (OR, 9.48; 95% CI, 4.65–19.34) MDD and for lifetime (OR, 2.27; 95% CI, 1.06–4.87) and 12-month (OR, 5.99; 95% CI, 3.01–11.94) mood disorder than rural African American women. Adjusted prevalence analyses revealed significantly lower rates of lifetime (4.2%) and 12-month (1.5%) MDD among rural African American women than their urban counterparts (10.4% vs 5.3%; P< .01). The same pattern was found for mood disorder, with rural African American women experiencing significantly lower rates of lifetime (6.7%) and 12-month (3.3%) mood disorder when compared to urban African American women (13.9% vs 7.6%; P< .01) Conversely, rural non-Hispanic white women had significantly higher rates of 12–month MDD (10.3%) and mood disorder (10.3%) than their urban counterparts (3.7% vs 3.8%; P< .01). CONCLUSIONS AND RELEVANCE Rural residence differentially influences MDD and mood disorder prevalence among African American women and non-Hispanic white women. These findings offer a first step toward understanding the cumulative effect of rural residence and race/ethnicity on women’s depression prevalence, suggesting the need for further research in this area. PMID:25853939

Microbial abundance on the eggs of a passerine bird and related fitness consequences between urban and rural habitats

PubMed Central

Lee, Sang-im; Lee, Hyunna; Jablonski, Piotr G.; Choe, Jae Chun

2017-01-01

Urban environments present novel and challenging habitats to wildlife. In addition to well-known difference in abiotic factors between rural and urban environments, the biotic environment, including microbial fauna, may also differ significantly. In this study, we aimed to compare the change in microbial abundance on eggshells during incubation between urban and rural populations of a passerine bird, the Eurasian Magpie (Pica pica), and examine the consequences of any differences in microbial abundances in terms of hatching success and nestling survival. Using real-time PCR, we quantified the abundances of total bacteria, Escherichia coli/Shigella spp., surfactin-producing Bacillus spp. and Candida albicans on the eggshells of magpies. We found that urban magpie eggs harboured greater abundances of E. coli/Shigella spp. and C. albicans before incubation than rural magpie eggs. During incubation, there was an increase in the total bacterial load, but a decrease in C. albicans on urban eggs relative to rural eggs. Rural eggs showed a greater increase in E. coli/Shigella spp. relative to their urban counterpart. Hatching success of the brood was generally lower in urban than rural population. Nestling survival was differentially related with the eggshell microbial abundance between urban and rural populations, which was speculated to be the result of the difference in the strength of the interaction among the microbes. This is the first demonstration that avian clutches in urban and rural populations differ in eggshell microbial abundance, which can be further related to the difference in hatching success and nestling survival in these two types of environments. We suggest that future studies on the eggshell microbes should investigate the interaction among the microbes, because the incubation and/or environmental factors such as urbanization or climate condition can influence the dynamic interactions among the microbes on the eggshells which can further determine the breeding success of the parents. PMID:28953940

Microbial abundance on the eggs of a passerine bird and related fitness consequences between urban and rural habitats.

PubMed

Lee, Sang-Im; Lee, Hyunna; Jablonski, Piotr G; Choe, Jae Chun; Husby, Magne

2017-01-01

Urban environments present novel and challenging habitats to wildlife. In addition to well-known difference in abiotic factors between rural and urban environments, the biotic environment, including microbial fauna, may also differ significantly. In this study, we aimed to compare the change in microbial abundance on eggshells during incubation between urban and rural populations of a passerine bird, the Eurasian Magpie (Pica pica), and examine the consequences of any differences in microbial abundances in terms of hatching success and nestling survival. Using real-time PCR, we quantified the abundances of total bacteria, Escherichia coli/Shigella spp., surfactin-producing Bacillus spp. and Candida albicans on the eggshells of magpies. We found that urban magpie eggs harboured greater abundances of E. coli/Shigella spp. and C. albicans before incubation than rural magpie eggs. During incubation, there was an increase in the total bacterial load, but a decrease in C. albicans on urban eggs relative to rural eggs. Rural eggs showed a greater increase in E. coli/Shigella spp. relative to their urban counterpart. Hatching success of the brood was generally lower in urban than rural population. Nestling survival was differentially related with the eggshell microbial abundance between urban and rural populations, which was speculated to be the result of the difference in the strength of the interaction among the microbes. This is the first demonstration that avian clutches in urban and rural populations differ in eggshell microbial abundance, which can be further related to the difference in hatching success and nestling survival in these two types of environments. We suggest that future studies on the eggshell microbes should investigate the interaction among the microbes, because the incubation and/or environmental factors such as urbanization or climate condition can influence the dynamic interactions among the microbes on the eggshells which can further determine the breeding success of the parents.

Urban-rural differences in atmospheric mercury speciation

NASA Astrophysics Data System (ADS)

Liu, Bian; Keeler, Gerald J.; Timothy Dvonch, J.; Barres, James A.; Lynam, Mary M.; Marsik, Frank J.; Morgan, Joy Taylor

2010-05-01

Measurements of gaseous elemental mercury (GEM), particulate mercury (Hg p), and reactive gaseous mercury (RGM) were concurrently recorded at an urban site in Detroit and a rural site in Dexter, both in Michigan for the calendar year 2004. Their average concentrations (±standard deviation) for the urban area were 2.5 ± 1.4 ng m -3, 18.1 ± 61.0 pg m -3, and 15.5 ± 54.9 pg m -3, respectively, while their rural counterparts were 1.6 ± 0.6 ng m -3, 6.1 ± 5.5 pg m -3, and 3.8 ± 6.6 pg m -3, respectively. The medians of urban-to-rural ratios of Hg concentrations indicate approximately 1-fold, 2-fold, and 3-fold gradients between Detroit and Dexter for GEM, Hg p, and RGM, respectively. The urban-rural differences in Hg also varied considerably on different temporal scales and with wind flow patterns, which was most evident in RGM. Our results show that while Hg at both sites was impacted by regional sources, meteorological conditions, and photochemical transformations, the extent of variations in the observed urban-to-rural gradients, particularly in RGM, cannot be fully accounted for by these processes. Both analyses of the annual data and case studies indicate that the more variable and episodic nature of Hg, particularly RGM, seen in Detroit compared with Dexter, was the result of direct impact from local anthropogenic sources.

Risk factors for infant mortality in rural and urban Nigeria: evidence from the national household survey.

PubMed

Adewuyi, Emmanuel Olorunleke; Zhao, Yun; Lamichhane, Reeta

2017-07-01

This study investigates the rural-urban differences in infant mortality rates (IMRs) and the associated risk factors in Nigeria. The dataset from the 2013 Nigeria demographic and health survey (NDHS), disaggregated by rural-urban residence, was analyzed using complex samples statistics. A multivariable logistic regression analysis was computed to explore the adjusted relationship and identify risk factors for infant mortality. In rural and urban Nigeria, IMRs were 70 and 49 deaths per 1000 live births, respectively. Risk factors in rural residence were past maternal marital union (adjusted odds ratio (AOR): 1.625, p = 0.020), small birth size (AOR: 1.550, p < 0.001), birth interval <24 months (AOR: 2.057, p < 0.001), residence in North-East (AOR: 1.346, p = 0.038) and North-West (AOR: 1.653, p < 0.001) regions, and cesarean delivery (AOR: 2.922, p = 0.001). Risk factors in urban residence were poor wealth index (AOR: 2.292, p < 0.001), small birth size (AOR: 2.276, p < 0.001), male gender (AOR: 1.416, p = 0.022), birth interval <24 months (AOR: 1.605, p = 0.002), maternal obesity (AOR: 1.641, p = 0.008), and cesarean delivery (AOR: 1.947, p = 0.032). Infants in rural residence had higher rates of mortality than their urban counterparts and disparities in risk factors exist between the residences.

A comparison of the workload of rural and urban primary care physicians in Germany: analysis of a questionnaire survey

PubMed Central

2011-01-01

Background Many western countries are facing an existing or imminent shortage of primary care physicians especially in rural areas. In Germany, working in rural areas is often thought to be associated with more working hours, a higher number of patients and a lower income than working in urban areas. These perceptions might be key reasons for the shortage. The aim of this analysis was to explore if working time, number of treated patients per week or proportion of privately insured patients vary between rural and urban areas in Germany using two different definitions of rurality within a sample of primary care physicians including general practitioners, general internists and paediatricians. Methods This is a secondary analysis of pre-collected data raised by a questionnaire that was sent to a representative random sample of 1500 primary care physicians chosen by data of the National Association of Statutory Health Insurance Physicians from all federal states in Germany. We employed two different methods of defining rurality; firstly, level of rurality as rated by physicians themselves (urban area, small town, rural area); secondly, rurality defined according to the Organisation for Economic Co-operation and Development. Results This analysis was based upon questionnaire data from 715 physicians. Primary care physicians in single-handed practices in rural areas worked on average four hours more per week than their urban counterparts (p < 0.05). Physicians' gender, the number of patients treated per week and the type of practice (single/group handed) were significantly related to the number of working hours. Neither the proportion of privately insured patients nor the number of patients seen per week differed significantly between rural and urban areas when applying the self-rated classification of rurality. Conclusion Overall this analysis identified few differences between urban and rural primary care physician working conditions. To counter future misdistribution of primary care, students should receive practical experience in rural areas to get more practical knowledge on working conditions. PMID:21988900

Formative Evaluation for a Healthy Corner Store Initiative in Pitt County, North Carolina: Assessing the Rural Food Environment, Part 1

PubMed Central

Bringolf, Karamie R.; Lawton, Katherine K.; McGuirt, Jared T.; Wall-Bassett, Elizabeth; Morgan, Jo; Laska, Melissa Nelson; Sharkey, Joseph R.

2013-01-01

Introduction Obesity prevalence in the rural United States is higher than in urban or suburban areas, perhaps as a result of the food environment. Because rural residents live farther from supermarkets than their urban- and suburban-dwelling counterparts, they may be more reliant on smaller corner stores that offer fewer healthful food items. Methods As part of a Communities Putting Prevention to Work (CPPW) healthy corner store initiative, we reviewed audit tools in the fall of 2010 to measure the consumer food environment in eastern North Carolina and chose the NEMS-S-Rev (Nutrition Environment Measures Survey-Stores-Revised) to assess 42 food stores. During the spring and summer of 2011, 2 trained graduate assistants audited stores, achieving interrater reliability of at least 80%. NEMS-S-Rev scores of stores in rural versus urban areas were compared. Results Overall, healthful foods were less available and of lower quality in rural areas than in urban areas. NEMS-S-Rev scores indicated that healthful foods were more likely to be available and had similar pricing and quality in rural corner stores than in urban corner stores. Conclusion Food store audit data provided a baseline to implement and evaluate a CPPW healthy corner store initiative in Pitt County. This work serves as a case study, providing lessons learned for engaging community partners when conducting rural food store audits. PMID:23866165

Does living in urban or rural settings affect aspects of physical fitness in children? An allometric approach

PubMed Central

Tsimeas, P; Tsiokanos, A; Koutedakis, Y; Tsigilis, N; Kellis, S

2005-01-01

Objective: The aim of this study was to investigate physical fitness in relation to fatness in urban and rural Greek children by means of allometric scaling. Methods: The sample consisted of 360 (189 urban and 171 rural; age 12.3±0.42 years) boys and 247 (125 urban and 122 rural; age 12.3±0.43 years) girls. The sample was highly representative (32–64%) of all 12 year old children registered in the prefecture of Trikala, Greece. All volunteers were assessed for BMI and % body fat, as well as sit and reach, basketball throw (BT), vertical jump (VJ), handgrip strength (HG), 40 m sprint, agility run, and 20 m shuttle run. To correct for possible associations between fatness and fitness, a single cause allometric scaling was employed using the natural logarithms (ln) of fitness parameters that were significantly correlated with the ln body fat. Results: Independent-samples t tests revealed that VJ (p<0.05) was significantly higher in boys living in urban settings compared to their rural counterparts. Similarly, BT was found to be significantly better (p<0.05) in urban girls, whereas HG was significantly higher (p<0.05) in rural girls. Conclusion: Considering that (a) only three out of the 14 possible cases (seven fitness parameters for boys and seven for girls) were significantly different between urban and rural children, and (b) these differences were not uniformly distributed in children living in either urban or rural environments, it is concluded that the place of residence has no clear impact on physical fitness as studied herein. PMID:16118308

Determinants of neonatal mortality in rural and urban Nigeria: Evidence from a population-based national survey.

PubMed

Adewuyi, Emmanuel O; Zhao, Yun

2017-02-01

Significant reduction in the global burden of neonatal mortality was achieved through the millennium development goals. In Nigeria, however, only a marginal reduction was realized. This study assesses the rural-urban differences in neonatal mortality rate (NMR) and the associated risk factors in Nigeria. The dataset from the 2013 Nigeria demographic and health survey (NDHS), disaggregated by rural-urban residence (n = 20 449 and 9935, respectively), was explored using univariate, bivariate, and multivariable analysis. Complex samples analysis was applied to adjust for the unequal selection probabilities due to the multi-stage cluster sampling method used in the 2013 NDHS. The adjusted relationship between the outcome and predictor variables was assessed on multi-level logistic regression analysis. NMR for rural and urban populations was 36 and 28 deaths per 1000 live births, respectively. Risk factors in urban residence were lack of electricity access (adjusted OR [AOR], 1.555; 95%CI: 1.089-2.220), small birth size (as a proxy for low birthweight; AOR, 3.048; 95%CI: 2.047-4.537), and male gender (AOR, 1.666; 95%CI: 1.215-2.284). Risk factors in rural residence were small birth size (a proxy for low birthweight; AOR, 2.118; 95%CI: 1.600-2.804), and birth interval <2 years (AOR, 2.149; 95%CI: 1.760-2.624). Cesarean delivery was a risk factor both in rural (AOR, 5.038; 95%CI: 2.617-9.700) and urban Nigeria (AOR, 2.632; 95%CI: 1.543-4.489). Determinants of neonatal mortality were different in rural and urban Nigeria, and rural neonates had greater risk of mortality than their urban counterparts. © 2016 Japan Pediatric Society.

Rural-urban migration and child survival in urban Bangladesh: are the urban migrants and poor disadvantaged?

PubMed

Islam, M Mazharul; Azad, Kazi Md Abul Kalam

2008-01-01

This paper analyses the levels and trends of childhood mortality in urban Bangladesh, and examines whether children's survival chances are poorer among the urban migrants and urban poor. It also examines the determinants of child survival in urban Bangladesh. Data come from the 1999-2000 Bangladesh Demographic and Health Survey. The results indicate that, although the indices of infant and child mortality are consistently better in urban areas, the urban-rural differentials in childhood mortality have diminished in recent years. The study identifies two distinct child morality regimes in urban Bangladesh: one for urban natives and one for rural-urban migrants. Under-five mortality is higher among children born to urban migrants compared with children born to life-long urban natives (102 and 62 per 1000 live births, respectively). The migrant-native mortality differentials more-or-less correspond with the differences in socioeconomic status. Like childhood mortality rates, rural-urban migrants seem to be moderately disadvantaged by economic status compared with their urban native counterparts. Within the urban areas, the child survival status is even worse among the migrant poor than among the average urban poor, especially recent migrants. This poor-non-poor differential in childhood mortality is higher in urban areas than in rural areas. The study findings indicate that rapid growth of the urban population in recent years due to rural-to-urban migration, coupled with higher risk of mortality among migrant's children, may be considered as one of the major explanations for slower decline in under-five mortality in urban Bangladesh, thus diminishing urban-rural differentials in childhood mortality in Bangladesh. The study demonstrates that housing conditions and access to safe drinking water and hygienic toilet facilities are the most critical determinants of child survival in urban areas, even after controlling for migration status. The findings of the study may have important policy implications for urban planning, highlighting the need to target migrant groups and the urban poor within urban areas in the provision of health care services.

Respiratory performance and grip strength tests in Indian school bodys of different socio-economic status.

PubMed Central

De, A. K.; Debnath, P. K.; Dey, N. K.; Nagchaudhuri, J.

1980-01-01

Physical efficiency tests were performed on urban school boys drawn from high socio-economic status in comparison to rural school boys. The height and weight records of the subjects indicating growing process showed that the rural boys attained less physical growth than their urban counterparts. The Vital Capacity and Peak Expiratory Flow Rate data expressed either per unit of height or body surface area were significantly lower in rual boys. these findings indicated a poor development of the thorax in the rural group. However, the determined grip strengths for both the group were similar. The grip test might reflect improvement of muscle mass in case of rural boys as a result of regular physical activity employing the arm muscles. Images p145-a p145-b PMID:7407454

Obesity risk in rural, urban and rural-to-urban migrants: prospective results of the PERU MIGRANT study

PubMed Central

Carrillo-Larco, R M; Bernabé-Ortiz, A; Pillay, T D; Gilman, R H; Sanchez, J F; Poterico, J A; Quispe, R; Smeeth, L; Miranda, J J

2016-01-01

Background: Although migration and urbanization have been linked with higher obesity rates, especially in low-resource settings, prospective information about the magnitude of these effects is lacking. We estimated the risk of obesity and central obesity among rural subjects, rural-to-urban migrants and urban subjects. Methods: Prospective data from the PERU MIGRANT Study were analyzed. Baseline data were collected in 2007–2008 and participants re-contacted in 2012–2013. At follow-up, outcomes were obesity and central obesity measured by body mass index and waist circumference. At baseline, the primary exposure was demographic group: rural, rural-to-urban migrant and urban. Other exposures included an assets index and educational attainment. Cumulative incidence, incidence ratio (IR) and 95% confidence intervals (95% CI) for obesity and central obesity were estimated with Poisson regression models. Results: At baseline, mean age (±s.d.) was 47.9 (±12.0) years, and 53.0% were females. Rural subjects comprised 20.2% of the total sample, whereas 59.7% were rural-to-urban migrants and 20.1% were urban dwellers. A total of 3598 and 2174 person-years were analyzed for obesity and central obesity outcomes, respectively. At baseline, the prevalence of obesity and central obesity was 20.0 and 52.5%. In multivariable models, migrant and urban groups had an 8- to 9.5-fold higher IR of obesity compared with the rural group (IR migrants=8.19, 95% CI=2.72–24.67; IR urban=9.51, 95% CI=2.74–33.01). For central obesity, there was a higher IR only among the migrant group (IR=1.95; 95% CI=1.22–3.13). Assets index was associated with a higher IR of central obesity (IR top versus bottom tertile 1.45, 95% CI=1.03–2.06). Conclusions: Peruvian urban individuals and rural-to-urban migrants show a higher incidence of obesity compared with their rural counterparts. Given the ongoing urbanization occurring in middle-income countries, the rapid development of increased obesity risk by rural-to-urban migrants suggests that measures to reduce obesity should be a priority for this group. PMID:26228458

Depression and Rural Environment are Associated With Poor Oral Health Among Pregnant Women in Northern Appalachia.

PubMed

McNeil, Daniel W; Hayes, Sarah E; Randall, Cameron L; Polk, Deborah E; Neiswanger, Kathy; Shaffer, John R; Weyant, Robert J; Foxman, Betsy; Kao, Elizabeth; Crout, Richard J; Chapman, Stella; Brown, Linda J; Maurer, Jennifer L; Marazita, Mary L

2016-01-01

Both oral health problems and depression among pregnant women contribute to maternal-infant health outcomes. Little is known, however, about the potential effects of clinically significant depression on the oral health status of pregnant women. The purpose of the present study was to determine the influence of clinically significant depression and rural- or urban-dwelling status on oral health outcomes among pregnant women. Pregnant women (N = 685) in rural (i.e., West Virginia) and urban (i.e., Pittsburgh, PA) areas of northern Appalachia were assessed by calibrated examiners regarding gingivitis, oral hygiene, and DMFT (decayed, missing, and filled teeth), completed the Center for Epidemiologic Studies-Depression Scale (CES-D) and provided demographics. Participants were categorized based on clinically significant depressive symptoms (CES-D ≥ 16) and rural/urban domicile. Women with depression and those living in rural areas had worse oral health on all three indices than their non-depressed and urban counterparts. Depression, particularly among women in rural areas, affects certain oral health indices and represents a modifiable target for intervention. Moreover, treatments designed specifically for rural populations may be of particular utility. Women who are pregnant or planning to become pregnant may benefit from regular depression screenings from their dental and medical health care providers. © The Author(s) 2015.

Urbanization disrupts latitude-size rule in 17-year cicadas.

PubMed

Beasley, DeAnna E; Penick, Clint A; Boateng, Nana S; Menninger, Holly L; Dunn, Robert R

2018-03-01

Many ectotherms show a decrease in body size with increasing latitude due to changes in climate, a pattern termed converse Bergmann's rule. Urban conditions-particularly warmer temperatures and fragmented landscapes-may impose stresses on development that could disrupt these body size patterns. To test the impact of urbanization on development and latitudinal trends in body size, we launched a citizen science project to collect periodical cicadas ( Magicicada septendecim ) from across their latitudinal range during the 2013 emergence of Brood II. Periodical cicadas are long-lived insects whose distribution spans a broad latitudinal range covering both urban and rural habitats. We used a geometric morphometric approach to assess body size and developmental stress based on fluctuating asymmetry in wing shape. Body size of rural cicadas followed converse Bergmann's rule, but this pattern was disrupted in urban habitats. In the north, urban cicadas were larger than their rural counterparts, while southern populations showed little variation in body size between habitats. We detected no evidence of differences in developmental stress due to urbanization. To our knowledge, this is the first evidence that urbanization disrupts biogeographical trends in body size, and this pattern highlights how the effects of urbanization may differ over a species' range.

Balance and gait performance in an urban and a rural population.

PubMed

Ringsberg, K A; Gärdsell, P; Johnell, O; Jónsson, B; Obrant, K J; Sernbo, I

1998-01-01

To compare the differences in standing balance and gait performance between two populations, correlated with age and physical activities of daily living. A cross-sectional study. Malmö, the third largest city in Sweden, and Sjöbo, a typical agricultural community 60 km east of Malmö. Participants were 570 men and women from the urban community (urban) and 391 from the rural community (rural), born in 1938, 1928, 1918, and 1908, and women born in 1948. The two cohorts were subdivided into true urbans, who had lived only in the city (n = 269), and true rurals, who had never lived in a city (n = 354). Information about workload, housing, spare time activities, medication, and illness during different decades of life was gathered using two questionnaires. The first questionnaire was sent to the home after agreement to participate, and the second was presented at the test session. The clinical measurements were standing balance, gait speed, and step length. The urban subjects had significantly (P < .001) impaired balance compared with rural subjects. This difference increased with increasing age. The urban subjects walked faster than the rural subjects (P < .001), and the urban subjects used fewer steps than their rural counterparts (P < .001). Spare time activities had a significant influence on the above tests, but, except for gait velocity (P = .011), workload was of minor importance according to analysis of covariance. Background factors such as usual daily activities of living and lifestyle seem to be of importance when evaluating and comparing different populations with respect to their balance and gait performance.

Safety in Numbers: Are Major Cities the Safest Places in the United States?

PubMed Central

Myers, Sage R.; Branas, Charles C.; French, Benjamin C.; Nance, Michael L.; Kallan, Michael J.; Wiebe, Douglas J.; Carr, Brendan G.

2014-01-01

Study objectives Many US cities have experienced population reductions, often blamed on crime and interpersonal injury. Yet the overall injury risk in urban areas compared with suburban and rural areas has not been fully described. We begin to investigate this evidence gap by looking specifically at injury-related mortality risk, determining the risk of all injury death across the rural-urban continuum. Methods A cross-sectional time-series analysis of US injury deaths from 1999 to 2006 in counties classified according to the rural-urban continuum was conducted. Negative binomial generalized estimating equations and tests for trend were completed. Total injury deaths were the primary comparator, whereas differences by mechanism and age were also explored. Results A total of 1,295,919 injury deaths in 3,141 US counties were analyzed. Injury mortality increased with increasing rurality. Urban counties demonstrated the lowest death rates, significantly less than rural counties (mean difference=24.0 per 100,000; 95% confidence interval 16.4 to 31.6 per 100,000). After adjustment, the risk of injury death was 1.22 times higher in the most rural counties compared with the most urban (95% confidence interval 1.07 to 1.39). Conclusion Using total injury death rate as an overall safety metric, US urban counties were safer than their rural counterparts, and injury death risk increased steadily as counties became more rural. Greater emphasis on elevated injury-related mortality risk outside of large cities, attention to locality-specific injury prevention priorities, and an increased focus on matching emergency care needs to emergency care resources are in order. PMID:23886781

High-Rising Rec Centers.

ERIC Educational Resources Information Center

Whitney, Tim

2000-01-01

Examines how tight urban sites can yield sports spaces that favorably compare to their more rural campus counterparts. Potential areas of concern when recreation centers are reconfigured into high-rise structures are highlighted, including building codes, building access, noise control, building costs, and lighting. (GR)

Causes and Disparities in Death Rates Among Urban American Indian and Alaska Native Populations, 1999–2009

PubMed Central

Espey, David K.; Groom, Amy V.; Phillips, Leslie E.; Haverkamp, Donald S.; Stanley, Sandte L.

2016-01-01

Objectives. To characterize the leading causes of death for the urban American Indian/Alaska Native (AI/AN) population and compare with urban White and rural AI/AN populations. Methods. We linked Indian Health Service patient registration records with the National Death Index to reduce racial misclassification in death certificate data. We calculated age-adjusted urban AI/AN death rates for the period 1999–2009 and compared those with corresponding urban White and rural AI/AN death rates. Results. The top-5 leading causes of death among urban AI/AN persons were heart disease, cancer, unintentional injury, diabetes, and chronic liver disease and cirrhosis. Compared with urban White persons, urban AI/AN persons experienced significantly higher death rates for all top-5 leading causes. The largest disparities were for diabetes and chronic liver disease and cirrhosis. In general, urban and rural AI/AN persons had the same leading causes of death, although urban AI/AN persons had lower death rates for most conditions. Conclusions. Urban AI/AN persons experience significant disparities in death rates compared with their White counterparts. Public health and clinical interventions should target urban AI/AN persons to address behaviors and conditions contributing to health disparities. PMID:26890168

Dietary practices and nutritional status of under-five children in rural and urban communities of Lagos State, Nigeria.

PubMed

Senbanjo, Idowu O; Olayiwola, Ibiyemi O; Afolabi, Wasiu A O

2016-01-01

Evidence shows that urban children generally have a better nutritional status than their rural counterparts. However, data establishing whether this difference in prevalence of undernutrition could be ascribed to difference in dietary practices are few. The aim of this study was to compare dietary practices and nutritional status of children in rural and urban communities of Lagos State, Nigeria. This was a comparative-analytical study conducted using the multistage sampling technique to select the study cases. A total of 300 mother-child pairs were studied, including 150 each from rural and urban communities. Data collected include demographics, socioeconomic characteristics, feeding practices and anthropometric measurements of the participants. Food intake data were collected using 24-h dietary recall. Malnutrition in children was determined by calculating the prevalence of low height-for-age (stunting), low weight-for-age (underweight), and low weight-for-height (wasting) using the World Health Organization cutoff points. The prevalence of exclusive breastfeeding for 6 months (25.3% vs. 28.7%; P = 0.516), use of formula feeds (48.7% vs. 44%; P = 0.077), and mean age of child at introduction of semisolid foods (7.54 ± 4.0 months vs. 8.51 ± 7.3 months; P = 0.117) were not significantly different between urban and rural communities. The diversity of food choices and frequencies of consumption were similar between urban and rural communities. However, prevalence levels of underweight and stunted children were significantly higher in rural than that of urban communities (19.4% vs. 9.3%, P < 0.001 and 43.3% vs. 12.6%, P < 0.001, respectively). Other risk factors besides inappropriate feeding practices need to be considered for higher prevalence of undernutrition among children in rural communities.

Dietary practices and nutritional status of under-five children in rural and urban communities of Lagos State, Nigeria

PubMed Central

Senbanjo, Idowu O.; Olayiwola, Ibiyemi O.; Afolabi, Wasiu A. O.

2016-01-01

Background: Evidence shows that urban children generally have a better nutritional status than their rural counterparts. However, data establishing whether this difference in prevalence of undernutrition could be ascribed to difference in dietary practices are few. Objective: The aim of this study was to compare dietary practices and nutritional status of children in rural and urban communities of Lagos State, Nigeria. Methods: This was a comparative-analytical study conducted using the multistage sampling technique to select the study cases. A total of 300 mother–child pairs were studied, including 150 each from rural and urban communities. Data collected include demographics, socioeconomic characteristics, feeding practices and anthropometric measurements of the participants. Food intake data were collected using 24-h dietary recall. Malnutrition in children was determined by calculating the prevalence of low height-for-age (stunting), low weight-for-age (underweight), and low weight-for-height (wasting) using the World Health Organization cutoff points. Results: The prevalence of exclusive breastfeeding for 6 months (25.3% vs. 28.7%; P = 0.516), use of formula feeds (48.7% vs. 44%; P = 0.077), and mean age of child at introduction of semisolid foods (7.54 ± 4.0 months vs. 8.51 ± 7.3 months; P = 0.117) were not significantly different between urban and rural communities. The diversity of food choices and frequencies of consumption were similar between urban and rural communities. However, prevalence levels of underweight and stunted children were significantly higher in rural than that of urban communities (19.4% vs. 9.3%, P < 0.001 and 43.3% vs. 12.6%, P < 0.001, respectively). Conclusions: Other risk factors besides inappropriate feeding practices need to be considered for higher prevalence of undernutrition among children in rural communities. PMID:27942096

Decomposing the causes of socioeconomic-related health inequality among urban and rural populations in China: a new decomposition approach.

PubMed

Cai, Jiaoli; Coyte, Peter C; Zhao, Hongzhong

2017-07-18

In recent decades, China has experienced tremendous economic growth and also witnessed growing socioeconomic-related health inequality. The study aims to explore the potential causes of socioeconomic-related health inequality in urban and rural areas of China over the past two decades. This study used six waves of the China Health and Nutrition Survey (CHNS) from 1991 to 2006. The recentered influence function (RIF) regression decomposition method was employed to decompose socioeconomic-related health inequality in China. Health status was derived from self-rated health (SRH) scores. The analyses were conducted on urban and rural samples separately. We found that the average level of health status declined from 1989 to 2006 for both urban and rural populations. Average health scores were greater for the rural population compared with those for the urban population. We also found that there exists pro-rich health inequality in China. While income and secondary education were the main factors to reduce health inequality, older people, unhealthy lifestyles and a poor home environment increased inequality. Health insurance had the opposite effects on health inequality for urban and rural populations, resulting in lower inequality for urban populations and higher inequality for their rural counterparts. These findings suggest that an effective way to reduce socioeconomic-related health inequality is not only to increase income and improve access to health care services, but also to focus on improvements in the lifestyles and the home environment. Specifically, for rural populations, it is particularly important to improve the design of health insurance and implement a more comprehensive insurance package that can effectively target the rural poor. Moreover, it is necessary to comprehensively promote the flush toilets and tap water in rural areas. For urban populations, in addition to promoting universal secondary education, healthy lifestyles should be promoted, including measures such as alcohol control.

Climate change accelerates growth of urban trees in metropolises worldwide.

PubMed

Pretzsch, Hans; Biber, Peter; Uhl, Enno; Dahlhausen, Jens; Schütze, Gerhard; Perkins, Diana; Rötzer, Thomas; Caldentey, Juan; Koike, Takayoshi; Con, Tran van; Chavanne, Aurélia; Toit, Ben du; Foster, Keith; Lefer, Barry

2017-11-13

Despite the importance of urban trees, their growth reaction to climate change and to the urban heat island effect has not yet been investigated with an international scope. While we are well informed about forest growth under recent conditions, it is unclear if this knowledge can be simply transferred to urban environments. Based on tree ring analyses in ten metropolises worldwide, we show that, in general, urban trees have undergone accelerated growth since the 1960s. In addition, urban trees tend to grow more quickly than their counterparts in the rural surroundings. However, our analysis shows that climate change seems to enhance the growth of rural trees more than that of urban trees. The benefits of growing in an urban environment seem to outweigh known negative effects, however, accelerated growth may also mean more rapid ageing and shortened lifetime. Thus, city planners should adapt to the changed dynamics in order to secure the ecosystem services provided by urban trees.

The Effects of Behavioral Health Reform on Safety-Net Institutions: A Mixed-Method Assessment in a Rural State

PubMed Central

Sommerfeld, David H.; Aarons, Gregory A.; Waitzkin, Howard

2013-01-01

In July 2005, New Mexico initiated a major reform of publicly-funded behavioral healthcare to reduce cost and bureaucracy. We used a mixed-method approach to examine how this reform impacted the workplaces and employees of service agencies that care for low-income adults in rural and urban areas. Information technology problems and cumbersome processes to enroll patients, procure authorizations, and submit claims led to payment delays that affected the financial status of the agencies, their ability to deliver care, and employee morale. Rural employees experienced lower levels of job satisfaction and organizational commitment and higher levels of turnover intentions under the reform when compared to their urban counterparts. PMID:23307162

Repeatability and degree of territorial aggression differs among urban and rural great tits (Parus major).

PubMed

Hardman, Samuel I; Dalesman, Sarah

2018-03-22

Animals in urban habitats face many novel selection pressures such as increased human population densities and human disturbance. This is predicted to favour bolder and more aggressive individuals together with greater flexibility in behaviour. Previous work has focussed primarily on studying these traits in captive birds and has shown increased aggression and reduced consistency between traits (behavioural syndromes) in birds from urban populations. However, personality (consistency within a behavioural trait) has not been well studied in the wild. Here we tested whether urban free-living male great tits show greater territorial aggression than rural counterparts. We also tested predictions that both behavioural syndromes and personality would show lower consistency in urban populations. We found that urban populations were more aggressive than rural populations and urban birds appeared to show lower levels of individual behavioural repeatability (personality) as predicted. However, we found no effect of urbanisation on behavioural syndromes (correlations between multiple behavioural traits). Our results indicate that urban environments may favour individuals which exhibit increased territorial aggression and greater within-trait flexibility which may be essential to success in holding urban territories. Determining how urban environments impact key fitness traits will be important in predicting how animals cope with ongoing urbanisation.

Children's height and weight in rural and urban populations in low-income and middle-income countries: a systematic analysis of population-representative data.

PubMed

Paciorek, Christopher J; Stevens, Gretchen A; Finucane, Mariel M; Ezzati, Majid

2013-11-01

Urban living affects children's nutrition and growth, which are determinants of their survival, cognitive development, and lifelong health. Little is known about urban-rural differences in children's height and weight, and how these differences have changed over time. We aimed to investigate trends in children's height and weight in rural and urban settings in low-income and middle-income countries, and to assess changes in the urban-rural differentials in height and weight over time. We used comprehensive population-based data and a Bayesian hierarchical mixture model to estimate trends in children's height-for-age and weight-for-age Z scores by rural and urban place of residence, and changes in urban-rural differentials in height and weight Z scores, for 141 low-income and middle-income countries between 1985 and 2011. We also estimated the contribution of changes in rural and urban height and weight, and that of urbanisation, to the regional trends in these outcomes. Urban children are taller and heavier than their rural counterparts in almost all low-income and middle-income countries. The urban-rural differential is largest in Andean and central Latin America (eg, Peru, Honduras, Bolivia, and Guatemala); in some African countries such as Niger, Burundi, and Burkina Faso; and in Vietnam and China. It is smallest in southern and tropical Latin America (eg, Chile and Brazil). Urban children in China, Chile, and Jamaica are the tallest in low-income and middle-income countries, and children in rural areas of Burundi, Guatemala, and Niger the shortest, with the tallest and shortest more than 10 cm apart at age 5 years. The heaviest children live in cities in Georgia, Chile, and China, and the most underweight in rural areas of Timor-Leste, India, Niger, and Bangladesh. Between 1985 and 2011, the urban advantage in height fell in southern and tropical Latin America and south Asia, but changed little or not at all in most other regions. The urban-rural weight differential also decreased in southern and tropical Latin America, but increased in east and southeast Asia and worldwide, because weight gain of urban children outpaced that of rural children. Further improvement of child nutrition will require improved access to a stable and affordable food supply and health care for both rural and urban children, and closing of the the urban-rural gap in nutritional status. Bill & Melinda Gates Foundation, Grand Challenges Canada, UK Medical Research Council. Copyright © 2013 Paciorek et al. Open Access article distributed under the terms of CC BY. Published by .. All rights reserved.

Disparities in economic development in Eastern China: impact on nutritional status of adolescents.

PubMed

Hesketh, Therese; Ding, Qu Jian; Tomkins, Andrew M

2002-04-01

To compare the effects of disparities in economic development in urban and rural Eastern China on the nutritional status of adolescents. A cross-sectional survey consisting of self-completion questionnaires, anthropometry and haemoglobin measurement. Twelve middle schools in an urban and a rural area of Zhejiang Province: Hangzhou, the capital, and Chunan, a poor mountainous area. Some 4835 young adolescents (predominant age range 13-16 years). The mean body mass index (BMI) was significantly higher in urban Hangzhou (P = 0.01) Overweight affected 3.6% overall; adjusted odds ratios (ORs) showed male sex (OR 2.1, 95% confidence interval (CI) 1.1-3.4) and urban residence (OR 9.1, 95% CI 3.7-22) to be the most important risk factors. The prevalence of underweight was 18%, with no significant urban-rural difference. Predictors of underweight were male sex (OR 1.5, 95% CI 1.1-2.0) and low household income (OR, 1.3, 95% CI 1.1-1.5). Mean haemoglobin was significantly lower in the rural area. Anaemia was more common in girls, 51% compared with 21% of the boys, but rural residence was not an independent risk factor. Rural students exercised more and had a less varied diet than their urban counterparts. Around one-third of the respondents consumed dietary supplements on a regular basis. These results suggest that in urban areas of Eastern China a dual picture is emerging with the problems of excess (overweight and obesity) coexisting with underweight and anaemia. In rural areas the problems of relative nutritional deprivation predominate, but the long-term consequences of such marginal underweight and anaemia are not clear.

An Examination of Past and Current Influences of Rurality on Lesbians' Overweight/Obesity Risks.

PubMed

Barefoot, K Nikki; Warren, Jacob C; Smalley, K Bryant

2015-06-01

The purpose of our study was to separately examine past (i.e., rural or non-rural background) and present (i.e., current rural or urban location) influences of rurality on the weight status and diet/exercise behaviors of lesbians. A total of 895 lesbians participated in the online study. Participants were surveyed regarding their rurality status, weight/height, and diet/exercise patterns. A 2×2 (location×background) ANCOVA was conducted to explore influences of rurality on body mass index (BMI), while controlling for age, race, and education. Chi-square analyses were used to examine the relationship between dimensions of rurality and diet/exercise behaviors. There was a significant main effect of current location on BMI. No significant interaction between location and background on BMI was found nor was there a significant main effect of background. Lesbians currently living in rural areas were on average obese (M=30.61), with significantly higher BMIs than urban-residing lesbians (M=28.53). The only significant differences that emerged for lesbians' diet/exercise patterns were for current location-more rural-residing lesbians reported they never engage in exercise in comparison to their urban-residing counterparts, with a greater percentage of urban-residing lesbians reporting frequent exercise. Rural lesbians were also more likely to report a diet high in protein. Findings suggest that current rather than past influences of rurality may have a significant impact on lesbians' weight and diet/exercise behaviors and highlight significant obesity-related health disparities for rural-residing lesbians. These findings offer support for the development of culturally-appropriate healthy diet/exercise and weight promotion efforts that are accessible to rural lesbians.

[Characteristics of physical growth of schoolchildren in Mongolia and their forming factors].

PubMed

Pogorelova, I G; Amgalan, G

The article considers the findings of hygienic assessments of educational conditions in urban and rural schools in Mongolia and socio-economic conditions of living of schoolchildren and analysis of anthropometric measurements of schoolchildren aged of 7-16 years in relation to the assessment of harmonicity of their physical development. Hygienic conditions in Mongolian schools are characterized by improper organization of the educational - accomplishment process, high occupancy rate in classes causing insufficient space for a pupil and disconformity of school furniture parameters of school desks and chairs to growth and age requirements of pupils. Comparative assessment of socio-economic factors revealed (выделено автором) that the majority (84.1%) of rural pupils reside in uncomfortable houses and gerdwellings, 58.5 % - in large families with many children, 46.3 % - in families with poor living conditions. There were obtained data about differences in physical development of urban and rural schoolchildren pronounced with age by the gain in the number of children with disharmonious development and children with lower physical indices of the development, delayed by 1-2 years appearance of the crossing of growth and growth shift typical for rural children in comparison with their urban counterparts. According to results of multivariate regression analysis most significant factors for the formation of physical development of school children in descending order are academic workload, the place of residence, the number of children in the family, uncomfortable living conditions, household income and parent’s education. In the presence of these factors, the risk of the formation of disharmonious physical growth of school children increases by 1.8-2.8 times. The probability of the risk offormation of disharmonious physical development of schoolchildren living in rural areas was found to be by 2.5 times more than for their urban counterparts. The results can be usedfor scientific substantiation and development of targeted health measures.

Differential impacts of social support on mental health: A comparison study of Chinese rural-to-urban migrant adolescents and their urban counterparts in Beijing, China.

PubMed

Zhuang, Xiao Yu; Wong, Daniel Fu Keung

2017-02-01

The number of internal migrant children in China has reached 35.8 million by the end of 2010. Previous studies revealed inconsistent findings regarding the mental health status of rural-to-urban migrant adolescents, as well as the impact of peer, teacher and parental support on the mental health of Chinese adolescent migrants. Using a comparative approach, this study attempted to compare the mental health status between migrant and urban-born adolescents and to clarify the specific roles of different sources of social support in the mental health of migrant and urban adolescents. A cross-sectional survey using a cluster convenience sampling strategy was performed in Beijing, China. A structured questionnaire was filled out by 368 rural-to-urban migrant adolescents and 325 urban-born adolescents. A significant difference was found only for positive affect (PA) but not for negative affect (NA) between the two groups, favouring the urban-born adolescents. Social support from all the three sources were all predictive of PA among rural-to-urban migrant adolescents, while only peer support contributed to PA among urban-born adolescents. Unexpectedly, teachers' support contributed to an increase in NA among urban-born adolescents. The findings contribute to understanding of the mental health status of migrant adolescents in China and the differential impact of the various sources of social support on migrant and urban-born adolescents. Also the findings may inform the development of mental health services and programmes that can potentially benefit a large number of internal migrant adolescents in China.

Population Density and AIDS-Related Stigma in Large-Urban, Small-Urban, and Rural Communities of the Southeastern USA.

PubMed

Kalichman, Seth; Katner, Harold; Banas, Ellen; Kalichman, Moira

2017-07-01

AIDS stigmas delay HIV diagnosis, interfere with health care, and contribute to mental health problems among people living with HIV. While there are few studies of the geographical distribution of AIDS stigma, research suggests that AIDS stigmas are differentially experienced in rural and urban areas. We conducted computerized interviews with 696 men and women living with HIV in 113 different zip code areas that were classified as large-urban, small-urban, and rural areas in a southeast US state with high-HIV prevalence. Analyses conducted at the individual level (N = 696) accounting for clustering at the zip code level showed that internalized AIDS-related stigma (e.g., the sense of being inferior to others because of HIV) was experienced with greater magnitude in less densely populated communities. Multilevel models indicated that after adjusting for potential confounding factors, rural communities reported greater internalized AIDS-related stigma compared to large-urban areas and that small-urban areas indicated greater experiences of enacted stigma (e.g., discrimination) than large-urban areas. The associations between anticipated AIDS-related stigma (e.g., expecting discrimination) and population density at the community-level were not significant. Results suggest that people living in rural and small-urban settings experience greater AIDS-related internalized and enacted stigma than their counterparts living in large-urban centers. Research is needed to determine whether low-density population areas contribute to or are sought out by people who experienced greater AIDS-related stigma. Regardless of causal directions, interventions are needed to address AIDS-related stigma, especially among people in sparsely populated areas with limited resources.

Media use and HIV/AIDS knowledge: a knowledge gap perspective.

PubMed

Bekalu, Mesfin Awoke; Eggermont, Steven

2014-12-01

Despite the widespread utilization of the mass media in HIV/AIDS prevention, little is known about the knowledge gap that results from disparities in mass media use. This study examined the relationship between HIV/AIDS-related mass media use and HIV/AIDS-related knowledge among urban and rural residents of northwestern Ethiopia. A hierarchical regression analysis indicated that HIV/AIDS-related mass media use has both sequestering and mainstreaming effects in certain segments of the study population, although it was not a significant predictor of HIV/AIDS-related knowledge in the total population. The knowledge gaps between individuals with high and low education and between individuals who experience high and low levels of interpersonal communication about HIV/AIDS narrowed as HIV/AIDS-related media use increased, but the gap between urban and rural residents widened. The widening gap could be explained by differences in perceptions of information salience and several theoretical assumptions. Current mass media information campaigns, which are often prepared and broadcast from urban centers, may not only fail to improve the HIV/AIDS knowledge of the rural populace but also put rural populations at a disadvantage relative to their urban counterparts. Communication interventions informed by socioecological models might be helpful to redress and/or narrow the widening knowledge gap between urban and rural residents. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

From the litter up and the sky down: Perspectives on urban ...

EPA Pesticide Factsheets

The structure of the urban forest represents the complex product of local biophysical conditions, socio-economic milieu, people preferences and management with rare counterparts in rural forests. However, urban forest structure, as similarly observed in rural forests, affects key ecological and hydrological processes as well as the plethora of organisms regulating these processes. This seminar talk will firstly present key mechanisms regulating urban eco-hydrological processes “from a litter up” perspective. In particular, fine scale effects of urban forest structure upon i) organic matter decomposition, and comminution, ii) community-assembly of decomposers, detritivores, and ecosystem engineers (i.e. bacteria, litter-dwelling macrofauna, ants), and iii) stormwater runoff infiltration and interception will be discussed. The second part of this intervention will look at the structure of the urban forest “from a sky down” perspective. Recent findings from large scale LiDAR investigations will be presented to discuss social and biophysical drivers affecting urban forest structure at sub-continental scale, as well as short-term tree loss dynamics across residential landscapes, and how these can potentially affect eco-hydrological processes at large scale. Urban forest structure, as similarly observed in rural forests, affects key ecological and hydrological processes as well as the plethora of organisms regulating these processes.

Children's height and weight in rural and urban populations in low-income and middle-income countries: a systematic analysis of population-representative data

PubMed Central

Paciorek, Christopher J; Stevens, Gretchen A; Finucane, Mariel M; Ezzati, Majid

2013-01-01

Summary Background Urban living affects children's nutrition and growth, which are determinants of their survival, cognitive development, and lifelong health. Little is known about urban–rural differences in children's height and weight, and how these differences have changed over time. We aimed to investigate trends in children's height and weight in rural and urban settings in low-income and middle-income countries, and to assess changes in the urban–rural differentials in height and weight over time. Methods We used comprehensive population-based data and a Bayesian hierarchical mixture model to estimate trends in children's height-for-age and weight-for-age Z scores by rural and urban place of residence, and changes in urban–rural differentials in height and weight Z scores, for 141 low-income and middle-income countries between 1985 and 2011. We also estimated the contribution of changes in rural and urban height and weight, and that of urbanisation, to the regional trends in these outcomes. Findings Urban children are taller and heavier than their rural counterparts in almost all low-income and middle-income countries. The urban–rural differential is largest in Andean and central Latin America (eg, Peru, Honduras, Bolivia, and Guatemala); in some African countries such as Niger, Burundi, and Burkina Faso; and in Vietnam and China. It is smallest in southern and tropical Latin America (eg, Chile and Brazil). Urban children in China, Chile, and Jamaica are the tallest in low-income and middle-income countries, and children in rural areas of Burundi, Guatemala, and Niger the shortest, with the tallest and shortest more than 10 cm apart at age 5 years. The heaviest children live in cities in Georgia, Chile, and China, and the most underweight in rural areas of Timor-Leste, India, Niger, and Bangladesh. Between 1985 and 2011, the urban advantage in height fell in southern and tropical Latin America and south Asia, but changed little or not at all in most other regions. The urban–rural weight differential also decreased in southern and tropical Latin America, but increased in east and southeast Asia and worldwide, because weight gain of urban children outpaced that of rural children. Interpretation Further improvement of child nutrition will require improved access to a stable and affordable food supply and health care for both rural and urban children, and closing of the the urban–rural gap in nutritional status. Funding Bill & Melinda Gates Foundation, Grand Challenges Canada, UK Medical Research Council. PMID:25104494

Population, migration and urbanization.

PubMed

1982-06-01

Despite recent estimates that natural increase is becoming a more important component of urban growth than rural urban transfer (excess of inmigrants over outmigrants), the share of migration in the total population growth has been consistently increasing in both developed and developing countries. From a demographic perspective, the migration process involves 3 elements: an area of origin which the mover leaves and where he or she is considered an outmigrant; the destination or place of inmigration; and the period over which migration is measured. The 2 basic types of migration are internal and international. Internal migration consists of rural to urban migration, urban to urban migration, rural to rural migration, and urban to rural migration. Among these 4 types of migration various patterns or processes are followed. Migration may be direct when the migrant moves directly from the village to the city and stays there permanently. It can be circular migration, meaning that the migrant moves to the city when it is not planting season and returns to the village when he is needed on the farm. In stage migration the migrant makes a series of moves, each to a city closer to the largest or fastest growing city. Temporary migration may be 1 time or cyclical. The most dominant pattern of internal migration is rural urban. The contribution of migration to urbanization is evident. For example, the rapid urbanization and increase in urban growth from 1960-70 in the Republic of Korea can be attributed to net migration. In Asia the largest component of the population movement consists of individuals and groups moving from 1 rural location to another. Recently, because urban centers could no longer absorb the growing number of migrants from other places, there has been increased interest in the urban to rural population redistribution. This reverse migration also has come about due to slower rates of employment growth in the urban centers and improved economic opportunities in rural areas. According to UN data, at the global level the trend in longterm and permanent migration is towards stabilization or decline in the rate of movement into developed countries like the US, Canada, the UK, and Australia from developing countries. Migrants in the Asian and Pacific region mostly tend to be in the 15-25 year age group. Most migrants streams are male dominant. The rural urban migration stream includes a large proportion of people who are better educated than their rural counterparts but generally less educated than the urban natives. Reasons for migrating in the Asian and Pacific region are economic, educational, sociocultural and political. A negative factor in rural migration is that it deprives villages of the ablest people.

Indoor dust and air concentrations of endotoxin in urban and rural environments.

PubMed

Barnig, C; Reboux, G; Roussel, S; Casset, A; Sohy, C; Dalphin, J-C; de Blay, F

2013-03-01

Rural dairy farming is associated with high exposure to indoor endotoxins as compared to rural nonfarming houses and urban houses. The time spent on the mattress (7 h for an adult) and of the proximity of the contaminated source should be taken into account with the other causes of exposure. Studies in European children from a farming background have shown that these children have a reduced risk of asthma and atopic sensitization compared to their urban counterparts. It has been suggested that this might be due to exposure to high levels of endotoxin in the farming environment. The aim of this study was to compare indoor endotoxin concentrations in air and dust samples from randomly selected urban and rural dwellings. In the rural area, endotoxins were analysed in farmhouses and nonfarmhouses as well as housing characteristics, lifestyle factors and agricultural practices likely to influence air and dust endotoxin levels. Endotoxin levels were significantly higher in floor (6600 ± 6100 vs 3600 ± 5600 and 3800 ± 17,000 ng g⁻¹; P < 0·001) and mattress dust (2900 ± 4100 vs 1100 ± 2400 and 800 ± 2600 ng g⁻¹; P < 0·001) from farmhouses compared to other rural and urban homes. However, no difference was observed between endotoxin concentrations in the air of urban and rural houses, and airborne endotoxin levels did not correlate to dust levels. Lack of ventilation and direct entry into the house were correlated with an increase in dust endotoxin levels. These results confirm that dairy farming is associated with high exposure to endotoxins in indoor dust samples. No difference was observed between indoor airborne concentrations between urban and rural houses. These results suggest that measuring endotoxin in dust is the most relevant method to assess endotoxin exposure. © 2012 The Society for Applied Microbiology.

Community-Level Exposure to the Rural Mining Industry: The Potential Influence on Early Adolescent Alcohol and Tobacco Use.

PubMed

Gay, Christopher; Clements-Nolle, Kristen; Packham, John; Ackerman, Gerald; Lensch, Taylor; Yang, Wei

2018-01-31

Rural youth have higher rates of alcohol and tobacco use compared to their urban counterparts. However, the economic dependence of rural communities may differentially influence risk behaviors. While research has shown that adults working in mining have elevated rates of alcohol and tobacco use, the influence of living in a mining community on early adolescent substance use is unknown. Using data from a representative sample of 4,535 middle school students in a state with heavy reliance on mining, we conducted weighted logistic regression to investigate whether community-level mining economic dependence influences rural-urban differences in adolescent alcohol and tobacco use. All models adjusted for sociodemographics, military family involvement, parental monitoring, and length of residence. Over one quarter of the sampled students lived in rural counties and approximately half of these counties met the USDA mining economic typology. After stratifying rural counties by mining and nonmining economic dependence, students in rural mining counties had significantly higher odds of all measures of alcohol use (AORs ranged from 1.83 to 3.99) and tobacco use (AORs ranged from 1.61 to 5.05) compared to students in urban counties. Only use of smokeless tobacco was higher among students in rural nonmining counties. Our findings demonstrate rural-urban disparities in adolescent substance use that are particularly pronounced among youth living in counties with economic dependence on mining. Future research on this subject should include a wider range of community-level factors that may have specific relevance in rural settings to inform the development of population-level interventions. © 2018 National Rural Health Association.

Health and urban living.

PubMed

Dye, Christopher

2008-02-08

The majority of people now live in urban areas and will do so for the foreseeable future. As a force in the demographic and health transition, urbanization is associated with falling birth and death rates and with the shift in burden of illness from acute childhood infections to chronic, noncommunicable diseases of adults. Urban inhabitants enjoy better health on average than their rural counterparts, but the benefits are usually greater for the rich than for the poor, thus magnifying the differences between them. Subject to better evidence, I suggest that the main obstacles to improving urban health are not technical or even financial, but rather are related to governance and the organization of civil society.

Patterns and correlates of objectively measured free-living physical activity in adults in rural and urban Cameroon.

PubMed

Assah, Felix; Mbanya, Jean Claude; Ekelund, Ulf; Wareham, Nicholas; Brage, Soren

2015-07-01

Urbanisation in sub-Saharan Africa is changing lifestyles and raising non-communicable disease burden. Understanding the underlying pattern of physical activity and its correlates may inform preventive interventions. We examined correlates of objectively-measured physical activity in rural and urban Cameroon. Participants were 544 adults resident in rural (W-156, M-89) or urban (W-189, M-110) regions. Physical activity was measured using individually-calibrated combined heart rate and movement sensing over seven continuous days. Sociodemographic data were collected by self-report. Independent associations of sociodemographic correlates with physical activity energy expenditure (PAEE) or moderate-to-vigorous physical activity (MVPA) were analysed in multivariate regression models. Rural dwellers were significantly more active than their urban counterparts (PAEE: 58.0 vs 42.9 kJ/kg/day; MVPA: 107 vs 62 min/day; MVPA of 150 min/week in >10 min bouts: 62 vs 39%) and less sedentary (923 vs 1026 min/day); p<0.001. There was no significant seasonal difference (dry vs rainy) in activity in urban dwellers whereas in rural dwellers activity was higher during dry seasons compared to rainy seasons (p<0.001). Age, obesity and education showed significant inverse associations with activity. Urban dwellers who considered themselves adequately active were only as active as rural dwellers who thought they were not adequately active. This is the first study providing data on sociodemographic patterning of objectively-measured physical activity in rural and urban sub-Saharan Africa. Age, urban residence, obesity and higher educational level are important correlates of lower levels of physical activity. These suggest targets for public health interventions to improve physical activity in Cameroon. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Age-period-cohort analysis of infectious disease mortality in urban-rural China, 1990-2010.

PubMed

Li, Zhi; Wang, Peigang; Gao, Ge; Xu, Chunling; Chen, Xinguang

2016-03-31

Although a number of studies on infectious disease trends in China exist, these studies have not distinguished the age, period, and cohort effects simultaneously. Here, we analyze infectious disease mortality trends among urban and rural residents in China and distinguish the age, period, and cohort effects simultaneously. Infectious disease mortality rates (1990-2010) of urban and rural residents (5-84 years old) were obtained from the China Health Statistical Yearbook and analyzed with an age-period-cohort (APC) model based on Intrinsic Estimator (IE). Infectious disease mortality is relatively high at age group 5-9, reaches a minimum in adolescence (age group 10-19), then rises with age, with the growth rate gradually slowing down from approximately age 75. From 1990 to 2010, except for a slight rise among urban residents from 2000 to 2005, the mortality of Chinese residents experienced a substantial decline, though at a slower pace from 2005 to 2010. In contrast to the urban residents, rural residents experienced a rapid decline in mortality during 2000 to 2005. The mortality gap between urban and rural residents substantially narrowed during this period. Overall, later birth cohorts experienced lower infectious disease mortality risk. From the 1906-1910 to the 1941-1945 birth cohorts, the decrease of mortality among urban residents was significantly faster than that of subsequent birth cohorts and rural counterparts. With the rapid aging of the Chinese population, the prevention and control of infectious disease in elderly people will present greater challenges. From 1990 to 2010, the infectious disease mortality of Chinese residents and the urban-rural disparity have experienced substantial declines. However, the re-emergence of previously prevalent diseases and the emergence of new infectious diseases created new challenges. It is necessary to further strengthen screening, immunization, and treatment for the elderly and for older cohorts at high risk.

Health and health-related indicators in slum, rural, and urban communities: a comparative analysis.

PubMed

Mberu, Blessing U; Haregu, Tilahun Nigatu; Kyobutungi, Catherine; Ezeh, Alex C

2016-01-01

It is generally assumed that urban slum residents have worse health status when compared with other urban populations, but better health status than their rural counterparts. This belief/assumption is often because of their physical proximity and assumed better access to health care services in urban areas. However, a few recent studies have cast doubt on this belief. Whether slum dwellers are better off, similar to, or worse off as compared with rural and other urban populations remain poorly understood as indicators for slum dwellers are generally hidden in urban averages. The aim of this study was to compare health and health-related indicators among slum, rural, and other urban populations in four countries where specific efforts have been made to generate health indicators specific to slum populations. We conducted a comparative analysis of health indicators among slums, non-slums, and all urban and rural populations as well as national averages in Bangladesh, Kenya, Egypt, and India. We triangulated data from demographic and health surveys, urban health surveys, and special cross-sectional slum surveys in these countries to assess differences in health indicators across the residential domains. We focused the comparisons on child health, maternal health, reproductive health, access to health services, and HIV/AIDS indicators. Within each country, we compared indicators for slums with non-slum, city/urban averages, rural, and national indicators. Between-country differences were also highlighted. In all the countries, except India, slum children had much poorer health outcomes than children in all other residential domains, including those in rural areas. Childhood illnesses and malnutrition were higher among children living in slum communities compared to those living elsewhere. Although treatment seeking was better among slum children as compared with those in rural areas, this did not translate to better mortality outcomes. They bear a disproportionately much higher mortality burden than those living elsewhere. Slum communities had higher coverage of maternal health services than rural communities but it was not possible to compare maternal mortality rates across these residential domains. Compared to rural areas, slum communities had lower fertility and higher contraceptive use rates but these differences were reversed when slums were compared to other urban populations. Slum-rural differences in infant mortality were found to be larger in Bangladesh compared to Kenya. Mortality and morbidity indicators were worse in slums than elsewhere. However, indicators of access to care and health service coverage were found to be better in slums than in rural communities.

Health and health-related indicators in slum, rural, and urban communities: a comparative analysis

PubMed Central

Mberu, Blessing U.; Haregu, Tilahun Nigatu; Kyobutungi, Catherine; Ezeh, Alex C.

2016-01-01

Background It is generally assumed that urban slum residents have worse health status when compared with other urban populations, but better health status than their rural counterparts. This belief/assumption is often because of their physical proximity and assumed better access to health care services in urban areas. However, a few recent studies have cast doubt on this belief. Whether slum dwellers are better off, similar to, or worse off as compared with rural and other urban populations remain poorly understood as indicators for slum dwellers are generally hidden in urban averages. Objective The aim of this study was to compare health and health-related indicators among slum, rural, and other urban populations in four countries where specific efforts have been made to generate health indicators specific to slum populations. Design We conducted a comparative analysis of health indicators among slums, non-slums, and all urban and rural populations as well as national averages in Bangladesh, Kenya, Egypt, and India. We triangulated data from demographic and health surveys, urban health surveys, and special cross-sectional slum surveys in these countries to assess differences in health indicators across the residential domains. We focused the comparisons on child health, maternal health, reproductive health, access to health services, and HIV/AIDS indicators. Within each country, we compared indicators for slums with non-slum, city/urban averages, rural, and national indicators. Between-country differences were also highlighted. Results In all the countries, except India, slum children had much poorer health outcomes than children in all other residential domains, including those in rural areas. Childhood illnesses and malnutrition were higher among children living in slum communities compared to those living elsewhere. Although treatment seeking was better among slum children as compared with those in rural areas, this did not translate to better mortality outcomes. They bear a disproportionately much higher mortality burden than those living elsewhere. Slum communities had higher coverage of maternal health services than rural communities but it was not possible to compare maternal mortality rates across these residential domains. Compared to rural areas, slum communities had lower fertility and higher contraceptive use rates but these differences were reversed when slums were compared to other urban populations. Slum–rural differences in infant mortality were found to be larger in Bangladesh compared to Kenya. Conclusion Mortality and morbidity indicators were worse in slums than elsewhere. However, indicators of access to care and health service coverage were found to be better in slums than in rural communities. PMID:27924741

The association between socioeconomic status and health-related quality of life among Polish postmenopausal women from urban and rural communities.

PubMed

Kaczmarek, M; Pacholska-Bogalska, J; Kwaśniewski, W; Kotarski, J; Halerz-Nowakowska, B; Goździcka-Józefiak, A

2017-01-01

In recent years, more scholarly attention has been paid to a growing range of geographic characteristics as antecedents of inequalities in women's health and well-being. The purpose of this study was to evaluate differences in health-related quality of life between rural and urban Polish postmenopausal women. Using a data set from a reproductive health preventive screening of 660 postmenopausal women aged 48-60 years, inhabitants of Wielkopolska and Lublin provinces, the association of place of residence, socioeconomic status and lifestyle factors with health-related quality of life (the SF-36 instrument) was evaluated using ANCOVA models and multiple logistic regression analysis with backward elimination steps. A consistent rural-to-urban gradient was found in all indices of physical health functioning and well-being but not in vitality, social functioning, emotional role and mental health scales with women in large cities being likely to enjoy the highest and those in villages the lowest quality of life. The rural-urban disparities in health-related quality of life were mediated by women's socioeconomic status. The likelihood of worse physical and mental functioning and well-being was 2-3 times greater for the low socioeconomic status rural women than their counterparts from more affluent urban areas. The educational attainment and employment status were the most powerful independent risk factors for health-related quality of life in both rural and urban women. Better understanding of the role of socioeconomic status that acts as a mediator in the association between area of residence and health-related quality of life may be useful in developing public health policies on health inequalities among women at midlife. Copyright © 2016. Published by Elsevier GmbH.

Factors influencing interest in recreational sports participation and its rural-urban disparity.

PubMed

Chen, Chiehfeng; Tsai, Liang-Ting; Lin, Ching-Feng; Huang, Chun-Ching; Chang, Yao-Tsung; Chen, Ruey-Yu; Lyu, Shu-Yu

2017-01-01

Recreational sports are important leisure activities. However, most studies investigating barrier factors and motivation for participation in recreational sports have been limited to specific areas (e.g., a city or school) or demographic groups (e.g., adolescents). Therefore, this study set out to gain a more comprehensive understanding of the behavioral and socioeconomic factors influencing interest in recreational sports participation in Taiwan, as well as to evaluate the effect of any urban-rural divide. This study analyzed data collected by the "Taiwan Social Change Survey" (program five, wave 3) "Leisure Life" questionnaire. We used hierarchical linear modeling to assess respondent interest in recreational sports participation and evaluated the influence of behavioral factors, socioeconomic factors, and residence location (urban/rural). Of the 2,146 participants in this study, 50.3% were male, and the average age was 43.9 years. Location of residence (urban/rural) accounted for 35.3% of the variation in interest in recreational sports participation, while the remaining 64.7% came from the individual level. Participants who lived in rural settings were less interested in recreational sports than their urban counterparts. Gender, educational attainment, participation frequency, health-motivated interest, and appearance-motivated interest were also associated with interest in recreational sports participation. Different communication strategies may be needed to effectively reach different demographic groups. We suggest that future public health campaigns aiming to increase recreational sports participation include tailored interventions and messages to effectively encourage leisure physical activities among all, regardless of demographic boundaries.

Exposing some important barriers to health care access in the rural USA.

PubMed

Douthit, N; Kiv, S; Dwolatzky, T; Biswas, S

2015-06-01

To review research published before and after the passage of the Patient Protection and Affordable Care Act (2010) examining barriers in seeking or accessing health care in rural populations in the USA. This literature review was based on a comprehensive search for all literature researching rural health care provision and access in the USA. Pubmed, Proquest Allied Nursing and Health Literature, National Rural Health Association (NRHA) Resource Center and Google Scholar databases were searched using the Medical Subject Headings (MeSH) 'Rural Health Services' and 'Rural Health.' MeSH subtitle headings used were 'USA,' 'utilization,' 'trends' and 'supply and distribution.' Keywords added to the search parameters were 'access,' 'rural' and 'health care.' Searches in Google Scholar employed the phrases 'health care disparities in the USA,' inequalities in 'health care in the USA,' 'health care in rural USA' and 'access to health care in rural USA.' After eliminating non-relevant articles, 34 articles were included. Significant differences in health care access between rural and urban areas exist. Reluctance to seek health care in rural areas was based on cultural and financial constraints, often compounded by a scarcity of services, a lack of trained physicians, insufficient public transport, and poor availability of broadband internet services. Rural residents were found to have poorer health, with rural areas having difficulty in attracting and retaining physicians, and maintaining health services on a par with their urban counterparts. Rural and urban health care disparities require an ongoing program of reform with the aim to improve the provision of services, promote recruitment, training and career development of rural health care professionals, increase comprehensive health insurance coverage and engage rural residents and healthcare providers in health promotion. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

"Before Today, I Was Afraid of Trees": Rethinking Nature Deficit Disorder

ERIC Educational Resources Information Center

Larkin, Doug

2011-01-01

Science teachers in urban schools often serve students whose experiences with the natural environment are more obviously constrained by human factors than their suburban or rural counterparts. At the same time, parents and teachers are contending with an increase in sedentary indoor activities that have affected youth of every demographic. Coupled…

Urban rural differences in diet, physical activity and obesity in India: are we witnessing the great Indian equalisation? Results from a cross-sectional STEPS survey.

PubMed

Tripathy, Jaya Prasad; Thakur, J S; Jeet, Gursimer; Chawla, Sohan; Jain, Sanjay; Prasad, Rajender

2016-08-18

The rising morbidity and mortality due to non-communicable diseases can be partly attributed to the urbanized lifestyle leading to unhealthy dietary practices and increasing physical levels of inactivity. The demographic and nutrition transition in India has also contributed to the emerging epidemic of non-communicable diseases in this country. In this context, there is limited information in India on dietary patterns, levels of physical activity and obesity. The aim of the present study was thus to assess the urban rural differences in dietary habits, physical activity and obesity in India. A household survey was done in the state of Punjab, India in a multistage stratified sample of 5127 individuals using the WHO STEPS questionnaire. No rural urban difference was found in dietary practices and prevalence of overweight and obesity except the fact that a significantly higher proportion of respondents belonging to rural area (15.6 %) always/often add salt before/when eating as compared to urban area (9.1 %). Overall 95.8 % (94.6-97.0) of participants took less than 5 servings of fruits and/or vegetables on average per day. No significant urban rural difference was noted in both sexes in all three domains of physical activity such as work, transport and recreation. However, rural females (19.1 %) were found to be engaged in vigorous activity more than the urban females (6.3 %). Males reported high levels of physical activity in both the settings. Absence of recreational activity was reported by more than 95 % of the subjects. Higher prevalence of obesity (asian cut offs used) was seen among urban females (34.3 %) as compared to their rural counterparts (23.2 %). Abdominal obesity was found to be significantly higher among females in both the settings compared to males (p < 0.001). Poor dietary practices and physical inactivity seems to fuel the non-communicable disease epidemic in India. Non communicable disease control strategy need to address these issues with a gender equity lens. Rapid urbanization of rural India might be responsible for the absence of a significant urban rural difference.

Levels, Trends and Disparities in Public-Health-Related Indicators among Reproductive-Age Women in Bangladesh by Urban-Rural and Richest-Poorest Groups, 1993-2011

PubMed Central

Khan, Md. Mobarak Hossain; Zanuzdana, Arina; Kraemer, Alexander

2013-01-01

Background And Objectives Although Bangladesh has already achieved noticeable progress in the field of development and health, disparities in public health indicators for several markers are still reported. To assess public health development in Bangladesh during the last two decades, firstly, we analysed levels, trends and disparities in public-health-related indicators by rural versus urban as well as by the richest versus poorest group of women who have ever been married. Secondly, using the most recent data set we performed multiple analyses to check whether urban-rural and richest-poorest disparities were still significant. Methods The analysis was based on six nationally representative data sets from the Bangladesh Demographic and Health Surveys (BDHS) conducted in 1993-94 (n=9,640), 1996-1997 (n=9,127), 1999-2000 (n=10,544), 2004 (n=11,440), 2007 (n=10,996) and 2011 (n=17,749). The outcome variables were six selected public-health-related indicators. We performed various types of analyses, including multiple logistic regressions. Results The trend of all indicators except being overweight (1993-2011) displayed gradual improvements for both markers. However, the urban and richest groups revealed a better situation than their counterparts in both simple and multiple analyses. Disparities between richest-poorest groups were more pronounced than urban-rural disparities. For instance, the prevalence of delivery at any healthcare facility in 2011 was 20.4% in rural areas and 46.5% in urban areas, whereas it was 9.1% in the poorest group and 57.6% in the richest group. Conclusion The public health sector in Bangladesh has achieved some successes over the last two decades. However, urban-rural and richest-poorest disparities are still considerable and therefore more public health strategies and efforts are clearly needed for the rural and poorest groups of women in order to reduce these gaps further. PMID:24086485

A Comparison of the Number of Men Who Have Sex with Men among Rural-To-Urban Migrants with Non-Migrant Rural and Urban Residents in Wuhan, China: A GIS/GPS-Assisted Random Sample Survey Study

PubMed Central

Chen, Xinguang; Yu, Bin; Zhou, Dunjin; Zhou, Wang; Gong, Jie; Li, Shiyue; Stanton, Bonita

2015-01-01

Background Mobile populations and men who have sex with men (MSM) play an increasing role in the current HIV epidemic in China and across the globe. While considerable research has addressed both of these at-risk populations, more effective HIV control requires accurate data on the number of MSM at the population level, particularly MSM among migrant populations. Methods Survey data from a random sample of male rural-to-urban migrants (aged 18-45, n=572) in Wuhan, China were analyzed and compared with those of randomly selected non-migrant urban (n=566) and rural counterparts (580). The GIS/GPS technologies were used for sampling and the survey estimation method was used for data analysis. Results HIV-related risk behaviors among rural-to-urban migrants were similar to those among the two comparison groups. The estimated proportion of MSM among migrants [95% CI] was 5.8% [4.7, 6.8], higher than 2.8% [1.2, 4.5] for rural residents and 1.0% [0.0, 2.4] for urban residents, respectively. Among these migrants, the MSM were more likely than non-MSM to be older in age, married, and migrated to more cities. They were also more likely to co-habit with others in rental properties located in new town and neighborhoods with fewer old acquaintances and more entertainment establishments. In addition, they were more likely to engage in commercial sex and less likely to consistently use condoms. Conclusion Findings of this study indicate that compared to rural and urban populations, the migrant population in Wuhan consists of a higher proportion of MSM who also exhibit higher levels of HIV-related risk behaviors. More effective interventions should target this population with a focus on neighborhood factors, social capital and collective efficacy for risk reduction. PMID:26241900

Knowledge and attitudes toward organ donation: a community-based study comparing rural and urban populations.

PubMed

Alghanim, Saad Abdullah

2010-01-01

The study was set to determine whether knowledge and attitudes toward organ donation differ according to geographical location. Self-administered questionnaires were employed to collect data such as demographic characteristics, basic knowledge, attitudes and source of information about organ donation from subjects in rural and urban areas. The questionnaires were distributed randomly to 1,000 individuals in both areas during 2008. The data were analyzed in a descriptive fashion. Despite similarities in knowledge and attitudes of respondents in both areas, rural respondents were less likely to have information about organ donation, to report willingness to donate organs, and to have knowledge about "brain death" or the "organ donation card" than their counterparts in urban areas. The study identified that the principle respondents' source of information about organ donation was the television. More than 90% of respondents in rural and urban areas reported that the contribution of health care providers in providing them with knowledge about organ donation and transplantation was "none" or "little". Respondents identified several reasons, which may influence their decisions to donate organs. In conclusion, the deficit in knowledge and attitudes of rural respondents about organ donation may be justified by the lack of information about this significant issue. Accordingly, health facilities, local mass media and educational institutions should provide intensive educational programs to encourage the public donate organs.

The hustle and bustle of city life: monitoring the effects of urbanisation in the African lesser bushbaby.

PubMed

Scheun, Juan; Bennett, Nigel C; Ganswindt, Andre; Nowack, Julia

2015-10-01

Urbanisation has become a severe threat to pristine natural areas, causing habitat loss and affecting indigenous animals. Species occurring within an urban fragmented landscape must cope with changes in vegetation type as well as high degrees of anthropogenic disturbance, both of which are possible key mechanisms contributing to behavioural changes and perceived stressors. We attempted to elucidate the effects of urbanisation on the African lesser bushbaby, Galago moholi, by (1) recording activity budgets and body condition (body mass index, BMI) of individuals of urban and rural populations and (2) further determining adrenocortical activity in both populations as a measure of stress via faecal glucocorticoid metabolite (fGCM) levels, following successful validation of an appropriate enzyme immunoassay test system (adrenocorticotropic hormone (ACTH) challenge test). We found that both sexes of the urban population had significantly higher BMIs than their rural counterparts, while urban females had significantly higher fGCM concentrations than rural females. While individuals in the urban population fed mainly on provisioned anthropogenic food sources and spent comparatively more time resting and engaging in aggressive interactions, rural individuals fed almost exclusively on tree exudates and spent more time moving between food sources. Although interactions with humans are likely to be lower in nocturnal than in diurnal species, our findings show that the impact of urbanisation on nocturnal species is still considerable, affecting a range of ecological and physiological aspects.

The hustle and bustle of city life: monitoring the effects of urbanisation in the African lesser bushbaby

NASA Astrophysics Data System (ADS)

Scheun, Juan; Bennett, Nigel C.; Ganswindt, Andre; Nowack, Julia

2015-10-01

Urbanisation has become a severe threat to pristine natural areas, causing habitat loss and affecting indigenous animals. Species occurring within an urban fragmented landscape must cope with changes in vegetation type as well as high degrees of anthropogenic disturbance, both of which are possible key mechanisms contributing to behavioural changes and perceived stressors. We attempted to elucidate the effects of urbanisation on the African lesser bushbaby, Galago moholi, by (1) recording activity budgets and body condition (body mass index, BMI) of individuals of urban and rural populations and (2) further determining adrenocortical activity in both populations as a measure of stress via faecal glucocorticoid metabolite (fGCM) levels, following successful validation of an appropriate enzyme immunoassay test system (adrenocorticotropic hormone (ACTH) challenge test). We found that both sexes of the urban population had significantly higher BMIs than their rural counterparts, while urban females had significantly higher fGCM concentrations than rural females. While individuals in the urban population fed mainly on provisioned anthropogenic food sources and spent comparatively more time resting and engaging in aggressive interactions, rural individuals fed almost exclusively on tree exudates and spent more time moving between food sources. Although interactions with humans are likely to be lower in nocturnal than in diurnal species, our findings show that the impact of urbanisation on nocturnal species is still considerable, affecting a range of ecological and physiological aspects.

Occupational Exposure to Vapor-Gas, Dust, and Fumes in a Cohort of Rural Adults in Iowa Compared with a Cohort of Urban Adults.

PubMed

Doney, Brent C; Henneberger, Paul K; Humann, Michael J; Liang, Xiaoming; Kelly, Kevin M; Cox-Ganser, Jean M

2017-11-03

Many rural residents work in the field of agriculture; however, employment in nonagricultural jobs also is common. Because previous studies in rural communities often have focused on agricultural workers, much less is known about the occupational exposures in other types of jobs in rural settings. Characterizing airborne occupational exposures that can contribute to respiratory diseases is important so that differences between rural and urban working populations can be assessed. 1994-2011. This investigation used data from the baseline questionnaire completed by adult rural residents participating in the Keokuk County Rural Health Study (KCRHS). The distribution of jobs and occupational exposures to vapor-gas, dust, and fumes (VGDF) among all participants was analyzed and stratified by farming status (current, former, and never) then compared with a cohort of urban workers from the Multi-Ethnic Study of Atherosclerosis (MESA). Occupational exposure in the last job was assessed with a job-exposure matrix (JEM) developed for chronic obstructive pulmonary disease (COPD). The COPD JEM assesses VGDF exposure at levels of none or low, medium, and high. The 1,699 KCRHS (rural) participants were more likely to have medium or high occupational VGDF exposure (43.2%) at their last job than their urban MESA counterparts (15.0% of 3,667 participants). One fifth (20.8%) of the rural participants currently farmed, 43.1% were former farmers, and approximately one third (36.1%) had never farmed. These three farming groups differed in VGDF exposure at the last job, with the prevalence of medium or high exposure at 80.2% for current farmers, 38.7% for former farmers, and 27.4% for never farmers, and all three percentages were higher than the 15.0% medium or high level of VGDF exposure for urban workers. Rural workers, including those who had never farmed, were more likely to experience occupational VGDF exposure than urban workers. The occupational exposures of rural adults assessed using the COPD JEM will be used to investigate their potential association with obstructive respiratory health problems (e.g., airflow limitation and chronic bronchitis). This assessment might highlight occupations in need of preventive interventions.

Urban-rural differences in the association between access to healthcare and health outcomes among older adults in China.

PubMed

Zhang, Xufan; Dupre, Matthew E; Qiu, Li; Zhou, Wei; Zhao, Yuan; Gu, Danan

2017-07-19

Studies have shown that inadequate access to healthcare is associated with lower levels of health and well-being in older adults. Studies have also shown significant urban-rural differences in access to healthcare in developing countries such as China. However, there is limited evidence of whether the association between access to healthcare and health outcomes differs by urban-rural residence at older ages in China. Four waves of data (2005, 2008/2009, 2011/2012, and 2014) from the largest national longitudinal survey of adults aged 65 and older in mainland China (n = 26,604) were used for analysis. The association between inadequate access to healthcare (y/n) and multiple health outcomes were examined-including instrumental activities of daily living (IADL) disability, ADL disability, cognitive impairment, and all-cause mortality. A series of multivariate models were used to obtain robust estimates and to account for various covariates associated with access to healthcare and/or health outcomes. All models were stratified by urban-rural residence. Inadequate access to healthcare was significantly higher among older adults in rural areas than in urban areas (9.1% vs. 5.4%; p < 0.01). Results from multivariate models showed that inadequate access to healthcare was associated with significantly higher odds of IADL disability in older adults living in urban areas (odds ratio [OR] = 1.58-1.79) and rural areas (OR = 1.95-2.30) relative to their counterparts with adequate access to healthcare. In terms of ADL disability, we found significant increases in the odds of disability among rural older adults (OR = 1.89-3.05) but not among urban older adults. Inadequate access to healthcare was also associated with substantially higher odds of cognitive impairment in older adults from rural areas (OR = 2.37-3.19) compared with those in rural areas with adequate access to healthcare; however, no significant differences in cognitive impairment were found among older adults in urban areas. Finally, we found that inadequate access to healthcare increased overall mortality risks in older adults by 33-37% in urban areas and 28-29% in rural areas. However, the increased risk of mortality in urban areas was not significant after taking into account health behaviors and baseline health status. Inadequate access to healthcare was significantly associated with higher rates of disability, cognitive impairment, and all-cause mortality among older adults in China. The associations between access to healthcare and health outcomes were generally stronger among older adults in rural areas than in urban areas. Our findings underscore the importance of providing adequate access to healthcare for older adults-particularly for those living in rural areas in developing countries such as China.

Megacities and Large Urban Complexes - WMO Role in Addressing Challenges and Opportunities

NASA Astrophysics Data System (ADS)

Terblanche, Deon; Jalkanen, Liisa

2013-04-01

Megacities and Large Urban Complexes - WMO Role in Addressing Challenges and Opportunities Deon E. Terblanche and Liisa Jalkanen dterblanche@wmo.int ljalkanen@wmo.int World Meteorological Organization, Geneva, Switzerland The 21st Century could amongst others, become known as the century in which our species has evolved from Homo sapiens to Homo urbanus. By now the urban population has surpassed the rural population and the rate of urbanization will continue at such a pace that by 2050 urban dwellers could outnumber their rural counterpart by more than two to one. Most of this growth in urban population will occur in developing countries and along coastal areas. Urbanization is to a large extent the outcome of humans seeking a better life through improved opportunities presented by high-density communities. Megacities and large urban complexes provide more job opportunities and social structures, better transport and communication links and a relative abundance of physical goods and services when compared to most rural areas. Unfortunately these urban complexes also present numerous social and environmental challenges. Urban areas differ from their surroundings by morphology, population density, and with high concentration of industrial activities, energy consumption and transport. They also pose unique challenges to atmospheric modelling and monitoring and create a multi-disciplinary spectrum of potential threats, including air pollution, which need to be addressed in an integrated way. These areas are also vulnerable to the changing climate and its implications to sea-level and extreme events, air quality and related health impacts. Many urban activities are significantly impacted by weather events that would not be considered to be of high impact in less densely populated areas. For instance, moderate precipitation events can cause flooding and landslides as modified urban catchments generally have higher run-off to rainfall ratios than their more pristine rural counterparts. The urban environment also provides numerous opportunities. One example being the better use of weather and environmental predictions to proactively optimize the functioning of the urban environment in terms of the use of energy, goods and services. Another is the providing of air quality forecasting services to benefit the health of the population. To address the challenges and opportunities facing megacities and large urban complexes, WMO has established the Global Atmosphere Watch (GAW) Urban Research Meteorology and Environment (GURME). Air pollution questions in urban areas, in particular megacities, is the main focus, building observational and modelling capabilities in developing countries through pilot projects and transfer of scientific expertise. GURME contributes to improving capabilities to handle meteorological and related features of air pollution by addressing end-to-end aspects of air quality, linking observational capabilities with the needs of chemical weather prediction, with the goal of providing high quality air quality services. Using examples from around the world but with specific reference to Africa, the unique challenges and opportunities related to megacities and large urban complexes, as perceived by the World Meteorological Organization (WMO) are highlighted.

Impact of a Health Promotion Nurse Intervention on Disability and Health Care Costs among Elderly Adults with Heart Conditions

ERIC Educational Resources Information Center

Meng, Hongdao; Wamsley, Brenda R.; Eggert, Gerald M.; Van Nostrand, Joan F.

2007-01-01

Context: Patients with heart conditions in rural areas may have different responses to health promotion-disease Self-management interventions compared to their urban counterparts. Purpose: To estimate the impact of a multi-component health promotion nurse intervention on physical function and total health care expenditures among elderly adults…

Are We Making Education Count in Remote Australian Communities or Just Counting Education?

ERIC Educational Resources Information Center

Guenther, John

2013-01-01

For quite some time the achievements of students in remote Australian schools have been lamented. There is not necessarily anything new about the relative difference between the results of Aboriginal and Torres Strait Islander students in remote communities and their counterparts in urban, regional and rural schools across Australia. However, in…

Rural–urban differences in exposure to adverse childhood experiences among South Carolina adults.

PubMed

Radcliff, Elizabeth; Crouch, Elizabeth; Strompolis, Melissa

2018-02-01

Adverse childhood experiences (ACEs) are traumatic events that occur in a child's life between birth and 18 years. Exposure to one or more ACE has been linked to participation in risky health behaviors and the experience of chronic health conditions in adulthood. The risk for poor outcomes increases as the number of ACEs experienced increases. This research investigates rural-urban differences in exposure to ACEs using a sample from a representative southern US state, South Carolina. Using data from the 2014-2015 South Carolina Behavioral Risk Factor Surveillance System (BRFSS) and residential rurality based on UICs, ACE exposure among South Carolina adults was tabulated by urban versus rural residence and selected other demographic characteristics. Using standard descriptive statistics, frequencies and proportions were calculated for each categorical variable. Multivariable regression modeling was used to examine the impact of residential rurality and selected sociodemographic characteristics on overall and specific types of ACE exposure. All analyses used survey sampling weights that accounted for the BRFSS sampling strategy. The analytic sample of 18 176 respondents comprised 15.9% rural residents. Top reported ACEs for both rural and urban residents were the same: parental divorce/separation, emotional abuse, and household substance use. Compared to urban residents, a higher proportion of rural respondents reported experiencing no ACEs (41.4% vs 38.3%, p<0.01). The prevalence of four or more ACEs in rural respondents was 15.0%; in comparison, 17.6% of urban respondents had four or more ACEs (p<0.01). In logistic regression predicting exposure to four or more ACEs and adjusting for sex, age, race/ethnicity, education, and income, rural respondents were less likely than urban respondents to report four or more ACEs (adjusted odds ratio 0.75, 95% confidence interval 0.74-0.75). Despite reporting less ACE exposure than urban counterparts, almost 60% of rural residents reported at least one ACE and 15% reported experiencing four or more ACEs. In contrast to urban residents, rural residents may experience more social connections within their families and communities, which may influence ACE exposure; however, care coordination, social support services, and access to health care are limited in rural areas. Thus, families in rural areas may be less equipped to mitigate and manage the effects of ACEs. Findings from this study thus suggest that interventions to prevent ACE exposure are just as needed in rural southern communities as they are in urban southern communities. Topics important for future research could include an examination of ACEs in rural communities in terms of individuals' health outcomes and their access to health care, as well as the role of protective factors. Programs and policies that assist in ACE prevention in rural areas are important to reducing these multigenerational threats to health and wellbeing.

Factors influencing interest in recreational sports participation and its rural-urban disparity

PubMed Central

Chen, Chiehfeng; Tsai, Liang-Ting; Lin, Ching-Feng; Huang, Chun-Ching; Chang, Yao-Tsung; Chen, Ruey-Yu; Lyu, Shu-Yu

2017-01-01

Objectives Recreational sports are important leisure activities. However, most studies investigating barrier factors and motivation for participation in recreational sports have been limited to specific areas (e.g., a city or school) or demographic groups (e.g., adolescents). Therefore, this study set out to gain a more comprehensive understanding of the behavioral and socioeconomic factors influencing interest in recreational sports participation in Taiwan, as well as to evaluate the effect of any urban-rural divide. Methods This study analyzed data collected by the “Taiwan Social Change Survey” (program five, wave 3) “Leisure Life” questionnaire. We used hierarchical linear modeling to assess respondent interest in recreational sports participation and evaluated the influence of behavioral factors, socioeconomic factors, and residence location (urban/rural). Results Of the 2,146 participants in this study, 50.3% were male, and the average age was 43.9 years. Location of residence (urban/rural) accounted for 35.3% of the variation in interest in recreational sports participation, while the remaining 64.7% came from the individual level. Participants who lived in rural settings were less interested in recreational sports than their urban counterparts. Gender, educational attainment, participation frequency, health-motivated interest, and appearance-motivated interest were also associated with interest in recreational sports participation. Conclusions Different communication strategies may be needed to effectively reach different demographic groups. We suggest that future public health campaigns aiming to increase recreational sports participation include tailored interventions and messages to effectively encourage leisure physical activities among all, regardless of demographic boundaries. PMID:28542455

Research on monocentric model of urbanization by agent-based simulation

NASA Astrophysics Data System (ADS)

Xue, Ling; Yang, Kaizhong

2008-10-01

Over the past years, GIS have been widely used for modeling urbanization from a variety of perspectives such as digital terrain representation and overlay analysis using cell-based data platform. Similarly, simulation of urban dynamics has been achieved with the use of Cellular Automata. In contrast to these approaches, agent-based simulation provides a much more powerful set of tools. This allows researchers to set up a counterpart for real environmental and urban systems in computer for experimentation and scenario analysis. This Paper basically reviews the research on the economic mechanism of urbanization and an agent-based monocentric model is setup for further understanding the urbanization process and mechanism in China. We build an endogenous growth model with dynamic interactions between spatial agglomeration and urban development by using agent-based simulation. It simulates the migration decisions of two main types of agents, namely rural and urban households between rural and urban area. The model contains multiple economic interactions that are crucial in understanding urbanization and industrial process in China. These adaptive agents can adjust their supply and demand according to the market situation by a learning algorithm. The simulation result shows this agent-based urban model is able to perform the regeneration and to produce likely-to-occur projections of reality.

Lipid profiles and determinants of total cholesterol and hypercholesterolaemia among 25–74 year-old urban and rural citizens of the Yangon Region, Myanmar: a cross-sectional study

PubMed Central

Htet, Aung Soe; Aung, Wai Phyo; Moe Myint, Aye Nyein; Aye, Win Thuzar; Wai, Myint Myint; Nu, Than Than; Hla, Ei Mon; Soe, Pyone Pyone; Tun, Nan Wut Yi; Angela, Naw; Khaing, Mya Mya; Htoo, Aung Kyaw; Tun, Soe; Thitsar, Pai; Lwin, Theeoo; Wai, San San; Aung, Thi Thi; Thant, Khin Aye; Aung Po, Wai Wai; Gauzam, Seng Taung; Naing, Tun Tun; Tun, Thet Min; Myint, Khin San; Oo, Kyi Kyi; Mang, Nang Kee Myu; Naing, Soe Moe; Zaw, Ko Ko; Bjertness, Marius Bergsmark; Sherpa, Lhamo Yangchen; Oo, Win Myint; Stigum, Hein; Bjertness, Espen

2017-01-01

Objective The first is to estimate the prevalence of dyslipidaemia (hypercholesterolaemia, hypertriglyceridaemia, high low-density lipoprotein (LDL) level and low high-density lipoprotein (HDL) level), as well as the mean levels of total cholesterol, triglyceride, LDL and HDL, in the urban and rural Yangon Region, Myanmar. The second is to investigate the association between urban-rural location and total cholesterol. Design Two cross-sectional studies using the WHO STEPS methodology. Setting Both the urban and rural areas of the Yangon Region, Myanmar. Participants A total of 1370 men and women aged 25–74 years participated based on a multistage cluster sampling. Physically and mentally ill people, monks, nuns, soldiers and institutionalised people were excluded. Results Compared with rural counterparts, urban dwellers had a significantly higher age-standardised prevalence of hypercholesterolaemia (50.7% vs 41.6%; p=0.042) and a low HDL level (60.6% vs 44.4%; p=0.001). No urban-rural differences were found in the prevalence of hypertriglyceridaemia and high LDL. Men had a higher age-standardised prevalence of hypertriglyceridaemia than women (25.1% vs 14.8%; p<0.001), while the opposite pattern was found in the prevalence of a high LDL (11.3% vs 16.3%; p=0.018) and low HDL level (35.3% vs 70.1%; p<0.001). Compared with rural inhabitants, urban dwellers had higher age-standardised mean levels of total cholesterol (5.31 mmol/L, SE: 0.044 vs 5.05 mmol/L, 0.068; p=0.009), triglyceride (1.65 mmol/L, 0.049 vs 1.38 mmol/L, 0.078; p=0.017), LDL (3.44 mmol/L, 0.019 vs 3.16 mmol/L, 0.058; p=0.001) and lower age-standardised mean levels of HDL (1.11 mmol/L, 0.010 vs 1.25 mmol/L, 0.012; p<0.001). In linear regression, the total cholesterol was significantly associated with an urban location among men, but not among women. Conclusion The mean level of total cholesterol and the prevalence of hypercholesterolaemia were alarmingly high in men and women in both the urban and rural areas of Yangon Region, Myanmar. Preventive measures to reduce cholesterol levels in the population are therefore needed. PMID:29146640

Knowledge of Obstetric Fistula Prevention amongst Young Women in Urban and Rural Burkina Faso: A Cross-Sectional Study

PubMed Central

Banke-Thomas, Aduragbemi O.; Kouraogo, Salam F.; Siribie, Aboubacar; Taddese, Henock B.; Mueller, Judith E.

2013-01-01

Obstetric fistula is a sequela of complicated labour, which, if untreated, leaves women handicapped and socially excluded. In Burkina Faso, incidence of obstetric fistula is 6/10,000 cases amongst gynaecological patients, with more patients affected in rural areas. This study aims to evaluate knowledge on obstetric fistula among young women in a health district of Burkina Faso, comparing rural and urban communities. This cross-sectional study employed multi-stage sampling to include 121 women aged 18-20 years residing in urban and rural communities of Boromo health district. Descriptive statistics and multiple logistic regression analysis were used to compare differences between the groups and to identify predictors of observed knowledge levels. Rural women were more likely to be married (p<0.000) and had higher propensity to teenage pregnancy (p=0.006). The survey showed overall poor obstetric fistula awareness (36%). Rural residents were less likely to have adequate preventive knowledge than urban residents [OR=0.35 (95%-CI, 0.16–0.79)]. This effect was only slightly explained by lack of education [OR=0.41 (95%-CI, 0.18–0.93)] and only slightly underestimated due to previous pregnancy [OR=0.27 (95%-CI, 0.09–0.79)]. Media were the most popular source of awareness amongst urban young women in contrast to their rural counterparts (68% vs. 23%). Most rural young women became ‘aware’ through word-of-mouth (68% vs. 14%). All participants agreed that the hospital was safer for emergency obstetric care, but only 11.0% believed they could face pregnancy complications that would require emergency treatment. There is urgent need to increase emphasis on neglected health messages such as the risks of obstetric fistula. In this respect, obstetric fistula prevention programs need to be adapted to local contexts, whether urban or rural, and multi-sectoral efforts need to be exerted to maximise use of other sectoral resources and platforms, including existing routine health services and schools, to ensure sustainability of health literacy efforts. PMID:24392032

High-tech rural clinics and hospitals in Japan: a comparison to the Japanese average.

PubMed

Matsumoto, Masatoshi; Okayama, Masanobu; Inoue, Kazuo; Kajii, Eiji

2004-10-01

Japanese medical facilities are noted for being heavily equipped with high-tech equipment compared to other industrialised countries. Rural facilities are anecdotally said to be better equipped than facilities in other areas due to egalitarian health resource diffusion policies by public sectors whose goal is to secure fair access to modern medical technologies among the entire population. To show the technology status of rural practice and compare it to the national level. Nationwide postal survey. Questionnaires were sent to the directors of 1362 public hospitals and clinics (of the 1723 municipalities defined as 'rural' by four national laws). Information was collected about the technologies they possessed. The data were compared with figures from a national census of all hospitals and clinics. A total of 766 facilities responded (an effective response rate of 56%). Rural facilities showed higher possession rates in most comparable technologies than the national level. It is noted that almost all rural hospitals had gastroscopes and colonoscopes and their possession rates of bronchoscopes and dialysis equipment were twice as high as the national level. The discrepancy in possession rates between rural and national was even more remarkable in clinics than in hospitals. Rural clinics owned twice as many abdominal ultrasonographs, and three times as many gastroscopes, colonoscopes, defibrillators and computed tomography scanners as the national level. Rural facilities are equipped with more technology than urban ones. Government-led, tax based, technology diffusion in the entire country seems to have attained its goal. What is already known on this subject: As a general tendency in both developing and developed countries, rural medical facilities are technologically less equipped than their urban counterparts. What does this paper add?: In Japan, rural medical facilities are technologically better equipped than urban facilities.

Utilization of hospital services by cardiovascular patients, Alberta, Canada.

PubMed Central

Bay, K S; Maher, M; Lee, S J

1989-01-01

Using hospital discharge records, and United States DRG (diagnosis related groups) data, we studied hospital utilization by cardiovascular patients, associated hospital expenditures, and the per capita cost of treating cardiovascular diseases in Alberta, Canada between 1971 and 1986. Expressed in constant 1984 Canadian dollars, the estimated total hospital cost increased from $84 million in 1971 to $131 million in 1986; during this period the Province of Alberta spent about $51 Canadian per resident each year for cardiovascular hospital services. It was noted that rural residents consumed a higher volume of resources per capita than their urban counterparts. A patient origin-destination analysis indicated an increasing dependence of rural patients on urban hospitals for secondary or tertiary care, underscoring the effects of medical technology on referral patterns. PMID:2499201

The influence of loan repayment on rural healthcare provider recruitment and retention in Colorado.

PubMed

Renner, Daniel M; Westfall, John M; Wilroy, Lou Ann; Ginde, Adit A

2010-01-01

There is an ongoing shortage of rural healthcare providers relative to urban healthcare providers worldwide. Many strategies have been implemented to increase the distribution of rural healthcare providers, and financial incentives such as loan repayment programs have become popular means to both recruit and retain healthcare providers in rural communities. Studies detailing the effects of such programs on rural provider recruitment and retention are limited. The objective of this study was to assess the influence of loan repayment and other factors on the recruitment and retention of healthcare providers in rural Colorado, USA, and to compare the motivations and attitudes of these rural providers with their urban counterparts. A survey was sent to 122 healthcare providers who had participated in one of three loan repayment programs in Colorado between the years of 1992 and 2007: the Colorado Health Professional Loan Repayment Program; the Colorado Rural Outreach Program; and the Dental Loan Repayment Program of Colorado. Differentiation between rural and urban communities was accomplished by using the Rural Urban Commuting Area Codes developed by the University of Washington's Rural Health Research Center and Economic Research Service. Statistical analysis was performed using STATA from StataCorp. Of the 93 respondents included in the study, 57 worked in rural communities and 36 worked in urban communities during their programs. Of the rural participants, 74% were already working in or intending to work in an eligible community when they were made aware of the loan repayment program. Of those planning to work in a rural community regardless of any loan repayment option, 42% reported that the loan repayment program had an important influence on the specific community in which they chose to practice. Of the rural participants already working in a rural community, 38% reported loan repayment as being an important factor in their retention. The most important factors the rural providers cited for their recruitment were the location of the community, scope of practice, and family fit with the community. The most important factors for the urban providers were the location of the community, salary, and scope of practice. Of the rural providers, 36% attended rural high schools, while 9% of urban providers attended rural high schools. Of the rural providers who were planning on practicing in a rural area regardless of any loan repayment option, 37% had attended rural high schools. Rural participants most often left their communities because their families wanted to move, personal or professional isolation, and dissatisfaction with the medical community. Of rural participants 22% cited the desire for a higher income as an important reason to leave their communities, while the desire for a higher income was the most commonly cited reason for the urban providers. Rural retention rates were not influenced by past attendance at rural high schools or by intention to practice in a rural community regardless of loan repayment. Loan repayment programs targeting rural Colorado usually enroll providers who would have worked in a rural area regardless of loan repayment opportunities, but are likely to play a role in providers' choice of specific rural community for practice. They also appear to have a limited but important influence on rural provider retention, though financial concerns are generally less influential for non-retained rural providers than are family preferences and professional dissatisfaction.

Occupational Exposure to Vapor-Gas, Dust, and Fumes in a Cohort of Rural Adults in Iowa Compared with a Cohort of Urban Adults

PubMed Central

Henneberger, Paul K.; Humann, Michael J.; Liang, Xiaoming; Kelly, Kevin M.; Cox-Ganser, Jean M.

2017-01-01

Problem/Condition Many rural residents work in the field of agriculture; however, employment in nonagricultural jobs also is common. Because previous studies in rural communities often have focused on agricultural workers, much less is known about the occupational exposures in other types of jobs in rural settings. Characterizing airborne occupational exposures that can contribute to respiratory diseases is important so that differences between rural and urban working populations can be assessed. Reporting Period 1994–2011. Description of System This investigation used data from the baseline questionnaire completed by adult rural residents participating in the Keokuk County Rural Health Study (KCRHS). The distribution of jobs and occupational exposures to vapor-gas, dust, and fumes (VGDF) among all participants was analyzed and stratified by farming status (current, former, and never) then compared with a cohort of urban workers from the Multi-Ethnic Study of Atherosclerosis (MESA). Occupational exposure in the last job was assessed with a job-exposure matrix (JEM) developed for chronic obstructive pulmonary disease (COPD). The COPD JEM assesses VGDF exposure at levels of none or low, medium, and high. Results The 1,699 KCRHS (rural) participants were more likely to have medium or high occupational VGDF exposure (43.2%) at their last job than their urban MESA counterparts (15.0% of 3,667 participants). One fifth (20.8%) of the rural participants currently farmed, 43.1% were former farmers, and approximately one third (36.1%) had never farmed. These three farming groups differed in VGDF exposure at the last job, with the prevalence of medium or high exposure at 80.2% for current farmers, 38.7% for former farmers, and 27.4% for never farmers, and all three percentages were higher than the 15.0% medium or high level of VGDF exposure for urban workers. Interpretation Rural workers, including those who had never farmed, were more likely to experience occupational VGDF exposure than urban workers. Public Health Action The occupational exposures of rural adults assessed using the COPD JEM will be used to investigate their potential association with obstructive respiratory health problems (e.g., airflow limitation and chronic bronchitis). This assessment might highlight occupations in need of preventive interventions. PMID:29095802

Differences in severity at admission for heart failure between rural and urban patients: the value of adding laboratory results to administrative data.

PubMed

Smith, Mark W; Owens, Pamela L; Andrews, Roxanne M; Steiner, Claudia A; Coffey, Rosanna M; Skinner, Halcyon G; Miyamura, Jill; Popescu, Ioana

2016-04-18

Rural/urban variations in admissions for heart failure may be influenced by severity at hospital presentation and local practice patterns. Laboratory data reflect clinical severity and guide hospital admission decisions and treatment for heart failure, a costly chronic illness and a leading cause of hospitalization among the elderly. Our main objective was to examine the role of laboratory test results in measuring disease severity at the time of admission for inpatients who reside in rural and urban areas. We retrospectively analyzed discharge data on 13,998 hospital discharges for heart failure from three states, Hawai'i, Minnesota, and Virginia. Hospital discharge records from 2008 to 2012 were derived from the State Inpatient Databases of the Healthcare Cost and Utilization Project, and were merged with results of laboratory tests performed on the admission day or up to two days before admission. Regression models evaluated the relationship between clinical severity at admission and patient urban/rural residence. Models were estimated with and without use of laboratory data. Patients residing in rural areas were more likely to have missing laboratory data on admission and less likely to have abnormal or severely abnormal tests. Rural patients were also less likely to be admitted with high levels of severity as measured by the All Patient Refined Diagnosis Related Groups (APR-DRG) severity subclass, derivable from discharge data. Adding laboratory data to discharge data improved model fit. Also, in models without laboratory data, the association between urban compared to rural residence and APR-DRG severity subclass was significant for major and extreme levels of severity (OR 1.22, 95% CI 1.03-1.43 and 1.55, 95% CI 1.26-1.92, respectively). After adding laboratory data, this association became non-significant for major severity and was attenuated for extreme severity (OR 1.12, 95% CI 0.94-1.32 and 1.43, 95% CI 1.15-1.78, respectively). Heart failure patients from rural areas are hospitalized at lower severity levels than their urban counterparts. Laboratory test data provide insight on clinical severity and practice patterns beyond what is available in administrative discharge data.

General dentist characteristics associated with rural practice location.

PubMed

McKernan, Susan C; Kuthy, Raymond A; Kavand, Golnaz

2013-08-01

To examine whether there is a difference in the likelihood that a general dentist practices in a rural location based on individual characteristics, including dental school attended, birth state, practice arrangement, sex, and age. All private practice, general dentists in Iowa were included in this study. Data were extracted from the year 2010 version of the Iowa Dentist Tracking System, which monitors practice patterns of active dentists. Rurality of primary office location, categorized using Rural-Urban Commuting Area codes, served as the outcome variable. Chi-square tests and multivariable logistic regression were used to explain associations between rural practice location and dentist characteristics. Fifteen percent of the state's population resided in isolated small rural towns, but only 8% of general dentists practiced here. Approximately 17% of dentists in isolated small rural towns were age 40 or younger, compared to 32% of dentists in urban areas. Among male dentists, those who were born in Iowa (P = .002) were older (P = .020), and graduated from dental schools other than the University of Iowa (P = .009) were more likely to practice in rural areas than were their counterparts. Conversely, among female dentists, solo practice (P = .016) was the only variable significantly associated with rural practice location. The dentist workforce in rural areas of Iowa is dominated by older males who were born in Iowa. As this generation retires and increasing numbers of women enter the profession, state policy makers and planners will need to monitor changing trends in the rural workforce. © 2013 National Rural Health Association.

Oncology service initiatives and research in regional Australia.

PubMed

Murphy, Caitlin; Sabesan, Sabe; Steer, Christopher; Yates, Patsy; Booms, Anne; Jones, Victoria; Simpson, Alison; Clarke, Kerrie; Eek, Richard; Ashley, David; Goldstein, David; Packer, Chris; Tuthill, Fiona; Boyce, Adam; Underhill, Craig

2015-02-01

This paper reflects on the recent growth of cancer research being conducted through some of Australia's rural centres. It encompasses work being done across the fields of clinical, translational and health services research. This is a collaborative piece with contributions from rural health researchers, clinical and cancer services staff from several different regions. The past decade has seen an expansion in cancer research in rural and regional Australia driven in part by the recognition that cancer patients in remote areas experience poorer outcomes than their metropolitan counterparts. This work has led to the development of more effective cancer networks and new models of care designed to meet the particular needs of the rural cancer patient. It is hoped that the growth of cancer research in regional centres will, in time, reduce the disparity between rural and urban communities and improve outcomes for cancer patients across both populations. © 2015 National Rural Health Alliance Inc.

Primary health-care teams as adaptive organizations: exploring and explaining work variation using case studies in rural and urban Scotland.

PubMed

Farmer, Jane; West, Christina; Whyte, Bruce; Maclean, Margaret

2005-08-01

It is acknowledged, internationally, that health-care practitioners' work differs between and urban areas. While several factors affect individual teams' activities, there is little understanding about how patterns of work evolve. Consideration of work in relation to local circumstances is important for training, devising contracts and redesigning services. Six case studies centred on Scottish rural and urban general practices were used to examine, in-depth, the activity of primary health-care teams. Quantitative workload data about patient contacts were collected over 24 months. Interviews and diaries revealed insightful qualitative data. Findings revealed that rural general practitioners and district nurses tended to conduct more consultations per practice patient compared with their urban counterparts. Conditions seen and work tasks varied between case study teams. Qualitative data suggested that the key reasons for variation were: local needs and circumstances; choices made about deployment of available time, team composition and the extent of access to other services. Primary care teams might be viewed as adaptive organization, with co-evolution of services produced by health professionals and local people. The study highlights limitations in the application of workload data and suggests that understanding the nature of work in relation to local circumstances is important in service redesign.

The efficacy of economic-development programs in forest-dependent communities

Treesearch

Rory Fraser

1997-01-01

West Virginia is one of the poorest states in the nation and its rural communities are more hard pressed than their urban counterparts. At the same time, West Virginia is one of the most densely forested states in the USA. The combination of poverty amidst a wealth of forest suggest that economic development based on the forest resource could provide solutions for poor...

Urban-rural disparities in the nutritional status of school adolescent girls in the Mizan district, south-western Ethiopia.

PubMed

Berheto, Tezera M; Mikitie, Wondafrash K; Argaw, Alemayehu

2015-01-01

Malnutrition that occurs during adolescence has important consequences for the future growth and development of the individual, particularly in girls in developing countries. Besides limiting growth, adolescent malnutrition has important consequences for society. Despite this, there is a lack of information on the nutritional status of adolescent girls in Ethiopia. This study was therefore performed to help redress this lack of data and to provide information for future improvements by health planners and policy makers. A comparative cross-sectional study design was employed to determine the urban-rural disparity in nutritional status of adolescent school girls in the Mizan district in south-western Ethiopia. A two-stage sampling procedure was used to randomly select 622 adolescent girls, 311 each from urban and rural locations. Trained field workers used structured questionnaires to obtain the desired information from the respondents. Anthropometric measurements of height and weight were collected using standard procedures and appropriate quality control measures. Height-for-age Z-scores and body mass index (BMI)-for-age Z-scores were generated using AnthroPlus software. The independent sample t-test and χ2 test were used to determine statistical significance. There were no significant differences in the ages or physical activities of the two populations of girls studied. Consumption of cereal, vegetables, sweets, sugars, fats, meat, and eggs was similar between the two groups, although slight differences were found with regard to legumes, milk, and fruit consumption. No significant differences were found in the prevalence of mild underweight girls and overweight girls in the urban and rural groups (26.5% vs 22.3% and 7.5% vs 5.2%, respectively). Significant stunting was, however, present in the rural population (40.9% vs. 17.8% in the urban group). Although overall lower than the reference data provided by WHO, the mean BMI-for-age Z-scores and height-for-age Z-scores were significantly higher in the urban girls than in their rural counterparts, with mean differences of 0.18 (95% confidence interval (CI) 0.02-0.34) and 0.58 (95% CI 0.45-0.72), respectively. Malnutrition was present in both urban and rural adolescent girls. The most obvious disparity between the two populations was significant stunting in the rural population. There is therefore an urgent need for strategies to address severe nutritional problems in rural adolescent girls and to improve the nutrition of adolescent girls within the urban environment.

Health Selection, Migration, and HIV Infection in Malawi.

PubMed

Anglewicz, Philip; VanLandingham, Mark; Manda-Taylor, Lucinda; Kohler, Hans-Peter

2018-04-27

Despite its importance in studies of migrant health, selectivity of migrants-also known as migration health selection-has seldom been examined in sub-Saharan Africa (SSA). This neglect is problematic because several features of the context in which migration occurs in SSA-very high levels of HIV, in particular-differ from contextual features in regions that have been studied more thoroughly. To address this important gap, we use longitudinal panel data from Malawi to examine whether migrants differ from nonmigrants in pre-migration health, assessed via SF-12 measures of mental and physical health. In addition to overall health selection, we focus on three more-specific factors that may affect the relationship between migration and health: (1) whether migration health selection differs by destination (rural-rural, rural-town, and rural-urban), (2) whether HIV infection moderates the relationship between migration and health, and (3) whether circular migrants differ in pre-migration health status. We find evidence of the healthy migrant phenomenon in Malawi, where physically healthier individuals are more likely to move. This relationship varies by migration destination, with healthier rural migrants moving to urban and other rural areas. We also find interactions between HIV-infected status and health: HIV-infected women moving to cities are physically healthier than their nonmigrant counterparts.

A comparison of rural and urban rheumatoid arthritis populations.

PubMed

Basu, N; Steven, M

2009-02-01

There is evidence to suggest that remote populations have poorer clinical outcomes in certain disease processes such as asthma and cancer. This study looks to identify any disparities in the management of patients with rheumatoid arthritis in the context of rurality. A retrospective observational study was performed on all 1314 patients with a diagnosis of rheumatoid arthritis who have been under the care of the principal rheumatologist at Raigmore Hospital, Inverness, between the years 1994 and 2004 inclusive. Rurality was defined according to the Scottish Household Survey. Populations were assessed in terms of age; sex; duration of diagnosis; number of years of Disease Modifying AntiRheumatic Drugs (DMARD) therapy, prednisolone use and the number of musculoskeletal practical interventions undertaken (eg joint aspiration or replacement). Two thirds of patients were considered rural dwellers. No significant difference was established between the populations with regards to management. DMARD therapy had been prescribed in 77% of rural patients vs 70% of their city counterparts for a mean 5.4 and 4.0 years respectively. The proportion of patients exposed to prednisolone therapy and who underwent musculoskeletal procedures were equivalent. Rural dwellers, with rheumatoid arthritis in the Highlands of Scotland, do not appear to be disadvantaged in regards to their disease management in comparison to the urban population.

Lipid profiles and determinants of total cholesterol and hypercholesterolaemia among 25-74 year-old urban and rural citizens of the Yangon Region, Myanmar: a cross-sectional study.

PubMed

Htet, Aung Soe; Kjøllesdal, Marte Karoline; Aung, Wai Phyo; Moe Myint, Aye Nyein; Aye, Win Thuzar; Wai, Myint Myint; Nu, Than Than; Hla, Ei Mon; Soe, Pyone Pyone; Tun, Nan Wut Yi; Angela, Naw; Khaing, Mya Mya; Htoo, Aung Kyaw; Tun, Soe; Thitsar, Pai; Lwin, Theeoo; Wai, San San; Aung, Thi Thi; Thant, Khin Aye; Aung Po, Wai Wai; Gauzam, Seng Taung; Naing, Tun Tun; Tun, Thet Min; Myint, Khin San; Oo, Kyi Kyi; Mang, Nang Kee Myu; Naing, Soe Moe; Zaw, Ko Ko; Bjertness, Marius Bergsmark; Sherpa, Lhamo Yangchen; Oo, Win Myint; Stigum, Hein; Bjertness, Espen

2017-11-15

The first is to estimate the prevalence of dyslipidaemia (hypercholesterolaemia, hypertriglyceridaemia, high low-density lipoprotein (LDL) level and low high-density lipoprotein (HDL) level), as well as the mean levels of total cholesterol, triglyceride, LDL and HDL, in the urban and rural Yangon Region, Myanmar. The second is to investigate the association between urban-rural location and total cholesterol. Two cross-sectional studies using the WHO STEPS methodology. Both the urban and rural areas of the Yangon Region, Myanmar. A total of 1370 men and women aged 25-74 years participated based on a multistage cluster sampling. Physically and mentally ill people, monks, nuns, soldiers and institutionalised people were excluded. Compared with rural counterparts, urban dwellers had a significantly higher age-standardised prevalence of hypercholesterolaemia (50.7% vs 41.6%; p=0.042) and a low HDL level (60.6% vs 44.4%; p=0.001). No urban-rural differences were found in the prevalence of hypertriglyceridaemia and high LDL. Men had a higher age-standardised prevalence of hypertriglyceridaemia than women (25.1% vs 14.8%; p<0.001), while the opposite pattern was found in the prevalence of a high LDL (11.3% vs 16.3%; p=0.018) and low HDL level (35.3% vs 70.1%; p<0.001).Compared with rural inhabitants, urban dwellers had higher age-standardised mean levels of total cholesterol (5.31 mmol/L, SE: 0.044 vs 5.05 mmol/L, 0.068; p=0.009), triglyceride (1.65 mmol/L, 0.049 vs 1.38 mmol/L, 0.078; p=0.017), LDL (3.44 mmol/L, 0.019 vs 3.16 mmol/L, 0.058; p=0.001) and lower age-standardised mean levels of HDL (1.11 mmol/L, 0.010 vs 1.25 mmol/L, 0.012; p<0.001). In linear regression, the total cholesterol was significantly associated with an urban location among men, but not among women. The mean level of total cholesterol and the prevalence of hypercholesterolaemia were alarmingly high in men and women in both the urban and rural areas of Yangon Region, Myanmar. Preventive measures to reduce cholesterol levels in the population are therefore needed. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The awareness of primary caregivers in South Africa of the human rights of their children with intellectual disabilities.

PubMed

Huus, K; Dada, S; Bornman, J; Lygnegård, F

2016-11-01

Besides the right to freedom, human rights can be seen as a basic requirement also for the maintenance of human dignity and the opportunity to thrive - particularly in the case of children with disabilities. It is imperative to explore primary caregivers' awareness of the human rights of their children with intellectual disabilities in view of the role they may play in either facilitating or restricting these rights. This paper explores the awareness of 219 primary caregivers of the human rights of their children with intellectual disabilities. A descriptive survey design was used with a custom-designed questionnaire that employed a deductive content analysis based on the articles of the United Nations Convention on the Rights of a Child. Comparisons were drawn between the awareness of primary caregivers from urban and those from rural areas. The majority (85.5%) of participants agreed that their child with intellectual disability had rights. Three broad kinds of right were mentioned (in descending order): provision rights, protection rights and participation rights. Participants from both urban and rural areas mentioned education (a provision right) most frequently. However, participants from urban areas were more aware of the different rights that existed than were their counterparts from rural areas. Primary caregivers in both rural and urban areas are aware of the rights of their children with disabilities, although there are significant differences between them. © 2016 John Wiley & Sons Ltd.

Individual, household, programme and community effects on childhood malnutrition in rural India.

PubMed

Rajaram, S; Zottarelli, Lisa K; Sunil, T S

2007-04-01

The children living in rural areas of India disproportionately suffer from malnutrition compared with their urban counterparts. The present article analyses the individual, household, community and programme factors on nutritional status of children in rural India. Additionally, we consider the random variances at village and state levels after introducing various observed individual-, household- and programme-level characteristics in the model. A multilevel model is conducted using data from the National Family and Health Survey 2. The results show that maternal characteristics, such as socio-economic and behavioural factors, are more influential in determining childhood nutritional status than the prevalence of programme factors. Also, it was found that individual factors show evidence of state- and village-level clustering of malnutrition.

Neighbourhood food environment and area deprivation: spatial accessibility to grocery stores selling fresh fruit and vegetables in urban and rural settings.

PubMed

Smith, Dianna M; Cummins, Steven; Taylor, Mathew; Dawson, John; Marshall, David; Sparks, Leigh; Anderson, Annie S

2010-02-01

The 'deprivation amplification' hypothesis suggests that residents of deprived neighbourhoods have universally poorer access to high-quality food environments, which in turn contributes to the development of spatial inequalities in diet and diet-related chronic disease. This paper presents results from a study that quantified access to grocery stores selling fresh fruit and vegetables in four environmental settings in Scotland, UK. Spatial accessibility, as measured by network travel times, to 457 grocery stores located in 205 neighbourhoods in four environmental settings (island, rural, small town and urban) in Scotland was calculated using Geographical Information Systems. The distribution of accessibility by neighbourhood deprivation in each of these four settings was investigated. Overall, the most deprived neighbourhoods had the best access to grocery stores and grocery stores selling fresh produce. Stratified analysis by environmental setting suggests that the least deprived compared with the most deprived urban neighbourhoods have greater accessibility to grocery stores than their counterparts in island, rural and small town locations. Access to fresh produce is better in more deprived compared with less deprived urban and small town neighbourhoods, but poorest in the most affluent island communities with mixed results for rural settings. The results presented here suggest that the assumption of a universal 'deprivation amplification' hypothesis in studies of the neighbourhood food environment may be misguided. Associations between neighbourhood deprivation and grocery store accessibility vary by environmental setting. Theories and policies aimed at understanding and rectifying spatial inequalities in the distribution of neighbourhood exposures for poor diet need to be context specific.

Coexistence of coyotes (Canis latrans) and red foxes (Vulpes vulpes) in an urban landscape.

PubMed

Mueller, Marcus A; Drake, David; Allen, Maximilian L

2018-01-01

Urban environments are increasing worldwide and are inherently different than their rural counterparts, with a variety of effects on wildlife due to human presence, increased habitat fragmentation, movement barriers, and access to anthropogenic food sources. Effective management of urban wildlife requires an understanding of how urbanization affects their behavior and ecology. The spatial activity and interactions of urban wildlife, however, have not been as rigorously researched as in rural areas. From January 2015 to December 2016, we captured, radio-collared, and tracked 11 coyotes and 12 red foxes in Madison, WI. Within our study area, coyotes strongly selected home ranges with high proportions of natural areas; conversely, red foxes selected home ranges with open space and moderately developed areas. Use of highly developed areas best explained variation among individual home range sizes and inversely affected home range size for coyotes and red foxes. Coyote and red fox home ranges showed some degree of spatial and temporal overlap, but generally appeared partitioned by habitat type within our study area. Coyotes and red foxes were both active at similar times of the day, but their movement patterns differed based on species-specific habitat use. This spatial partitioning may promote positive co-existence between these sympatric canids in urban areas, and our findings of spatial activity and interactions will better inform wildlife managers working in urban areas.

Coexistence of coyotes (Canis latrans) and red foxes (Vulpes vulpes) in an urban landscape

PubMed Central

Drake, David; Allen, Maximilian L.

2018-01-01

Urban environments are increasing worldwide and are inherently different than their rural counterparts, with a variety of effects on wildlife due to human presence, increased habitat fragmentation, movement barriers, and access to anthropogenic food sources. Effective management of urban wildlife requires an understanding of how urbanization affects their behavior and ecology. The spatial activity and interactions of urban wildlife, however, have not been as rigorously researched as in rural areas. From January 2015 to December 2016, we captured, radio-collared, and tracked 11 coyotes and 12 red foxes in Madison, WI. Within our study area, coyotes strongly selected home ranges with high proportions of natural areas; conversely, red foxes selected home ranges with open space and moderately developed areas. Use of highly developed areas best explained variation among individual home range sizes and inversely affected home range size for coyotes and red foxes. Coyote and red fox home ranges showed some degree of spatial and temporal overlap, but generally appeared partitioned by habitat type within our study area. Coyotes and red foxes were both active at similar times of the day, but their movement patterns differed based on species-specific habitat use. This spatial partitioning may promote positive co-existence between these sympatric canids in urban areas, and our findings of spatial activity and interactions will better inform wildlife managers working in urban areas. PMID:29364916

Functional health status among rural and urban older adults in Taiwan: the effect of personal control and social control.

PubMed

Chiu, Tzu-I; Spencer, Gale A

2010-09-01

To assess the relationship between perceived social control/personal control and functional health status among older adults in rural and urban Taiwan. The ageing of the population is poised to emerge as a preeminent worldwide phenomenon. It is assumed that even though older adults experience many decades of autonomy and independence, the potential for illness or bodily decline will induce a serious reduction in the level of perceived control in older adult populations. This is a descriptive correlational study using a secondary data base, Social Environment and Biomarkers of Aging Study. Social Environment and Biomarkers of Aging Study is a nationally representative study of health outcomes in the Taiwanese population. Both perceived levels of social control and personal control had a statistically significant relationship with functional health status. Functional health status was significantly higher for urban older adults than their rural counterparts. Personal control and social control were both found to be predictors of functional health status. Major findings are supported by previous studies. Nurses should create programs and plan activities to assist older adults to enhance their perceptions of social control or personal control in order to improve the health status of older adults and minimize associated health care costs. © 2009 Blackwell Publishing Ltd.

The distribution of refractive errors among children attending Lumbini Eye Institute, Nepal.

PubMed

Rai, S; Thapa, H B; Sharma, M K; Dhakhwa, K; Karki, R

2012-01-01

Uncorrected refractive error is an important cause of childhood blindness and visual impairment. To describe the patterns of refractive errors among children attending the outpatient clinic at the Department of Pediatric Ophthalmology, Lumbini Eye Institute, Bhairahawa, Nepal. Records of 133 children with refractive errors aged 5 - 15 years from both the urban and rural areas of Nepal and the adjacent territory of India attending the hospital between September and November 2010 were examined for patterns of refractive errors. The SPSS statistical software was used to perform data analysis. The commonest type of refractive error among the children was astigmatism (47 %) followed by myopia (34 %) and hyperopia (15 %). The refractive error was more prevalent among children of both the genders of age group 11-15 years as compared to their younger counterparts (RR = 1.22, 95 % CI = 0.66 - 2.25). The refractive error was more common (70 %) in the rural than the urban children (26 %). The rural females had a higher (38 %) prevalence of myopia than urban females (18 %). Among the children with refractive errors, only 57 % were using spectacles at the initial presentation. Astigmatism is the commonest type of refractive error among the children of age 5 - 15 years followed by hypermetropia and myopia. Refractive error remains uncorrected in a significant number of children. © NEPjOPH.

PTSD Treatment-Seeking Among Rural Latino Combat Veterans: A Review of the Literature*

PubMed Central

Duke, Michael R.; Moore, Roland S.; Ames, Genevieve M.

2013-01-01

Latino combat soldiers report both higher prevalence and greater overall severity of post-traumatic stress disorder (PTSD) symptoms than non-Hispanic Caucasians. However, these veterans face unique social and cultural barriers to accessing treatment for PTSD that distinguish them from their non-Hispanic white counterparts. Latino veterans who reside in rural settings face additional socio-cultural and structural impediments, in that they are likely to reside far from VA (Veterans Administration) medical facilities, have limited access to public transportation, and hold more conservative views toward mental health treatment than those residing in urban locales. However, little is known about the unique individual, sociocultural, and structural barriers to treatment faced by rural Latino veterans. This paper synthesizes the separate mental health and treatment-seeking literatures pertaining to Latinos, rural populations, and veterans, with the goal of identifying fruitful areas of conceptual overlap, and providing direction for future theory building, research, and targeted interventions. PMID:23762782

The Fly-in Fly-out and Drive-in Drive-out model of health care service provision for rural and remote Australia: benefits and disadvantages.

PubMed

Hussain, Rafat; Maple, Myfanwy; Hunter, Sally V; Mapedzahama, Virginia; Reddy, Prasuna

2015-01-01

Rural Australians experience poorer health and poorer access to health care services than their urban counterparts, and there is a chronic shortage of health professionals in rural and remote Australia. Strategies designed to reduce this rural-urban divide include fly-in fly-out (FIFO) and drive-in drive-out (DIDO) services. The aim of this article is to examine the opportunities and challenges involved in these forms of service delivery. This article reviews recent literature relating to FIFO and DIDO healthcare services and discusses their benefits and potential disadvantages for rural Australia, and for health practitioners. FIFO and DIDO have short-term benefits for rural Australians seeking healthcare services in terms of increasing equity and accessibility to services and reducing the need to travel long distances for health care. However, significant disadvantages need to be considered in the longer term. There is a potential for burnout among health professionals who travel long distances and work long hours, often without adequate peer support or supervision, in order to deliver these services. A further disadvantage, particularly in the use of visiting medical practitioners to provide generalist services, is the lack of development of a sufficiently well-resourced local primary healthcare system in small rural communities. Given the potential negative consequences for both health professionals and rural Australians, the authors caution against the increasing use of FIFO and DIDO services, without the concurrent development of well-resourced, funded and staffed primary healthcare services in rural and remote communities.

Parental migration and children's academic engagement: The case of China

NASA Astrophysics Data System (ADS)

Chen, Shuang; Adams, Jennifer; Qu, Zhiyong; Wang, Xiaohua; Chen, Li

2013-12-01

In the context of China's increasing rural-urban migration, few studies have investigated how parental migration affects children's experience in school. The high cost of schooling, taken together with the institutional barriers in destination cities, have compelled many rural parents in China to migrate without their children, leaving them in the care of their spouses, grandparents, relatives or other caregivers. Still other parents migrate with their children, many of whom then attend urban migrant schools in their destination city. Understanding the academic engagement of children of migrant workers is particularly salient because the poor qualities of migrant schools, a lack of parental support, and exposure to competing alternatives to schooling may render both migrant children in the cities and left-behind children in the rural villages vulnerable to disengagement, and ultimately school dropout. Using data collected in 2008 in the urban Haidian and Changping districts of Beijing and rural Henan and Shaanxi provinces, the authors of this paper investigate the association between parental migration status and two measures of academic engagement, academic aspirations and the odds of liking school, by comparing migrant children attending migrant schools and left-behind children with their rural counterparts who do not have migrant parents. The authors' findings show that migrant children attending migrant schools have lower academic engagement compared to rural children of non-migrant parents. The correlation between academic engagement and parental migration status can be accounted for in part by the support children receive from family and teachers. The association between certain measures of family and school support and academic engagement also varies by parental migration status: for example, high teacher turnover rates significantly reduce migrant children's odds of liking schools, but do not affect children of non-migrant parents.

Effects of a dietary self-management programme for community-dwelling older adults: a quasi-experimental design.

PubMed

Chen, Su-Hui; Huang, Yu-Ping; Shao, Jung-Hua

2017-09-01

Nutritional health plays a crucial role in determining successful ageing and differs by different living area. Although nutritional interventions have long been advocated, little research has directly assessed the effectiveness of nutritional interventions on community-dwelling older adults in urban and rural areas and compared intervention effects on these two populations. To examine the effectiveness of a 12-week dietary self-management programme for salt-, fluid-, fat- and cholesterol-intake behaviours of community-dwelling older adults and to compare these effects in rural- and urban-dwelling older adults. For this quasi-experimental two-group study, older adults (≥65 years old) were recruited from two randomly selected public health centres in a rural north-eastern county and a northern city of Taiwan from January through December 2011. Outcomes included nutritional status, nutritional self-efficacy and health locus of control. Data were collected at baseline and 12 weeks later. To compare changes in outcome variables over time between the control (usual care) and intervention (nutritional programme) groups and between the urban- and rural-dwelling participants in the experimental group, we used generalised estimating equation analysis. Of the 129 participants, 120 completed this study (58 in the intervention group and 62 in the control group). After 12 weeks, the intervention group had significantly better nutritional status and higher internal health locus of control than the control group. Moreover, older rural participants who received the intervention tended towards higher nutritional self-efficacy and internal health locus of control than their urban counterparts. Our research findings support the positive effect of our nutritional self-management programme for community-dwelling older adults. The knowledge gained from this study can help stakeholders recognise the need for healthcare policy to establish effective strategies and sustainable intervention programmes for this population, especially those living in rural areas. © 2016 Nordic College of Caring Science.

Phytate intake and molar ratios of phytate to zinc, iron and calcium in the diets of people in China.

PubMed

Ma, G; Li, Y; Jin, Y; Zhai, F; Kok, F J; Yang, X

2007-03-01

To assess the phytate intake and molar ratios of phytate to calcium, iron and zinc in the diets of people in China. 2002 China Nationwide Nutrition and Health Survey is a cross-sectional nationwide representative survey on nutrition and health. The information on dietary intakes was collected using consecutive 3 days 24 h recall by trained interviewers. The data of 68 962 residents aged 2-101 years old from 132 counties were analyzed. The median daily dietary intake of phytate, calcium, iron and zinc were 1186, 338.1, 21.2 and 10.6 mg, respectively. Urban residents consumed less phytate (781 vs 1342 mg/day), more calcium (374.5 vs 324.1 mg/day) and comparable amounts of iron (21.1 vs 21.2 mg/day) and zinc (10.6 vs 10.6 mg/day) than their rural counterparts. A wide variation in phytate intake among residents from six areas was found, ranging from 648 to 1433 mg/day. The median molar ratios of phytate to calcium, iron, zinc and phytate x calcium/zinc were 0.22, 4.88, 11.1 and 89.0, respectively, with a large variation between urban and rural areas. The phytate:zinc molar ratios ranged from 6.2 to 14.2, whereas the phytate x calcium/zinc molar ratios were from 63.7 to 107.2. The proportion of subjects with ratios above the critical values of phytate to iron, phytate to calcium, phytate to zinc and phytate x calcium/zinc were 95.4, 43.7, 23.1 and 8.7%, respectively. All the phytate/mineral ratios of rural residents were higher than that of their urban counterparts. The dietary phytate intake of people in China was higher than those in Western developed countries and lower than those in developing countries. Phytate may impair the bioavailability of iron, calcium and zinc in the diets of people in China.

Role of Family and Peers in Initiation and Continuation of Substance Use

PubMed Central

Tsering, Dechenla; Pal, Ranabir

2009-01-01

Aims: To assess the impact of family and peers on both initiation and continuation of substance use among eighth, ninth and tenth grade adolescent high school students. Design: Population based cross-sectional study. Setting: Two high schools of West Bengal, India. Participants: 416 students in class VIII, IX, and X in two schools. Interventions: None. Measurements: Substance use: initiation, sources, reasons for continuation. Then proportions and chi-square test was used for statistical analysis. Materials and Methods: This was a population based cross sectional study conducted among 416 students from class VII, IX and X in two high schools( urban and rural) of West Bengal, India selected by Multistage random sampling. A self administered anonymous pretested close ended questionnaire was used with the main outcome measures of initiation, sources, reasons for continuation of substance use based on WHO study team questionnaire. Results: Prevalence of substance use was found to be higher among the urban students (15.1%) than their rural counterparts (10.7%). The proportion of users was higher in the higher grades as compared to the lower grades. Among urban as well as rural students, 16 years and above were significantly more likely than their counterparts aged 15 years and below to report lifetime use. The mean age of initiation ranged from 12.6 to 13.9 years. Family members and friends were found to have a considerable influence not only on initiation but also important sources for money as well as the substance. Easy availability in the neighborhood was also an important correlate to continuation of substances. Conclusions: Family environment as well as peer groups has an important bearing on initiation and continuation of substance use. Experimentation of substance use motivated by peer groups is common among adolescents and starts early in life. Hence, it is necessary to provide health promotion programs directed toward students and their families which encourage attitude shaping among school children towards self-confidence and adequacy. PMID:21938088

Trans fatty acids and conjugated linoleic acids in the milk of urban women and nomadic Fulani of northern Nigeria.

PubMed

Glew, Robert H; Herbein, Joseph H; Moya, Monica H; Valdez, Jessica M; Obadofin, Michael; Wark, Wendy A; Vanderjagt, Dorothy J

2006-05-01

Trans fatty acids (TFAs) and conjugated linoleic acids (CLAs) are present in dairy products and human milk and can have detrimental and beneficial effects in humans. The content of TFAs and CLAs in milk is determined largely by the diet of the mother. We compared the proportions of TFAs and CLAs in the milk of rural Fulani in northern Nigeria who consume dairy products to that of women living in an urban center who consume little in the way of dairy products. Lactating Fulani women (n=41) and women residing in the city of Jos, Nigeria (n=41) were recruited into the study. We predicted that the milk of the Fulani pastoralists would contain higher amounts of TFAs and CLAs compared to their urban counterparts. The mean total TFA proportions for the Fulani and urban women were 0.22% and 0.34%, respectively, and were not significantly different. The percentages of CLAs in milk fat were not different between rural and urban women (0.16% vs 0.14%). These TFA and CLA values were 4- to 10-fold lower than for milk of women elsewhere in the world. The percentages of TFAs and CLAs in milk were not different between rural and urban dwellers in northern Nigeria whose diets differ greatly in the amounts of dairy products they contain. However, the fact that the percentages of TFAs and CLAs in the milk of Nigerian women were much lower than the percentages reported from other parts of the world may have implications for the long-term growth and development of infants in the northern Nigeria and elsewhere in the Western Sahel.

Does light pollution alter daylength? A test using light loggers on free-ranging European blackbirds (Turdus merula).

PubMed

Dominoni, Davide M; Partecke, Jesko

2015-05-05

Artificial light at night is one of the most apparent environmental changes accompanying anthropogenic habitat change. The global increase in light pollution poses new challenges to wild species, but we still have limited understanding of the temporal and spatial pattern of exposure to light at night. In particular, it has been suggested by several studies that animals exposed to light pollution, such as songbirds, perceive a longer daylength compared with conspecifics living in natural darker areas, but direct tests of such a hypothesis are still lacking. Here, we use a combination of light loggers deployed on individual European blackbirds, as well as automated radio-telemetry, to examine whether urban birds are exposed to a longer daylength than forest counterparts. We first used activity data from forest birds to determine the level of light intensity which defines the onset and offset of daily activity in rural areas. We then used this value as threshold to calculate the subjective perceived daylength of both forest and urban blackbirds. In March, when reproductive growth occurs, urban birds were exposed on average to a 49-min longer subjective perceived daylength than forest ones, which corresponds to a 19-day difference in photoperiod at this time of the year. In the field, urban blackbirds reached reproductive maturity 19 day earlier than rural birds, suggesting that light pollution could be responsible of most of the variation in reproductive timing found between urban and rural dwellers. We conclude that light at night is the most relevant change in ambient light affecting biological rhythms in avian urban-dwellers, most likely via a modification of the perceived photoperiod. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

Does light pollution alter daylength? A test using light loggers on free-ranging European blackbirds (Turdus merula)

PubMed Central

Dominoni, Davide M.; Partecke, Jesko

2015-01-01

Artificial light at night is one of the most apparent environmental changes accompanying anthropogenic habitat change. The global increase in light pollution poses new challenges to wild species, but we still have limited understanding of the temporal and spatial pattern of exposure to light at night. In particular, it has been suggested by several studies that animals exposed to light pollution, such as songbirds, perceive a longer daylength compared with conspecifics living in natural darker areas, but direct tests of such a hypothesis are still lacking. Here, we use a combination of light loggers deployed on individual European blackbirds, as well as automated radio-telemetry, to examine whether urban birds are exposed to a longer daylength than forest counterparts. We first used activity data from forest birds to determine the level of light intensity which defines the onset and offset of daily activity in rural areas. We then used this value as threshold to calculate the subjective perceived daylength of both forest and urban blackbirds. In March, when reproductive growth occurs, urban birds were exposed on average to a 49-min longer subjective perceived daylength than forest ones, which corresponds to a 19-day difference in photoperiod at this time of the year. In the field, urban blackbirds reached reproductive maturity 19 day earlier than rural birds, suggesting that light pollution could be responsible of most of the variation in reproductive timing found between urban and rural dwellers. We conclude that light at night is the most relevant change in ambient light affecting biological rhythms in avian urban-dwellers, most likely via a modification of the perceived photoperiod. PMID:25780232

Post-Cranial Traumatic Injury Patterns in Two Medieval Polish Populations: The Effects of Lifestyle Differences

PubMed Central

Agnew, Amanda M.; Betsinger, Tracy K.; Justus, Hedy M.

2015-01-01

Traumatic injuries can be used as general indicators of activity patterns in past populations. This study tests the hypothesis that contemporaneous (10th–12th century) rural and urban populations in medieval Poland will have a significantly different prevalence of non-violent fractures. Traumatic injuries to the post-cranial skeleton were recorded for 180 adults from rural Giecz and for 96 adults from urban Poznań-Śródka. They were statistically analyzed by body region and individual skeletal element. Results reveal that Giecz had a significantly higher rate of trunk fractures than Poznań-Śródka (Fisher’s exact, p<0.05). In particular, rib and vertebral fractures were more common in Giecz males and females than in their Poznań-Śródka counterparts. Traumatic injuries in the extremities were comparable between the two samples, suggesting similar risks of trauma to these regions. These results indicate that in early medieval Poland, activities associated with a rural lifestyle resulted in more injuries. These stress or accidental fractures, which are related to a high-risk setting, were not consistent with an urban lifestyle. Overall, agricultural populations like Giecz were engaged in a laborious lifestyle, reflected in a variety of injuries related to repetitive, high-risk activities. Although urban populations like Poznań engaged in craft specialization participated in repetitive activities, their lifestyle resulted in lesser fracture-risk. PMID:26068106

Household food security and HIV status in rural and urban communities in the Free State province, South Africa

PubMed Central

Pienaar, Michélle; van Rooyen, Francois C.; Walsh, Corinna M.

2017-01-01

Abstract Higher socioeconomic status impacts profoundly on quality of life. Life-event stressors, such as loss of employment, marital separation/divorce, death of a spouse and food insecurity, have been found to accelerate disease progression among people with human immunodeficiency virus (HIV). The objective of this study was to determine significant independent sociodemographic and food security factors associated with HIV status in people from rural and urban communities in the Assuring Health for All study, which was undertaken in rural Trompsburg, Philippolis and Springfontein and urban Mangaung, in the Free State Province of South Africa. Sociodemographic and food security factors associated with HIV status were determined in 886 households. Logistic regression with forward selection (p < 0.05) was used to select significant independent factors associated with HIV status. Variables with a p-value of <0.15 were considered for inclusion in the model. Adults 25–64 years of age were eligible to participate. Of the 567 rural participants, 97 (17.1%) were HIV-infected, and 172 (40.6%) of the 424 urban participants. A relatively high percentage of respondents had never attended school, while very few participants in all areas had a tertiary education. The unemployment rate of HIV-infected adults was higher than that of HIV-uninfected adults. A high percentage of respondents in all areas reported running out of money to buy food, with this tendency occurring significantly more among urban HIV-infected than HIV-uninfected respondents. In all areas, a high percentage of HIV-infected respondents relied on a limited number of foods to feed their children, with significantly more HIV-infected urban respondents compared to their uninfected counterparts reporting this. Most participants in all areas had to cut the size of meals, or ate less because there was not enough food in the house or not enough money to buy food. During periods of food shortage, more than 50% of respondents in all areas asked family, relatives or neighbours for assistance with money and/or food, which occurred at a higher percentage of HIV-infected rural participants compared to HIV-uninfected rural participants. More than half of all participants reported feeling sad, blue or depressed for two weeks or more in a row. HIV infection was negatively associated with being married (odds ratio 0.20 in rural areas and 0.54 in urban areas), while church membership decreased the likelihood of HIV (odds ratio 0.22 in rural areas and 0.46 in urban areas). Indicators of higher socioeconomic status (having a microwave oven and access to vegetables from local farmers or shops) decreased the likelihood of HIV in rural areas (odds ratios 0.15 and 0.43, respectively). Indicators of lower socioeconomic status such as spending less money on food in the rural sample (odds ratio 3.29) and experiencing periods of food shortages in the urban sample (odds ratio 2.14), increased the likelihood of being HIV-infected. Interventions aimed at poverty alleviation and strengthening values can contribute to addressing HIV infection in South Africa. PMID:29020850

Household food security and HIV status in rural and urban communities in the Free State province, South Africa.

PubMed

Pienaar, Michélle; van Rooyen, Francois C; Walsh, Corinna M

2017-12-01

Higher socioeconomic status impacts profoundly on quality of life. Life-event stressors, such as loss of employment, marital separation/divorce, death of a spouse and food insecurity, have been found to accelerate disease progression among people with human immunodeficiency virus (HIV). The objective of this study was to determine significant independent sociodemographic and food security factors associated with HIV status in people from rural and urban communities in the Assuring Health for All study, which was undertaken in rural Trompsburg, Philippolis and Springfontein and urban Mangaung, in the Free State Province of South Africa. Sociodemographic and food security factors associated with HIV status were determined in 886 households. Logistic regression with forward selection (p < 0.05) was used to select significant independent factors associated with HIV status. Variables with a p-value of <0.15 were considered for inclusion in the model. Adults 25-64 years of age were eligible to participate. Of the 567 rural participants, 97 (17.1%) were HIV-infected, and 172 (40.6%) of the 424 urban participants. A relatively high percentage of respondents had never attended school, while very few participants in all areas had a tertiary education. The unemployment rate of HIV-infected adults was higher than that of HIV-uninfected adults. A high percentage of respondents in all areas reported running out of money to buy food, with this tendency occurring significantly more among urban HIV-infected than HIV-uninfected respondents. In all areas, a high percentage of HIV-infected respondents relied on a limited number of foods to feed their children, with significantly more HIV-infected urban respondents compared to their uninfected counterparts reporting this. Most participants in all areas had to cut the size of meals, or ate less because there was not enough food in the house or not enough money to buy food. During periods of food shortage, more than 50% of respondents in all areas asked family, relatives or neighbours for assistance with money and/or food, which occurred at a higher percentage of HIV-infected rural participants compared to HIV-uninfected rural participants. More than half of all participants reported feeling sad, blue or depressed for two weeks or more in a row. HIV infection was negatively associated with being married (odds ratio 0.20 in rural areas and 0.54 in urban areas), while church membership decreased the likelihood of HIV (odds ratio 0.22 in rural areas and 0.46 in urban areas). Indicators of higher socioeconomic status (having a microwave oven and access to vegetables from local farmers or shops) decreased the likelihood of HIV in rural areas (odds ratios 0.15 and 0.43, respectively). Indicators of lower socioeconomic status such as spending less money on food in the rural sample (odds ratio 3.29) and experiencing periods of food shortages in the urban sample (odds ratio 2.14), increased the likelihood of being HIV-infected. Interventions aimed at poverty alleviation and strengthening values can contribute to addressing HIV infection in South Africa.

Health anthropology and urban health research.

PubMed

Obrist, Brigit; VAN Eeuwijk, Peter; Weiss, Mitchell G

2003-12-01

We live in a rapidly urbanising world. According to the 2001 statistics of the United Nations,a the proportion of urban dwellers rose from 30% in 1950 to 47% in 2000 and will probably attain 60% in 2030. Almost 70% of these urban dwellers live in cities of developing regions. At the current rates of urbanisation, the number of city dwellers in the world will equal that of their rural counterparts by 2007. In the late 1980s, researchers became increasingly concerned about the combined impact of rapid urban growth and economic recession on the health of a majority of people in African and Asian cities. Several books established urban health research with a focus on developing countries as a multidisciplinary field of inquiry (Harpham et al., 1988; Salem &Jeannée, 1989). It is now widely recognised that urbanisation per se is not necessarily bad for health, but it becomes so if urban governments fail to establish and support necessary infrastructure and services to protect citizens from environmental hazards and from social, economic and political insecurity.

Artemisinin-based combination therapy availability and use in the private sector of five AMFm phase 1 countries

PubMed Central

2013-01-01

Background In 2009, the Global Fund to Fight AIDS, Tuberculosis and Malaria established the Affordable Medicines Facility-malaria (AMFm) in order to increase access to quality-assured artemisinin combination therapy (QAACT). AMFm Phase 1, which includes nine pilot programmes in eight countries, was launched in 2009. The objective of this study was to assess anti-malarial stock and purchase patterns at private outlets in five AMFm Phase 1 countries in regard to three of the core AMFm goals: increase the affordability of QAACT, increase the availability of QAACT, and crowd out artemisinin monotherapies and other substandard therapies. Methods The study was conducted between April and May 2012 and included interviews with personnel in 598 private pharmaceutical outlets in Ghana, Kenya, Nigeria, Tanzania, and Uganda. Questionnaires were administered at private retail outlets and the data were analyzed to assess within- and between-country differences in QAACT price, availability, and popularity. Results AMFm medications were less expensive than their non-AMFm counterparts, yet prices for both types were above country-specific suggested retail prices. Market penetration of AMFm QAACT in both urban and rural areas was high, although stock-outs of both AMFm and non-AMFm products were more common in rural compared with urban outlets in Ghana and Kenya (p = 0.0013). Government recommendation was the most significant factor influencing anti-malarial stock choices in urban (41.5%) and rural (31.9%) outlets. The three top-selling anti-malarials reported for both urban and rural areas in each country were, with the exception of rural Uganda and urban Nigeria, combination therapies. Conclusions Results from this study indicate that the AMFm has not fully achieved its affordability and crowd-out objectives. Still, the final purchase price of AMFm QAACT was substantially lower than non-AMFm equivalents. Moreover, for both urban and rural areas, AMFm QAACT availability was found to be high, and the various forms of QAACT were the best-selling products among all anti-malarials. These findings suggest a continued need for initiatives like the AMFm that improve the affordability and accessibility of QAACT. Similar programmes may be especially effective if employed in combination with rapid diagnostic testing to ensure the appropriate use of these products. PMID:23607504

[Nutritional status and diet characteristics of a group of adolescents from the rural locality Calama, Bolivia].

PubMed

Pérez-Cueto, F J A; Almanza-López, M J; Pérez-Cueto, J D; Eulert, M E

2009-01-01

In 2003 a pilot study was carried out in the rural area of the Bolivian Department of La Paz aiming at the identification of dietary patterns among a group of secondary school adolescents who have little or scarce contact with the urban centres. The study consisted of a food intake survey (24 h recall), the measurement of anthropometrics and sociodemographic information. Nine percent was the global prevalence of overweight, although it was more present in girls. No statistically significant differences were found between nutrients in the diets of boys and girls. The energy intake was distributed in the five usual eating times as follows: 22% breakfast, 20% break time at school, 24% lunch, 12% tea time and 22% dinner. Furthermore, the anthropometric measures of boys were compared with their urban counterparts, where the differences were only significant with students in private schools. The present study can be used for the formulation of nutritional policies in Bolivia.

Nutrition-Related Policy and Environmental Strategies to Prevent Obesity in Rural Communities: A Systematic Review of the Literature, 2002–2013

PubMed Central

Leeman, Jennifer; Jilcott Pitts, Stephanie B.; Khan, Laura Kettel; Fleischhacker, Sheila; Evenson, Kelly R.; Schreiner, Michelle; Byker, Carmen; Owens, Clint; McGuirt, Jared; Barnidge, Ellen; Dean, Wesley; Johnson, Donna; Kolodinsky, Jane; Piltch, Emily; Pinard, Courtney; Quinn, Emilee; Whetstone, Lauren; Ammerman, Alice

2015-01-01

Introduction Residents of rural communities in the United States are at higher risk for obesity than their urban and suburban counterparts. Policy and environmental-change strategies supporting healthier dietary intake can prevent obesity and promote health equity. Evidence in support of these strategies is based largely on urban and suburban studies; little is known about use of these strategies in rural communities. The purpose of this review was to synthesize available evidence on the adaptation, implementation, and effectiveness of policy and environmental obesity-prevention strategies in rural settings. Methods The review was guided by a list of Centers for Disease Control and Prevention Recommended Community Strategies and Measurements to Prevent Obesity in the United States, commonly known as the “COCOMO” strategies. We searched PubMed, Cumulative Index of Nursing and Allied Health Literature, Public Affairs Information Service, and Cochrane databases for articles published from 2002 through 2013 that reported findings from research on nutrition-related policy and environmental strategies in rural communities in the United States and Canada. Two researchers independently abstracted data from each article, and resolved discrepancies by consensus. Results Of the 663 articles retrieved, 33 met inclusion criteria. The interventions most commonly focused on increasing access to more nutritious foods and beverages or decreasing access to less nutritious options. Rural adaptations included accommodating distance to food sources, tailoring to local food cultures, and building community partnerships. Conclusions Findings from this literature review provide guidance on adapting and implementing policy and environmental strategies in rural communities. PMID:25927605

Recent Changes in Health Insurance Coverage for Urban and Rural Veterans: Evidence from the First Year of the Affordable Care Act.

PubMed

Boudreaux, Michel; Barath, Deanna; Blewett, Lynn A

2018-04-25

Prior to the Affordable Care Act, as many as 1.3 million veterans lacked health insurance. With the passage of the Affordable Care Act, veterans now have new pathways to coverage through Medicaid expansion in those states that chose to expand Medicaid and through private coverage options offered through the Health Insurance Marketplace. We examined the impact of the ACA on health insurance coverage for veterans in expansion and non-expansion states and for urban and rural veterans. We examined changes in veterans' health insurance coverage following the first year of the ACA, focusing on whether they lived in an urban or rural area and whether they live in a Medicaid expansion state. We used data on approximately 200,000 non-elderly community-dwelling veterans, obtained from the 2013-2014 American Community Survey and estimated differences in the adjusted probability of being uninsured between 2013 and 2014 for both urban and rural areas. Adjusted probabilities were computed by fitting logistic regressions controlling for age, gender, race, marital status, poverty status, education, and employment. There were an estimated 10.1 million U.S. non-elderly veterans in 2013; 82% lived in predominantly urban areas (8.3 million), and the remaining 18% (1.8 million) lived in predominately rural areas. Most veterans lived in the South (43.6%), and rural veterans were more likely to be Southerners than their urban counterparts. On every marker of economic well-being, rural veterans fared worse than urban veterans. They had a statistically significant higher chance of having incomes below 138% of FPG (20.0% versus 17.0%), of being out of the labor force (29.1% versus 23.0%), and of having no more than a high school education (39.6% versus 28.8%). Rural veterans were also more likely to experience at least one functional limitation. Overall, veterans in Medicaid expansion states experienced a significantly larger increase in insurance compared to veterans living in non-expansion states. For rural veterans in Medicaid expansion states, the increase in insurance was 3.5 percentage points, compared with 1.2 percentage points in non-expansion states. Our analysis found a substantial 24% relative decline in the rate of uninsurance for U.S. Veterans, from 9.3 to 7.1% between 2013 and 2014. We found that coverage gains in rural areas were due to gains in Medicaid and individual market coverage. Residence in a Medicaid expansion state was particularly influential for rural veterans - the increase in the insured rate was three times larger in Medicaid expansion states versus non-expansion states. The ACA has had a positive and significant impact on the ability of U.S. Veterans to obtain health insurance coverage specifically for low-income veterans living in rural areas. The poverty rate among Veterans is rising and is particularly an issue for the more recent Gulf War veterans. Providing affordable and accessible health insurance options is part of our commitment to those who have served our country. Our analysis also presents yet another reason for the 17 non-expansion states to consider a Medicaid expansion.

Nebraska's rural behavioral healthcare workforce distribution and relationship between supply and county characteristics.

PubMed

Nguyen, Anh T; Trout, Kate E; Chen, Li-Wu; Madison, Lynda; Watkins, Katherine L; Watanabe-Galloway, Shinobu

2016-01-01

Specific attention is needed to improve mental health outcomes in rural communities. Rural communities continue to have higher unmet mental health needs than their urban counterparts. Quantifying workforce supply and shortages can aid in identifying areas in need of the recruitment, training, licensure, and retention of behavioral health professionals. However, workforce analyses have presented a challenge as comprehensive workforce data are limited. This study examines the geographic distribution of behavioral healthcare professionals and the relationship between supply and county characteristics in Nebraska in 2012. Practice location data for behavioral healthcare professionals were obtained from the 2012 University of Nebraska Medical Center's Health Profession Tracking Service Survey. Behavioral healthcare professionals included were psychiatric prescribers, independent behavioral professionals, mental health practitioners, and addiction counselors. The rural and urban distribution of professionals was examined using descriptive statistics. The relationships between county-level provider-to-population ratios and county characteristics were examined using multivariate Poisson regression analyses. In 2012, there were 2468 behavioral health professionals actively practicing in Nebraska. The majority (71.2%) of all behavioral professionals in Nebraska were actively practicing in metropolitan areas as compared to 27.3% in rural and 1.5% in frontier areas. For all categories of professions, excluding physician assistants, Nebraska's urban areas had the highest ratios of provider to 100 000 population as compared to rural and frontier areas in Nebraska. The total supply of behavioral health professionals was positively associated with metropolitan areas and the percentage of populations in poverty. The total supply of behavioral health professionals was negatively associated with the percentage of children under 18 years of age and the percentage of elderly aged 65 years or older. Rural counties and areas with high proportions of children and aging populations in Nebraska face significant challenges in recruiting and retaining behavioral healthcare professionals. The findings from this study have implications for quantifying the need and demand for behavioral healthcare professionals in workforce planning and policy analysis.

Distribution and Determinants of Unmet Need for Supportive Care Among Women with Breast Cancer in China.

PubMed

Wang, Shouhua; Li, Yanqing; Li, Chaozhuo; Qiao, Yijun; He, Shuling

2018-03-21

BACKGROUND The aim of this study was to determine the need for supportive care among women suffering from breast cancer in China and to identify its potential determinants to inform the development of effective and efficient healthcare services across different settings. MATERIAL AND METHODS In a tertiary-care hospital in Weifang, China, between July 2015 and January 2016, all women attending the Breast Cancer Clinic for regular physical examinations after treatment for breast cancer were consecutively recruited. The 34-item Supportive Care Needs Survey tool (Chinese version) (SCNS-SF34-C) was used to assess the unmet needs among participants. RESULTS Among 264 recruited patients, based on at least single-item endorsement, 60.2% had moderate to high level of need for supportive care, while only 13.3% expressed no need. Lack of information regarding health systems was the most common domain with moderate to high unmet needs, more so among rural patients (8 vs. 5 out of 10). In each information-related domain, huge unmet need was observed among all patients irrespective of urban or rural residence. Both overall and individual information-related domain-specific unmet needs were significantly higher among rural patients as opposed to their urban counterparts. Multiple regression analyses revealed a significant rural-urban variation of unmet needs. Moreover, education and post-diagnosis time duration were negatively associated with unmet needs while stage of cancer was positively associated with these unmet needs. CONCLUSIONS There is a huge burden of unmet needs for information on the healthcare system among breast cancer survivors in China. Rural residence, less education, advanced stage of cancer, and shorter duration since diagnosis were the identified determinants requiring targeted intervention.

Factors influencing rural and urban emergency clinicians' participation in an online knowledge exchange intervention.

PubMed

Curran, Janet A; Murphy, Andrea L; Sinclair, Douglas; McGrath, Patrick

2013-01-01

Rural emergency departments (EDs) generally have limited access to continuing education and are typically staffed by clinicians without pediatric emergency specialty training. Emergency care of children is complex and the majority of children receive emergency care in non-pediatric tertiary care centers. In recent decades, there has been a call to action to improve quality and safety in the emergency care of children. Of the one million ED visits by children in Ontario in 2005-2006, one in three visited more than once in a year and one in 15 returned to the ED within 72 hours of the index visit. This study explored factors influencing rural and urban ED clinicians' participation in a Web-based knowledge exchange intervention that focused on best practice knowledge about pediatric emergency care. The following questions guided the study: (i) What are the individual, context of practice or knowledge factors which impact a clinician's decision to participate in a Web-based knowledge exchange intervention?; (ii) What are clinicians' perceptions of organizational expectations regarding knowledge and information sources to be used in practice?; and (iii) What are the preferred knowledge sources of rural and urban emergency clinicians? A Web-based knowledge exchange intervention, the Pediatric Emergency Care Web Based Knowledge Exchange Project, for rural and urban ED clinicians was developed. The website contained 12 pediatric emergency practice learning modules with linked asynchronous discussion forums. The topics for the modules were determined through a needs assessment and the module content was developed by known experts in the field. A follow-up survey was sent to a convenience sample of 187 clinicians from nine rural and two urban Canadian EDs participating in the pediatric emergency Web-based knowledge exchange intervention study. The survey response rate was 56% (105/187). Participation in the knowledge exchange intervention was related to individual involvement in research activities (χ(2)=5.23, p=0.019), consultation with colleagues from other EDs (χ(2)=6.37, p=0.01) and perception of organizational expectations to use research evidence to guide practice (χ(2)=5.52, p=0.015). Most clinicians (95/105 or 92%) reported relying on colleagues from their own ED as a primary knowledge source. Urban clinicians were more likely than their rural counterparts to perceive that use of research evidence to guide practice was an expectation. Rural clinicians were more likely to rely on physicians from their own ED as a preferred knowledge source. The decision made by emergency clinicians to participate in a Web-based knowledge exchange intervention was influenced by a number of individual and contextual factors. Differences in these factors and preferences for knowledge sources require further characterization to enhance engagement of rural ED clinicians in online knowledge exchange interventions.

The disproportionate high risk of HIV infection among the urban poor in sub-Saharan Africa.

PubMed

Magadi, Monica A

2013-06-01

The link between HIV infection and poverty in sub-Saharan Africa (SSA) is rather complex and findings from previous studies remain inconsistent. While some argue that poverty increases vulnerability, existing empirical evidence largely support the view that wealthier men and women have higher prevalence of HIV. In this paper, we examine the association between HIV infection and urban poverty in SSA, paying particular attention to differences in risk factors of HIV infection between the urban poor and non-poor. The study is based on secondary analysis of data from the Demographic and Health Surveys from 20 countries in SSA, conducted during 2003-2008. We apply multilevel logistic regression models, allowing the urban poverty risk factor to vary across countries to establish the extent to which the observed patterns are generalizable across countries in the SSA region. The results reveal that the urban poor in SSA have significantly higher odds of HIV infection than their urban non-poor counterparts, despite poverty being associated with a significantly lower risk among rural residents. Furthermore, the gender disparity in HIV infection (i.e. the disproportionate higher risk among women) is amplified among the urban poor. The paper confirms that the public health consequence of urban poverty that has been well documented in previous studies with respect to maternal and child health outcomes does apply to the risk of HIV infection. The positive association between household wealth and HIV prevalence observed in previous studies largely reflects the situation in the rural areas where the majority of the SSA populations reside.

Community-Based Prevalence of Genital Human Papilloma Virus (HPV) Infection: a Systematic Review and Meta-Analysis

PubMed Central

Sabeena, Sasidharanpillai; Bhat, Parvati V; Kamath, Veena; Bhat, Shashikala K; Nair, Sreekumaran; N, Ravishankar; Chandrabharani, Kiran; Arunkumar, Govindakarnavar

2017-01-01

Introduction: Cervical cancer probably represents the best-studied human cancer caused by a viral infection and the causal association of this preventable cancer with human papilloma virus (HPV) is well established. Worldwide there is a scarcity of data regarding HPV prevalence with vast differences existing among populations. Objective: The aim of this meta-analysis was to determine the community-based HPV prevalence estimates among asymptomatic women from urban and rural set ups and in participants of cancer screening clinics. Study design: Systematic review and meta-analysis. Methods: PubMed-Medline, CINAHL, Scopus, and Google scholar were systematically searched for studies providing prevalence data for HPV infection among asymptomatic women between 1986 and 2016. Results: The final analysis included 32 studies comprising a population of 224,320 asymptomatic women. The overall pooled HPV prevalence was 11% (95% confidence interval (CI), 9%-12%). The pooled HPV prevalence of 11% (95% CI, 9%-11%) was observed among women attending cervical cancer screening clinics. The pooled HPV prevalences were 10% (95% CI 8%-12%) and 11% (95% CI 4%-18%) from urban and rural areas respectively, indicating higher infection rates among the rural women with the least access to cancer screening and cancer care. Conclusion: The prevalence rates in this systematic quantitative review provide a reliable estimate of the burden of HPV infection among asymptomatic women from developed as well as developing nations. Rural women and women attending cervical cancer screening programmes feature higher genital HPV prevalences compared to their urban counterparts. PMID:28240509

Community-Based Prevalence of Genital Human Papilloma Virus (HPV) Infection: a Systematic Review and Meta-Analysis

PubMed

Sabeena, Sasidharanpillai; Bhat, Parvati V; Kamath, Veena; Bhat, Shashikala K; Nair, Sreekumaran; n, Ravishankar; Chandrabharani, Kiran; Arunkumar, Govindakarnavar

2017-01-01

Introduction: Cervical cancer probably represents the best-studied human cancer caused by a viral infection and the causal association of this preventable cancer with human papilloma virus (HPV) is well established. Worldwide there is a scarcity of data regarding HPV prevalence with vast differences existing among populations. Objective: The aim of this meta-analysis was to determine the community-based HPV prevalence estimates among asymptomatic women from urban and rural set ups and in participants of cancer screening clinics. Study design: Systematic review and meta-analysis. Methods: PubMed-Medline, CINAHL, Scopus, and Google scholar were systematically searched for studies providing prevalence data for HPV infection among asymptomatic women between 1986 and 2016. Results: The final analysis included 32 studies comprising a population of 224,320 asymptomatic women. The overall pooled HPV prevalence was 11% (95% confidence interval (CI), 9%-12%). The pooled HPV prevalence of 11% (95% CI, 9%-11%) was observed among women attending cervical cancer screening clinics. The pooled HPV prevalences were 10% (95% CI 8%-12%) and 11% (95% CI 4%-18%) from urban and rural areas respectively, indicating higher infection rates among the rural women with the least access to cancer screening and cancer care. Conclusion: The prevalence rates in this systematic quantitative review provide a reliable estimate of the burden of HPV infection among asymptomatic women from developed as well as developing nations. Rural women and women attending cervical cancer screening programmes feature higher genital HPV prevalences compared to their urban counterparts. Creative Commons Attribution License

The effect of access to contraceptive services on injectable use and demand for family planning in Malawi.

PubMed

Skiles, Martha Priedeman; Cunningham, Marc; Inglis, Andrew; Wilkes, Becky; Hatch, Ben; Bock, Ariella; Barden-O'Fallon, Janine

2015-03-01

Previous studies have identified positive relationships between geographic proximity to family planning services and contraceptive use, but have not accounted for the effect of contraceptive supply reliability or the diminishing influence of facility access with increasing distance. Kernel density estimation was used to geographically link Malawi women's use of injectable contraceptives and demand for birth spacing or limiting, as drawn from the 2010 Demographic and Health Survey, with contraceptive logistics data from family planning service delivery points. Linear probability models were run to identify associations between access to injectable services-measured by distance alone and by distance combined with supply reliability-and injectable use and family planning demand among rural and urban populations. Access to services was an important predictor of injectable use. The probability of injectable use among rural women with the most access by both measures was 7‒8 percentage points higher than among rural dwellers with the least access. The probability of wanting to space or limit births among urban women who had access to the most reliable supplies was 18 percentage points higher than among their counterparts with the least access. Product availability in the local service environment plays a critical role in women's demand for and use of contraceptive methods. Use of kernel density estimation in creating facility service environments provides a refined approach to linking women with services and accounts for both distance to facilities and supply reliability. Urban and rural differences should be considered when seeking to improve contraceptive access.

Trends in Rehabilitation Services Use in Chinese Children and Adolescents With Intellectual Disabilities: 2007-2013.

PubMed

He, Ping; Guo, Chao; Luo, Yanan; Wen, Xu; Salas, J M Ian; Chen, Gong; Zheng, Xiaoying

2017-12-01

To investigate trends in rehabilitation services use in children and adolescents with intellectual disabilities, and to explore factors potentially contributing to the trends. A population-based study using a multistage, randomized cluster-sampling process to ascertain participants in 2006. A subsample was selected for follow-up surveys from 2007 to 2013. Thirty-one provinces of China. Children (N=5432) aged 0 to 17 years with intellectual disabilities were followed up for 7 years. Not applicable. The outcome variable was whether individuals received at least 1 of the following rehabilitation services in the past 12 months: occupational therapy, physical therapy, and speech or communication therapy. Overall, the utilization rates of rehabilitation services significantly increased from 14.4% in 2007 to 37.1% in 2013. The trends were also significant in children aged 0 to 10 and 11 to 17 years, in boys and girls, and in rural participants. From 2007 to 2013, rehabilitation services utilization increased at an annual rate of 22.39% (95% confidence interval, 18.11%-26.82%) in the total sample. The rise was only significant in rural rather than urban individuals, resulting in the urban-rural gap in rehabilitation services use being narrowed. However, minority populations and those without health insurance still received fewer rehabilitation services than their respective counterparts. There were upward trends in rehabilitation services use in participants over time, and the urban-rural gap was narrowed. However, there were still socioeconomic differences on rehabilitation services use among children and adolescents with intellectual disabilities. Copyright © 2017. Published by Elsevier Inc.

Rural Health Networks and Care Coordination: Health Care Innovation in Frontier Communities to Improve Patient Outcomes and Reduce Health Care Costs

PubMed Central

Conway, Pat; Favet, Heidi; Hall, Laurie; Uhrich, Jenny; Palcher, Jeanette; Olimb, Sarah; Tesch, Nathan; York-Jesme, Margaret; Bianco, Joe

2017-01-01

Rural residents’ health is challenged by high health care costs, chronic diseases, and policy decisions affecting rural health care. This single-case, embedded design study, guided by community-based participatory research principles and using mixed methods, describes outcomes of implementation of a community care team (CCT) and care coordination to improve outcomes of patients living in a frontier community. Seventeen organizations and 165 adults identified as potential care coordination candidates constituted the target populations. Following CCT development, collaboration and cohesion increased among organizations. Patients who participated in care coordination reported similar physical and lower emotional health quality of life than national counterparts; emergency department use decreased following care coordination. Key components identified as successful in urban settings seem applicable in rural settings, with emphasis on the key role of team facilitators; need for intense care coordination for people with complex health needs, especially behavioral health needs; and access to specialty care through technology. PMID:27818417

Patterns of computer usage among medical practitioners in rural and remote Queensland.

PubMed

White, Col; Sheedy, Vicki; Lawrence, Nicola

2002-06-01

As part of a more detailed needs analysis, patterns of computer usage among medical practitioners in rural and remote Queensland were investigated. Utilising a questionnaire approach, a response rate of 23.82% (n = 131) was obtained. Results suggest that medical practitioners in rural and remote Queensland are relatively sophisticated in their use of computer and information technologies and have embraced computerisation to a substantially higher extent compared with their urban counterparts and previously published estimates. Findings also indicate that a substantial number of rural and remote practitioners are utilising computer and information technologies for clinical purposes such as pathology, patient information sheets, prescribing, education, patient records and patient recalls. Despite barriers such as bandwidth limitations, cost and the sometimes unreliable quality of Internet service providers, a majority of rural and remote respondents rated an Internet site with continuing medical education information and services as being important or very important. Suggestions that "rural doctors are slow to adapt to new technologies" are questioned, with findings indicating that rural and remote medical practitioners in Queensland have adapted to, and utilise, information technology to a far higher extent than has been previously documented.

The Future of the Small Rural Grocery Store: A Qualitative Exploration.

PubMed

Pinard, Courtney A; Fricke, Hollyanne E; Smith, Teresa M; Carpenter, Leah R; Yaroch, Amy L

2016-11-01

Rural communities face unique challenges to and opportunities for offering more healthful foods and are often understudied in comparison to their urban counterparts. The purpose of this study was to conduct a qualitative assessment of rural storeowners' perceptions of their communities, their business practices, and factors that influences their viability, sustainability, and ability to support healthy food choices. We conducted interviews with storeowners (N = 15) in small stores in rural Nebraska and explored perceptions of business practices, role in the community, and consumer demand for more healthful foods. The storeowners reported strategies they employ to remain competitive, such as selling alcohol and tobacco, focusing on customer service, and ensuring quality of products. Manufacturer and distributor agreements often put constraints on their business models. Key challenges reported included a dwindling population and competition with larger chains in neighboring towns set in a sparsely populated landscape. Goals for the future included expanding equipment, largely to offer more prepared foods. This study adds to the literature around food access in rural communities, and can inform future implementation strategies to work with storeowners to improve healthy food access.

Training to reduce behavioral health disparities: How do we optimally prepare family medicine residents for practice in rural communities?

PubMed

Robohm, Jennifer S

2017-05-01

Family physicians are a critical part of the healthcare system in rural areas, but little is known about the training they need to more effectively address behavioral health disparities. Practicing family physicians in Montana were surveyed about the behavioral health needs of their patients, the behavioral resources at their disposal, their prioritization of a number of behavioral skills and interventions in the training of family physicians, factors that limit their own use of behavioral skills, and the extent of their behavioral science training. Respondents across the state reported high rates of mental/emotional health issues and high need for health behavior change in their patients. Surprisingly, although rural family physicians reported access to significantly fewer behavioral health resources, they did not rate any of the behavioral skills as higher training priorities than their urban counterparts and they were more likely to identify limitations (lack of patient interest, lack of confidence or competence, and inadequate knowledge or training) on their own use of such skills in practice. Family physicians, both rural and urban, whose residency programs had a higher emphasis on behavioral science felt better prepared to use behavioral skills in practice. Consequently, rural training programs are encouraged to emphasize behavioral science training for their family medicine residents, particularly training that focuses on mental health stigma reduction, emphasizes time savings and practicality, covers more severe psychiatric presentations, promotes cultural sensitivity to rural values of autonomy and self-sufficiency, and teaches skills to advocate for individual and community health with regard to behavioral health disparities.

Formative Evaluation to Increase Availability of Healthy Snacks and Beverages in Stores Near Schools in Two Rural Oregon Counties, 2013

PubMed Central

Findholt, Nancy E.; Pickus, Hayley A.

2015-01-01

Introduction Children living in rural areas are at greater risk for obesity than their urban counterparts. Differences in healthy food access may contribute to this disparity. Most healthy food access initiatives target stores in urban areas. We conducted a formative evaluation to increase availability of healthy snacks and beverages in food stores near schools in rural Oregon. Methods We assessed availability of healthy snacks and beverages in food stores (n = 15) using the SNACZ (Students Now Advocating to Create Healthy Snacking Zones) checklist and conducted in-depth interviews with food store owners (n = 6). Frequency distributions were computed for SNACZ checklist items, and interview data were analyzed by using applied thematic analysis. Results Overall, availability of healthy snacks and beverages in study communities was low. Four interrelated themes regarding store owner perspectives on stocking healthy snacks and beverages emerged from the interviews: customer demand, space constraints, vendor influence, and perishability. Conclusion In addition to working with food store owners, efforts to increase availability of healthy snacks and beverages in rural areas should engage young people, food buyers (eg, schools), and vendors as stakeholders for identifying strategies to increase demand for and availability of these items. Further research will be needed to determine which strategies or combinations of strategies are feasible to implement in the study communities. PMID:26632956

Formative Evaluation to Increase Availability of Healthy Snacks and Beverages in Stores Near Schools in Two Rural Oregon Counties, 2013.

PubMed

Izumi, Betty T; Findholt, Nancy E; Pickus, Hayley A

2015-12-03

Children living in rural areas are at greater risk for obesity than their urban counterparts. Differences in healthy food access may contribute to this disparity. Most healthy food access initiatives target stores in urban areas. We conducted a formative evaluation to increase availability of healthy snacks and beverages in food stores near schools in rural Oregon. We assessed availability of healthy snacks and beverages in food stores (n = 15) using the SNACZ (Students Now Advocating to Create Healthy Snacking Zones) checklist and conducted in-depth interviews with food store owners (n = 6). Frequency distributions were computed for SNACZ checklist items, and interview data were analyzed by using applied thematic analysis. Overall, availability of healthy snacks and beverages in study communities was low. Four interrelated themes regarding store owner perspectives on stocking healthy snacks and beverages emerged from the interviews: customer demand, space constraints, vendor influence, and perishability. In addition to working with food store owners, efforts to increase availability of healthy snacks and beverages in rural areas should engage young people, food buyers (eg, schools), and vendors as stakeholders for identifying strategies to increase demand for and availability of these items. Further research will be needed to determine which strategies or combinations of strategies are feasible to implement in the study communities.

Are Structural Changes in Polish Rural Areas Fostering Leisure-Time Physical Activity?

PubMed Central

Biernat, Elżbieta; Bartkiewicz, Piotr; Buchholtz, Sonia

2017-01-01

Background: In this study, we analyze the determinants of leisure-time physical activity (LTPA) of farmers and non-farmers living in rural areas. Methods: We use statistical analysis to describe urban and rural populations, as well as econometric techniques (Heckman regressions and propensity score matching) to assess the role of rural lifestyle in physical activity. Results: World Health Organization (WHO) pro-health PA (physical activity) recommendations are not met by 66% of farmers and 49% of other dwellers in rural areas. Approximately two thirds of them are completely inactive. Farmers enjoy vigorous PA (VPA), cycling and recreational walking less than their non-farming counterparts and are 46% less likely to be active than them; however the difference disappears when they take up an activity. The amount of PA is negatively correlated with age, but tends to increase for older people compared to those in middle age. Women are 6%–7% less active than men, yet the odds of being active at all are higher for women than for men. Household size is negatively correlated with LTPA. Conclusion: Considering the structural changes, rural area dwellers, especially farmers, require public intervention aimed at increasing their awareness of the advantages of LTPA. PMID:28368322

Perceptions about interpersonal relationships and school environment among middle school students with asthma.

PubMed

Rhee, Hyekyun; McQuillan, Brenda; Chen, Ding-Geng; Atis, Shannska

2017-11-01

To examine interpersonal relationships involving peers and teachers and perceptions about school environment among middle school students with asthma in comparison to their healthy counterparts. The study also assesses asthma prevalence in a large sample of middle school students representing different geographic locations. Cross-sectional data were collected from 1059 middle school students in grades 6-8 enrolled in schools in a northeastern region of the United States. Students reported their chronic health conditions including asthma and completed questionnaires measuring perceptions about their relationships with peers and teachers as well as school environment. Analyses of covariance (ANCOVAs) were used to compare students with asthma and their healthy counterparts in the study variables. Asthma was reported by 16.5% of the sample (n = 169). The rate was higher among minority students (23%) than their white counterparts (15%). Greater proportion of urban students (28%) reported asthma than rural (18%) and suburban (14%) students. Students with asthma reported significantly poorer relationships with peers (B = -1.74, p <.001) and teachers (B = -1.41, p =.009), and their perceptions about overall school environment (B = -1.30, p =.009) were also lower than their healthy counterparts. Race showed no significant effects on school factors. Overall asthma prevalence was substantially higher than the national average of adolescent asthma, particularly those residing in the urban area. Poor perceptions of interpersonal relationships with peers and teachers among students with asthma may indicate compromised quality of life. Suboptimal interpersonal relationships and school environment need to be identified and adequately addressed, given their implications for asthma management at the school setting among middle school students.

Non-Western students' causal reasoning about biologically adaptive changes in humans, other animals and plants: instructional and curricular implications

NASA Astrophysics Data System (ADS)

Mbajiorgu, Ngozika; Anidu, Innocent

2017-06-01

Senior secondary school students (N = 360), 14- to 18-year-olds, from the Igbo culture of eastern Nigeria responded to a questionnaire requiring them to give causal explanations of biologically adaptive changes in humans, other animals and plants. A student subsample (n = 36) was, subsequently, selected for in-depth interviews. Significant differences were found between prompts within the prompt categories, suggesting item feature effects. However, the most coherent pattern was found within the plant category as patterns differed for the mechanistic proximate (MP) reasoning category only. Patterns also differed highly significantly between the prompt categories, with patterns for teleology, MP, mechanistic ultimate and don't know categories similar for plants and other animals but different for the human category. Both urban and rural students recognise commonalities in causality between the three prompt categories, in that their preferences for causal explanations were similar across four reasoning categories. The rural students, however, were more likely than their urban counterparts to give multiple causal explanations in the span of a single response and less likely to attribute causal agency to God. Two factors, religious belief and language, for all the students; and one factor, ecological closeness to nature, for rural students were suspected to have produced these patterns.

Effect of severe kwashiorkor on intellectual development among Nigerian children.

PubMed

Nwuga, V C

1977-09-01

A study was conducted to investigated the intellectual sequelae of severe kwashiorkor among Nigerian children of school age. The design for the study had an experimental urban kwashiorkor (index) group and four control groups, namely, a sibling group, a lower class group, an upper class group, and a rural kwashiorkor group. Various psychological tests measuring specific intellectual abilities were administered to all of the subjects taking part in the study. The findings showed that the index group had lower levels of certain types of intellectual skill-specifically the higher cognitive skills-at school age than their siblings, and more so than other controls except their rural counterparts; males showed a tendency to be more affected by severe kwashiorkor with regard to mental development than their female counterparts; there was no relationship between scores in the psychological tests and the ages at which the index cases were admitted into hospital; the upper class was clearly superior in performance of the tests and also in measures of weight and head measurements when compared to all of the other groups; there was no relationship between head circumference and scores in the tests among subjects in the five groups.

Differences in development among children and adolescents in eastern and western China.

PubMed

Zhang, Ying-Xiu; Wang, Shu-Rong

2010-01-01

There are wide-ranging differences in human growth, not only between ethnic groups but also between regions. China covers a vast area and has a very large population. However, no studies on the differences in development among children and adolescents in eastern and western China have been reported. This study assessed the differences in stature and body weight in children and adolescents in eastern and western China. Using data derived from two national surveys on students' constitution and health carried out by the Chinese government in 1985 and 2005, the average stature and body weight for children and adolescents aged 7-18 years in eastern and western China were calculated. The differences of mean values between eastern and western China were compared. Boys and girls in eastern China were taller and heavier than their counterparts in western China in all age groups (7-18 years) in 2005, the average differences being 3.56 cm, 4.56 kg (urban boys), 3.05 cm, 2.92 kg (urban girls), 4.04 cm, 4.19 kg (rural boys) and 3.48 cm, 2.96 kg (rural girls). In 18-year-old groups, the differences in the stature and body weight between eastern and western China were 2.82 cm, 5.17 kg for urban boys, 1.86 cm, 2.11 kg for urban girls, 2.26 cm, 3.38 kg for rural boys and 1.96 cm, 1.38 kg for rural girls, respectively. From 1985 to 2005, differences in stature and body weight of children and adolescents between eastern and western China have continuously expanded. There have been obvious regional variations in development in children and adolescents in China, the variations in development in children and adolescents between eastern and western China being related to regional economic status and living standards of residents.

Rural retention of doctors graduating from the rural medical education project to increase rural doctors in Thailand: a cohort study.

PubMed

Pagaiya, Nonglak; Kongkam, Lalitaya; Sriratana, Sanya

2015-03-01

In Thailand, the inequitable distribution of doctors between rural and urban areas has a major impact on access to care for those living in rural communities. The rural medical education programme 'Collaborative Project to Increase Rural Doctors (CPIRD)' was implemented in 1994 with the aim of attracting and retaining rural doctors. This study examined the impact of CPIRD in relation to doctor retention in rural areas and public health service. Baseline data consisting of age, sex and date of entry to the Ministry of Health (MoH) service was collected from 7,157 doctors graduating between 2000 and 2007. There were 1,093 graduates from the CPIRD track and 6,064 that graduated through normal channels. Follow-up data, consisting of workplace, number of years spent in rural districts and years within the MoH service, were retrieved from June 2000 to July 2011. The Kaplan-Meier method of survival analysis and Cox proportional hazards ratios were used to interpret the data. Female subjects slightly outnumbered their male counterparts. Almost half of the normal track (48%) and 33% of the CPIRD doctors eventually left the MoH. The retention rate at rural hospitals was 29% for the CPIRD doctors compared to 18% for those from the normal track. Survival curves indicated a dramatic drop rate after 3 years in service for both groups, but normal track individuals decreased at a faster rate. Multivariate Cox proportional hazards modelling revealed that the normal track doctors had a significantly higher risk of leaving rural areas at about 1.3 times the CPIRD doctors. The predicted median survival time in rural hospitals was 4.2 years for the CPIRD group and 3.4 years for the normal track. The normal track doctors had a significantly higher risk of leaving public service at about 1.5 times the CPIRD doctors. The project evaluation results showed a positive impact in that CPIRD doctors were more likely to stay longer in rural areas and in public service than their counterparts. However, turnover has been increasing in recent years for both groups. There is a need for the MoH to review and improve upon the project implementation.

Chasm in primary care provision in a universal health system: Findings from a nationally representative survey of health facilities in Malaysia

PubMed Central

Sivasampu, Sheamini; Khoo, Ee Ming; Mohamad Noh, Kamaliah

2017-01-01

Background Malaysia has achieved universal health coverage since 1980s through the expansion of direct public provision, particularly in rural areas. However, no systematic examination of the rural-urban distribution of primary care services and resources has been conducted to date for policy impact evaluation. Methods We conducted a national cross-sectional survey of 316 public and 597 private primary care clinics, selected through proportionate stratified random sampling, from June 2011 through February 2012. Using a questionnaire developed based on the World Health Organization toolkits on monitoring health systems strengthening, we examined the availability of primary care services/resources and the associations between service/resource availability and clinic ownership, locality, and patient load. Data were weighted for all analyses to account for the complex survey design and produce unbiased national estimates. Results Private primary care clinics and doctors outnumbered their public counterparts by factors of 5.6 and 3.9, respectively, but the private clinics were significantly less well-equipped with basic facilities and provided a more limited range of services. Per capita densities of primary care clinics and workforce were higher in urban areas (2.2 clinics and 15.1 providers per 10,000 population in urban areas versus 1.1 clinics and 11.7 providers per 10,000 population in rural areas). Within the public sector, the distribution of health services and resources was unequal and strongly favored the urban clinics. Regression analysis revealed that rural clinics had lower availability of services and resources after adjusting for ownership and patient load, but the associations were not significant except for workforce availability (adjusted odds ratio [OR]: 0.82; 95% confidence interval [CI]: 0.71–0.96). Conclusions Targeted primary care expansion in rural areas could be an effective first step towards achieving universal health coverage, especially in countries with limited healthcare resources. Nonetheless, geographic expansion alone is inadequate to achieve effective coverage in a dichotomous primary care system, and the role of the private sector in primary care delivery should not be overlooked. PMID:28196113

Chasm in primary care provision in a universal health system: Findings from a nationally representative survey of health facilities in Malaysia.

PubMed

Lim, Huy Ming; Sivasampu, Sheamini; Khoo, Ee Ming; Mohamad Noh, Kamaliah

2017-01-01

Malaysia has achieved universal health coverage since 1980s through the expansion of direct public provision, particularly in rural areas. However, no systematic examination of the rural-urban distribution of primary care services and resources has been conducted to date for policy impact evaluation. We conducted a national cross-sectional survey of 316 public and 597 private primary care clinics, selected through proportionate stratified random sampling, from June 2011 through February 2012. Using a questionnaire developed based on the World Health Organization toolkits on monitoring health systems strengthening, we examined the availability of primary care services/resources and the associations between service/resource availability and clinic ownership, locality, and patient load. Data were weighted for all analyses to account for the complex survey design and produce unbiased national estimates. Private primary care clinics and doctors outnumbered their public counterparts by factors of 5.6 and 3.9, respectively, but the private clinics were significantly less well-equipped with basic facilities and provided a more limited range of services. Per capita densities of primary care clinics and workforce were higher in urban areas (2.2 clinics and 15.1 providers per 10,000 population in urban areas versus 1.1 clinics and 11.7 providers per 10,000 population in rural areas). Within the public sector, the distribution of health services and resources was unequal and strongly favored the urban clinics. Regression analysis revealed that rural clinics had lower availability of services and resources after adjusting for ownership and patient load, but the associations were not significant except for workforce availability (adjusted odds ratio [OR]: 0.82; 95% confidence interval [CI]: 0.71-0.96). Targeted primary care expansion in rural areas could be an effective first step towards achieving universal health coverage, especially in countries with limited healthcare resources. Nonetheless, geographic expansion alone is inadequate to achieve effective coverage in a dichotomous primary care system, and the role of the private sector in primary care delivery should not be overlooked.

Community size and organization of practice predict family physician recertification success.

PubMed

Schulte, Bradley M; Mannino, David M; Royal, Kenneth D; Brown, Sabrina L; Peterson, Lars E; Puffer, James C

2014-01-01

Health disparities exist between rural and urban areas. Rural physicians may lack sufficient medical knowledge, which may lead to poor quality of care. Therefore, we sought to determine whether medical knowledge differed between family physicians (FPs) practicing in rural areas compared with those practicing in metropolitan areas. We studied 8361 FPs who took the American Board of Family Medicine maintenance of certification (MOC) examination in 2009. Data sources were examination results and data from a demographic survey of practice structure and activities, completed as part of the examination application process. FPs' location of practice was categorized as either rural or metropolitan using a moderate and conservative definition based on reported community size. Univariate statistics assessed differences in FP characteristics between rural and metropolitan areas. Logistic regression analyses determined the adjusted relationship between rural status and the odds of passing the MOC examination. Metropolitan FPs were less likely than their rural counterparts to pass the MOC examination using both the moderate (odds ratio, 0.67; 95% confidence interval, 0.54-0.83) and conservative (odds ratio, 0.56; 95% confidence interval, 0.42-0.74) definitions. Physicians in solo practice were less likely to pass the examination than physicians in group practice. Rural physicians were more likely to pass the MOC examination, suggesting that rural health disparities do not result from a lack of provider knowledge.

Tele-Interpersonal Psychotherapy Acutely Reduces Depressive Symptoms in Depressed HIV-Infected Rural Persons: A Randomized Clinical Trial.

PubMed

Heckman, Timothy G; Heckman, Bernadette D; Anderson, Timothy; Lovejoy, Travis I; Markowitz, John C; Shen, Ye; Sutton, Mark

2017-01-01

Human immunodeficiency virus (HIV)-positive rural individuals carry a 1.3-times greater risk of a depressive diagnosis than their urban counterparts. This randomized clinical trial tested whether telephone-administered interpersonal psychotherapy (tele-IPT) acutely relieved depressive symptoms in 132 HIV-infected rural persons from 28 states diagnosed with Diagnostic and Statistical Manual of Mental Disorders-IV major depressive disorder (MDD), partially remitted MDD, or dysthymic disorder. Patients were randomized to either 9 sessions of one-on-one tele-IPT (n = 70) or standard care (SC; n = 62). A series of intent-to-treat (ITT), therapy completer, and sensitivity analyses assessed changes in depressive symptoms, interpersonal problems, and social support from pre- to postintervention. Across all analyses, tele-IPT patients reported significantly lower depressive symptoms and interpersonal problems than SC controls; 22% of tele-IPT patients were categorized as a priori "responders" who reported 50% or higher reductions in depressive symptoms compared to only 4% of SC controls in ITT analyses. Brief tele-IPT acutely decreased depressive symptoms and interpersonal problems in depressed rural people living with HIV.

Avoiding decline: Fostering resilience and sustainability in midsize cities

USGS Publications Warehouse

Allen, Craig R.; Birge, Hannah E.; Bartelt-Hunt, Shannon; Bevans, Rebecca A.; Burnett, Jessica L.; Cosens, Barbara; Cai, Ximing; Garmestani, Ahjond S.; Linkov, Igor; Scott, Elizabeth A.; Solomon, Mark D.; Uden, Daniel R.

2016-01-01

Eighty-five percent of United States citizens live in urban areas. However, research surrounding the resilience and sustainability of complex urban systems focuses largely on coastal megacities (>1 million people). Midsize cities differ from their larger counterparts due to tight urban-rural feedbacks with their immediate natural environments that result from heavy reliance and close management of local ecosystem services. They also may be less path-dependent than larger cities due to shorter average connection length among system components, contributing to higher responsiveness among social, infrastructural, and ecological feedbacks. These distinct midsize city features call for a framework that organizes information and concepts concerning the sustainability of midsize cities specifically. We argue that an integrative approach is necessary to capture properties emergent from the complex interactions of the social, infrastructural, and ecological subsystems that comprise a city system. We suggest approaches to estimate the relative resilience of midsize cities, and include an example assessment to illustrate one such estimation approach. Resilience assessments of a midsize city can be used to examine why some cities end up on sustainable paths while others diverge to unsustainable paths, and which feedbacks may be partially responsible. They also provide insight into how city planners and decision makers can use information about the resilience of midsize cities undergoing growth or shrinkage relative to their larger and smaller counterparts, to transform them into long-term, sustainable social-ecological systems.

Rural women's perspectives of maternity services in the Midland Region of New Zealand.

PubMed

Gibbons, Veronique; Lancaster, Gytha; Gosman, Kim; Lawrenson, Ross

2016-09-01

INTRODUCTION Rural women face many challenges with regards to maternity services. Many rural primary birthing facilities in New Zealand have closed. The Lead Maternity Carer (LMC) model of maternity care, introduced in 1990, has moved provision of rural maternity care from doctors to independent midwifery services. Shortages of rural midwives in the Midland region led to rural maternity care being seen as a vulnerable service. AIM To understand the views and experiences of rural women concerning maternity care, to inform the future design and provision of rural maternity services. METHODS Participants were drawn from areas purposively selected to represent the five District Health Boards comprising the Midland health region. A demographic questionnaire, focus groups and individual interviews explored rural women's perspectives of antenatal care provision. These were analysed thematically. RESULTS Sixty-two women were recruited. Key themes emerging from focus groups and interviews included: access to services, the importance of safety and quality of care, the need for appropriate information at different stages, and the role of partners, family and friends in the birthing journey. While most women were happy with access to services, quality of care, provision of information, and the role of family in their care, for some women, this experience could be enhanced. CONCLUSION Midwives are the frontline service for women seeking antenatal services. Support for rural midwives and for local birthing units is needed to ensure rural women receive services equal to that of their urban counterparts.

Health Insurance Marketplaces: Early Findings on Changes in Plan Availability and Premiums in Rural Places, 2014-2015.

PubMed

Barker, Abigail; McBride, Timothy D; Kemper, Leah M; Mueller, Keith

2015-05-01

The Patient Protection and Affordable Care Act established Health Insurance Marketplaces (HIMs) in all 50 states and the District of Columbia. This policy brief assesses the changes in HIMs from 2014 to 2015 in terms of choices offered and premiums charged, with emphasis on how these measures vary across rural and urban places. Key Findings. (1) In 74 percent of HIM rating areas, the number of firms operating increased by at least one, while the number of firms decreased in only about 6 percent of rating areas. Further, 64 percent of rating areas with fewer than 50 persons per square mile gained at least one firm. (2) There was no consistent pattern of premium increases with respect to rating area population density (used as a proxy here for the degree of "ruralness" of the rating areas). Nationally, rural areas are not experiencing higher premium increases than their urban counterparts. In fact, the lowest increases in second-lowest cost silver plan premiums occurred in the medium-density population rating areas of 51 to 300 persons per square mile. (3) Average adjusted premiums increased from 2014 to 2015 by 6.7 percent in Federally-Facilitated Marketplaces (FFMs) compared to just 1.4 percent in State-Based Marketplaces (SBMs). Regardless of SBM or FFM status, premium increases across the United States were negatively correlated with the number of firms entering the market. (4) Analysis of the most rural states, in terms of percentage of the population classified as nonmetropolitan, shows that, in general, premiums fell significantly in rural places where they had been rather high, and they increased in rural places where they had been rather low. The five rural states with the lowest premium increases had an average of 0.17 firms entering the market, while the five with the highest premium increases had an average of 0.50 firms exiting the market.

Rural-urban differences of neonatal mortality in a poorly developed province of China.

PubMed

Yi, Bin; Wu, Li; Liu, Hong; Fang, Weimin; Hu, Yang; Wang, Youjie

2011-06-18

The influence of rural-urban disparities in children's health on neonatal death in disadvantaged areas of China is poorly understood. In this study of rural and urban populations in Gansu province, a disadvantaged province of China, we describe the characteristics and mortality of newborn infants and evaluated rural-urban differences of neonatal death. We analyzed all neonatal deaths in the data from the Surveillance System of Child Death in Gansu Province, China from 2004 to 2009. We calculated all-cause neonatal mortality rates (NMR) and cause-specific death rates for infants born to rural or urban mothers during 2004-09. Rural-urban classifications were determined based on the residence registry system of China. Chi-square tests were used to compare differences of infant characteristics and cause-specific deaths by rural-urban maternal residence. Overall, NMR fell in both rural and urban populations during 2004-09. Average NMR for rural and urban populations was 17.8 and 7.5 per 1000 live births, respectively. For both rural and urban newborn infants, the four leading causes of death were birth asphyxia, preterm or low birth weight, congenital malformation, and pneumonia. Each cause-specific death rate was higher in rural infants than in urban infants. More rural than urban neonates died out of hospital or did not receive medical care before death. Neonatal mortality declined dramatically both in urban and rural groups in Gansu province during 2004-09. However, profound disparities persisted between rural and urban populations. Strategies that address inequalities of accessibility and quality of health care are necessary to improve neonatal health in rural settings in China.

Smoking prevalence differs by location of residence among Ghanaians in Africa and Europe: The RODAM study

PubMed Central

Brathwaite, Rachel; Addo, Juliet; Kunst, Anton E.; Agyemang, Charles; Owusu-Dabo, Ellis; de-Graft Aikins, Ama; Beune, Erik; Meeks, Karlijn; Klipstein-Grobusch, Kerstin; Bahendeka, Silver; Mockenhaupt, Frank P.; Amoah, Stephen; Galbete, Cecilia; Schulze, Matthias B.; Danquah, Ina; Smeeth, Liam

2017-01-01

Background Although the prevalence of smoking is low in Ghana, little is known about the effect of migration on smoking. Comparing Ghanaians living in their country of origin to those living in Europe offers an opportunity to investigate smoking by location of residence and the associations between smoking behaviours and migration-related factors. Methods Data on a relatively homogenous group of Ghanaians living in London (n = 949), Amsterdam (n = 1400), Berlin (n = 543), rural Ghana (n = 973) and urban Ghana (n = 1400) from the cross-sectional RODAM (Research on Obesity & Diabetes in African Migrants) study were used. Age-standardized prevalence rates of smoking by location of residence and factors associated with smoking among Ghanaian men were estimated using prevalence ratios (PR: 95% CIs). Results Current smoking was non-existent among women in rural and urban Ghana and London but was 3.2% and 3.3% in women in Amsterdam and Berlin, respectively. Smoking prevalence was higher in men in Europe (7.8%) than in both rural and urban Ghana (4.8%): PR 1.91: 95% CI 1.27, 2.88, adjusted for age, marital status, education and employment. Factors associated with a higher prevalence of smoking among Ghanaian men included European residence, being divorced or widowed, living alone, Islam religion, infrequent attendance at religious services, assimilation (cultural orientation), and low education. Conclusion Ghanaians living in Europe are more likely to smoke than their counterparts in Ghana, suggesting convergence to European populations, although prevalence rates are still far below those in the host populations. PMID:28475620

Climate shocks and rural-urban migration in Mexico: Exploring nonlinearities and thresholds.

PubMed

Nawrotzki, Raphael J; DeWaard, Jack; Bakhtsiyarava, Maryia; Ha, Jasmine Trang

2017-01-01

Adverse climatic conditions may differentially drive human migration patterns between rural and urban areas, with implications for changes in population composition and density, access to infrastructure and resources, and the delivery of essential goods and services. However, there is little empirical evidence to support this notion. In this study, we investigate the relationship between climate shocks and migration between rural and urban areas within Mexico. We combine individual records from the 2000 and 2010 Mexican censuses (n=683,518) with high-resolution climate data from Terra Populus that are linked to census data at the municipality level (n=2,321). We measure climate shocks as monthly deviation from a 30-year (1961-1990) long-term climate normal period, and uncover important nonlinearities using quadratic and cubic specifications. Satellite-based measures of urban extents allow us to classify migrant-sending and migrant-receiving municipalities as rural or urban to examine four internal migration patterns: rural-urban, rural-rural, urban-urban, and urban-rural. Among our key findings, results from multilevel models reveal that each additional drought month increases the odds of rural-urban migration by 3.6%. In contrast, the relationship between heat months and rural-urban migration is nonlinear. After a threshold of ~34 heat months is surpassed, the relationship between heat months and rural-urban migration becomes positive and progressively increases in strength. Policy and programmatic interventions may therefore reduce climate induced rural-urban migration in Mexico through rural climate change adaptation initiatives, while also assisting rural migrants in finding employment and housing in urban areas to offset population impacts.

Climate shocks and rural-urban migration in Mexico: Exploring nonlinearities and thresholds

PubMed Central

Nawrotzki, Raphael J.; DeWaard, Jack; Bakhtsiyarava, Maryia; Ha, Jasmine Trang

2016-01-01

Adverse climatic conditions may differentially drive human migration patterns between rural and urban areas, with implications for changes in population composition and density, access to infrastructure and resources, and the delivery of essential goods and services. However, there is little empirical evidence to support this notion. In this study, we investigate the relationship between climate shocks and migration between rural and urban areas within Mexico. We combine individual records from the 2000 and 2010 Mexican censuses (n=683,518) with high-resolution climate data from Terra Populus that are linked to census data at the municipality level (n=2,321). We measure climate shocks as monthly deviation from a 30-year (1961-1990) long-term climate normal period, and uncover important nonlinearities using quadratic and cubic specifications. Satellite-based measures of urban extents allow us to classify migrant-sending and migrant-receiving municipalities as rural or urban to examine four internal migration patterns: rural-urban, rural-rural, urban-urban, and urban-rural. Among our key findings, results from multilevel models reveal that each additional drought month increases the odds of rural-urban migration by 3.6%. In contrast, the relationship between heat months and rural-urban migration is nonlinear. After a threshold of ~34 heat months is surpassed, the relationship between heat months and rural-urban migration becomes positive and progressively increases in strength. Policy and programmatic interventions may therefore reduce climate induced rural-urban migration in Mexico through rural climate change adaptation initiatives, while also assisting rural migrants in finding employment and housing in urban areas to offset population impacts. PMID:28435176

[Prevalence of type 2 diabetes and obesity in two Chilean aboriginal populations living in urban zones].

PubMed

Carrasco, Elena P; Pérez, Francisco B; Angel, Bárbara B; Albala, Cecilia B; Santos, J Luis M; Larenas, Gladys Y; Montalvo, Domingo V

2004-10-01

The prevalence of cardiovascular risk factors is increasing in aboriginal populations in Chile. To study the prevalence of obesity, type 2 diabetes and serum lipids in two aboriginal populations, Mapuche and Aymara, that were transferred from a rural to a urban environment. Two groups of subjects over 20 years were analyzed, Mapuche and Aymara. The Mapuche group was formed by 42 men and 105 women, living in four urban communities of Santiago, and an Aymara group formed by 42 men and 118 women, living in Arica, in Northern Chile. Anthropometric measurements, blood pressure, lipid profile, oral glucose tolerance test, fasting insulin and serum leptin were determined. The prevalence of type 2 diabetes was 6.9% in Aymara and 8.2% in Mapuche subjects. The frequency of glucose intolerance was similar in both groups, but greater among men. A total blood cholesterol over 200 mg/dl was observed in 43.1% of Aymara and 27.9% of Mapuche subjects (p <0.008). Serum triglycerides over 150 mg/dl were observed in 16.9 and 23.1% of Aymara and Mapuche individuals, respectively (p= NS). The prevalence of type 2 diabetes and dyslipidemia in turban aboriginal populations is higher than that of their rural counterparts. A possible explanation for these results are changes in lifestyles that come along with urbanization, characterized by a high consumption of saturated fat and refined sugars and a low level of physical activity.

How do the definitions of urban and rural matter for transportation safety? Re-interpreting transportation fatalities as an outcome of regional development processes.

PubMed

McAndrews, Carolyn; Beyer, Kirsten; Guse, Clare E; Layde, Peter

2016-12-01

Urban and rural places are integrated through economic ties and population flows. Despite their integration, most studies of road safety dichotomize urban and rural places, and studies have consistently demonstrated that rural places are more dangerous for motorists than urban places. Our study investigates whether these findings are sensitive to the definition of urban and rural. We use three different definitions of urban-rural continua to quantify and compare motor vehicle occupant fatality rates per person-trip and person-mile for the state of Wisconsin. The three urban-rural continua are defined by: (1) popular impressions of urban, suburban, and rural places using a system from regional economics; (2) population density; and (3) the intensity of commute flows to core urbanized areas. In this analysis, the three definitions captured different people and places within each continuum level, highlighting rural heterogeneity. Despite this heterogeneity, the three definitions resulted in similar fatality rate gradients, suggesting a potentially latent "rural" characteristic. We then used field observations of urban-rural transects to refine the definitions. When accounting for the presence of higher-density towns and villages in rural places, we found that low-density urban places such as suburbs and exurbs have fatality rates more similar to those in rural places. These findings support the need to understand road safety within the context of regional development processes instead of urban-rural categories. Copyright © 2016 Elsevier Ltd. All rights reserved.

Is there an urban advantage in child survival in sub-saharan Africa? Evidence from 18 countries in the 1990s.

PubMed

Bocquier, Philippe; Madise, Nyovani Janet; Zulu, Eliya Msiyaphazi

2011-05-01

Evidence of higher child mortality of rural-to-urban migrants compared with urban nonmigrants is growing. However, less attention has been paid to comparing the situation of the same families before and after they migrate with the situation of urban-to-rural migrants. We use DHS data from 18 African countries to compare child mortality rates of six groups based on their mothers' migration status: rural nonmigrants; urban nonmigrants; rural-to-urban migrants before and after they migrate; and urban-to-rural migrants before and after they migrate. The results show that rural-to-urban migrants had, on average, lower child mortality before they migrated than rural nonmigrants, and that their mortality levels dropped further after they arrived in urban areas. We found no systematic evidence of higher child mortality for rural-to-urban migrants compared with urban nonmigrants. Urban-to-rural migrants had higher mortality in the urban areas, and their move to rural areas appeared advantageous because they experienced lower or similar child mortality after living in rural areas. After we control for known demographic and socioeconomic correlates of under-5 mortality, the urban advantage is greatly reduced and sometimes reversed. The results suggest that it may not be necessarily the place of residence that matters for child survival but, rather, access to services and economic opportunities.

Socioeconomic status and survival among older adults with dementia and depression.

PubMed

Chen, Ruoling; Hu, Zhi; Wei, Li; Wilson, Kenneth

2014-06-01

People from lower socioeconomic groups have a higher risk of mortality. The impact of low socioeconomic status on survival among older adults with dementia and depression remains unclear. To investigate the association between socioeconomic status and mortality in people with dementia and late-life depression in China. Using Geriatric Mental Status - Automated Geriatric Examination for Computer Assisted Taxonomy (GMS-AGECAT) we interviewed 2978 people aged ⩾60 years in Anhui, China. We characterised baseline socioeconomic status and risk factors and diagnosed 223 people with dementia and 128 with depression. All-cause mortality was followed up over 5.6 years. Individuals with dementia living in rural areas had a three times greater risk of mortality (multivariate adjusted hazard ratio (HR) = 2.96, 95% CI 1.45-6.04) than those in urban areas, and for those with depression the HR was 4.15 (95% CI 1.59-10.83). There were similar mortality rates when comparing people with dementia with low v. high levels of education, occupation and income, but individuals with depression with low v. high levels had non-significant increases in mortality of 11%, 50% and 55% respectively Older adults with dementia and depression living in rural China had a significantly higher risk of mortality than urban counterparts. Interventions should be implemented in rural areas to tackle survival inequality in dementia and depression. Royal College of Psychiatrists.

The Urban-Rural Disparity in Nursing Home Quality Indicators: The Case of Facility-Acquired Contractures

PubMed Central

Bowblis, John R; Meng, Hongdao; Hyer, Kathryn

2013-01-01

Objective To identify and quantify the sources of the urban-rural disparity in facility-acquired contracture rates in nursing homes. Data Sources Survey inspection data of U.S. nursing homes from 1999 to 2008 and standardized national rural definition file from the Rural-Urban Commuting Area Codes. Study Design We estimated regressions of facility-level contracture rate as a function of urban-rural categories (urban, micropolitan, small rural town, and isolated small rural town) and other related facility characteristics to identify size of the urban-rural disparity. We used Blinder–Oaxaca decomposition techniques to determine the extent to which the disparity is attributable to the differences in facility and aggregate resident characteristics. Principal Findings Rural nursing homes have higher contracture rates than urban nursing homes. About half of the urban-rural disparity is explained by differences in observable characteristics among urban and rural nursing homes. Differences in staffing levels explain less than 5 percent of the disparity, case-mix explains 6–8 percent, and structure and operational characteristics account for 10–22 percent of the disparity. Conclusion While a lower level and quality of staffing are a concern for rural nursing homes, facility structure and funding sources explain a larger proportion of the urban-rural disparity in the quality of care. PMID:22670847

The urban-rural disparity in nursing home quality indicators: the case of facility-acquired contractures.

PubMed

Bowblis, John R; Meng, Hongdao; Hyer, Kathryn

2013-02-01

To identify and quantify the sources of the urban-rural disparity in facility-acquired contracture rates in nursing homes. Survey inspection data of U.S. nursing homes from 1999 to 2008 and standardized national rural definition file from the Rural-Urban Commuting Area Codes. We estimated regressions of facility-level contracture rate as a function of urban-rural categories (urban, micropolitan, small rural town, and isolated small rural town) and other related facility characteristics to identify size of the urban-rural disparity. We used Blinder-Oaxaca decomposition techniques to determine the extent to which the disparity is attributable to the differences in facility and aggregate resident characteristics. Rural nursing homes have higher contracture rates than urban nursing homes. About half of the urban-rural disparity is explained by differences in observable characteristics among urban and rural nursing homes. Differences in staffing levels explain less than 5 percent of the disparity, case-mix explains 6-8 percent, and structure and operational characteristics account for 10-22 percent of the disparity. While a lower level and quality of staffing are a concern for rural nursing homes, facility structure and funding sources explain a larger proportion of the urban-rural disparity in the quality of care. © Health Research and Educational Trust.

Distribution of essential medicines to primary care institutions in Hubei of China: effects of centralized procurement arrangements.

PubMed

Yang, Lianping; Huang, Cunrui; Liu, Chaojie

2017-11-14

Poor distribution of essential medicines to primary care institutions has attracted criticism since China adopted provincial centralized regional tendering and procurement systems. This study evaluated the impact of new procurement arrangements that limit the number of distributors at the county level in Hubei province, China. Procurement ordering and distribution data were collected from four counties that pioneered a new distribution arrangement (commencing September 2012) compared with six counties that continued the existing arrangement over the period from August 2011 to September 2013. The new arrangement allowed primary care institutions and/or suppliers to select a local distributor from a limited panel (from 3 to 5) of government nominated distributors. Difference-in-differences analyses were performed to assess the impact of the new arrangements on delivery and receipt of essential medicines. Overall, the new distribution arrangement has not improved distribution of essential medicines to primary care institutions. On the contrary, we found a 7.78-19.85 percentage point (p < 0.01) decrease in distribution rates to rural primary care institutions. Similar results were demonstrated using the indicator of received rates, with a 7.89-19.65 percentage point (p < 0.01) decrease. Simply limiting the number of distributors does not offer a solution to the poor performance of delivery of essential medicines for primary care institutions, especially those located in rural areas. Procurement arrangements need to consider the special characteristics of rural facilities. In a county, there are more rural primary care institutions than urban ones. On average, rural primary care institutions demand more and are more geographically dispersed compared to their urban counterparts, which may impose increased distribution costs.

Is there a rural gradient in the diagnosis of aortic stenosis? An analysis of a remote Scottish cohort.

PubMed

Maycock, Matthew I; Farman, Colin; Mort, Alasdair; Turpie, David; Leslie, Stephen J

2013-01-01

Calcific aortic stenosis is the most common cardiac valve lesion and is becoming increasingly prevalent as life expectancy rises. There is evidence that patients in remote and rural areas with certain diseases have worse outcomes and present to specialist services later than their urban counterparts. It is not known whether patients with aortic stenosis follow a similar pattern. The aim of this study was to investigate whether increasing rurality was associated with later presentation to healthcare services at a more advanced stage of aortic stenosis. This was a retrospective cohort study. Using ICD-10 discharge codes and local databases, 605 patients with aortic stenosis who presented between 31 November 1999 and 1 December 2008 were identified. Aortic stenosis was defined as a pressure gradient across the aortic valve of 25 mmHg or more. Patients with prior aortic valve replacement were excluded. Clinical notes were reviewed for all patients. Gender, age and pressure gradient across the aortic valve at presentation and patient GP-practice location were recorded. Patients were then assigned a Clinical Peripherality Index score based on the postcode of their GP's practice to define rurality. Patient data were compared across the six defined levels of clinical peripherality by ANOVA. Mean patient age was 73 ± 13 years, and 336 (54%) were male. The peak gradient across the valve was 41.1 ± 26.7 mmHg. There was no association between the level of clinical peripherality and the stage of aortic stenosis at presentation, age or gender (all p >0.05). There was no urban-rural gradient in the severity of aortic stenosis at presentation in this remote Scottish cohort. This suggests that patients with this condition in remote areas do not present later in their disease trajectory.

Rural development and urban migration: can we keep them down on the farm?

PubMed

Rhoda, R

1983-01-01

This study tests the hypothesis that rural development projects and programs reduce rural-urban migration. The author presents various factors in the social theories of migration, including those relating to origin and destination, intervening obstacles such as distance, and personal factors. 3 economic models of migration are the human capital or cost-benefit approach, the expected income model, and the intersectoral linkage model. Empirical studies of migration indicate that: 1) rural areas with high rates of out-migration tend to have high population densities or high ratios of labor to arable land, 2) distance inhibits migration, 3) rural-urban migration is positively correlated with family income level, and 4) selectivity differences in socioeconomic status between migrants and nonmigrants often are grouped into development packages which might include irrigation, new varieties of seed, subsidized credit, increased extension, and improved marketing arrangements. The migration impacts of some of these efforts are described: 1) land reform usually is expected to slow rural out-migration because it normally increases labor utilization in rural areas, but this is a limited effect, 2) migration effects of the Green Revolution technology are mainly in rural-rural migration, and 3) agricultural mechanization may stimulate rural-urban migration in the long run. Development of rural social services migh have various effects on rural-urban migration. Better rural education, which improves the chances of urban employment, will stimulate rural-urban migration, while successful rural family planning programs will have a negative effect in the long run as there will be reduced population pressure on arable land. Better rural health services might reduce the incentive for rural-urban migration as well. It is suggested that governments reconsider policies which rely on rural development to curb rural-urban migration and alleviate problems of urban poverty and underemployment.

Urban-Rural Disparities in Injury Mortality in China, 2006

ERIC Educational Resources Information Center

Hu, Guoqing; Baker, Susan P.; Baker, Timothy D.

2010-01-01

Context: Urban-rural disparity is an important issue for injury control in China. Details of the urban-rural disparities in fatal injuries have not been analyzed. Purpose: To target key injury causes that most contribute to the urban-rural disparity, we decomposed total urban-rural differences in 2006 injury mortality by gender, age, and cause.…

[The rural-urban nature and geographical nature of patterns of internal migration].

PubMed

Raczynski, D

1981-07-01

The rural-urban nature and geographical patterns of internal migration in Chile are studied. The magnitude, nature, and relative importance of rural-urban, interurban, inter-rural, and urban-rural movements in the country are examined, with a focus on the impact of internal migration on urbanization and on the demographic growth of cities and rural areas. Rural and urban differentials in propensity to migrate and in the capacity to attract and retain population are investigated using 1970 census data on migratory flows to and from the Santiago metropolitan area and those directed to other parts of the country.

THE LEVEL OF BREAST AND CERVICAL CANCER AWARENESS AMONG WOMEN IN A RURAL AREA OF SOUTH AFRICA.

PubMed

Zeitoun, O; Shemesh, N

2017-06-01

In South Africa breast and cervical cancer are the most predominant cancers amongst women, with mortality rates reaching surprising proportions. As a result of the continued rise of these conditions it is vital to determine these women's awareness of both, so as to determine the exact factors contributing to this rise. Whilst both urban and rural areas are afflicted, this study focused primarily on women in a rural area. This was a descriptive cross-sectional study conducted in a shopping mall located in the rural area of Bushbuckridge, Mpumalanga, South Africa. A total of 300 women of reproductive age were randomly identified and requested to fill out a study questionnaire assessing their level of breast and cervical cancer awareness. A total of 300 women participated in the study. The mean age of participants was 35.66 with a range of 13.53. Overall levels of knowledge about breast and cervical cancer in rural Bushbuckridge were found to be reduced with 66.89% and 74.49% of women who rated themselves with a poor understanding of breast and cervical cancer knowledge respectively. Among the participating women, those over the age of 40, with higher level of education were found to be more cognizant in terms of breast and cervical cancer awareness with a 30% (p = 0.0923) and 52% (p < 0.001) respectively. Their younger and less educated counterparts had a 21% (p = 0.078) and 32% (p = 0.034) awareness of breast and cervical cancer, respectively. The leading source of information for both breast and cervical cancer was healthcare facilities with a 67.11% and 63.5% respectively. This study highlights the lack of awareness and knowledge of breast and cervical cancer in women living in the rural area of Bushbuckridge, South Africa. There is also evidence showing that the older and more educated women have better knowledge than their younger and less educated counterparts, therefore there is a need for increased breast and cervical cancer education and awareness campaigns amongst women in rural South Africa. The Results further point to education and availability of health care services as pivotal determinants of health.

Job location decisions of pharmacy graduates in British Columbia.

PubMed

Pearson, Marion L; Andres, Lesley

2010-05-12

To determine the factors influencing pharmacy graduates' selection of their first professional job location. A survey was conducted of the 2007 graduating class of the University of British Columbia, examining hometown location, community and workplace factors, personal relationships, financial factors, and leisure activities. Responses were analyzed to determine whether community size or demographic characteristics affected the degree to which each factor influenced the job location decision. The majority of graduates moved from their hometowns to larger communities, mainly to the largest city in British Columbia. Most of those taking jobs in rural and remote communities grew up in or near those communities, and were more influenced by community size and anticipated working conditions, and less influenced by access to cultural and social activities, than their urban counterparts. The admission of students from rural and remote communities is modestly effective in ensuring a supply of pharmacists for these areas.

Population density controls on microbial pollution across the Ganga catchment.

PubMed

Milledge, D G; Gurjar, S K; Bunce, J T; Tare, V; Sinha, R; Carbonneau, P E

2018-01-01

For millions of people worldwide, sewage-polluted surface waters threaten water security, food security and human health. Yet the extent of the problem and its causes are poorly understood. Given rapid widespread global urbanisation, the impact of urban versus rural populations is particularly important but unknown. Exploiting previously unpublished archival data for the Ganga (Ganges) catchment, we find a strong non-linear relationship between upstream population density and microbial pollution, and predict that these river systems would fail faecal coliform standards for irrigation waters available to 79% of the catchment's 500 million inhabitants. Overall, this work shows that microbial pollution is conditioned by the continental-scale network structure of rivers, compounded by the location of cities whose growing populations contribute c. 100 times more microbial pollutants per capita than their rural counterparts. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Examining the influence of urban definition when assessing relative safety of drinking-water in Nigeria.

PubMed

Christenson, Elizabeth; Bain, Robert; Wright, Jim; Aondoakaa, Stephen; Hossain, Rifat; Bartram, Jamie

2014-08-15

Reducing inequalities is a priority from a human rights perspective and in water and public health initiatives. There are periodic calls for differential national and global standards for rural and urban areas, often justified by the suggestion that, for a given water source type, safety is worse in urban areas. For instance, initially proposed post-2015 water targets included classifying urban but not rural protected dug wells as unimproved. The objectives of this study were to: (i) examine the influence of urban extent definition on water safety in Nigeria, (ii) compare the frequency of thermotolerant coliform (TTC) contamination and prevalence of sanitary risks between rural and urban water sources of a given type and (iii) investigate differences in exposure to contaminated drinking-water in rural and urban areas. We use spatially referenced data from a Nigerian national randomized sample survey of five improved water source types to assess the extent of any disparities in urban-rural safety. We combined the survey data on TTC and sanitary risk with map layers depicting urban versus rural areas according to eight urban definitions. When examining water safety separately for each improved source type, we found no significant urban-rural differences in TTC contamination and sanitary risk for groundwater sources (boreholes and protected dug wells) and inconclusive findings for piped water and stored water. However, when improved and unimproved source types were combined, TTC contamination was 1.6 to 2.3 times more likely in rural compared to urban water sources depending on the urban definition. Our results suggest that different targets for urban and rural water safety are not justified and that rural dwellers are more exposed to unsafe water than urban dwellers. Additionally, urban-rural analyses should assess multiple definitions or indicators of urban to assess robustness of findings and to characterize a gradient that disaggregates the urban-rural dichotomy. Copyright © 2014 Elsevier B.V. All rights reserved.

Physical activity and cardiovascular risk factors among rural and urban groups and rural-to-urban migrants in Peru: a cross-sectional study

PubMed Central

Creber, Ruth M. Masterson; Smeeth, Liam; Gilman, Robert H.; Miranda, J. Jaime

2010-01-01

Objectives To compare physical activity and sedentary behavior patterns of rural-to-urban migrants in Peru versus lifetime rural and urban residents and to determine any associations between low physical activity and four cardiovascular risk factors: obesity (body mass index ≥ 30 kg/m2), systolic and diastolic blood pressure, hypertension, and metabolic syndrome. Methods The PERU MIGRANT (PEru’s Rural to Urban MIGRANTs) cross-sectional study was designed to measure physical activity among rural, urban, and rural-to-urban migrants with the International Physical Activity Questionnaire (IPAQ). Results The World Health Organization (WHO) age-standardized prevalence of low physical activity was 2.2% in lifetime rural residents, 32.2% in rural-to-urban migrants, and 39.2% in lifetime urban residents. The adjusted odds ratios for low physical activity were 21.43 and 32.98 for migrant and urban groups respectively compared to the rural group. The adjusted odds ratio for being obese was 1.94 for those with low physical activity. There was no evidence of an association between low physical activity and blood pressure levels, hypertension, or metabolic syndrome. Conclusions People living in a rural area had much higher levels of physical activity and lower risk of being overweight and obese compared to those living in an urban area of Lima. Study participants from the same rural area who had migrated to Lima had levels of physical inactivity and obesity similar to those who had always lived in Lima. Interventions aimed at maintaining higher levels of physical activity among rural-to-urban migrants may help reduce the epidemic of obesity in urban areas. PMID:20857014

Physical activity and cardiovascular risk factors among rural and urban groups and rural-to-urban migrants in Peru: a cross-sectional study.

PubMed

Masterson Creber, Ruth M; Smeeth, Liam; Gilman, Robert H; Miranda, J Jaime

2010-07-01

To compare physical activity and sedentary behavior patterns of rural-to-urban migrants in Peru versus lifetime rural and urban residents and to determine any associations between low physical activity and four cardiovascular risk factors: obesity (body mass index > 30 kg/m²), systolic and diastolic blood pressure, hypertension, and metabolic syndrome. The PERU MIGRANT (PEru's Rural to Urban MIGRANTs) cross-sectional study was designed to measure physical activity among rural, urban, and rural-to-urban migrants with the International Physical Activity Questionnaire (IPAQ). The World Health Organization (WHO) age-standardized prevalence of low physical activity was 2.2% in lifetime rural residents, 32.2% in rural-to-urban migrants, and 39.2% in lifetime urban residents. The adjusted odds ratios for low physical activity were 21.43 and 32.98 for migrant and urban groups respectively compared to the rural group. The adjusted odds ratio for being obese was 1.94 for those with low physical activity. There was no evidence of an association between low physical activity and blood pressure levels, hypertension, or metabolic syndrome. People living in a rural area had much higher levels of physical activity and lower risk of being overweight and obese compared to those living in an urban area of Lima. Study participants from the same rural area who had migrated to Lima had levels of physical inactivity and obesity similar to those who had always lived in Lima. Interventions aimed at maintaining higher levels of physical activity among rural-to-urban migrants may help reduce the epidemic of obesity in urban cities.

Increased vulnerability of rural children on antiretroviral therapy attending public health facilities in South Africa: a retrospective cohort study

PubMed Central

2010-01-01

Background A large proportion of the 340,000 HIV-positive children in South Africa live in rural areas, yet there is little sub-Saharan data comparing rural paediatric antiretroviral therapy (ART) programme outcomes with urban facilities. We compared clinical, immunological and virological outcomes between children at seven rural and 37 urban facilities across four provinces in South Africa. Methods We conducted a retrospective cohort study of routine data of children enrolled on ART between November 2003 and March 2008 in three settings, namely: urban residence and facility attendance (urban group); rural residence and facility attendance (rural group); and rural residents attending urban facilities (rural/urban group). Outcome measures were: death, loss to follow up (LTFU), virological suppression, and changes in CD4 percentage and weight-for-age-z (WAZ) scores. Kaplan-Meier estimates, logrank tests, multivariable Cox regression and generalized estimating equation models were used to compare outcomes between groups. Results In total, 2332 ART-naïve children were included, (1727, 228 and 377 children in the urban, rural and rural/urban groups, respectively). At presentation, rural group children were older (6.7 vs. 5.6 and 5.8 years), had lower CD4 cell percentages (10.0% vs. 12.8% and 12.7%), lower WAZ scores (-2.06 vs. -1.46 and -1.41) and higher proportions with severe underweight (26% vs.15% and 15%) compared with the urban and rural/urban groups, respectively. Mortality was significantly higher in the rural group and LTFU significantly increased in the rural/urban group. After 24 months of ART, mortality probabilities were 3.4% (CI: 2.4-4.8%), 7.7% (CI: 4.5-13.0%) and 3.1% (CI: 1.7-5.6%) p = 0.0137; LTFU probabilities were 11.5% (CI: 9.3-14.0%), 8.8% (CI: 4.5-16.9%) and 16.6% (CI: 12.4-22.6%), p = 0.0028 in the urban, rural and rural/urban groups, respectively. The rural group had an increased adjusted mortality probability, adjusted hazards ratio 2.41 (CI: 1.25-4.67) and the rural/urban group had an increased adjusted LTFU probability, aHR 2.85 (CI: 1.41-5.79). The rural/urban group had a decreased adjusted probability of virological suppression compared with the urban group at any timepoint on treatment, adjusted odds ratio 0.67 (CI: 0.48-0.93). Conclusions Rural HIV-positive children are a vulnerable group, exhibiting delayed access to ART and an increased risk of poor outcomes while on ART. Expansion of rural paediatric ART programmes, with future research exploring improvements to rural health system effectiveness, is required. PMID:21108804

Maternal responses to childhood fevers: a comparison of rural and urban residents in coastal Kenya.

PubMed

Molyneux, C S; Mung'Ala-Odera, V; Harpham, T; Snow, R W

1999-12-01

Urbanization is an important demographic phenomenon in sub-Saharan Africa, and rural-urban migration remains a major contributor to urban growth. In a context of sustained economic recession, these demographic processes have been associated with a rise in urban poverty and ill health. Developments in health service provision need to reflect new needs arising from demographic and disease ecology change. In malaria-endemic coastal Kenya, we compared lifelong rural (n = 248) and urban resident (n = 284) Mijikenda mothers' responses to childhood fevers. Despite marked differences between the rural and urban study areas in demographic structure and physical access to biomedical services, rural and urban mothers' treatment-seeking patterns were similar: most mothers sought only biomedical treatment (88%). Shop-bought medicines were used first or only in 69% of the rural and urban fevers that were treated, and government or private clinics were contacted in 49%. A higher proportion of urban informal vendors stocked prescription-only drugs, and urban mothers more likely to contact a private than a government facility. We conclude that improving self-treatment has enormous potential to reduce morbidity and mortality in low-income urban areas, as has frequently been argued for rural areas. However, because of the underlying socio-economic, cultural and structural differences between rural and urban areas, rural approaches to tackle this may have to be modified in urban environments.

Migrating husbands and changing cardiovascular risk factors in the wife: a cross sectional study in Asian Indian women.

PubMed

Gupta, Rajeev; Gupta, Rajiv; Agrawal, Aachu; Misra, Anoop; Guptha, Soneil; Pandey, Ravindra M; Misra, Puneet; Vikram, Naval K; Dey, Sanjit; Rao, Shobha; Menon, V Usha; Kamalamma, N; Revathi, K; Mathur, Beena; Sharma, Vinita

2012-10-01

The authors studied the influence of migration of husband on cardiovascular risk factors in Asian Indian women. Population-based studies in women aged 35-70 years were performed in four urban and five rural locations. 4608 (rural 2604 and urban 2004) of the targeted 8000 (57%) were enrolled. Demographic details, lifestyle factors, anthropometry, fasting glucose and cholesterol were measured. Multivariate logistic and quadratic regression was performed to compare influence of migration and its duration on prevalence of risk factors. Details of migration were available in 4573 women (rural 2267, rural-urban migrants 455, urban 1552 and urban-rural migrants 299). Majority were married, and illiteracy was high. Median (interquartile) duration of residence in urban locations among rural-urban migrants was 9 (4-18) years and in rural areas for urban-rural migrants 23 (18-30) years. In rural, rural-urban migrants, urban and urban-rural migrants, age-adjusted prevalence (%) of risk factors was tobacco use 41.9, 22.7, 18.8 and 38.1; sedentary lifestyle 69.7, 82.0, 79.9 and 74.6; high-fat diet 33.3, 54.2, 66.1 and 61.1; overweight 21.3, 42.7, 46.3 and 29.7; large waist 8.5, 38.5, 29.2 and 29.2; hypertension 30.4, 49.4, 47.7 and 38.4; hypercholesterolaemia 14.4, 31.3, 26.6 and 9.1 and diabetes 3.9, 15.8, 14.9 and 8.4, respectively (p<0.001). In rural-urban migrants, there was a significant correlation of duration of migration with waist size, waist-to-hip ratio and systolic blood pressure (quadratic regression, p<0.001). Association of risk factors with migration remained significant, though attenuated, after adjustment for socioeconomic, lifestyle and obesity variables (logistic regression, p<0.01). Compared with rural women, rural-urban migrants and urban have significantly greater cardiometabolic risk factors. Prevalence is lower in urban-rural migrants. There is significant correlation of duration of migration with obesity and blood pressure. Differences are attenuated after adjusting for social and lifestyle variables.

A qualitative study of recruitment barriers, motivators, and community-based strategies for increasing clinical trials participation among rural and urban populations.

PubMed

Friedman, Daniela B; Foster, Caroline; Bergeron, Caroline D; Tanner, Andrea; Kim, Sei-Hill

2015-01-01

Participation in clinical trials (CTs) is low among rural communities. Investigators report difficulty recruiting rural individuals for CTs. The study purpose was to identify recruitment barriers, motivators, and strategies to help increase access to and participation in CTs in rural and urban communities. Qualitative focus groups/interviews. Rural and urban counties in one southeastern state. Two hundred twelve African-American and white men and women ages 21+. Nineteen focus groups and nine interviews were conducted. Audio files were transcribed and organized into NVivo10. Recurring themes were examined by geographic location. Although similar barriers, motivators, and strategies were reported by urban and rural groups, perceptions regarding their importance varied. Recruitment barriers mentioned in both rural and urban groups included fear, side effects, limited understanding, limited time, and mistrust. Rural groups were more mindful of time commitment involved. Both rural and urban participants reported financial incentives as the top motivator to CT participation, followed by personal illness (urban groups) and benefits to family (rural groups). Recruitment strategies suggested by rural participants involved working with schools/churches and using word of mouth, whereas partnering with schools, word of mouth, and media were recommended most by urban groups. Perceived recruitment barriers, motivators, and strategies did not differ considerably between rural and urban groups. Major barriers identified by participants should be addressed in future CT recruitment and education efforts. Findings can inform recruitment and communication strategies for reaching both urban and rural communities.

Neighbourhood Environmental Attributes Associated with Walking in South Australian Adults: Differences between Urban and Rural Areas

PubMed Central

Coffee, Neil T.; Nolan, Rebecca; Dollman, James; Sugiyama, Takemi

2017-01-01

Although the health benefits of walking are well established, participation is lower in rural areas compared to urban areas. Most studies on walkability and walking have been conducted in urban areas, thus little is known about the relevance of walkability to rural areas. A computer-assisted telephone survey of 2402 adults (aged ≥18 years) was conducted to determine walking behaviour and perceptions of neighbourhood walkability. Data were stratified by urban (n = 1738) and rural (n = 664). A greater proportion of respondents reported no walking in rural (25.8%) compared to urban areas (18.5%). Compared to urban areas, rural areas had lower walkability scores and urban residents reported higher frequency of walking. The association of perceived walkability with walking was significant only in urban areas. These results suggest that environmental factors associated with walking in urban areas may not be relevant in rural areas. Appropriate walkability measures specific to rural areas should be further researched. PMID:28846597

Trends in Rural and Urban Deliveries and Vaginal Births: California 1998-2002

ERIC Educational Resources Information Center

Hughes, Susan; Zweifler, John A.; Garza, Alvaro; Stanich, Matthew A.

2008-01-01

Context: Pregnant women in rural areas may give birth in either rural or urban hospitals. Differences in outcomes between rural and urban hospitals may influence patient decision making. Purpose: Trends in rural and urban obstetric deliveries and neonatal and maternal mortality in California were compared to inform policy development and patient…

Maternal mobility across the rural-urban divide: empirical data from coastal Kenya

PubMed Central

Molyneux, C S; Mung’ala-Odera, V; Harpham, T; Snow, R W

2013-01-01

This paper describes the mobility patterns, rural-urban linkages and household structures for a low-income neighbourhood on the outskirts of Mombasa, Kenya’s main port, and a rural settlement 60 kilometres away. Drawing on interviews with a sample of mothers resident in each location, it documents their perceptions of the advantages and disadvantages of rural and urban life, and shows the continuous interchange between the two areas. It also highlights how most rural to urban migrants are familiar with urban environments before moving and how, having moved, many maintain strong rural ties. The ways in which households are split across rural and urban areas is influenced by intra-household relations and by household efforts to balance the income-earning opportunities in town, the relatively low cost of living in rural areas and future family security. This produces dramatic differences between and among rural and urban mothers and suggests a need for policy makers and planners to recognize diversity and to build upon complex livelihood strategies that span the rural-urban divide. PMID:23814409

Effect of urbanisation on asthma, allergy and airways inflammation in a developing country setting.

PubMed

Robinson, Colin L; Baumann, Lauren M; Romero, Karina; Combe, Juan M; Gomez, Alfonso; Gilman, Robert H; Cabrera, Lilia; Gonzalvez, Guillermo; Hansel, Nadia N; Wise, Robert A; Barnes, Kathleen C; Breysse, Patrick N; Checkley, William

2011-12-01

Asthma is a growing public health problem in developing countries. However, few studies have studied the role of urbanisation in this phenomenon. It was hypothesised that children living in a peri-urban setting in Peru have higher rates of asthma and allergy than rural counterparts. 1441 adolescents aged 13-15 years were enrolled from two settings: a peri-urban shanty town in Lima (n = 725) and 23 rural villages in Tumbes (n = 716). Participants filled in questionnaires on asthma and allergy symptoms, environmental exposures and sociodemographics, and underwent spirometry, and exhaled nitric oxide (eNO) and allergy skin testing. Indoor particulate matter (PM) concentrations were measured in 170 households. Lima adolescents had higher rates of lifetime wheezing (22% vs 10%), current asthma symptoms (12% vs 3%) and physician-diagnosed asthma (13% vs 2%; all p <0.001). Current rhinitis (23% vs 12%), eczema (12% vs 0.4%), atopy (56% vs 38%), personal history of cigarette smoking (7.4% vs 1.3%) and mean indoor PM (31 vs 13 μg/m(3)) were also higher in Lima (all p < 0.001). The peri-urban environment of Lima was associated with a 2.6-fold greater odds (95% CI 1.3 to 5.3) of asthma in multivariable regression. Forced expiratory volumes were higher and FEV(1)/FVC (forced expiratory volume in 1 s/forced vital capacity) ratios were lower in Lima (all p < 0.001). Higher eNO values in Lima (p < 0.001) were attributable to higher rates of asthma and atopy. Peri-urban adolescents had more asthma, atopy and airways inflammation and were exposed to more indoor pollution. The findings provide evidence of the risks posed to lung health by peri-urban environments in developing countries.

Effect of urbanisation on asthma, allergy and airways inflammation in a developing country setting

PubMed Central

Robinson, Colin L; Baumann, Lauren M; Romero, Karina; Combe, Juan M; Gomez, Alfonso; Gilman, Robert H; Cabrera, Lilia; Gonzalvez, Guillermo; Hansel, Nadia N; Wise, Robert A; Barnes, Kathleen C; Breysse, Patrick N; Checkley, William

2017-01-01

Background Asthma is a growing public health problem in developing countries. However, few studies have studied the role of urbanisation in this phenomenon. It was hypothesised that children living in a peri-urban setting in Peru have higher rates of asthma and allergy than rural counterparts. Methods 1441 adolescents aged 13–15 years were enrolled from two settings: a peri-urban shanty town in Lima (n=725) and 23 rural villages in Tumbes (n=716). Participants filled in questionnaires on asthma and allergy symptoms, environmental exposures and sociodemographics, and underwent spirometry, and exhaled nitric oxide (eNO) and allergy skin testing. Indoor particulate matter (PM) concentrations were measured in 170 households. Results Lima adolescents had higher rates of lifetime wheezing (22% vs 10%), current asthma symptoms (12% vs 3%) and physician-diagnosed asthma (13% vs 2%; all p <0.001). Current rhinitis (23% vs 12%), eczema (12% vs 0.4%), atopy (56% vs 38%), personal history of cigarette smoking (7.4% vs 1.3%) and mean indoor PM (31 vs 13 μg/m3) were also higher in Lima (all p <0.001). The peri-urban environment of Lima was associated with a 2.6-fold greater odds (95% CI 1.3 to 5.3) of asthma in multivariable regression. Forced expiratory volumes were higher and FEV1/FVC (forced expiratory volume in 1 s/forced vital capacity) ratios were lower in Lima (all p <0.001). Higher eNO values in Lima (p <0.001) were attributable to higher rates of asthma and atopy. Conclusions Peri-urban adolescents had more asthma, atopy and airways inflammation and were exposed to more indoor pollution. The findings provide evidence of the risks posed to lung health by peri-urban environments in developing countries. PMID:21730351

Agriculture and Rurality: Beginning the "Final Separation"?

ERIC Educational Resources Information Center

Friedland, William H.

2002-01-01

When is a farm a farm? When is rural rural? Has the issue of the rural-urban continuum returned? Decades ago rural sociology worked itself into two blind alleys: rural-urban differences and attempts to define the rural-urban fringe. Although these conceptual problems eventually were exhausted, recent developments in California raise the…

Geographical differences in whooping cough in Catalonia, Spain, from 1990 to 2010.

PubMed

Crespo, Inma; Soldevila, Núria; Muñoz, Pilar; Godoy, Pere; Carmona, Gloria; Domínguez, Angela

2014-03-20

Whooping cough is a communicable disease whose incidence has increased in recent years in some countries with vaccination. Since 1981, in Catalonia (Spain), cases must be reported to the Public Health Department. In 1997, surveillance changed from aggregated counts to individual report and the surveillance system was improved after 2002. Catalan public health is universal with equal coverage geographically. The aim of this study was to determine whether there are differences in whooping cough incidence in rural and urban counties. Cases in 1990-2010 were classified as rural or urban. Incidences and risk ratios (RR) between urban and rural counties and 95% CI were calculated. Associations between rural and urban counties and structural changes during the study period were analysed. Twelve years of the whole study period showed differences in incidence between rural and urban counties. The incidence was higher in urban counties in seven years and rural counties in five years. There was a positive association of whooping cough incidence in rural and urban counties in four-week periods. Structural changes were detected in the following four-week periods: 4th in 1993, 7th in 1996 and 3rd 2005 in rural counties and 5th 1993, 9th in 1996 and 8th in 2007 in urban counties. Differences in whooping cough between rural and urban counties were found. In most years, the incidence was higher in urban than in rural counties. Rural and urban counties show similar cyclic behaviour when four-week periods were considered.

Infection prevention needs assessment in Colorado hospitals: rural and urban settings.

PubMed

Reese, Sara M; Gilmartin, Heather; Rich, Karen L; Price, Connie S

2014-06-01

The purpose of our study was to conduct a needs assessment for infection prevention programs in both rural and urban hospitals in Colorado. Infection control professionals (ICPs) from Colorado hospitals participated in an online survey on training, personnel, and experience; ICP time allocation; and types of surveillance. Responses were evaluated and compared based on hospital status (rural or urban). Additionally, rural ICPs participated in an interview about resources and training. Surveys were received from 62 hospitals (77.5% response); 33 rural (75.0% response) and 29 urban (80.6% response). Fifty-two percent of rural ICPs reported multiple job responsibilities compared with 17.2% of urban ICPs. Median length of experience for rural ICPs was 4.0 years compared with 11.5 years for urban ICPs (P = .008). Fifty-one percent of rural ICPs reported no access to infectious disease physicians (0.0% urban) and 81.8% of rural hospitals reported no antimicrobial stewardship programs (31.0% urban). Through the interviews it was revealed that priorities for rural ICPs were training and communication. Our study revealed numerous differences between infection prevention programs in rural versus urban hospitals. An infection prevention outreach program established in Colorado could potentially address the challenges faced by rural hospital infection prevention departments. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Rural Industry Clustering Towards Transitional Rural-Urban Interface

NASA Astrophysics Data System (ADS)

Nugroho, P.

2018-05-01

Rural industrialization seems to be attractive for policymakers looking for counter-urbanization efforts – and nowadays peri-urbanization forces – in line with growing decentralized autonomy of local Indonesian authorities. To promote better rural development, an extended growth pole strategy has been introduced as well as an agropolitan approach and its derivatives. In fact, there is little evidence for their success; rural autonomy remains elusive instead. However, institutional capacity of rural authorities and organizations still fails to deliver rural development initiatives properly. This research was aimed at examining this issue by looking at rural industry clustering in the Greater Solo Region, Indonesia as a response against extended urbanization in peripheral regions. The study focused on batik industry clustering in the rural periphery of Solo City, which provides a transitional rural-urban interface necessary to drive rural independence. Having inherited the batik tradition underpinned by an agriculture-led peasant society, the rural batik industrialization has reinforced the socio-economic transition from a purely agrarian society to a mixed rural-urban society. This study employed an explanatory sequential mixed-method approach, where a quantitative spatial analysis was used to identify the expansion of urbanized areas in villages, and a qualitative case study analysis to figure out the socio-economic shift in rural livelihoods. The results showed that physical spatial changes in these villages do not conform to the socio-economic change into an urban industrial society in a substantial way. Rather, the local villagers preserve an informal economy to support the existence of a mixed rural-urban livelihood.

Rural and Urban Youth Programs.

ERIC Educational Resources Information Center

Backman, Kenneth; And Others

This publication provides a variety of information on prevention and intervention programs for rural and urban children and adolescents. Drawing from a rural sociological perspective, the introductory paper defines "rural," discusses rural-urban economic and social differences, and lists indicators of risk for rural youth. It discusses the extent…

[Live-birth rates by age of mother and total fertility rates by urban and rural areas].

PubMed

Kaneko, T; Shiraishi, N; Kasahara, R

1983-07-01

Live birth rates by age of mother and total fertility rates by urban and rural areas in Japan are generally decreasing. Japanese women ages 15-49 were studied. Graphs presenting fertility rates according to age in 1975 and 1980 in urban and rural areas show that fertility rates are considerably higher in rural areas than in urban centers (by as much as 20% for the 25-29 age group). In a table showing urban/rural total fertility rates and distributions among prefectures in 1975 and 1980, the prefecture with the highest total fertility rate (2.88495 in 1975 and 2.37804 in 1980) is Okinawa and the lowest total fertility rate is found in Tokyo (1.62287 in 1975 and 1.43693 in 1980). The average total fertility rate in 1980 was 1.82849; in urban centers it was 1.78919 and rural areas, 1.92105. Finally, a comparison of total fertility rates by urban and rural areas and by age shows that in 1975 the rural fertility rate was .16 higher than that of urban areas, and that in 1980 all fertility rates (total, urban, and rural) were lower, with the rural fertility rate decreasing at the same rate as did the urban fertility rate in 1975. It is interesting to note that between 1975-1980 birth rates have been decreasing in both urban and rural areas in all age groups except for the 30-34 year old group which in urban centers was higher in 1980 than in rural areas. This can be attributed to the recent trend among Japanese women of delaying childbirth.

Urban-rural differences in self-reported limiting long-term illness in Scotland.

PubMed

Levin, Kate A

2003-12-01

Previous research suggests that there are significant differences in health between urban and rural areas. The aim of this study is to describe the pattern and magnitude of urban-rural variation in health in Scotland and to examine the factors associated with health inequalities in urban and rural areas. The data used in this study were limiting long-term illness (LLTI) and socio-economic data collected by the 1991 Census. A rurality indicator was created using Scottish Household Survey rurality classifications. Multilevel Poisson regression modelling was carried out with LLTI as a health indicator for each type of rurality within Scotland. A variety of socio-economic factors were investigated for each rurality. Areas with the highest Standardized Illness Ratios (SIRs) (>125) are predominantly urban whereas the lowest SIRs (<75) are found in both urban and rural areas. Rural communities are more heterogeneous than urban areas in terms of their social make-up with relation to health; however, when these areas are split according to minor road length and different socio-economic factors are added, the model fit for each new model is improved and the reduction in total variation is comparable with that of the urban models. These findings suggest that rural areas should not be treated as a homogeneous group but should be subdivided into rural types.

Clinical peripherality: development of a peripherality index for rural health services.

PubMed

Swan, Gillian M; Selvaraj, Sivasubramaniam; Godden, David J

2008-01-25

The configuration of rural health services is influenced by geography. Rural health practitioners provide a broader range of services to smaller populations scattered over wider areas or more difficult terrain than their urban counterparts. This has implications for training and quality assurance of outcomes. This exploratory study describes the development of a "clinical peripherality" indicator that has potential application to remote and rural general practice communities for planning and research purposes. Profiles of general practice communities in Scotland were created from a variety of public data sources. Four candidate variables were chosen that described demographic and geographic characteristics of each practice: population density, number of patients on the practice list, travel time to nearest specialist led hospital and travel time to Health Board administrative headquarters. A clinical peripherality index, based on these variables, was derived using factor analysis. Relationships between the clinical peripherality index and services offered by the practices and the staff profile of the practices were explored in a series of univariate analyses. Factor analysis on the four candidate variables yielded a robust one-factor solution explaining 75% variance with factor loadings ranging from 0.83 to 0.89. Rural and remote areas had higher median values and a greater scatter of clinical peripherality indices among their practices than an urban comparison area. The range of services offered and the profile of staffing of practices was associated with the peripherality index. Clinical peripherality is determined by the nature of the practice and its location relative to secondary care and administrative and educational facilities. It has features of both gravity model-based and travel time/accessibility indicators and has the potential to be applied to training of staff for rural and remote locations and to other aspects of health policy and planning. It may assist planners in conceptualising the effects on general practices of centralising specialist clinical services or administrative and educational facilities.

Clinical peripherality: development of a peripherality index for rural health services

PubMed Central

Swan, Gillian M; Selvaraj, Sivasubramaniam; Godden, David J

2008-01-01

Background The configuration of rural health services is influenced by geography. Rural health practitioners provide a broader range of services to smaller populations scattered over wider areas or more difficult terrain than their urban counterparts. This has implications for training and quality assurance of outcomes. This exploratory study describes the development of a "clinical peripherality" indicator that has potential application to remote and rural general practice communities for planning and research purposes. Methods Profiles of general practice communities in Scotland were created from a variety of public data sources. Four candidate variables were chosen that described demographic and geographic characteristics of each practice: population density, number of patients on the practice list, travel time to nearest specialist led hospital and travel time to Health Board administrative headquarters. A clinical peripherality index, based on these variables, was derived using factor analysis. Relationships between the clinical peripherality index and services offered by the practices and the staff profile of the practices were explored in a series of univariate analyses. Results Factor analysis on the four candidate variables yielded a robust one-factor solution explaining 75% variance with factor loadings ranging from 0.83 to 0.89. Rural and remote areas had higher median values and a greater scatter of clinical peripherality indices among their practices than an urban comparison area. The range of services offered and the profile of staffing of practices was associated with the peripherality index. Conclusion Clinical peripherality is determined by the nature of the practice and its location relative to secondary care and administrative and educational facilities. It has features of both gravity model-based and travel time/accessibility indicators and has the potential to be applied to training of staff for rural and remote locations and to other aspects of health policy and planning. It may assist planners in conceptualising the effects on general practices of centralising specialist clinical services or administrative and educational facilities. PMID:18221533

Intellectually Gifted Rural-to-Urban Migrant Children's Attention

ERIC Educational Resources Information Center

Zhang, Hui; He, Yunfeng; Tao, Ting; Shi, Jian-Nong

2016-01-01

The term "intellectually gifted rural-to-urban migrant children" refers to intellectually gifted children who are in migration from rural to urban areas. We compared performances on seven attention tasks among intellectually gifted (n = 26) and average (n = 30) rural-to-urban migrant and intellectually gifted urban children (n = 31). Our…

Trend analysis of long-term temperature time series in the Greater Toronto Area (GTA)

NASA Astrophysics Data System (ADS)

Mohsin, Tanzina; Gough, William A.

2010-08-01

As the majority of the world’s population is living in urban environments, there is growing interest in studying local urban climates. In this paper, for the first time, the long-term trends (31-162 years) of temperature change have been analyzed for the Greater Toronto Area (GTA). Annual and seasonal time series for a number of urban, suburban, and rural weather stations are considered. Non-parametric statistical techniques such as Mann-Kendall test and Theil-Sen slope estimation are used primarily for the assessing of the significance and detection of trends, and the sequential Mann test is used to detect any abrupt climate change. Statistically significant trends for annual mean and minimum temperatures are detected for almost all stations in the GTA. Winter is found to be the most coherent season contributing substantially to the increase in annual minimum temperature. The analyses of the abrupt changes in temperature suggest that the beginning of the increasing trend in Toronto started after the 1920s and then continued to increase to the 1960s. For all stations, there is a significant increase of annual and seasonal (particularly winter) temperatures after the 1980s. In terms of the linkage between urbanization and spatiotemporal thermal patterns, significant linear trends in annual mean and minimum temperature are detected for the period of 1878-1978 for the urban station, Toronto, while for the rural counterparts, the trends are not significant. Also, for all stations in the GTA that are situated in all directions except south of Toronto, substantial temperature change is detected for the periods of 1970-2000 and 1989-2000. It is concluded that the urbanization in the GTA has significantly contributed to the increase of the annual mean temperatures during the past three decades. In addition to urbanization, the influence of local climate, topography, and larger scale warming are incorporated in the analysis of the trends.

Differences in cardiovascular risk factors in rural, urban and rural-to-urban migrants in Peru

PubMed Central

Miranda, J. Jaime; Gilman, Robert H.; Smeeth, Liam

2011-01-01

Objectives To assess differences in cardiovascular risk profiles among rural-to-urban migrants and non-migrant groups. Design Cross-sectional study. Setting Ayacucho and Lima, Peru Participants rural (n=201); rural-urban migrants (n=589) and urban (n=199). Main outcome measures Cardiovascular risk factors were assessed according to migrant status (migrants vs. non-migrants), age at first migration, length of residency in an urban area and lifetime exposure to an urban area. Results For most risk factors, the migrant group had intermediate levels of risk between those observed for the rural and urban groups. Prevalences, for rural, migrant and urban groups, was 3%, 20% and 33% for obesity and 0.8%, 3% and 6% for type-2 diabetes. This gradient of risk was not observed uniformly across all risk factors. Blood pressure did not show a clear gradient of difference between groups. The migrant group had similar systolic blood pressure (SBP) but lower diastolic blood pressure (DBP) than the rural group. The urban group had higher SBP but similar DBP than rural group. Hypertension was more prevalent among the urban (29%) compared to both rural and migrant groups (11% and 16% respectively). For HbA1c, although the urban group had higher levels, the migrant and rural groups were similar to each other. No differences were observed in triglycerides between the three groups. Within migrants, those who migrated when aged older than 12 years had higher odds of diabetes, impaired fasting glucose and metabolic syndrome compared to people who migrated at younger ages. Adjustment for age, sex and socioeconomic indicators had little impact on the patterns observed. Conclusions The impact of rural to urban migration on cardiovascular risk profile is not uniform across different risk factors, and is further influenced by the age at which migration occurs. A gradient in levels was observed for some risk factors across study groups. This observation indicates that urbanization is indeed detrimental to cardiovascular health. PMID:21478383

A meta-analysis of the impacts of internal migration on child health outcomes in China.

PubMed

Sun, Xiaoyue; Chen, Mengtong; Chan, Ko Ling

2016-01-22

According to China's 2010 population census, 38.81 million children migrated from rural to urban areas in Mainland China, a phenomenon that has attracted much scholarly attention. Due to the lack of quantitative synthesis of migrant children's developmental outcomes, we undertook a meta-analysis to compare their developmental outcomes with those of their urban counterparts. We searched Applied Social Sciences Index and Abstracts (ASSIA), Australian Education Index, British Education Index, ERIC, ProQuest Education Journals, PsycINFO, Social Services Abstracts, Family & Society Studies Worldwide, Medline, Women's Studies International databases and the Chinese CNKI database to identify relevant studies. Studies reporting physical and mental health outcomes of migrant children as well as potential protective and risk factors of child developmental outcomes were included. We assessed study quality using a quality assessment checklist. We selected 25 studies from a total of 1592. Our results reveal that migrant children in public schools present significantly greater mental health problems and lower well-being than their urban counterparts, while migrant children in migrant schools do not present significantly different outcomes. In addition, migrant children were found to be more likely to be exposed to physical health risks due to limited utilization of health services. The disadvantageous health outcomes of migrant children were found to be related to a series of individual and social factors, including academic performance, social relationships, and discrimination. Migrant children are disadvantaged by the sociocultural circumstances in urban areas. Government should target them and provide appropriate support in order to improve their developmental status, which will have a positive impact on the stability and development of society.

Rural-urban differences in objective and subjective measures of physical activity: findings from the National Health and Nutrition Examination Survey (NHANES) 2003-2006.

PubMed

Fan, Jessie X; Wen, Ming; Kowaleski-Jones, Lori

2014-08-21

Lower levels of physical activity among rural relative to urban residents have been suggested as an important contributor to rural-urban health disparity; however, empirical evidence is sparse. We examined rural-urban differences in 4 objective physical activity measures (2 intensity thresholds by 2 bout lengths) and 4 subjective measures (total, leisure, household, and transportation) in a nationally representative sample of participants in the National Health and Nutrition Examination Survey (NHANES) 2003-2006. The sample comprised 5,056 adults aged 20 to 75 years. Rural-Urban Commuting Area (RUCA) codes were matched with NHANES subjects to identify urban status and 2 types of rural status. Rural-urban and within-rural differences in physical activity were estimated without and with controls for demographic and socioeconomic variables. Rural residents were less active than urban residents in high-intensity long bout (2,020 counts per minute threshold and 10 miniutes or longer bout length) accelerometer-measured physical activity (42.5 ± 6.2 min/wk vs 55.9 ± 2.8 min/wk) but the difference disappeared with a lower-intensity threshold (760 counts per minute). Rural residents reported more total physical activity than urban residents (438.3 ± 35.3min/wk vs 371.2 ± 12.5 min/wk), with differences primarily attributable to household physical activity. Within rural areas, micropolitan residents were less active than residents in smaller rural areas. Controlling for other variables reduced the size of the differences. The direction and significance of rural-urban difference in physical activity varied by the method of physical activity measurement, likely related to rural residents spending more time in low-intensity household physical activity but less time in high-intensity physical activity. Micropolitan residents were substantially less active than residents in smaller rural areas, indicating that physical activity did not vary unidirectionally with degree of urbanization.

A Comparison of Health-Risk Behaviors of Rural Migrants with Rural Residents and Urban Residents in China

ERIC Educational Resources Information Center

Chen, Xinguang; Stanton, Bonita; Li, Xiaoming; Fang, Xiaoyi; Lin, Danhua; Xiong, Qing

2009-01-01

Objective: To determine whether rural-to-urban migrants in China are more likely than rural and urban residents to engage in risk behaviors. Methods: Comparative analysis of survey data between migrants and rural and urban residents using age standardized rate and multiple logistic regression. Results: The prevalence and frequency of tobacco…

Rural-urban differences in cooking practices and exposures in Northern Ghana

NASA Astrophysics Data System (ADS)

Wiedinmyer, Christine; Dickinson, Katherine; Piedrahita, Ricardo; Kanyomse, Ernest; Coffey, Evan; Hannigan, Michael; Alirigia, Rex; Oduro, Abraham

2017-07-01

Key differences between urban and rural populations can influence the adoption and impacts of new cooking technologies and fuels. We examine these differences among urban and rural households that are part of the REACCTING study in Northern Ghana. While urban and rural populations in the study area all use multiple stoves, the types of stoves and fuels differ, with urban participants more likely to use charcoal and LPG while rural households rely primarily on wood. Further, rural and urban households tend to use different stoves/fuels to cook the same dishes—for example, the staple porridge Tuo Zaafi (TZ) is primarily cooked over wood fires in rural areas and charcoal stoves in urban settings. This suggests that fuel availability and ability to purchase fuel may be a stronger predictor of fuel choice than cultural preferences alone. Ambient concentrations of air pollutants also differ in these two types of areas, with urban areas having pollutant hot spots to which residents can be exposed and rural areas having more homogeneous and lower pollutant concentrations. Further, exposures to carbon monoxide and particulate matter differ in magnitude and in timing between urban and rural study participants, suggesting different behaviors and sources of exposures. The results from this analysis highlight important disparities between urban and rural populations of a single region and imply that such a characterization is needed to successfully implement and assess the impacts of household energy interventions.

Ozone levels in European and USA cities are increasing more than at rural sites, while peak values are decreasing.

PubMed

Paoletti, Elena; De Marco, Alessandra; Beddows, David C S; Harrison, Roy M; Manning, William J

2014-09-01

Ground-level ozone (O3) levels are usually lower in urban centers than nearby rural sites. To compare trends in O3 levels during the period 1990-2010, we obtained monitoring data from paired urban and rural sites from the European Environment Agency and the US Environmental Protection Agency. Ozone peaks decreased at both station types, with no significant differences between urban and rural stations. Ozone annual averages increased at both urban and rural sites, with a faster rate of increase for urban centers. The overall trend was for convergence between urban and rural O3 data. Ozone levels exceeded the criteria established for the protection of human and vegetation health at both urban and rural sites. Copyright © 2014 Elsevier Ltd. All rights reserved.

Travel Distance to Cancer Treatment Facilities in the Deep South.

PubMed

Wills, Mary J; Whitman, Marilyn V; English, Thomas M

Despite ongoing efforts to improve rural healthcare, the health problems facing rural communities persist. The lack of healthcare providers and infrastructure in rural areas has been linked to a number of negative consequences. Among the elderly rural population, the lack of proximal access presents greater barriers because many elderly people are further limited in their ability to travel and pay for services. In the Deep South specifically, rural residents experience limited access to care and overall poor health outcomes. With cancer in particular, the Deep South has been dubbed the "cancer belt," faring far worse in prevalence and mortality rates than other areas of the country. The present study examines the average travel distance for rural elderly patients residing in the Deep South who are receiving treatment for prostate, breast, or colorectal cancer. We analyzed Medicare claims data of beneficiaries residing in the five Deep South states who had received a primary diagnosis of prostate, breast, or colorectal cancer, with a service date ranging from January 1, 2011, through December 31, 2014. The findings reveal that rural Medicare beneficiaries in the Deep South travel significantly greater distances than do their urban counterparts. In addition, travel distances to prostate cancer treatment facilities are significantly greater than those to breast or colorectal cancer treatment facilities. With cancer incidence predicted to increase, the need to reduce travel distances to treatment is vital in efforts to curb the mortality rate in the Deep South.

Urban and rural land use in Puerto Rico

Treesearch

Sebastian Martinuzzi; William A. Gould; Olga M. Ramos Gonzalez; Maya Quinones; Michael E. Jimenez

2008-01-01

We have developed three land use regions for Puerto Rico: Urban, Suburban, and Rural (Gould et al. 2008; Martinuzzi et al. 2007). These three regions can also be considered urban, densely-populated rural, and sparsely-populated rural or as urban and wildland with a wildland-urban interface. The suburban use is the most dynamic in terms of population growth and land...

Geographical differences in whooping cough in Catalonia, Spain, from 1990 to 2010

PubMed Central

2014-01-01

Background Whooping cough is a communicable disease whose incidence has increased in recent years in some countries with vaccination. Since 1981, in Catalonia (Spain), cases must be reported to the Public Health Department. In 1997, surveillance changed from aggregated counts to individual report and the surveillance system was improved after 2002. Catalan public health is universal with equal coverage geographically. The aim of this study was to determine whether there are differences in whooping cough incidence in rural and urban counties. Methods Cases in 1990–2010 were classified as rural or urban. Incidences and risk ratios (RR) between urban and rural counties and 95% CI were calculated. Associations between rural and urban counties and structural changes during the study period were analysed. Results Twelve years of the whole study period showed differences in incidence between rural and urban counties. The incidence was higher in urban counties in seven years and rural counties in five years. There was a positive association of whooping cough incidence in rural and urban counties in four-week periods. Structural changes were detected in the following four-week periods: 4th in 1993, 7th in 1996 and 3rd 2005 in rural counties and 5th 1993, 9th in 1996 and 8th in 2007 in urban counties. Conclusions Differences in whooping cough between rural and urban counties were found. In most years, the incidence was higher in urban than in rural counties. Rural and urban counties show similar cyclic behaviour when four-week periods were considered. PMID:24649975

Giardia duodenalis genotypes among schoolchildren and their families and pets in urban and rural areas of Sinaloa, Mexico.

PubMed

García-Cervantes, Patricia Catalina; Báez-Flores, María Elena; Delgado-Vargas, Francisco; Ponce-Macotela, Martha; Nawa, Yukifumi; De-la-Cruz-Otero, María Del-Carmen; Martínez-Gordillo, Mario N; Díaz-Camacho, Sylvia Páz

2017-02-28

Giardiasis is a human health concern worldwide, especially among schoolchildren. Giardia duodenalis genotypes A and B are infective to humans, but their zoonotic potential remains controversial. In Mexico, the most prevalent genotype is A, but B was also detected in southeastern Mexico. In Sinaloa state, northwestern Mexico, giardiasis is highly prevalent, but Giardia genotypes have been poorly studied. This study aimed to investigate the distribution and clinical-epidemiological correlation of G. duodenalis genotypes in schoolchildren and their families and pets in urban and rural areas of Sinaloa state, Mexico. Among 395 schoolchildren (274 urban, 121 rural), 76 (49 urban, 27 rural) were infected with G. duodenalis. In total, 22 families (15 urban, 7 rural) of infected schoolchildren, consisting of 60 family members (41 urban, 19 rural) and 21 pet dogs (15 urban, 6 rural) were examined; 10 family members (5 urban, 5 rural) and 5 pet dogs (3 urban, 2 rural) of 10 families (6 urban, 4 rural) were infected. After PCR-RFLP analyses of vsp417 and gdh genes, genotype prevalence among infected urban schoolchildren was 79.5% AI, 12.8% AII, and 7.7% mixed AI+B. However, only AI genotype was found in family members and pets. In the rural area, only the AI genotype was detected. Genotypes were not correlated with clinical manifestations. This paper shows the presence of B genotype in northwestern Mexico for the first time. Detection of AI genotype in dogs suggested the possible role of dogs as the reservoir for human giardiasis in Sinaloa, Mexico.

Rural and Urban Differences in Sexual Behaviors Among Adolescents in Florida.

PubMed

Thompson, Erika L; Mahony, Helen; Noble, Charlotte; Wang, Wei; Ziemba, Robert; Malmi, Markku; Maness, Sarah B; Walsh-Buhi, Eric R; Daley, Ellen M

2018-04-01

The national teen birth rate is higher in rural compared to urban areas. While national data suggest rural areas may present higher risk for adverse sexual health outcomes among adolescents, it is unknown whether there are differences within the state of Florida. Overall, Florida has poorer sexual health indicators for adolescents compared to national rates. The purpose of this study was to assess differences in sexual behaviors among Florida adolescents by rural-urban community location. This study includes baseline data from a randomized controlled trial conducted in Florida high schools. Of the 6316 participants, 74% were urban and 26% were rural. Participants responded to questions on sexual behaviors, sexual behavior intentions, and demographics. We estimated the effect of rural-urban status on risk outcomes after controlling for demographic variables using generalized linear mixed models. More teens from rural areas reported ever having sex (24.0%) compared to urban teens (19.7%). No significant differences were observed for most of sexual behaviors assessed. Nonetheless, urban participants were less likely to intend to have sex without a condom in the next year compared to rural participants (aOR = 0.76, 95% CI 0.63-0.92). Overall, there were no major differences in sexual behaviors between rural and urban adolescents in Florida. However, sexual intentions differed between rural and urban adolescents; specifically, rural adolescents were more likely to intend to have sex without a condom in the next year compared to urban adolescents. Understanding the specific disparities can inform contraception and sexual health interventions among rural youth.

Rural-urban migration and socioeconomic development in Ghana: some discussions.

PubMed

Twumasi-ankrah, K

1995-01-01

This article presents a discussion of rural-urban migration as a source of social and behavioral change in Ghana. It explores the extent to which the urban social environment in Ghana generates conflicts for migrants with a different value orientation and the degree of influence of the urban social environment on migrants' behavior. The first part of the discussion focuses on the nature of Ghana's urbanization process, the motivation and characteristics of rural-urban migrants, and the nature of the social interaction between migrants and the social urban environment. Migrants contribute directly and indirectly to rural development in many ways. Some urban migrants achieve economic and material wealth and, through their attachment to voluntary tribal associations, assist local community development. Government can augment this process of migrant investment in rural life by identifying these actions as patriotic efforts and awarding citizenship medals or challenge grants. Governments need to review their citizenship laws carefully in light of the "brain drain" issues in the new world order and maximize the flow of resources, technical skills, and ideas from international migrants. A high-quality rural labor force can be enticed to live in rural areas by offering higher salaries and benefits, low income tax rates, better housing, and rural electrification and sanitation. Private firms should be offered incentives to locate in rural areas and increase employment opportunities for rural labor. Career advancement of development planners should be tied to program success or some form of public accountability for careful allocation of resources in rural areas. Fertility policies should be sensitive to urban subgroups. Urban and rural social differences are minor and do not impede urban assimilation, but unemployment and underemployment are problems for many.

Child Nutritional Status by Rural/Urban Residence: A Cross-National Analysis

ERIC Educational Resources Information Center

Fox, Kiira; Heaton, Tim B.

2012-01-01

Purpose: Rural children in developing countries have poor health outcomes in comparison with urban children. This paper considers 4 questions regarding the rural/urban difference, namely: (1) do individual-level characteristics account for rural/urban differences in child nutritional status; (2) do community-level characteristics account for…

An Inquiry into Rural Dwellers' Opinions about Living Conditions in Urban and Rural Places.

ERIC Educational Resources Information Center

Azarkh, Emilia Davidovna; Korel, Liudmila Vasilyevna

Utilizing data derived from a questionnaire survey of the rural population of Novosibirsk province in the USSR, the following hypothesis was tested: the attitude of rural inhabitants toward urban and rural conditions is characterized by a considerable preponderance of positive evaluations of dominant rural conditions and transient urban conditions…

Uptake of Free HPV Vaccination among Young Women: A Comparison of Rural versus Urban Rates

ERIC Educational Resources Information Center

Crosby, Richard A.; Casey, Baretta R.; Vanderpool, Robin; Collins, Tom; Moore, Gregory R.

2011-01-01

Purpose: To contrast rates of initial HPV vaccine uptake, offered at no cost, between a rural clinic, a rural community college, and an urban college clinic and to identify rural versus urban differences in uptake of free booster doses. Methods: Young rural women attending rural clinics (n = 246), young women attending a rural community college (n…

Comparison of domestic violence against women in urban versus rural areas of southeast Nigeria.

PubMed

Ajah, Leonard Ogbonna; Iyoke, Chukwuemeka Anthony; Nkwo, Peter Onubiwe; Nwakoby, Boniface; Ezeonu, Paul

2014-01-01

The perception and prevalence of domestic violence (DV) in rural areas is poorly understood; the result is that most efforts at eradicating this harmful practice are concentrated in urban areas. The objective of the study was to compare the burden and perception of DV among women living in rural and urban Igbo communities of southeast Nigeria. This was a comparative, cross-sectional study of women residing in rural and urban communities in Enugu, Nigeria, who had gathered for an annual religious meeting from August 1-7, 2011. Data analysis involved descriptive and inferential statistics and was conducted with the Statistical Package for Social Sciences, software version 17.0, at a 95% level of confidence. A total of 836 women who met the eligibility criteria participated in the survey. Of these, 376 were from Okpanku, a rural community, while 460 were from Ogui Nike, an urban community. The prevalence of DV among rural women was significantly higher than that among urban women (97% versus 81%, P<0.001). In particular, the prevalence of physical violence was significantly higher among rural women than among urban women (37.2% versus 23.5%; P=0.05). In contrast, rural and urban women did not differ significantly in the proportions that had experienced psychological or sexual violence. The proportion of women who believed that DV was excusable was significantly higher among rural dwellers than among urban dwellers (58.5% versus 29.6%; P=0.03). The burden of DV against women may be higher in rural communities than in urban communities in southeast Nigeria. More rural women perceived DV as excusable; this finding suggests that factors that sustain DV could be strong in rural areas. A comprehensive program to curb DV in this area may need to significantly involve the rural areas.

Rural-Urban Differences in Maternal Responses to Childhood Fever in South East Nigeria

PubMed Central

Uzochukwu, Benjamin S. C.; Onwujekwe, Emmanuel O.; Onoka, Chima A.; Ughasoro, Maduka D.

2008-01-01

Background Childhood fevers due to malaria remain a major cause of morbidity and mortality among under-five children in Nigeria. The degree of vulnerability perceived by mothers will affect their perception of the severity and threat of their child's fever and the patterns of health care use. This study was undertaken to compare maternal responses to childhood fever in urban and rural areas of Enugu, south east Nigeria. Methodology/Principal Findings Data was collected with pre-tested interviewer-administered questionnaires from 276 and 124 urban and rural households respectively. In each household, only one woman aged 15–49 years who had lived in each of the urban and rural communities for at least one year and had at least one child less than 5 years old was interviewed. Malaria was mentioned as the commonest cause of childhood fevers. Rural mothers were more likely to recognize danger signs and symptoms than urban mothers. Rural mothers use more of informal than formal health services, and there is more home management of the fever with urban than rural mothers. Chloroquine, ACT, SP and Paracetamol are the main drugs given at home for childhood fevers, but the rural mothers were more likely to use leftover drugs from previous treatment to treat the fevers than urban mothers. The urban respondents were also more likely to use a preventive measure. Urban mothers sought actions faster than rural mothers and the total cost of treatment was also higher in urban areas. Conclusions/Significance Both urban and rural mothers are aware that malaria is the major cause of childhood fevers. Although rural mothers recognize childhood fever and danger signs better than urban mothers, the urban mothers' responses to fever seem to be better than that for rural mothers. These responses and differences may be important for geographical targeting by policy makers for malaria interventions. PMID:18335058

Microgeographic differentiation in thermal performance curves between rural and urban populations of an aquatic insect.

PubMed

Tüzün, Nedim; Op de Beeck, Lin; Brans, Kristien I; Janssens, Lizanne; Stoks, Robby

2017-12-01

The rapidly increasing rate of urbanization has a major impact on the ecology and evolution of species. While increased temperatures are a key aspect of urbanization ("urban heat islands"), we have very limited knowledge whether this generates differentiation in thermal responses between rural and urban populations. In a common garden experiment, we compared the thermal performance curves (TPCs) for growth rate and mortality in larvae of the damselfly Coenagrion puella from three urban and three rural populations. TPCs for growth rate shifted vertically, consistent with the faster-slower theoretical model whereby the cold-adapted rural larvae grew faster than the warm-adapted urban larvae across temperatures. In line with costs of rapid growth, rural larvae showed lower survival than urban larvae across temperatures. The relatively lower temperatures hence expected shorter growing seasons in rural populations compared to the populations in the urban heat islands likely impose stronger time constraints to reach a certain developmental stage before winter, thereby selecting for faster growth rates. In addition, higher predation rates at higher temperature may have contributed to the growth rate differences between urban and rural ponds. A faster-slower differentiation in TPCs may be a widespread pattern along the urbanization gradient. The observed microgeographic differentiation in TPCs supports the view that urbanization may drive life-history evolution. Moreover, because of the urban heat island effect, urban environments have the potential to aid in developing predictions on the impact of climate change on rural populations.

A Closer Look at Rural-Urban Health Disparities: Associations Between Obesity and Rurality Vary by Geospatial and Sociodemographic Factors.

PubMed

Cohen, Steven A; Cook, Sarah K; Kelley, Lauren; Foutz, Julia D; Sando, Trisha A

2017-04-01

Obesity affects over one-third of older adults in the United States. Both aging and obesity contribute to an increased risk for chronic disease, early mortality, and additional health care utilization. Obesity rates are higher in rural areas than in urban areas, although findings are mixed. The objectives of this study are to assess potential nonlinearity in the association between rurality and obesity, and to evaluate the potential for socioeconomic status and geographic area to moderate the associations between rurality and obesity. Using a representative sample of adults aged 65 and above from the Behavioral Risk Factor Surveillance System, obesity (BMI ≥ 30 kg/m 2 ) was modeled against the primary exposure of rural-urban status, as measured by the Index of Relative Rurality. Binary logistic regression models were used to estimate the odds of obesity by rurality both as a continuous variable and by decile of rurality. Models were then stratified by per-capita income and state to assess potential moderation by these factors. The prevalence of obesity in older adults was highest in intermediate rurality areas (OR in rurality decile #5 1.134, 95% CI: 1.086-1.184) and lowest in the most rural and most urban areas. Obesity was highest in low- and middle-income areas, regardless of rural-urban status. In high-income areas, obesity among older adults was highest in areas of intermediate rurality and lowest in the most rural areas (OR 0.726, 95% CI: 0.606-0.870) and more urban areas, showing a J-shaped association. There were substantial differences in the associations between rurality and obesity in older adults among states. Associations between rurality and obesity varied by degree of rurality, socioeconomic status, and geography. Therefore, traditional "one-size-fits-all" approaches to reducing rural-urban health disparities in older adults may be more effective if tailored to the area-specific rural-urban gradients in health. © 2016 National Rural Health Association.

Does Core Area Theory Apply to STIs in Rural Environments?

PubMed Central

Gesink, Dionne C; Sullivan, Ashleigh B; Norwood, Todd; Serre, Marc L; Miller, William C

2012-01-01

Background Our objective was to determine the extent to which geographical core areas for gonorrhea and syphilis are located in rural areas, as compared to urban areas. Methods Incident gonorrhea (January 1, 2005 to December 31, 2010) and syphilis (January 1, 1999 to December 31, 2010) rates were estimated and mapped by census tract and quarter. Rurality was measured using percent rural and rural-urban commuting area (RUCA; rural, small town, micropolitan, or urban). SaTScan was used to identify spatiotemporal clusters of significantly elevated rates of infection. Clusters lasting five years or longer were considered core areas; clusters of shorter duration were considered outbreaks. Clusters were overlaid on maps of rurality and qualitatively assessed for correlation. Results Twenty gonorrhea core areas were identified; 65% in urban centers, 25% in micropolitan areas, and the remaining 10% were geographically large capturing combinations of urban, micropolitan, small town and rural environments. Ten syphilis core areas were identified with 80% in urban centers and 20% capturing two or more RUCAs. All ten of the syphilis core areas (100%) overlapped with gonorrhea core areas. Conclusions Gonorrhea and syphilis rates were high for rural parts of North Carolina; however, no core areas were identified exclusively for small towns or rural areas. The main pathway of rural STI transmission may be through the interconnectedness of urban, micropolitan, small town and rural areas. Directly addressing STIs in urban and micropolitan communities may also indirectly help address STI rates in rural and small town communities. PMID:23254115

Medicaid Expansion Affects Rural And Urban Hospitals Differently.

PubMed

Kaufman, Brystana G; Reiter, Kristin L; Pink, George H; Holmes, George M

2016-09-01

Rural hospitals differ from urban hospitals in many ways. For example, rural hospitals are more reliant on public payers and have lower operating margins. In addition, enrollment in the health insurance Marketplaces of the Affordable Care Act (ACA) has varied across rural and urban areas. This study employed a difference-in-differences approach to evaluate the average effect of Medicaid expansion in 2014 on payer mix and profitability for urban and rural hospitals, controlling for secular trends. For both types of hospitals, we found that Medicaid expansion was associated with increases in Medicaid-covered discharges. However, the increases in Medicaid revenue were greater among rural hospitals than urban hospitals, and the decrease in the proportion of costs for uncompensated care were greater among urban hospitals than rural hospitals. This preliminary analysis of the early effects of Medicaid expansion suggests that its financial impacts may be different for hospitals in urban and rural locations. Project HOPE—The People-to-People Health Foundation, Inc.

Life Satisfaction among Older Persons: Rural-Urban and Racial Comparisons.

ERIC Educational Resources Information Center

Donnenwerth, Gregory V.; And Others

1978-01-01

Investigates the effect of residence and race on life satisfaction among older persons living in rural and urban counties in the mid-South. Finds satisfaction highest among rural Blacks followed by urban Whites, rural Whites, and urban Blacks. Examines income and social contact as correlates of life satisfaction. (Author/KC)

Social and Psychiatric Influences on Urban-Rural Differentials in Australian Suicide

ERIC Educational Resources Information Center

Taylor, Richard; Page, Andrew; Morrell, Stephen; Harrison, James; Carter, Greg

2005-01-01

The purpose of this study was to investigate urban-rural differentials in Australian suicide rates, and to examine influences that previously have remained largely speculative. Suicide rates for males (all ages and young adults) were significantly higher in rural areas compared to urban areas. Urban-rural suicide rate differences in males were…

Urban-Rural Extension: Urban-Rural Reproduction among Different Groups of Children

ERIC Educational Resources Information Center

Jialing, Han; Yong, Gao; Yan, Zhang; Chengming, Han

2017-01-01

The authors analyze survey data from four groups of children (urban children, migrant children, rural left-behind children, and ordinary rural children) to explore their social resource access with respect to educational resources, health resources, and family support. The study finds that urban children are advantaged in all three areas compared…

Is economic inequality in infant mortality higher in urban than in rural India?

PubMed

Kumar, Abhishek; Singh, Abhishek

2014-11-01

This paper examines the trends in economic inequality in infant mortality across urban-rural residence in India over last 14 years. We analysed data from the three successive rounds of the National Family Health Survey conducted in India during 1992-1993, 1998-1999, and 2005-2006. Asset-based household wealth index was used as the economic indicator for the study. Concentration index and pooled logistic regression analysis were applied to measure the extent of economic inequality in infant mortality in urban and rural India. Infant mortality rate differs considerably by urban-rural residence: infant mortality in rural India being substantially higher than that in urban India. The findings suggest that economic inequalities are higher in urban than in rural India in each of the three survey rounds. Pooled logistic regression results suggest that, in urban areas, infant mortality has declined by 22 % in poorest and 43 % in richest. In comparison, the decline is 29 and 32 % respectively in rural India. Economic inequality in infant mortality has widened more in urban than in rural India in the last two decades.

Breakfast food patterns among urban and rural Croatian schoolchildren.

PubMed

Colic Baric, Irena; Satalic, Zvonimir

2003-01-01

The aim of this study was to report breakfast food patterns among the rural and urban Croatian schoolchildren in the post-war socioeconomic changes. A quantitative Food Frequency Questionnaire was used. Subjects were 7-18 year old schoolchildren (815 from urban and 375 from rural areas). The average energy intake was 27.5 and 23.0% of the Recommended Dietary Allowance (RDA) in the urban and rural area respectively. Urban subjects tend to choose healthier options when older, while the rural subjects displayed the opposite (significantly correlated age with energy intake (% RDA) and dietary fibre intake (% of 'age + 5' rule). The same applied to age versus iron intake (urban positive, rural negative correlation). Breakfasts providing 20-30% RDA for energy and more than 300 mg of calcium were consumed by 20.7 and 32.4% of the urban and rural subjects respectively. Cereal products and milk and dairy products were the major breakfast constituents everywhere. Meat and its products, and eggs seem to be uncommon breakfast foods. The urban subjects had a more adequate energy intake at breakfast, but better food choices were observed among rural subjects.

Rural:urban inequalities in post 2015 targets and indicators for drinking-water.

PubMed

Bain, R E S; Wright, J A; Christenson, E; Bartram, J K

2014-08-15

Disparities in access to drinking water between rural and urban areas are pronounced. Although use of improved sources has increased more rapidly in rural areas, rising from 62% in 1990 to 81% in 2011, the proportion of the rural population using an improved water source remains substantially lower than in urban areas. Inequalities in coverage are compounded by disparities in other aspects of water service. Not all improved sources are safe and evidence from a systematic review demonstrates that water is more likely to contain detectable fecal indicator bacteria in rural areas. Piped water on premises is a service enjoyed primarily by those living in urban areas so differentiating amongst improved sources would exacerbate rural:urban disparities yet further. We argue that an urban bias may have resulted due to apparent stagnation in urban coverage and the inequity observed between urban and peri-urban areas. The apparent stagnation at around 95% coverage in urban areas stems in part from relative population growth - over the last two decades more people gained access to improved water in urban areas. There are calls for setting higher standards in urban areas which would exacerbate the already extreme rural disadvantage. Instead of setting different targets, health, economic, and human rights perspectives, We suggest that the focus should be kept on achieving universal access to safe water (primarily in rural areas) while monitoring progress towards higher service levels, including greater water safety (both in rural and urban areas and among different economic strata). Copyright © 2014 Elsevier B.V. All rights reserved.

Comparative Analysis of Households Solid Waste Management in Rural and Urban Ghana

PubMed Central

Appiah, Divine Odame; Poku, Adjoa Afriyie; Garsonu, Emmanuel Kofi

2016-01-01

The comparative analysis of solid waste management between rural and urban Ghana is largely lacking. This study investigated the solid waste situation and the organisation of solid waste management in both urban and rural settings from the perspective of households. The study employed cross-sectional survey covering both rural and urban districts in the Ashanti and Greater Accra Regions of Ghana. The study systematically sampled houses from which 400 households and respondents were randomly selected. Pearson's Chi square test was used to compare demographic and socioeconomic variables in rural and urban areas. Multivariate Test, Tests of Between-Subjects Effects, and Pair-Wise Comparisons were performed through one-way MANOVA to determine whether or not solid waste situations in rural and urban areas are significantly different. The results revealed that location significantly affects solid waste management in Ghana. Urban communities had lower mean scores than rural communities for poor solid waste situation in homes. However, urban communities had higher mean scores than rural communities for poor solid waste situation in principal streets and dumping sites. The study recommends that the local government authorities implement very comprehensive policies (sanitary inspection, infrastructure development, and community participation) that will take into consideration the specific solid waste management needs of both urban and rural areas. PMID:27807453

Comparative Analysis of Households Solid Waste Management in Rural and Urban Ghana.

PubMed

Boateng, Simon; Amoako, Prince; Appiah, Divine Odame; Poku, Adjoa Afriyie; Garsonu, Emmanuel Kofi

2016-01-01

The comparative analysis of solid waste management between rural and urban Ghana is largely lacking. This study investigated the solid waste situation and the organisation of solid waste management in both urban and rural settings from the perspective of households. The study employed cross-sectional survey covering both rural and urban districts in the Ashanti and Greater Accra Regions of Ghana. The study systematically sampled houses from which 400 households and respondents were randomly selected. Pearson's Chi square test was used to compare demographic and socioeconomic variables in rural and urban areas. Multivariate Test, Tests of Between-Subjects Effects, and Pair-Wise Comparisons were performed through one-way MANOVA to determine whether or not solid waste situations in rural and urban areas are significantly different. The results revealed that location significantly affects solid waste management in Ghana. Urban communities had lower mean scores than rural communities for poor solid waste situation in homes. However, urban communities had higher mean scores than rural communities for poor solid waste situation in principal streets and dumping sites. The study recommends that the local government authorities implement very comprehensive policies (sanitary inspection, infrastructure development, and community participation) that will take into consideration the specific solid waste management needs of both urban and rural areas.

Built Environment and Active Commuting: Rural-Urban Differences in the U.S.

PubMed

Fan, Jessie X; Wen, Ming; Wan, Neng

2017-12-01

The purpose of this research was to investigate rural-urban differences in participation rates in three modes of active commuting (AC) and their built environmental correlates. The 2010 Census supplemented with other datasets were used to analyze AC rates in percent of workers age 16+ walking, biking, or taking public transportation to work in 70,172 Census tracts, including 12,844 rural and 57,328 urban. Random-intercept factional logit regressions were used to account for zero-inflated data and for clustering of tracts within counties. We found that the average AC rates were 3.44% rural and 2.77% urban (p<0.01) for walking to work, 0.40% rural and 0.58% urban (p<0.01) for biking to work, and 0.59% rural and 5.86% urban (p<0.01) for public transportation to work. Some environmental variables had similar relationships with AC in rural and urban tracts, such as a negative association between tract greenness and prevalence of walking to work. Others had opposite correlational directions for rural vs. urban, such as street connectivity for walking to work and population density for both walking to work and public transportation to work. We concluded that rurality is an important moderator in AC-environment relationships. In developing strategies to promote AC, attention needs to be paid to rural-urban differences to avoid unintended consequences.

An Empirical Analysis of Rural-Urban Differences in Out-Of-Pocket Health Expenditures in a Low-Income Society of China.

PubMed

Wang, Lidan; Wang, Anjue; Zhou, Detong; FitzGerald, Gerry; Ye, Dongqing; Jiang, Qicheng

2016-01-01

The paper examines whether out-of-pocket health care expenditure also has regional discrepancies, comparing to the equity between urban and rural areas, and across households. Sampled data were derived from Urban Household Survey and Rural Household Survey data for 2011/2012 for Anhui Province, and 11049 households were included in this study. The study compared differences in out-of-pocket expenditure on health care between regions (urban vs. rural areas) and years (2011 vs. 2012) using two-sample t-test, and also investigated the degree of inequality using Lorenz and concentration curves. Approximately 5% and 8% of total household consumption expenditure was spent on health care for urban and rural populations, respectively. In 2012, the wealthiest 20% of urban and rural population contributed 49.7% and 55.8% of urban and rural total health expenditure respectively, while the poorest 20% took only 4.7% and 4.4%. The concentration curve for out-of-pocket expenditure in 2012 fell below the corresponding concentration curve for 2011 for both urban and rural areas, and the difference between curves for rural areas was greater than that for urban areas. A substantial and increasing gap in health care expenditures existed between urban and rural areas in Anhui. The health care financing inequality merits ample attention, with need for policymaking to focus on improving the accessibility to essential health care services, particularly for rural and poor residents. This study may provide useful information on low income areas of China.

Determinants of adolescent suicidal ideation: rural versus urban.

PubMed

Murphy, Sean M

2014-01-01

The existing literature on disparities between rural and urban adolescents as they pertain to suicidal behavior is limited; identifying these distinctions could be pivotal in the decision of how to efficiently allocate scarce resources to reduce youth suicide rates. This study aimed to identify dissimilarities in predictors of suicidal ideation across the rural/urban threshold, as ideation is one of the most important predictors of suicide. Given that substance abuse is generally considered one of the strongest risk factors for suicidal behavior, a secondary aim was the isolation of the differences in usage of particular substances between rural and urban adolescents, and their effects on the likelihood of suicidal ideation, which is something that previous studies have had difficulty addressing. A global test determined that individual predictors of suicidal ideation differed across rural and urban adolescents, and simply including a rural/urban indicator in a multiple regression would result in biased estimates. Therefore, this paper assessed rural/urban differences among a comprehensive list of traditionally perceived risk and protective factors via bivariate analyses and separate multiple full-information-maximum-likelihood regressions, which account for missing data. Somewhat contrary to the extant literature, the findings indicate important differences among predictors of suicidal ideation for rural and urban youths. These differences should be taken into consideration when developing plans to combat adolescent suicide. The results further indicate that analyzing potential predictors of suicidal ideation for rural and urban adolescents via bivariate analyses alone, or a rural/urban indicator in a multiple regression, is not sufficient. © 2013 National Rural Health Association.

An Empirical Analysis of Rural-Urban Differences in Out-Of-Pocket Health Expenditures in a Low-Income Society of China

PubMed Central

Wang, Lidan; Wang, Anjue; Zhou, Detong; FitzGerald, Gerry; Ye, Dongqing; Jiang, Qicheng

2016-01-01

Objective The paper examines whether out-of-pocket health care expenditure also has regional discrepancies, comparing to the equity between urban and rural areas, and across households. Method Sampled data were derived from Urban Household Survey and Rural Household Survey data for 2011/2012 for Anhui Province, and 11049 households were included in this study. The study compared differences in out-of-pocket expenditure on health care between regions (urban vs. rural areas) and years (2011 vs. 2012) using two-sample t-test, and also investigated the degree of inequality using Lorenz and concentration curves. Result Approximately 5% and 8% of total household consumption expenditure was spent on health care for urban and rural populations, respectively. In 2012, the wealthiest 20% of urban and rural population contributed 49.7% and 55.8% of urban and rural total health expenditure respectively, while the poorest 20% took only 4.7% and 4.4%. The concentration curve for out-of-pocket expenditure in 2012 fell below the corresponding concentration curve for 2011 for both urban and rural areas, and the difference between curves for rural areas was greater than that for urban areas. Conclusion A substantial and increasing gap in health care expenditures existed between urban and rural areas in Anhui. The health care financing inequality merits ample attention, with need for policymaking to focus on improving the accessibility to essential health care services, particularly for rural and poor residents. This study may provide useful information on low income areas of China. PMID:27223811

Projected impact of urbanization on cardiovascular disease in China.

PubMed

Chan, Faye; Adamo, Susana; Coxson, Pamela; Goldman, Lee; Gu, Dongfeng; Zhao, Dong; Chen, Chung-Shiuan; He, Jiang; Mara, Valentina; Moran, Andrew

2012-10-01

The Coronary Heart Disease (CHD) Policy Model-China, a national scale cardiovascular disease computer simulation model, was used to project future impact of urbanization. Populations and cardiovascular disease incidence rates were stratified into four submodels: North-Urban, South-Urban, North-Rural, and South-Rural. 2010 was the base year, and high and low urbanization rate scenarios were used to project 2030 populations. Rural-to-urban migration, population growth, and aging were projected to more than double cardiovascular disease events in urban areas and increase events by 27.0-45.6% in rural areas. Urbanization is estimated to raise age-standardized coronary heart disease incidence by 73-81 per 100,000 and stroke incidence only slightly. Rural-to-urban migration will likely be a major demographic driver of the cardiovascular disease epidemic in China.

Investigation of cancer mortality inequalities between rural and urban areas in South Korea.

PubMed

Choi, Kyung-Mee

2016-02-01

Little is known about rural-urban cancer disparities, particularly in South Korea, and this study is to identify cancer-specific mortality inequalities between the rural and urban areas of the country. For 11 specific cancer sites, age-standardised mortality rates were analysed for the rural and urban administrative districts of South Korea during 2006-2011. The Poisson log linear regression models were employed to estimate cancer-specific mortality rates, and Bonferroni comparison method was used to identify rural-urban disparities. There were significant rural-urban disparities observed for all cancer sites except prostate, pancreas and leukaemia. The mortality rates of lung, liver and stomach cancers, the three most common cancers in the country, were observed to be significantly higher in rural areas than in metropolitan areas. In contrast, the reverse relationship was observed for the reproductive system (breast and uterus) and colon cancers. Central nervous system cancer mortality was observed to be significantly higher in rural areas than in non-metro urban areas. For the first time ever, significant rural-urban disparity patterns in cancer mortality rates in South Korea have been identified in this paper. Future investigations on cancer risk factors for the country should address these disparity patterns. © 2015 National Rural Health Alliance Inc.

Secular change in the growth status of urban and rural schoolchildren aged 6-13 years in Oaxaca, southern Mexico.

PubMed

Malina, Robert M; Peña Reyes, Maria Eugenia; Little, Bertis B

2008-01-01

Populations in the state of Oaxaca in southern Mexico are at high risk for malnutrition and marginalization. The study compared secular changes in the growth status of urban and rural schoolchildren in the Valley of Oaxaca between the 1970s and 2000. Cross-sectional surveys of boys and girls aged 6-13 years (n = 1472) were carried out in an urban colonia populares in 1972 and 2000 and a rural indigenous community in 1978 and 2000. Height, sitting height and weight were measured; leg length, sitting height ratio, BMI, and prevalence of stunting, underweight, overweight and obesity were calculated. Sex-specific ANCOVA controlling for age was used. Both urban and rural children experienced significant secular gains in linear dimensions, body weight and the BMI between the 1970s and 2000. Estimated rates of secular gain overlapped considerably between urban and rural children. Secular gains in the BMI are significantly greater in urban than rural boys and girls. Urban-rural differences in linear dimensions and body weight in 2000 compared to the 1970s do not differ in either sex, but urban-rural differences in the BMI are greater in boys and girls in 2000 compared to the 1970s. The prevalence of stunting declined while that of overweight and obesity increased. Significant secular increases in body size occurred between the 1970s and 2000, but there was considerable overlap between urban and rural children. Only secular gains in the BMI were significantly greater in urban than rural boys and girls and the magnitudes of urban-rural differences in the BMI were greater in 2000 than in the 1970s.

A community survey of the pattern and determinants of household sources of energy for cooking in rural and urban south western, Nigeria.

PubMed

Desalu, Olufemi Olumuyiwa; Ojo, Ololade Olusola; Ariyibi, Ebenezer Kayode; Kolawole, Tolutope Fasanmi; Ogunleye, Ayodele Idowu

2012-01-01

The use of solid fuels for cooking is associated with indoor pollution and lung diseases. The objective of the study was to determine the pattern and determinants of household sources of energy for cooking in rural and urban South Western, Nigeria. We conducted a cross sectional study of households in urban (Ado-Ekiti) and rural (Ido-Ekiti) local council areas from April to July 2010. Female respondents in the households were interviewed by trained interviewers using a semi-structured questionnaire. A total of 670 households participated in the study. Majority of rural dwellers used single source of energy for cooking (55.6%) and urban dwellers used multiple source of energy (57.8%). Solid fuel use (SFU) was higher in rural (29.6%) than in urban areas (21.7%). Kerosene was the most common primary source of energy for cooking in both urban and rural areas (59.0% vs.66.6%) followed by gas (17.8%) and charcoal (6.6%) in the urban areas, and firewood (21.6%) and charcoal (7.1%) in the rural areas. The use of solid fuel was strongly associated with lack of ownership of dwellings and larger household size in urban areas, and lower level of education and lower level of wealth in the rural areas. Kerosene was associated with higher level of husband education and modern housing in urban areas and younger age and indoor cooking in rural areas. Gas was associated with high income and modern housing in the urban areas and high level of wealth in rural areas. Electricity was associated with high level of education, availability of electricity and old age in urban and rural areas respectively. The use of solid fuel is high in rural areas, there is a need to reduce poverty and improve the use of cleaner source of cooking energy particularly in rural areas and improve lung health.

A community survey of the pattern and determinants of household sources of energy for cooking in rural and urban south western, Nigeria

PubMed Central

Desalu, Olufemi Olumuyiwa; Ojo, Ololade Olusola; Ariyibi, Ebenezer Kayode; Kolawole, Tolutope Fasanmi; Ogunleye, Ayodele Idowu

2012-01-01

Introduction The use of solid fuels for cooking is associated with indoor pollution and lung diseases. The objective of the study was to determine the pattern and determinants of household sources of energy for cooking in rural and urban South Western, Nigeria. Methods We conducted a cross sectional study of households in urban (Ado-Ekiti) and rural (Ido-Ekiti) local council areas from April to July 2010. Female respondents in the households were interviewed by trained interviewers using a semi-structured questionnaire. Results A total of 670 households participated in the study. Majority of rural dwellers used single source of energy for cooking (55.6%) and urban dwellers used multiple source of energy (57.8%). Solid fuel use (SFU) was higher in rural (29.6%) than in urban areas (21.7%). Kerosene was the most common primary source of energy for cooking in both urban and rural areas (59.0% vs.66.6%) followed by gas (17.8%) and charcoal (6.6%) in the urban areas, and firewood (21.6%) and charcoal (7.1%) in the rural areas. The use of solid fuel was strongly associated with lack of ownership of dwellings and larger household size in urban areas, and lower level of education and lower level of wealth in the rural areas. Kerosene was associated with higher level of husband education and modern housing in urban areas and younger age and indoor cooking in rural areas. Gas was associated with high income and modern housing in the urban areas and high level of wealth in rural areas. Electricity was associated with high level of education, availability of electricity and old age in urban and rural areas respectively. Conclusion The use of solid fuel is high in rural areas, there is a need to reduce poverty and improve the use of cleaner source of cooking energy particularly in rural areas and improve lung health. PMID:22826727

Rural-urban disparities in child nutrition in Bangladesh and Nepal

PubMed Central

2013-01-01

Background The persistence of rural-urban disparities in child nutrition outcomes in developing countries alongside rapid urbanisation and increasing incidence of child malnutrition in urban areas raises an important health policy question - whether fundamentally different nutrition policies and interventions are required in rural and urban areas. Addressing this question requires an enhanced understanding of the main drivers of rural-urban disparities in child nutrition outcomes especially for the vulnerable segments of the population. This study applies recently developed statistical methods to quantify the contribution of different socio-economic determinants to rural-urban differences in child nutrition outcomes in two South Asian countries – Bangladesh and Nepal. Methods Using DHS data sets for Bangladesh and Nepal, we apply quantile regression-based counterfactual decomposition methods to quantify the contribution of (1) the differences in levels of socio-economic determinants (covariate effects) and (2) the differences in the strength of association between socio-economic determinants and child nutrition outcomes (co-efficient effects) to the observed rural-urban disparities in child HAZ scores. The methodology employed in the study allows the covariate and coefficient effects to vary across entire distribution of child nutrition outcomes. This is particularly useful in providing specific insights into factors influencing rural-urban disparities at the lower tails of child HAZ score distributions. It also helps assess the importance of individual determinants and how they vary across the distribution of HAZ scores. Results There are no fundamental differences in the characteristics that determine child nutrition outcomes in urban and rural areas. Differences in the levels of a limited number of socio-economic characteristics – maternal education, spouse’s education and the wealth index (incorporating household asset ownership and access to drinking water and sanitation) contribute a major share of rural-urban disparities in the lowest quantiles of child nutrition outcomes. Differences in the strength of association between socio-economic characteristics and child nutrition outcomes account for less than a quarter of rural-urban disparities at the lower end of the HAZ score distribution. Conclusions Public health interventions aimed at overcoming rural-urban disparities in child nutrition outcomes need to focus principally on bridging gaps in socio-economic endowments of rural and urban households and improving the quality of rural infrastructure. Improving child nutrition outcomes in developing countries does not call for fundamentally different approaches to public health interventions in rural and urban areas. PMID:23767425

Rural-urban disparities in child nutrition in Bangladesh and Nepal.

PubMed

Srinivasan, Chittur S; Zanello, Giacomo; Shankar, Bhavani

2013-06-14

The persistence of rural-urban disparities in child nutrition outcomes in developing countries alongside rapid urbanisation and increasing incidence of child malnutrition in urban areas raises an important health policy question - whether fundamentally different nutrition policies and interventions are required in rural and urban areas. Addressing this question requires an enhanced understanding of the main drivers of rural-urban disparities in child nutrition outcomes especially for the vulnerable segments of the population. This study applies recently developed statistical methods to quantify the contribution of different socio-economic determinants to rural-urban differences in child nutrition outcomes in two South Asian countries - Bangladesh and Nepal. Using DHS data sets for Bangladesh and Nepal, we apply quantile regression-based counterfactual decomposition methods to quantify the contribution of (1) the differences in levels of socio-economic determinants (covariate effects) and (2) the differences in the strength of association between socio-economic determinants and child nutrition outcomes (co-efficient effects) to the observed rural-urban disparities in child HAZ scores. The methodology employed in the study allows the covariate and coefficient effects to vary across entire distribution of child nutrition outcomes. This is particularly useful in providing specific insights into factors influencing rural-urban disparities at the lower tails of child HAZ score distributions. It also helps assess the importance of individual determinants and how they vary across the distribution of HAZ scores. There are no fundamental differences in the characteristics that determine child nutrition outcomes in urban and rural areas. Differences in the levels of a limited number of socio-economic characteristics - maternal education, spouse's education and the wealth index (incorporating household asset ownership and access to drinking water and sanitation) contribute a major share of rural-urban disparities in the lowest quantiles of child nutrition outcomes. Differences in the strength of association between socio-economic characteristics and child nutrition outcomes account for less than a quarter of rural-urban disparities at the lower end of the HAZ score distribution. Public health interventions aimed at overcoming rural-urban disparities in child nutrition outcomes need to focus principally on bridging gaps in socio-economic endowments of rural and urban households and improving the quality of rural infrastructure. Improving child nutrition outcomes in developing countries does not call for fundamentally different approaches to public health interventions in rural and urban areas.

Is the Urban Child Health Advantage Declining in Malawi?: Evidence from Demographic and Health Surveys and Multiple Indicator Cluster Surveys.

PubMed

Lungu, Edgar Arnold; Biesma, Regien; Chirwa, Maureen; Darker, Catherine

2018-06-01

In many developing countries including Malawi, health indicators are on average better in urban than in rural areas. This phenomenon has largely prompted Governments to prioritize rural areas in programs to improve access to health services. However, considerable evidence has emerged that some population groups in urban areas may be facing worse health than rural areas and that the urban advantage may be waning in some contexts. We used a descriptive study undertaking a comparative analysis of 13 child health indicators between urban and rural areas using seven data points provided by nationally representative population based surveys-the Malawi Demographic and Health Surveys and Multiple Indicator Cluster Surveys. Rate differences between urban and rural values for selected child health indicators were calculated to denote whether urban-rural differentials showed a trend of declining urban advantage in Malawi. The results show that all forms of child mortality have significantly declined between 1992 and 2015/2016 reflecting successes in child health interventions. Rural-urban comparisons, using rate differences, largely indicate a picture of the narrowing gap between urban and rural areas albeit the extent and pattern vary among child health indicators. Of the 13 child health indicators, eight (neonatal mortality, infant mortality, under-five mortality rates, stunting rate, proportion of children treated for diarrhea and fever, proportion of children sleeping under insecticide-treated nets, and children fully immunized at 12 months) show clear patterns of a declining urban advantage particularly up to 2014. However, U-5MR shows reversal to a significant urban advantage in 2015/2016, and slight increases in urban advantage are noted for infant mortality rate, underweight, full childhood immunization, and stunting rate in 2015/2016. Our findings suggest the need to rethink the policy viewpoint of a disadvantaged rural and much better-off urban in child health programming. Efforts should be dedicated towards addressing determinants of child health in both urban and rural areas.

Trend differences in men and women in rural and urban U.S. settings.

PubMed

Cepeda-Benito, A; Doogan, N J; Redner, R; Roberts, M E; Kurti, A N; Villanti, A C; Lopez, A A; Quisenberry, A J; Stanton, C A; Gaalema, D E; Keith, D R; Parker, M A; Higgins, S T

2018-04-05

Smoking prevalence is declining at a slower rate in rural than urban settings in the United States (U.S.), and known predictors of smoking do not readily account for this trend difference. Given that socioeconomic and psychosocial determinants of health disparities accumulate in rural settings and that life-course disadvantages are often greater in women than men, we examined whether smoking trends are different for rural and urban men and women. We used yearly cross-sectional data (n = 303,311) from the U.S. National Survey on Drug Use and Health (NSDUH) from 2007 through 2014 to compare cigarette smoking trends in men and women across rural and urban areas. Current smoking status was modelled using logistic regression controlling for confounding risk factors. Regression derived graphs predicting unadjusted prevalence estimates and 95% confidence bands revealed that whereas the smoking trends of rural men, urban men, and urban women significantly declined from 2007 to 2014, the trend for rural women was flat. Controlling for demographic, socioeconomic and psychosocial predictors of smoking did not explain rural women's significantly different trend from those of the other three groups. Rural women lag behind rural men, urban men and urban women in decreasing smoking, a health disparity finding that supports the need for tobacco control and regulatory policies and interventions that are more effective in reducing smoking among rural women. Copyright © 2018 Elsevier Inc. All rights reserved.

HIV/AIDS-related sexual risk behaviors among rural residents in China: potential role of rural-to-urban migration

PubMed Central

Li, Xiaoming; Zhang, Liying; Stanton, Bonita; Fang, Xiaoyi; Xiong, Qing; Lin, Danhua

2007-01-01

The relationship between rural-to-urban migration and the spread of HIV is well described, although most studies focus on sexual risk behaviors among rural-to-urban migrants at the urban destination areas. Few studies have examined the sexual risk behaviors of migrants who have returned from urban areas to their rural homes (“return migrants”) in comparison with those of local rural residents who have never migrated to cities (“non-migrants”). This study examines the potential association between rural-to-urban migration and sexual risk behaviors by comparing sexual risk behaviors between 553 return migrants and 441 non-migrants from same rural communities in China. Findings reveal that, after controlling for sociodemographic characteristics, return migrants in rural areas had higher levels of sexual risk, including unprotected sex, than non-migrants. Among return migrants, sexual risk behaviors were associated with age, gender, marital status, and number of different jobs they had previously held in the cities. These findings underscore the importance for HIV/AIDS education and prevention efforts targeting the migrant population in urban destinations as well as the return migrant population in rural areas. PMID:17967110

[Comparative study on the situation of neglected children aged 3-6 year-olds between urban and rural areas of China].

PubMed

Li, Min; Pan, Jian-ping; Zhang, Song-jie; Zhang, Hua; Yang, Zi-Ni; Wang, Wei-qing; Cao, Chun-hong; Wang, Fei; Yang, Xiao-mei; Niu, Qian; Shen, Hong

2012-02-01

To investigate and analyze the situation of urban and rural neglected children aged 3 - 6, in China, so as to provide basis for the analysis and comparison on relevant risk factors. 1163 urban children aged 3 - 6 (with 49.6% males and 4.5% with minority ethnicity) were investigated from 25 cities of 14 provinces, autonomous regions and municipalities in the whole country. Multi-stage stratified cluster sampling method was used. Again, using the same sampling method, 4096 rural children (of whom 50.6% were males with 6.2% as minorities) were chosen from 26 cities of 10 provinces or municipalities. Identification of children being neglected was based on "Child Neglect Evaluation Norms of Children Aged 3 - 6 Years in Urban/Rural China". SPSS-Windows 13.0 was employed for data analysis. Scores, frequency/degrees, age, sex and types (physical, emotional, educational, safety, medical and social) of children under negligence on every group of the regions, were calculated. χ(2) test (Chi-Square) and Analysis of variance (ANOVA) were processed to determine the significance of their differences. The overall frequencies of negligence were 28.0% and 53.7% respectively among the urban and rural children aged 3 - 6, while the total degrees of negligence were 42.2 and 44.4 respectively. Significant difference was found between children from the urban and the rural areas (P < 0.05). Significant difference was also found between urban and rural children on every age group (P < 0.05). The frequencies of negligence among males were 32.6% and 55.9% respectively in urban and rural areas while among females, the figures appeared to be 23.7% and 51.6% respectively. The degrees of negligence were 42.7 and 44.6 among male while 41.8 and 44.3 among female children, in the urban or rural areas. Significant differences were found on male or female between urban and rural groups (P < 0.05). Frequencies of negligence in urban children aged 3 - 6 for the six types were from 5.1% to 12.9%, with the frequency in rural areas as 13.1% - 26.6%. Significant difference was found between urban and rural group for any other type (P < 0.05), in addition to the safety type. The degrees of negligence in urban children aged 3 - 6 for the different type were between 39.4 and 43.4, while in the rural areas as from 36.5 to 48.2, with significant difference for every type (P < 0.05). The degrees of negligence related to education, emotion, or physical strength were more serious on children from the urban than from the rural areas. The highest frequency of child negligence was seen in the single-parent families on both urban and rural groups (42.9% and 60.0% respectively), with no significant difference found (P > 0.05). The urban and rural children aged 3 - 6 were mainly involved in single item of negligence, with incidence rates as 16.5% and 22.7% and proportions as 58.9% and 45.1% respectively, despite the factors as age or sex. There were large differences on the situation of negligence between the urban and rural children aged 3 - 6. The frequencies and degrees of negligence in every age group and different sex for children living in the rural areas were higher than those urban children. The frequency of negligence among boys was higher than girls for both urban and rural areas. The rural children had suffered more serious negligence than the urban children at any other type, in addition to the 'safety'. Both urban and rural children had the highest frequency of negligence in single-parent family, and were mainly suffered from single item of negligence.

Bullying Behaviors and Psychosocial Adjustment Among School-Aged Children in China.

PubMed

Zhang, Huiping; Zhou, Huazhen; Tao, Tao

2018-06-01

Bullying behaviors have been studied extensively in Western countries; however, no national data exist regarding this issue in contemporary China. Using a sample of 14,536 children in Grades 6, 8, and 10 from public schools in 11 provinces or autonomous regions in rural and urban China, our study assesses the prevalence of bullying behaviors among school-aged children in China and examines the correlation between bullying and psychosocial adjustment. Results indicate that 6.3% of children reported having been bullied in the last 3 months, 2.5% of children admitted to bullying other students, and 2.2% said they were bullied and bullied others in that same time frame. More boys than girls reported bullying others and being victims of bullying. The frequency of bullying is higher in Grades 6 and 8 than in Grade 10. Rural children are more often involved in bullying than their urban counterparts. Perpetrating and being a victim of bullying are associated with poorer psychosocial adjustment, although different patterns are observed among bullies, those bullied, and those who bully others and have been bullied. Health care professionals should be sensitive to bullying behaviors when identifying students with psychosocial maladjustment. Moreover, programs designed to prevent and intervene in school bullying would benefit from a holistic approach.

The Association between Rural-Urban Continuum, Maternal Education and Adverse Birth Outcomes in Quebec, Canada

ERIC Educational Resources Information Center

Auger, Nathalie; Authier, Marie-Andree; Martinez, Jerome; Daniel, Mark

2009-01-01

Context: Rural relative to urban area and low socioeconomic status (SES) are associated with adverse birth outcomes. Whether a graded association of increasing magnitude is present across the urban-rural continuum, accounting for SES, is unclear. We examined the association between rural-urban continuum, SES and adverse birth outcomes. Methods:…

Creative Thinking Abilities of Rural and Urban Elementary School Students.

ERIC Educational Resources Information Center

Irons, Jerry Lee

The 1967 study was designed to determine if there were significant differences in the creative thinking abilities of students attending certain urban and rural elementary schools in North Texas. The target population was selected from 7 rural and 2 urban school districts. The subjects, 100 urban and 100 rural, were matched in terms of 6 selection…

Urban-rural differentials in child malnutrition: trends and socioeconomic correlates in sub-Saharan Africa.

PubMed

Fotso, Jean-Christophe

2007-03-01

This paper examines levels and trends of urban-rural differentials in child malnutrition, and investigates whether residual differences exist between urban and rural areas, given comparable measures of socioeconomic status (SES) of households and communities. Using data from Demographic and Health Surveys of 15 sub-Saharan African countries, and multilevel modelling, it shows that urban-rural differentials are considerable in all countries, that they have narrowed in most countries due primarily to an increase in urban malnutrition, and have widened in few countries as a result of sharp decline in urban malnutrition. These urban-rural gaps are abolished in almost all countries when SES is controlled. These results suggest that policies and programs contributing to the attainment of the MDGs should pay particular attention to the urban poor.

Environmental Influences on Physical Activity among Rural Adults in Montana, United States: Views from Built Environment Audits, Resident Focus Groups, and Key Informant Interviews.

PubMed

Lo, Brian K; Morgan, Emily H; Folta, Sara C; Graham, Meredith L; Paul, Lynn C; Nelson, Miriam E; Jew, Nicolette V; Moffat, Laurel F; Seguin, Rebecca A

2017-10-04

Rural populations in the United States have lower physical activity levels and are at a higher risk of being overweight and suffering from obesity than their urban counterparts. This paper aimed to understand the environmental factors that influence physical activity among rural adults in Montana. Eight built environment audits, 15 resident focus groups, and 24 key informant interviews were conducted between August and December 2014. Themes were triangulated and summarized into five categories of environmental factors: built, social, organizational, policy, and natural environments. Although the existence of active living features was documented by environmental audits, residents and key informants agreed that additional indoor recreation facilities and more well-maintained and conveniently located options were needed. Residents and key informants also agreed on the importance of age-specific, well-promoted, and structured physical activity programs, offered in socially supportive environments, as facilitators to physical activity. Key informants, however, noted that funding constraints and limited political will were barriers to developing these opportunities. Since building new recreational facilities and structures to support active transportation pose resource challenges, especially for rural communities, our results suggest that enhancing existing features, making small improvements, and involving stakeholders in the city planning process would be more fruitful to build momentum towards larger changes.

Sustaining and growing the rural nursing and midwifery workforce: understanding the issues and isolating directions for the future.

PubMed

Francis, Karen L; Mills, Jane E

2011-01-01

Nurses and midwives represent the largest group of health professionals in the Australian health care system. In rural environments nurses and midwives make up a greater proportion of the health workforce than in urban settings, which makes their role in service provision even more significant. The role and scope of these nurses and midwives' practice is by necessity more generalist than specialist, which results in disciplinary strengths and weaknesses. As generalist health professionals they work in diverse settings such as public hospitals, multi-purpose services, community health, aged care and in non-government and private for profit and no-profit organisations including general practices. Their scope of practice covers prevention, intervention and rehabilitation and is lifespan inclusive. Rural nurses and midwives are older than their metropolitan based counterparts, work part-time and traditionally have limited access to professional development often due to ineffective locum relief programs. Workplace inflexibility, access to acceptable housing and partner employment are factors cited as inhibitors to growing this workforces. The future of the rural nursing and midwifery workforce will only be secured if Government invests to a greater degree in both education and training and the development of a nationally agreed remuneration scale that allows for part-time work.

Rural-urban difference in the use of annual physical examination among seniors in Shandong, China: a cross-sectional study.

PubMed

Ge, Dandan; Chu, Jie; Zhou, Chengchao; Qian, Yangyang; Zhang, Li; Sun, Long

2017-05-23

Regular physical examination contributes to early detection and timely treatment, which is helpful in promoting healthy behaviors and preventing diseases. The objective of this study is to compare the annual physical examination (APE) use between rural and urban elderly in China. A total of 3,922 participants (60+) were randomly selected from three urban districts and three rural counties in Shandong Province, China, and were interviewed using a standardized questionnaire. We performed unadjusted and adjusted logistic regression models to examine the difference in the utilization of APE between rural and urban elderly. Two adjusted logistic regression models were employed to identify the factors associated with APE use in rural and urban seniors respectively. The utilization rates of APE in rural and urban elderly are 37.4% and 76.2% respectively. Factors including education level, exercise, watching TV, and number of non-communicable chronic conditions, are associated with APE use both in rural and urban elderly. Hospitalization, self-reported economic status, and health insurance are found to be significant (p < 0.05) predictors for APE use in rural elderly. Elderly covered by Urban Resident Basic Medical Insurance (URBMI) (p < 0.05, OR = 1.874) are more likely to use APE in urban areas. There is a big difference in APE utilization between rural and urban elderly. Interventions targeting identified at-risk subgroups, especially for those rural elderly, are essential to reduce such a gap. To improve health literacy might be helpful to increase the utilization rate of APE among the elderly.

Does living in an urban environment confer advantages for childhood nutritional status? Analysis of disparities in nutritional status by wealth and residence in Angola, Central African Republic and Senegal.

PubMed

Kennedy, Gina; Nantel, Guy; Brouwer, Inge D; Kok, Frans J

2006-04-01

The purpose of this paper is to examine the relationship between childhood undernutrition and poverty in urban and rural areas. Anthropometric and socio-economic data from Multiple Indicator Cluster Surveys in Angola-Secured Territory (Angola ST), Central African Republic and Senegal were used in this analysis. The population considered in this study is children 0-59 months, whose records include complete anthropometric data on height, weight, age, gender, socio-economic level and urban or rural area of residence. In addition to simple urban/rural comparisons, the population was stratified using a wealth index based on living conditions and asset ownership to compare the prevalence, mean Z-score and odds ratios for stunting and wasting. In all cases, when using a simple urban/rural comparison, the prevalence of stunting was significantly higher in rural areas. However, when the urban and rural populations were stratified using a measure of wealth, the differences in prevalence of stunting and underweight in urban and rural areas of Angola ST, Central African Republic and Senegal disappeared. Poor children in these urban areas were just as likely to be stunted or underweight as poor children living in rural areas. The odds ratio of stunting in the poorest compared with the richest quintile was 3.4, 3.2 and 1.5 in Angola ST, Senegal and Central African Republic, respectively. This paper demonstrates that simple urban/rural comparisons mask wide disparities in subgroups according to wealth. There is a strong relationship between poverty and chronic undernutrition in both urban and rural areas; this relationship does not change simply by living in an urban environment. However, urban and rural living conditions and lifestyles differ, and it is important to consider these differences when designing programmes and policies to address undernutrition.

Comparison of domestic violence against women in urban versus rural areas of southeast Nigeria

PubMed Central

Ajah, Leonard Ogbonna; Iyoke, Chukwuemeka Anthony; Nkwo, Peter Onubiwe; Nwakoby, Boniface; Ezeonu, Paul

2014-01-01

Background The perception and prevalence of domestic violence (DV) in rural areas is poorly understood; the result is that most efforts at eradicating this harmful practice are concentrated in urban areas. The objective of the study was to compare the burden and perception of DV among women living in rural and urban Igbo communities of southeast Nigeria. Methods This was a comparative, cross-sectional study of women residing in rural and urban communities in Enugu, Nigeria, who had gathered for an annual religious meeting from August 1–7, 2011. Data analysis involved descriptive and inferential statistics and was conducted with the Statistical Package for Social Sciences, software version 17.0, at a 95% level of confidence. Results A total of 836 women who met the eligibility criteria participated in the survey. Of these, 376 were from Okpanku, a rural community, while 460 were from Ogui Nike, an urban community. The prevalence of DV among rural women was significantly higher than that among urban women (97% versus 81%, P<0.001). In particular, the prevalence of physical violence was significantly higher among rural women than among urban women (37.2% versus 23.5%; P=0.05). In contrast, rural and urban women did not differ significantly in the proportions that had experienced psychological or sexual violence. The proportion of women who believed that DV was excusable was significantly higher among rural dwellers than among urban dwellers (58.5% versus 29.6%; P=0.03). Conclusion The burden of DV against women may be higher in rural communities than in urban communities in southeast Nigeria. More rural women perceived DV as excusable; this finding suggests that factors that sustain DV could be strong in rural areas. A comprehensive program to curb DV in this area may need to significantly involve the rural areas. PMID:25336992

Rural Versus Urban Use of Traditional and Emerging Tobacco Products in the United States, 2013-2014.

PubMed

Roberts, Megan E; Doogan, Nathan J; Stanton, Cassandra A; Quisenberry, Amanda J; Villanti, Andrea C; Gaalema, Diann E; Keith, Diana R; Kurti, Allison N; Lopez, Alexa A; Redner, Ryan; Cepeda-Benito, Antonio; Higgins, Stephen T

2017-10-01

To examine urban-rural differences in US prevalences of traditional and emerging tobacco product use as well as dual or polytobacco use of these products. Our data were derived from wave 1 (2013-2014) of the Population Assessment of Tobacco and Health (PATH) Study. We estimated weighted prevalences of adult tobacco use across urban-rural geographies and examined prevalences classified by gender, poverty level, and region of the country. Nationally, cigarette use and smokeless tobacco use, as well as dual or polytobacco use of traditional products, were more prevalent in rural than in urban areas. Conversely, cigarillo and hookah use and dual or polytobacco use of emerging products were higher in urban areas. There was no significant urban-rural difference in use of e-cigarettes. Gender, poverty, and region of the country did not seem to be driving most urban-rural differences, although differences related to cigarillo use and dual or polytobacco use of emerging products became nonsignificant after control for covariates. Our findings highlight important urban-rural differences in tobacco use. Whether the changing tobacco product landscape will contribute to a continuation of rural health disparities remains to be seen.

Utilization characteristics and importance of woody biomass resources on the rural-urban fringe in botswana.

PubMed

Nkambwe, Musisi; Sekhwela, Mogodisheng B M

2006-02-01

This article examines the utilization characteristics and importance of woody biomass resources in the rural-urban fringe zones of Botswana. In the literature for Africa, attention has been given to the availability and utilization of biomass in either urban or rural environments, but the rural-urban fringe has been neglected. Within southern Africa, this neglect is not justified; the rural-urban fringe, not getting the full benefits available in urban environments in Botswana, has developed problems in woody biomass availability and utilization that require close attention. In this article, socioeconomic data on the importance of woody biomass in the Batlokwa Tribal Territory, on the rural-urban fringe of Gaborone, Botswana, were collected together with ecologic data that reveal the utilization characteristics and potential for regrowth of woody biomass. The analysis of these results show that local woody biomass is very important in the daily lives of communities in the rural-urban fringe zones and that there is a high level of harvesting. However, there is no effort in planning land use in the tribal territory to either conserve this resource or provide alternatives to its utilization. The future of woody biomass resources in Botswana's rural-urban fringe is uncertain. The investigators recommend that a comprehensive policy for the development of the rural-urban fringe consider the importance of this resource. The neglect of this resource will have far-reaching implications on the livelihoods of residents as well as the environment in this zone.

Perceived needs of health tutors in rural and urban health training institutions in Ghana: Implications for health sector staff internal migration control

PubMed Central

Beyere, Christopher B.; Nketiah-Amponsah, Edward; Mwini-Nyaledzigbor, Prudence P.

2017-01-01

Background The population of Ghana is increasingly becoming urbanized with about 70% of the estimated 27 million people living in urban and peri-urban areas. Nonetheless, eight out of the ten regions in Ghana remain predominantly rural where only 32% of the national health sector workforce works. Moreover, the rural-urban disparities in the density of health tutors (staff responsible for pre-service training of health professionals) are enormous. This paper explores perceived needs of health tutors in rural and urban health training institutions in Ghana. Methods This is a descriptive qualitative study conducted in the Greater Accra and Northern regions of Ghana. The Study used the deductive thematic and sub-thematic analysis approaches. Five health training institutions were randomly sampled, and 72 tutors engaged in separate focus group discussions with an average size of 14 participants per group in each training institution. Results Perceived rural-urban disparities among health tutors were found in the payment of extra duty allowances; school infrastructure including libraries and internet connectivity; staff accommodation; and opportunities for scholarships and higher education. Health tutors in rural areas generally expressed more frustration with these work conditions than those in urban areas. Conclusions There is the need to initiate and sustain work incentives that promote motivation of rural health tutors to control ongoing rural-urban migration of qualified staff. It is recommended the following incentives be prioritized to promote retention of qualified health tutors in rural health training schools: payment of research, book and rural allowances; early promotion of rural staff; prioritizing rural tutors for scholarships, and introduction of national best health tutor awards. PMID:28982194

Perceived needs of health tutors in rural and urban health training institutions in Ghana: Implications for health sector staff internal migration control.

PubMed

Alhassan, Robert Kaba; Beyere, Christopher B; Nketiah-Amponsah, Edward; Mwini-Nyaledzigbor, Prudence P

2017-01-01

The population of Ghana is increasingly becoming urbanized with about 70% of the estimated 27 million people living in urban and peri-urban areas. Nonetheless, eight out of the ten regions in Ghana remain predominantly rural where only 32% of the national health sector workforce works. Moreover, the rural-urban disparities in the density of health tutors (staff responsible for pre-service training of health professionals) are enormous. This paper explores perceived needs of health tutors in rural and urban health training institutions in Ghana. This is a descriptive qualitative study conducted in the Greater Accra and Northern regions of Ghana. The Study used the deductive thematic and sub-thematic analysis approaches. Five health training institutions were randomly sampled, and 72 tutors engaged in separate focus group discussions with an average size of 14 participants per group in each training institution. Perceived rural-urban disparities among health tutors were found in the payment of extra duty allowances; school infrastructure including libraries and internet connectivity; staff accommodation; and opportunities for scholarships and higher education. Health tutors in rural areas generally expressed more frustration with these work conditions than those in urban areas. There is the need to initiate and sustain work incentives that promote motivation of rural health tutors to control ongoing rural-urban migration of qualified staff. It is recommended the following incentives be prioritized to promote retention of qualified health tutors in rural health training schools: payment of research, book and rural allowances; early promotion of rural staff; prioritizing rural tutors for scholarships, and introduction of national best health tutor awards.

Understanding Rural-Urban Differences in Depressive Symptoms Among Older Adults in China

PubMed Central

Li, Lydia W.; Liu, Jinyu; Xu, Hongwei; Zhang, Zhenmei

2016-01-01

Objectives Studies have reported that rural elders in China have higher levels of depression than their urban peers. We aimed to examine the extent to which four sets of factors (socioeconomic status (SES), healthcare access, health status, social support and participation) account for such rural-urban differences. Methods Cross-sectional data from the 2011 China Health and Retirement Longitudinal Study were analyzed. A representative sample (N = 5,103) of older Chinese (age 60+) was included. Depressive symptoms were measured by the CESD-10. Multilevel linear regression was conducted. Results Rural elders had more depressive symptoms than urban elders. When SES at the individual-, household- and community-level was simultaneously controlled, the rural-urban difference lost its statistical significance. Health status, social support and social participation accounted for some, whereas healthcare access explained almost none, of the rural-urban difference. Discussion Results suggest that SES is the predominant factor accounting for the rural-urban depression gap in China. PMID:26100620

Alcohol Use Patterns Among Urban and Rural Residents

PubMed Central

Dixon, Mark A.; Chartier, Karen G.

2016-01-01

Rates of alcohol use and alcohol use disorder (AUD) vary with geographic location. Research on risks for AUD associated with living in a rural versus urban setting is complicated by the varied systems used to classify geographic location. Studies comparing the prevalence of heavier or binge drinking and AUD based on a dichotomous urban/rural classification have mixed findings when compared with those using more detailed urban-to-rural categories. In addition, urban/rural residence interacts with other demographic factors such as age, U.S. region, and race/ethnicity to affect alcohol use. Social and cultural factors help explain the relationship between geographic location and alcohol use. However, this area of research could be improved by the use of standardized definitions as well as the analysis of a more complete urban-to-rural continuum (e.g., urban, suburban, and rural areas). Having a better understanding of how geographic characteristics influence alcohol use would help inform and improve prevention and treatment efforts. PMID:27159813

Risk assessment of metals in road-deposited sediment along an urban-rural gradient.

PubMed

Zhao, Hongtao; Li, Xuyong

2013-03-01

We applied the traditional risk assessment methods originally designed for soils and river sediments to evaluation of risk associated with metals in road-deposited sediment (RDS) along an urban-rural gradient that included central urban (UCA), urban village (UVA), central suburban county (CSA), rural town (RTA), and rural village (RVA) areas in the Beijing metropolitan region. A new indicator RI(RDS) was developed which integrated the RDS characteristics of mobility, grain size and amount with the potential ecological risk index. The risk associated with metals in RDS in urban areas was generally higher than that in rural areas based on the assessment using traditional methods, but the risk was higher in urban and rural village areas than the areas with higher administration units based on the indicator RI(RDS). These findings implied that RDS characteristics variation with the urban-rural gradient must be considered in metal risk assessment and RDS washoff pollution control. Copyright © 2012 Elsevier Ltd. All rights reserved.

Patterns of Home and School Behavior Problems in Rural and Urban Settings

PubMed Central

Hope, Timothy L; Bierman, Karen L

2009-01-01

This study examined the cross-situational patterns of behavior problems shown by children in rural and urban communities at school entry. Behavior problems exhibited in home settings were not expected to vary significantly across urban and rural settings. In contrast, it was anticipated that child behavior at school would be heavily influenced by the increased exposure to aggressive models and deviant peer support experienced by children in urban as compared to rural schools, leading to higher rates of school conduct problems for children in urban settings. Statistical comparisons of the patterns of behavior problems shown by representative samples of 89 rural and 221 urban children provided support for these hypotheses, as significant rural-urban differences emerged in school and not in home settings. Cross-situational patterns of behavior problems also varied across setting, with home-only patterns of problems characterizing more children at the rural site and school-only, patterns of behavior problems characterizing more children at the urban sites. In addition, whereas externalizing behavior was the primary school problem exhibited by urban children, rural children displayed significantly higher rates of internalizing problems at school. The implications of these results are discussed for developmental models of behavior problems and for preventive interventions. PMID:19834584

Forests [Chapter 7

Treesearch

Linda A. Joyce; Steven W. Running; David D. Breshears; Virginia H. Dale; Robert W. Malmsheimer; R. Neil Sampson; Brent Sohngen; Christopher W. Woodall

2014-01-01

Forests occur within urban areas, at the interface between urban and rural areas (wildland-urban interface), and in rural areas. Urban forests contribute to clean air, cooling buildings, aesthetics, and recreation in parks. Development in the wildland-urban interface is increasing because of the appeal of owning homes near or in the woods. In rural areas, market...

Not just a rural occurrence: differences in agricultural equipment crash characteristics by rural-urban crash site and proximity to town.

PubMed

Harland, Karisa K; Greenan, Mitchell; Ramirez, Marizen

2014-09-01

Although approximately one-third of agricultural equipment-related crashes occur near town, these crashes are thought to be a rural problem. This analysis examines differences between agricultural equipment-related crashes by their urban-rural distribution and distance from a town. Agricultural equipment crashes were collected from nine Midwest Departments of Transportation (2005-2008). Crash zip code was assigned as urban or rural (large, small and isolated) using Rural-Urban Commuting Areas. Crash proximity to a town was estimated with ArcGIS. Multivariable logistic regression was used to estimate the odds of crashing in an urban versus rural zip codes and across rural gradients. ANOVA analysis estimated mean distance (miles) from a crash site to a town. Over four years, 4444 crashes involved agricultural equipment. About 30% of crashes occurred in urban zip codes. Urban crashes were more likely to be non-collisions (aOR=1.69[1.24-2.30]), involve ≥2 vehicles (2 vehicles: aOR=1.58[1.14-2.20], 3+ vehicles: aOR=1.68[0.98-2.88]), occur in a town (aOR=2.06[1.73-2.45]) and within one mile of a town (aOR=1.65[1.40-1.95]) than rural crashes. The proportion of crashes within a town differed significantly across rural gradients (P<0.0001). Small rural crashes, compared to isolated rural crashes, were 1.98 (95%CI[1.28-3.06]) times more likely to be non-collisions. The distance from the crash to town differed significantly by the urban-rural distribution (P<0.0001). Crashes with agricultural equipment are unexpectedly common in urban areas and near towns and cities. Education among all roadway users, increased visibility of agricultural equipment and the development of complete rural roads are needed to increase road safety and prevent agricultural equipment-related crashes. Copyright © 2014 Elsevier Ltd. All rights reserved.

Rural versus urban academic hospital mortality following stroke in Canada.

PubMed

Fleet, Richard; Bussières, Sylvain; Tounkara, Fatoumata Korika; Turcotte, Stéphane; Légaré, France; Plant, Jeff; Poitras, Julien; Archambault, Patrick M; Dupuis, Gilles

2018-01-01

Stroke is one of the leading causes of death in Canada. While stroke care has improved dramatically over the last decade, outcomes following stroke among patients treated in rural hospitals have not yet been reported in Canada. To describe variation in 30-day post-stroke in-hospital mortality rates between rural and urban academic hospitals in Canada. We also examined 24/7 in-hospital access to CT scanners and selected services in rural hospitals. We included Canadian Institute for Health Information (CIHI) data on adjusted 30-day in-hospital mortality following stroke from 2007 to 2011 for all acute care hospitals in Canada excluding Quebec and the Territories. We categorized rural hospitals as those located in rural small towns providing 24/7 emergency physician coverage with inpatient beds. Urban hospitals were academic centres designated as Level 1 or 2 trauma centres. We computed descriptive data on local access to a CT scanner and other services and compared mean 30-day adjusted post-stroke mortality rates for rural and urban hospitals to the overall Canadian rate. A total of 286 rural hospitals (3.4 million emergency department (ED) visits/year) and 24 urban hospitals (1.5 million ED visits/year) met inclusion criteria. From 2007 to 2011, 30-day in-hospital mortality rates following stroke were significantly higher in rural than in urban hospitals and higher than the Canadian average for every year except 2008 (rural average range = 18.26 to 21.04 and urban average range = 14.11 to 16.78). Only 11% of rural hospitals had a CT-scanner, 1% had MRI, 21% had in-hospital ICU, 94% had laboratory and 92% had basic x-ray facilities. Rural hospitals in Canada had higher 30-day in-hospital mortality rates following stroke than urban academic hospitals and the Canadian average. Rural hospitals also have very limited local access to CT scanners and ICUs. These rural/urban discrepancies are cause for concern in the context of Canada's universal health care system.

Determinants of under-five mortality in rural and urban Kenya.

PubMed

Ettarh, R R; Kimani, J

2012-01-01

The disparity in under-five year-old mortality rates between rural and urban areas in Kenya (also reported in other in sub-Saharan African countries), is a critical national concern. The objective of this study was to investigate the influence of geographical location and maternal factors on the likelihood of mortality among under-five children in rural and urban areas in Kenya. Data from the 2008-2009 Kenya Demographic and Health Survey were used to determine mortality among under-five children (n=16,162) in rural and urban areas in the 5 years preceding the survey. Multivariate analysis was used to compare the influence of key risk factors in rural and urban areas. Overall, the likelihood of death among under-five children in the rural areas was significantly higher than that in the urban areas (p<0.05). Household poverty was a key predictor for mortality in the rural areas, but the influence of breastfeeding was similar in the two areas. The likelihood of under-five mortality was significantly higher in the rural areas of Coast, Nyanza and Western Provinces than in Central Province. The study shows that the determinants of under-five mortality differ in rural and urban areas in Kenya. Innovative and targeted strategies are required to address rural poverty and province-specific sociocultural factors in order to improve child survival in rural Kenya.

Implications of rural-urban migration for conservation of the Atlantic Forest and urban growth in Misiones, Argentina (1970-2030).

PubMed

Izquierdo, Andrea E; Grau, Héctor R; Aide, T Mitchell

2011-05-01

Global trends of increasing rural-urban migration and population urbanization could provide opportunities for nature conservation, particularly in regions where deforestation is driven by subsistence agriculture. We analyzed the role of rural population as a driver of deforestation and its contribution to urban population growth from 1970 to the present in the Atlantic Forest of Argentina, a global conservation priority. We created future land-use-cover scenarios based on human demographic parameters and the relationship between rural population and land-cover change between 1970 and 2006. In 2006, native forest covered 50% of the province, but by 2030 all scenarios predicted a decrease that ranged from 18 to 39% forest cover. Between 1970 and 2001, rural migrants represented 20% of urban population growth and are expected to represent less than 10% by 2030. This modeling approach shows how rural-urban migration and land-use planning can favor nature conservation with little impact on urban areas.

Internet support groups for suicide survivors: a new mode for gaining bereavement assistance.

PubMed

Feigelman, William; Gorman, Bernard S; Beal, Karyl Chastain; Jordan, John R

2008-01-01

Taken among parents who sustained the loss of a child to suicide this study explores the participation of parents in Internet support groups, comparing their demographic and loss-related characteristics (N = 104) to other parent survivors participating in face-to-face support groups (N = 297). Contrary to expectations that Internet affiliates would be concentrated in under-served rural areas, we found similar levels of urban, suburban, small city and rural residents in both Internet and face-to-face subsamples. Bivariate and multivariate analyses suggested several important factors contributing to interest in Internet grief support including: 24/7 availability and opportunities to invest more time into this type of support group experience. Compared to their face-to-face group counterparts, Internet affiliates experienced greater suicide stigmatization from their families and other associates. Unable to find ready comfort and support from their personal communities, Internet users-and especially highly depressed survivors-sought and obtained valuable help from the Internet support resource.

Using diatom assemblages to assess urban stream conditions

USGS Publications Warehouse

Walker, C.E.; Pan, Y.

2006-01-01

We characterized changes in diatom assemblages along an urban-to-rural gradient to assess impacts of urbanization on stream conditions. Diatoms, water chemistry, and physical variables of riffles at 19 urban and 28 rural stream sites were sampled and assessed during the summer base flow period. Near stream land use was characterized using GIS. In addition, one urban and one rural site were sampled monthly throughout a year to assess temporal variation of diatom assemblages between the urban and rural stream sites. Canonical correspondence analysis (CCA) showed that the 1st ordination axis distinctly separated rural and urban sites. This axis was correlated with conductivity (r = 0.75) and % near-stream commercial/industrial land use (r = 0.55). TWINSPAN classified all sites into four groups based on diatom assemblages. These diatom-based site groups were significantly different in water chemistry (e.g., conductivity, dissolved nutrients), physical habitat (e.g., % stream substrate as fines), and near-stream land use. CCA on the temporal diatom data set showed that diatom assemblages had high seasonal variation along the 2nd axis in both urban and rural sites, however, rural and urban sites were well separated along the 1st ordination axis. Our results suggest that changes in diatom assemblages respond to urban impacts on stream conditions. ?? Springer 2006.

Obesity in Malaysia.

PubMed

Ismail, M N; Chee, S S; Nawawi, H; Yusoff, K; Lim, T O; James, W P T

2002-08-01

This study was undertaken to assess the recent data on Malaysian adult body weights and associations of ethnic differences in overweight and obesity with comorbid risk factors, and to examine measures of energy intake, energy expenditure, basal metabolic rate (BMR) and physical activity changes in urban and rural populations of normal weight. Three studies were included (1) a summary of a national health morbidity survey conducted in 1996 on nearly 29 000 adults > or =20 years of age; (2) a study comparing energy intake, BMR and physical activity levels (PALs) in 409 ethnically diverse, healthy adults drawn from a population of 1165 rural and urban subjects 18-60 years of age; and (3) an examination of the prevalence of obesity and comorbid risk factors that predict coronary heart disease and type 2 diabetes in 609 rural Malaysians aged 30-65 years. Overweight and obesity were calculated using body mass index (BMI) measures and World Health Organization (WHO) criteria. Energy intake was assessed using 3-d food records, BMR and PALs were assessed with Douglas bags and activity diaries, while hypertension, hyperlipidaemia and glucose intolerance were specified using standard criteria. The National Health Morbidity Survey data revealed that in adults, 20.7% were overweight and 5.8% obese (0.3% of whom had BMI values of >40.0 kg m(-2)); the prevalence of obesity was clearly greater in women than in men. In women, obesity rates were higher in Indian and Malay women than in Chinese women, while in men the Chinese recorded the highest obesity prevalences followed by the Malay and Indians. Studies on normal healthy subjects indicated that the energy intake of Indians was significantly lower than that of other ethnic groups. In women, Malays recorded a significantly higher energy intake than the other groups. Urban male subjects consumed significantly more energy than their rural counterparts, but this was not the case in women. In both men and women, fat intakes (%) were significantly higher in Chinese and urban subjects. Men were moderately active with the exception of the Dayaks. Chinese women were considerably less active than Chinese men. Chinese and Dayak women were less active than Malay and Indian women. In both men and women, Indians recorded the highest PALs. Hence, current nutrition and health surveys reveal that Malaysians are already affected by western health problems. The escalation of obesity, once thought to be an urban phenomenon, has now spread to the rural population at an alarming rate. As Malaysia proceeds rapidly towards a developed economy status, the health of its population will probably continue to deteriorate. Therefore, a national strategy needs to be developed to tackle both dietary and activity contributors to the excess weight gain of the Malaysian population.

Accessing the Food Systems in Urban and Rural Minnesotan Communities

ERIC Educational Resources Information Center

Smith, Chery; Miller, Hannah

2011-01-01

Objective: Explore how urban and rural Minnesotans access the food system and to investigate whether community infrastructure supports a healthful food system. Design: Eight (4 urban and 4 rural) focus groups were conducted. Setting and Participants: Eight counties with urban influence codes of 1, 2, 4, 5, 8, and 10. Fifty-nine (urban, n = 27;…

Cognition and Context: Rural-Urban Differences in Cognitive Aging Among Older Mexican Adults.

PubMed

Saenz, Joseph L; Downer, Brian; Garcia, Marc A; Wong, Rebeca

2017-04-01

To describe differences in cognitive functioning across rural and urban areas among older Mexican adults. We include respondents aged 50+ in the 2012 Mexican Health and Aging Study (MHAS). Cognitive functioning by domain is regressed as a function of community size. The role of educational attainment in explaining rural/urban differences in cognitive functioning is examined. Respondents residing in more rural areas performed worse across five cognitive domains. The majority, but not all, of the association between community size and cognitive functioning was explained by lower education in rural areas. Respondents residing in more rural areas were disadvantaged in terms of cognitive functioning compared with those residing in more urban areas. Poorer cognitive functioning in late life may be the result of historical educational disadvantage in rural areas or selection through migration from rural to urban regions for employment.

Urban-rural inequality regarding drug prescriptions in primary care facilities - a pre-post comparison of the National Essential Medicines Scheme of China.

PubMed

Yao, Qiang; Liu, Chaojie; Ferrier, J Adamm; Liu, Zhiyong; Sun, Ju

2015-07-30

To assess the impact of the National Essential Medicines Scheme (NEMS) with respect to urban-rural inequalities regarding drug prescriptions in primary care facilities. A stratified two-stage random sampling strategy was used to sample 23,040 prescriptions from 192 primary care facilities from 2009 to 2010. Difference-in-Difference (DID) analyses were performed to test the association between NEMS and urban-rural gaps in prescription patterns. Between-Group Variance and Theil Index were calculated to measure urban-rural absolute and relative disparities in drug prescriptions. The use of the Essential Medicines List (EML) achieved a compliance rate of up to 90% in both urban and rural facilities. An overall reduction of average prescription cost improved economic access to drugs for patients in both areas. However, we observed an increased urban-rural disparity in average expenditure per prescription. The rate of antibiotics and glucocorticoids prescription remained high, despite a reduced disparity between urban and rural facilities. The average incidence of antibiotic prescription increased slightly in urban facilities (62 to 63%) and reduced in rural facilities (67% to 66%). The urban-rural disparity in the use of parenteral administration (injections and infusions) increased, albeit at a high level in both areas (44%-52%). NEMS interventions are effective in reducing the overall average prescription costs. Despite the increased use of the EML, indicator performances with respect to rational drug prescribing and use remain poor and exceed the WHO/INRUD recommended cutoff values and worldwide benchmarks. There is an increased gap between urban and rural areas in the use of parenteral administration and expenditure per prescription.

Prevalence and factors associated with non-utilization of healthcare facility for childbirth in rural and urban Nigeria: Analysis of a national population-based survey.

PubMed

Adewuyi, Emmanuel O; Zhao, Yun; Auta, Asa; Lamichhane, Reeta

2017-08-01

The aim of this study was to assess the rural-urban differences in the prevalence and factors associated with non-utilization of healthcare facility for childbirth (home delivery) in Nigeria. Dataset from the Nigeria demographic and health survey, 2013, disaggregated by rural-urban residence were analyzed with appropriate adjustment for the cluster sampling design of the survey. Factors associated with home delivery were identified using multivariable logistic regression analysis. In rural and urban residence, the prevalence of home delivery were 78.3% and 38.1%, respectively ( p < 0.001). The lowest prevalence of home delivery occurred in the South-East region for rural residence (18.6%) and the South-West region for urban residence (17.9%). The North-West region had the highest prevalence of home delivery, 93.6% and 70.5% in rural and urban residence, respectively. Low maternal as well as paternal education, low antenatal attendance, being less wealthy, the practice of Islam, and living in the North-East, North-West and the South-South regions increased the likelihood of home delivery in both rural and urban residences. Whether in rural or urban residence, birth order of one decreased the likelihood of home delivery. In rural residence only, living in the North-Central region increased the chances of home delivery. In urban residence only, maternal age ⩾ 36 years decreased the likelihood of home delivery, while 'Traditionalist/other' religion and maternal age < 20 years increased it. The prevalence of home delivery was much higher in rural than urban Nigeria and the associated factors differ to varying degrees in the two residences. Future intervention efforts would need to prioritize findings in this study.

A Vanishing Rural School Advantage? Changing Urban/Rural Student Achievement Differences in Latin America and the Caribbean

ERIC Educational Resources Information Center

Luschei, Thomas F.; Fagioli, Loris P.

2016-01-01

In 1997, a cross-national assessment of educational achievement in Latin America and the Caribbean found that rural schools in Colombia outperformed urban schools in tests of reading and mathematics, except in very large cities. Given a long history of urban/rural inequality in the region, Colombia's rural school advantage attracted substantial…

Rural-Urban Migration in Sierra Leone: Determinants and Policy Implications. African Rural Economy Paper No. 13.

ERIC Educational Resources Information Center

Byerlee, Derek; And Others

Study objectives were to: increase the understanding of rural to urban migration processes in Africa and Sierra Leone; develop and test a theoretical schema and survey methodology for migration research; and evaluate the effects of policy on migration. The migration survey was conducted in rural areas, urban areas, and again in the rural areas…

The South Carolina rural-urban HIV continuum of care.

PubMed

Edun, Babatunde; Iyer, Medha; Albrecht, Helmut; Weissman, Sharon

2017-07-01

The HIV continuum of care model is widely used by various agencies to describe the HIV epidemic in stages from diagnosis through to virologic suppression. It identifies the various points at which persons living with HIV (PLWHIV) within a population fail to reach their next step in HIV care. The rural population in the Southern United States is disproportionally affected by the HIV epidemic. The purpose of this study was to examine these rural-urban disparities using the HIV care continuum model and determine at what stages these differences become apparent. PLWHIV aged 13 years and older in South Carolina (SC) were identified using data from the enhanced HIV/AIDS Reporting System. The percentages of PLWHIV linked to care, retained in care, and virologically suppressed were determined. Rural versus urban residence was determined using the Office of Management and Budget classification. There were 14,523 PLWHIV in SC at the end of 2012; 11,193 (77%) of whom were categorized as urban and 3305 (22%) as rural. There was no difference between urban and rural for those who had received any care: 64% versus 64% (p = .61); retention in care 53% versus 53% (p = .71); and virologic suppression 49% versus 48% (p = .35), respectively. The SC rural-urban HIV cascade represents the first published cascade of care model using rural versus urban residence. Although significant health care disparities exist between rural and urban residents, there were no major differences between rural and urban residents at the various stages of engagement in HIV care using the HIV continuum of care model.

Correlates of late-life major depression: a comparison of urban and rural primary care patients.

PubMed

Friedman, Bruce; Conwell, Yeates; Delavan, Rachel L

2007-01-01

The objective of this study was to determine whether factors associated with depression differ between elderly residents of rural and urban areas. The research design was cross-sectional and observational. The study subjects consisted of 926 Medicare primary care patients (650 urban and 276 rural) who were age 65+ and cognitively intact and had enrolled in a randomized, controlled Medicare demonstration. Major depression was identified by the Mini International Neuropsychiatric Interview. A logistic regression model was estimated that included a rural-urban indicator variable, additional independent variables, and interaction terms between the rural-urban indicator and independent variables that were significant at p <0.10. A total of 8.3% of the rural and 14.8% of the urban patients were identified as having major depression. Reporting 0-1 close friends (odds ratio [OR]: 6.86; 95% confidence interval [CI]: 2.18-21.58), 2+ emergency room visits during the past 6 months (OR: 4.00; 95% CI: 1.19-13.43), and more financial strain (OR: 1.50; 95% CI: 1.01-2.23) were associated with significantly higher likelihood of major depression among rural as compared with urban patients. The SF-36 Physical Component Summary score had a curvilinear relationship with major depression and was higher for urban patients. The predicted probability for major depression is lower for the rural patients when financial strain is low, about the same for rural and urban patients when strain is intermediate, and higher for rural patients when strain is high. Clinicians in rural areas should be vigilant for major depression among patients with very few close friends, several recent emergency department visits, and financial strain.

RURAL/URBAN RESIDENCE, ACCESS, AND PERCEIVED NEED FOR TREATMENT AMONG AFRICAN AMERICAN COCAINE USERS

PubMed Central

BORDERS, TYRONE F.; BOOTH, BRENDA M.; STEWART, KATHARINE E.; CHENEY, ANN M.; CURRAN, GEOFFREY M.

2014-01-01

Objective To examine how rural/urban residence, perceived access, and other factors impede or facilitate perceived need for drug use treatment, a concept closely linked to treatment utilization. Study Design Two hundred rural and 200 urban African American cocaine users who were not receiving treatment were recruited via Respondent-Driven Sampling and completed a structured in-person interview. Bivariate and multivariate analyses were conducted to test the associations between perceived need and rural/urban residence, perceived access, and other predisposing (eg, demographics), enabling (eg, insurance), and health factors (eg, psychiatric distress). Principal Findings In bivariate analyses, rural relative to urban cocaine users reported lower perceived treatment need (37% vs 48%), availability, affordability, overall ease of access, and effectiveness, as well as lower perceived acceptability of residential, outpatient, self-help, and hospital-based services. In multivariate analyses, there was a significant interaction between rural/urban residence and the acceptability of religious counseling. At the highest level of acceptability, rural users had lower odds of perceived need (OR=.23); at the lowest level, rural users had higher odds of perceived need (OR=2.74) than urban users. Among rural users, the acceptability of religious counseling was negatively associated with perceived need (OR=.64). Ease of access was negatively associated (OR=.71) whereas local treatment effectiveness (OR=1.47) and the acceptability of hospital-based treatment (OR=1.29) were positively associated with perceived need among all users. Conclusions Our findings suggest rural/urban disparities in perceived need and access to drug use treatment. Among rural and urban cocaine users, improving perceptions of treatment effectiveness and expanding hospital-based services could promote treatment seeking. PMID:25213603

Differences in the social patterning of active travel between urban and rural populations: findings from a large UK household survey.

PubMed

Hutchinson, Jayne; White, Piran C L; Graham, Hilary

2014-12-01

To determine the social patterning of active travel of short journeys for urban and rural residents in a large UK representative sample. Associations between frequently walking or cycling short journeys and socio-demographic factors in the UK Household Longitudinal Study were determined using logistic regression. Urban residents were 64 % more likely to frequently engage in active travel than rural residents (95 % CI 1.52, 1.77). Being younger, male, without full-time employment and having a lower income independently predicted greater active travel for both urban and rural residents. Degree level education and not having children were independent predictors for urban, but not rural residents. Actively travelling short journeys is less common and independently associated with fewer socio-demographic factors in rural than in urban populations.

Urban-rural differences in disability-free life expectancy in Bangladesh using the 2010 HIES data.

PubMed

Islam, Md Shariful; Tareque, Md Ismail; Mondal, Md Nazrul Islam; Fazle Rabbi, Ahbab Mohammad; Khan, Hafiz T A; Begum, Sharifa

2017-01-01

Research on health expectancy has been carried out in Bangladesh but none of it has examined the differences in Disability-Free Life Expectancy (DFLE) between urban and rural setting in context of rapid urbanization of Bangladesh in past decades. The present study aims to estimate DFLE for people of all ages living in urban and rural areas in Bangladesh, and to examine the differences in DFLE between these two areas. Data from the Sample Vital Registration System 2010 and the Bangladesh Household Income and Expenditure Survey (HIES) 2010 were used in this study. The Sullivan method was applied to estimate DFLE in Bangladesh. Higher rates of mortality and disability were observed in rural areas compared to urban areas with few exceptions. Statistically significant differences in DFLE were revealed from birth to age 15 years for both sexes between urban and rural areas. Urban males had a longer life expectancy (LE), longer DFLE and shorter LE with disability both in number and proportion when compared to rural males. Rural females at age 20+ years had a longer LE than urban females but urban females had a longer DFLE and a shorter LE with disability in both number and proportion at all ages than did rural females. This study demonstrates that there were clear inequalities in LE, DFLE and LE with disability between rural and urban areas of Bangladesh along with age-specific differences as well. These findings may serve as useful and benchmark for intervention and policy implications for reducing the gap in health outcomes.

Self-efficacy of Osteopathic Medical Students in a Rural-Urban Underserved Pathway Program.

PubMed

Casapulla, Sharon L

2017-09-01

Self-efficacy has been shown to play a role in medical students' choice of practice location. More physicians are needed in rural and urban underserved communities. Ohio University Heritage College of Osteopathic Medicine has a co-curricular training program in rural and urban underserved practice to address this shortage. To assess whether participation in the co-curricular program in rural and urban underserved practice affects self-efficacy related to rural and underserved urban practice. This cross-sectional study explored self-efficacy using Bandura's 5 sources of self-efficacy (vicarious learning, verbal persuasion, positive emotional arousal, negative emotional arousal, and performance accomplishments). A validated scale on self-efficacy for rural practice was expanded to include self-efficacy for urban underserved practice and e-mailed to all 707 medical students across 4 years of medical school. Composite rural and urban underserved self-efficacy scores were calculated. Scores from participants in the rural and urban underserved training program were compared with those who were not in the program. Data were obtained from 277 students. In the overall sample, students who indicated that they grew up in a rural community reported significantly higher rural self-efficacy scores than those who did not grow up in a rural community (F1,250=27.56, P<.001). Conversely, students who indicated that they grew up in a nonrural community reported significantly higher urban underserved self-efficacy scores than those who grew up in a rural community (F1,237=7.50, P=.007). The participants who stated primary care as their career interest (n=122) had higher rural self-efficacy scores than the participants who reported a preference for generalist specialties (general surgery, general psychiatry, and general obstetrics and gynecology) or other specialties (n=155) (F2,249=7.16, P=.001). Students who participated in the rural and urban underserved training program (n=49) reported higher rural self-efficacy scores (mean [SD], 21.06 [5.06]) than those who were not in the program (19.22 [4.22]) (t65=2.36; P=.022; equal variances not assumed). The weakest source of self-efficacy for rural practice in participants was vicarious experience. The weakest source of urban underserved self-efficacy was verbal persuasion. Opportunities exist for strengthening weaker sources of self-efficacy for rural practice, including vicarious experience and verbal persuasion. The findings suggest a need for longitudinal research into self-efficacy and practice type interest in osteopathic medical students.

Effect of urban vs. rural residence on the association between atopy and wheeze in Latin America: findings from a case-control analysis.

PubMed

Endara, P; Vaca, M; Platts-Mills, T A E; Workman, L; Chico, M E; Barreto, M L; Rodrigues, L C; Cooper, P J

2015-02-01

The association between atopy and asthma is attenuated in non-affluent populations, an effect that may be explained by childhood infections such as geohelminths. To investigate the association between atopy and wheeze in schoolchildren living in urban and rural areas of Ecuador and examine the effects of geohelminths on this association. We performed nested case-control studies among comparable populations of schoolchildren living in rural communities and urban neighbourhoods in the Province of Esmeraldas, Ecuador. We detected geohelminths in stool samples, measured recent wheeze and environmental exposures by parental questionnaire, and atopy by specific IgE (sIgE) and skin prick test (SPT) reactivity to aeroallergens. Atopy, particularly sIgE to house dust mite (HDM), was more strongly associated with recent wheeze in urban than rural schoolchildren: (urban, adj. OR 5.19, 95% CI 3.37-8.00, P < 0.0001; rural, adj. OR 1.81, 95%CI 1.09-2.99, P = 0.02; interaction, P < 0.001). The population fractions of wheeze attributable to atopy were approximately two-fold greater in urban schoolchildren: SPT to any allergen (urban 23.5% vs. rural 10.1%), SPT to HDM (urban 18.5% vs. rural 9.6%), and anti-HDM IgE (urban 26.5% vs. rural 10.5%), while anti-Ascaris IgE was related to wheeze in a high proportion of rural (49.7%) and urban (35.4%) children. The association between atopy and recent wheeze was attenuated by markers of geohelminth infections. Our data suggest that urban residence modifies the association between HDM atopy and recent wheeze, and this effect is explained partly by geohelminth infections. © 2014 The Authors. Clinical & Experimental Allergy Published by John Wiley & Sons Ltd.

Rural-to-urban migration and risk of hypertension: longitudinal results of the PERU MIGRANT study

PubMed Central

Bernabe-Ortiz, A; Sanchez, J F; Carrillo-Larco, R M; Gilman, R H; Poterico, J A; Quispe, R; Smeeth, L; Miranda, J J

2017-01-01

Urbanization can be detrimental to health in populations due to changes in dietary and physical activity patterns. The aim of this study was to determine the effect of migration on the incidence of hypertension. Participants of the PERU MIGRANT study, that is, rural, urban and rural-to-urban migrants, were re-evaluated after 5 years after baseline assessment. The outcome was incidence of hypertension; and the exposures were study group and other well-known risk factors. Incidence rates, relative risks (RRs) and population attributable fractions (PAFs) were calculated. At baseline, 201 (20.4%), 589 (59.5%) and 199 (20.1%) participants were rural, rural-to-urban migrant and urban subjects, respectively. Overall mean age was 47.9 (s.d.±12.0) years, and 522 (52.9%) were female. Hypertension prevalence at baseline was 16.0% (95% confidence interval (CI) 13.7–18.3), being more common in urban group; whereas pre-hypertension was more prevalent in rural participants (P<0.001). Follow-up rate at 5 years was 94%, 895 participants were re-assessed and 33 (3.3%) deaths were recorded. Overall incidence of hypertension was 1.73 (95%CI 1.36–2.20) per 100 person-years. In multivariable model and compared with the urban group, rural group had a greater risk of developing hypertension (RR 3.58; 95%CI 1.42–9.06). PAFs showed high waist circumference as the leading risk factor for the hypertension development in rural (19.1%), migrant (27.9%) and urban (45.8%) participants. Subjects from rural areas are at higher risk of developing hypertension relative to rural–urban migrant or urban groups. Central obesity was the leading risk factor for hypertension incidence in the three population groups. PMID:26865219

Comparison of urban and rural general surgeons: motivations for practice location, practice patterns, and education requirements.

PubMed

Heneghan, Steven J; Bordley, James; Dietz, Patrick A; Gold, Michael S; Jenkins, Paul L; Zuckerman, Randall J

2005-11-01

The purpose of this study is to determine the differences between rural and urban surgeons with regard to practice patterns, factors in choosing a practice location, and educational needs. A list of surgeons obtained from the American Medical Association was examined using the Office of Management and Budget definition of rural. Seventeen hundred rural surgeons were mailed surveys; 421 responded. One hundred fourteen urban surgeons were contacted by telephone. Questions were designed to measure job and community satisfaction, factors influencing their decision to practice in their current location, spectrum and volume of cases, and their perceived educational needs. Age distribution did not differ markedly between urban and rural surgeons. Motivation to practice in their current location varied considerably between urban and rural surgeons. Both groups equally rated quality of life as the leading factor influencing their current practice location. Urban surgeons rated other factors, such as income, practice growth, hospital facilities, and proximity to family, higher than rural surgeons. Practice patterns and educational needs also varied between the two groups. Rural surgeons performed more procedures per year with more variety in procedure type. Both groups felt that additional training in advanced laparoscopic techniques would be helpful, and rural surgeons felt that additional training in the surgical subspecialty areas was important. Although rural and urban surgeons do not differ in age or the importance of lifestyle in deciding career location, different factors do impact their choice of location. Practice pattern and educational needs varied markedly between rural and urban general surgeons.

Positive body image: inter-ethnic and rural-urban differences among an indigenous sample from Malaysian Borneo.

PubMed

Swami, Viren; Kannan, Kumaraswami; Furnham, Adrian

2012-11-01

Previous studies examining body image from a cross-cultural perspective have tended to neglect samples from different ethnic groups or along a rural-urban continuum. To overcome this limitation, the present study examined positive body image among rural and urban women from three major indigenous ethnic groups in Sabah, Malaysia. A total of 202 women completed the Body Appreciation Scale, as well as measures of media exposure and financial security, and provided their demographic details. s showed that there were significant rural-urban differences in body appreciation, with rural participants having significantly higher body appreciation than urban participants. A comparison with a previous data set of West Malaysian women (Swami & Chamorro-Premuzic, 2008) showed that the current urban sample had significantly lower body appreciation and that the rural group had significantly higher body appreciation. Further results showed that research site (urban vs rural) explained 11.0% of the variance in body appreciation. Participant body mass index and exposure to western forms of media explained an additional 2.0% of the variance. These results suggest that there are differences in body image between rural and urban women. Results are discussed in relation to the promotion of positive body image, particularly in developing societies where health care resources may be limited.

Opioid Overdose Experience, Risk Behaviors, and Knowledge in Drug Users from a Rural versus an Urban Setting.

PubMed

Dunn, Kelly E; Barrett, Frederick S; Yepez-Laubach, Claudia; Meyer, Andrew C; Hruska, Bryce J; Petrush, Kathy; Berman, Suzan; Sigmon, Stacey C; Fingerhood, Michael; Bigelow, George E

2016-12-01

Opioid use is highly prevalent in the United States and there has been an increased incidence in the rate of opioid-related overdose. While evidence suggests there are substantial differences in opioid use among rural versus urban settings, the rate of overdose and corresponding frequency of opioid overdose risk behaviors and overdose knowledge between rural and urban settings have not been examined. Individuals with opioid use disorder from rural (N=98) and urban (N=247) settings completed a self-report survey regarding their lifetime history of overdose and overdose risk behaviors. Participants also completed the Brief Opioid Overdose Knowledge (BOOK) questionnaire, a 12-item self-report measure of opioid overdose knowledge. Overall, 35.6% of participants had experienced an overdose, and prevalence of overdose was significantly higher (p<.01) among rural (45.9%) vs. urban (31.6%) participants, though fewer rural participants reported past 30-day risk behaviors. There were few differences observed between the subset of rural and urban participants who had experienced an overdose, and fewer rural participants with a history of overdose reported past 30-day risk behaviors. Both rural and urban participants performed poorly on the BOOK, though the percent of correct responses was lowest among rural participants with a history of overdose. Results demonstrate higher rates of overdose among rural opioid users, though rural participants were less likely to report recent risk behaviors. Results also suggest that knowledge regarding key factors related to opioid overdose is severely lacking, particularly among rural opioid users, which could be a potential target for future intervention efforts.

One Family, Two Households: Rural-Urban Kin Networks in Nairobi.

ERIC Educational Resources Information Center

Weisner, Thomas S.

The document examines appropriate units for studying changes in familial relations and rural-urban ties, including the importance of the increasing interdependence of rural and urban contexts in family interaction. There have been two broadly contrasting approaches to the problems of urbanization and family change in Africa: (1)…

Early Academic Skills and Childhood Experiences across the Urban-Rural Continuum

ERIC Educational Resources Information Center

Miller, Portia; Votruba-Drzal, Elizabeth

2013-01-01

The urban-rural continuum provides unique contexts for development. Differences in access to resources and childrearing norms and practices in urban, suburban, and rural areas may be linked to disparities in early achievement. Yet, few studies examine associations between urbanicity and children's early academic skills. Using nationally…

Recruitment and retention of rural nursing students: a retrospective study.

PubMed

Bigbee, Jeri; Mixon, Diana

2013-01-01

The shortage of registered nurses is an issue globally, but particularly in rural and remote areas. Previous research in medicine suggests that recruiting students from rural backgrounds is an effective strategy to enhance the supply of rural healthcare providers. This strategy has not been widely adopted or evaluated in nursing. The purpose of this study was to compare rural and urban nursing students in relation to application, admission, and retention/graduation trends at a metropolitan state university in the Pacific Northwest area of the USA. A retrospective longitudinal descriptive design was used, analyzing existing data from 2005 to 2010. The sample included 1283 applicants, accepted students, and graduates. Rural-urban classification was made using rural urban commuting area (RUCA) codes based on high school zip codes, identifying 356 (28%) rural and 927 (72%) urban individuals. The data were analyzed quantitatively, assessing demographic characteristics along with application, admission and retention/graduation rates. The analysis indicated no significant differences between the rural and urban samples in relation to age, gender, parents' level of education, income, or retention rates. The acceptance rate for rural students (66.3%) was significantly lower than for urban students (73.1%) (p=0.015). When rural subgroups (isolated, small rural and large rural) were examined, the isolated group (n=61) had the highest acceptance rate of any rural or urban group (75%). This group was the least ethnically diverse (95% Caucasian), was the least likely to be first-generation college (22%), had the highest percentage of females (85%) and had the highest entering grade point average (3.65 on a four-point scale). In contrast, the subgroup including individuals from large rural communities (n=182) had the lowest acceptance rate (64%), the lowest retention rate 85%, the lowest entering grade point average (3.42), and the highest percentage of first-generation college individuals (50.9%). The findings suggest that students from rural backgrounds achieve similar levels of success in nursing education, despite lower acceptance rates, when compared with urban students. Addressing issues related to lower acceptance rates for rural nursing students, including targeted recruitment and support efforts with students interested in pursuing nursing at the junior and senior high school levels, may be indicated. Further research is indicated to explore differences among rural subgroups in relation to preparation for and achievement in nursing education. Greater research attention is also needed to assess if nursing students from rural backgrounds tend to practice in rural areas more than students from urban backgrounds, similar to previous research in medicine. Because students tend to practice near their place of education, nursing education programs may need to consider locating outside of large urban areas to promote rural practice. Inclusion of rural content and clinical experiences within nursing curricula is also recommended.

Household food security and hunger in rural and urban communities in the Free State Province, South Africa.

PubMed

Walsh, Corinna M; van Rooyen, Francois C

2015-01-01

Household food security impacts heavily on quality of life. We determined factors associated with food insecurity in 886 households in rural and urban Free State Province, South Africa. Significantly more urban than rural households reported current food shortage (81% and 47%, respectively). Predictors of food security included vegetable production in rural areas and keeping food for future use in urban households. Microwave oven ownership was negatively associated with food insecurity in urban households and using a primus or paraffin stove positively associated with food insecurity in rural households. Interventions to improve food availability and access should be emphasized.

Nonlinear Differential Equations and Feedback Control Design for the Urban-Rural Resident Pension Insurance in China

NASA Astrophysics Data System (ADS)

Wang, Lijian

2015-12-01

Facing many problems of the urban-rural resident pension insurance system in China, one should firstly make sure that this system can be optimized. This paper, based on the modern control theory, sets up differential equations as models to describe the urban-rural resident pension insurance system, and discusses the globally asymptotic stability in the sense of Liapunov for the urban-rural resident pension insurance system in the new equilibrium point. This research sets the stage for our further discussion, and it is theoretically important and convenient for optimizing the urban-rural resident pension insurance system.

Secular trends of obesity prevalence in Chinese children from 1985 to 2010: Urban-rural disparity.

PubMed

Song, Yi; Ma, Jun; Wang, Hai-Jun; Wang, Zhiqiang; Hu, Peijin; Zhang, Bing; Agard, Anette

2015-02-01

To examine the trend of urban-rural disparity in obesity prevalence among Chinese children from 1985 to 2010. The data were from five cross-sectional surveys (1985, 1995, 2000, 2005, and 2010) of Chinese National Surveys on Students' Constitution and Health. Logistic regression was used to estimate the prevalence odds ratio (POR) of urban-rural areas for obesity prevalence in different surveys. The standardized prevalence of obesity in Chinese children increased rapidly from 0.1% in 1985 to 5.0% in 2010, and significant differences were found between two adjacent surveys in most of the age subgroups (P<0.01). Although the obesity prevalence was significantly higher in urban than in rural children of all age subgroups at different survey points, the changing pace was faster in rural than in urban areas from 1995 to 2010. The PORs had increased in 1995 in most age subgroups and then began to decline in all age subgroups after 1995. The gradually decreasing urban-rural disparity suggests that the obesity prevalence in rural areas would contribute to a growing proportion of obese children. Therefore, rural children should be included in obesity prevention efforts even though obesity rates are still lower in rural than in urban areas. © 2014 The Obesity Society.

Rural-urban comparisons of dengue seroprevalence in Malaysia.

PubMed

Chew, Cheng Hoon; Woon, Yuan Liang; Amin, Faridah; Adnan, Tassha H; Abdul Wahab, Asmah Hani; Ahmad, Zul Edzhar; Bujang, Mohd Adam; Abdul Hamid, Abdul Muneer; Jamal, Rahman; Chen, Wei Seng; Hor, Chee Peng; Yeap, Lena; Hoo, Ling Ping; Goh, Pik Pin; Lim, Teck Onn

2016-08-18

Each year an estimated 390 million dengue infections occur worldwide. In Malaysia, dengue is a growing public health concern but estimate of its disease burden remains uncertain. We compared the urban-rural difference of dengue seroprevalence and determined age-specific dengue seroprevalence in Malaysia. We undertook analysis on 11,821 subjects from six seroprevalence surveys conducted in Malaysia between 2001 and 2013, which composed of five urban and two rural series. Prevalence of dengue increased with age in both urban and rural locations in Malaysia, which exceeded 90 % among those aged 70 years or beyond. The age-specific rates of the 5 urban surveys overlapped without clear separation among them, while prevalence was lower in younger subjects in rural series than in urban series, the trend reversed in older subjects. There were no differences in the seroprevalence by gender, ethnicity or region. Poisson regression model confirmed the prevalence have not changed in urban areas since 2001 but in rural areas, there was a significant positive time trend such that by year 2008, rural prevalence was as high as in urban areas. Dengue seroprevalence has stabilized but persisted at a high level in urban areas since 2001, and is fast stabilizing in rural areas at the same high urban levels by 2008. The cumulative seroprevalence of dengue exceeds 90 % by the age of 70 years, which translates into 16.5 million people or 55 % of the total population in Malaysia, being infected by dengue by 2013.

Bipolar Disorder Center for Pennsylvanians: Implementing an Effectiveness Trial to Improve Treatment for At-Risk Patients

PubMed Central

Kupfer, David J.; Friedman, Edward S.; Reynolds, Charles F.; Axelson, David A.; Grochocinski, Victoria J.; Stofko, Mary G.; Birmaher, Boris; Houck, Patricia R.; Swartz, Holly A.; Brown, Charlotte; Kilbourne, Amy M.; Thase, Michael E.; Curet, David E.; Mulsant, Benoit H.; Turkin, Scott R.; Fagiolini, Andrea; Pollock, Bruce G.; Whyte, Ellen M.; Frank, Ellen

2012-01-01

Objective Adolescents, elderly persons, African Americans, and rural residents with bipolar disorder are less likely than their middle-aged, white, urban counterparts to be diagnosed, receive adequate treatment, remain in treatment once identified, and have positive outcomes. The Bipolar Disorder Center for Pennsylvanians (BDCP) study was designed to address these disparities. This report highlights the methods used to recruit, screen, and enroll a cohort of difficult-to-recruit individuals with bipolar disorder. Methods Study sites included three specialty clinics for bipolar disorder in a university setting and a rural behavioral health clinic. Study operations were standardized, and all study personnel were trained in study procedures. Several strategies were used for recruitment. Results It was possible to introduce the identical assessment and screening protocol in settings regardless of whether they had a history of implementing research protocols. This protocol was also able to be used across the age spectrum, in urban and rural areas, and in a racially diverse cohort of participants. Across the four sites 515 individuals with bipolar disorder were enrolled as a result of these methods (69 African Americans and 446 non–African Americans). Although clinical characteristics at study entry did not differ appreciably between African Americans and non–African Americans, the pathways into treatment differed significantly. Conclusions Rigorous recruitment and assessment procedures can be successfully introduced in different settings and with different patient cohorts, thus facilitating access to high-quality treatment for individuals who frequently do not receive appropriate care for bipolar disorder. PMID:19564218

Diabetes and cardiometabolic risk factors in Cambodia: Results from two screening studies.

PubMed

Wagner, Julie; Naranjo, Diana; Khun, Touch; Seng, Serey; Horn, Ien S; Suttiratana, Sakinah C; Keuky, Lim

2018-02-01

Despite growing attention to diabetes throughout Asia, data from Southeast Asia are limited. This article reports rates of diabetes, hypertension, and obesity in Cambodia. Two studies were conducted across different regions of Cambodia: (i) a 2012 screening study across urban, semi-urban, and rural areas that used point-of-care capillary glucose for determination of diabetes (n = 13 997); and (ii) a 2005 epidemiological study with random selection from two main urban areas that used oral glucose tolerance tests for determination of diabetes (n = 1863). Blood pressure and anthropometrics were also measured. In the screening study, rates of diabetes were significantly higher in urban than rural sites, with intermediate rates in semi-urban areas. There was a significant dose-response effect for urbanicity on overweight, obesity, and waist:hip ratio, with higher rates for urban versus semi-urban and for semi-urban versus rural locales. Rural sites had the lowest rates of hypertension, followed by urban and semi-urban sites. Among people who screened positive for diabetes, there was a dose-response effect for urbanicity on undiagnosed diabetes; rates of previously undiagnosed diabetes were lowest in urban (51%), followed by semi-urban (55%) and rural (67%) locales. Rural participants reported the highest rates of smoking and alcohol use. In the urban epidemiological study, prevalence rates of diabetes and impaired glucose tolerance were approximately 10%, indicating a prevalence of total glucose intolerance of approximately 20%. In Cambodia, diabetes rates are high among urban residents and undiagnosed diabetes is highest among rural residents. A country-wide public health response is urgently needed; as development continues, rates of diabetes are expected to rise. © 2017 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

Residence in Rural Areas of the United States and Lung Cancer Mortality. Disease Incidence, Treatment Disparities, and Stage-Specific Survival.

PubMed

Atkins, Graham T; Kim, Taeha; Munson, Jeffrey

2017-03-01

There is increased lung cancer mortality in rural areas of the United States. However, it remains unclear to what extent rural-urban differences in disease incidence, stage at diagnosis, or treatment explain this finding. To explore the relationship between smoking rates, lung cancer incidence, and lung cancer mortality in populations across the rural-urban continuum and to determine whether survival is decreased in rural patients diagnosed with lung cancer and whether this is associated with rural-urban differences in stage at diagnosis or the treatment received. We conducted a retrospective cohort study of 348,002 patients diagnosed with lung cancer between 2000 and 2006. Data from metropolitan, urban, suburban, and rural areas in the United States were obtained from the Surveillance, Epidemiology, and End Results program database. County-level population estimates for 2003 were obtained from the U.S. Census Bureau, and corresponding estimates of smoking prevalence were obtained from published literature. The exposure was rurality, defined by the rural-urban continuum code area linked to each cohort participant by county of residence. Outcomes included lung cancer incidence, mortality, diagnostic stage, and treatment received. Lung cancer mortality increased with rurality in a dose-dependent fashion across the rural-urban continuum. The most rural areas had almost twice the smoking prevalence and lung cancer incidence of the largest metropolitan areas. Rural patients diagnosed with stage I non-small cell lung cancer underwent fewer surgeries (69% vs. 75%; P < 0.001) and had significantly reduced median survival (40 vs. 52 mo; P = 0.0006) compared with the most urban patients. Stage at diagnosis was similar across the rural-urban continuum, as was median survival for patients with stages II-IV lung cancer. Higher rural smoking rates drive increased disease incidence and per capita lung cancer mortality in rural areas of the United States. There were no rural-urban discrepancies in diagnostic stage, suggesting similar access to diagnostic services. Rural patients diagnosed with stage I non-small cell lung cancer had shorter survival, which may reflect disparities in access to surgical care. No survival difference for patients with advanced-stage lung cancer is attributed to lack of effective treatment during the time period of this study.

Smoking and heavy drinking patterns in rural, urban and rural-to-urban migrants: the PERU MIGRANT Study.

PubMed

Taype-Rondan, Alvaro; Bernabe-Ortiz, Antonio; Alvarado, Germán F; Gilman, Robert H; Smeeth, Liam; Miranda, J Jaime

2017-02-03

Previous studies have found mixed results about cigarette and alcohol consumption patterns among rural-to-urban migrants. Moreover, there are limited longitudinal data about consumption patterns in this population. As such, this study aimed to compare the smoking and heavy drinking prevalence among rural, urban, and rural-to-urban migrants in Peru, as well as the smoking and heavy drinking incidence in a 5-year follow-up. We analyzed the PERU MIGRANT Study data from rural, urban, and rural-to-urban migrant populations in Peru. The baseline study was carried out in 2006-2007 and follow-up was performed five years later. For the baseline data analysis, the prevalence of lifetime smoking, current smokers, and heavy drinking was compared by population group using prevalence ratios (PR) and 95% confidence intervals (95% CI). For the longitudinal analysis, the incidence of smoking and heavy drinking was compared by population group with risk ratios (RR) and 95% CI. Poisson regression with robust variance was used to calculate both PRs and RRs. We analyzed data from 988 participants: 200 rural dwellers, 589 migrants, and 199 urban dwellers. Compared with migrants, lifetime smoking prevalence was higher in the urban group (PR = 2.29, 95% CI = 1.64-3.20), but lower in the rural group (PR = 0.55, 95% CI = 0.31-0.99). Compared with migrants, the urban group had a higher current smoking prevalence (PR = 2.29, 95% CI = 1.26-4.16), and a higher smoking incidence (RR = 2.75, 95% CI = 1.03-7.34). Current smoking prevalence and smoking incidence showed no significant difference between rural and migrant groups. The prevalence and incidence of heavy drinking was similar across the three population groups. Our results show a trend in lifetime smoking prevalence (urban > migrant > rural), while smoking incidence was similar between migrant and rural groups, but higher in the urban group. In addition, our results suggest that different definitions of smoking status could lead to different smoking rates and potentially different measures of association. The prevalence and incidence of heavy drinking were similar between the three population groups.

Urban Malaria: Understanding its Epidemiology, Ecology, and Transmission across Seven Diverse ICEMR Network Sites

PubMed Central

Wilson, Mark L.; Krogstad, Donald J.; Arinaitwe, Emmanuel; Arevalo-Herrera, Myriam; Chery, Laura; Ferreira, Marcelo U.; Ndiaye, Daouda; Mathanga, Don P.; Eapen, Alex

2015-01-01

A major public health question is whether urbanization will transform malaria from a rural to an urban disease. However, differences about definitions of urban settings, urban malaria, and whether malaria control should differ between rural and urban areas complicate both the analysis of available data and the development of intervention strategies. This report examines the approach of the International Centers of Excellence for Malaria Research (ICEMR) to urban malaria in Brazil, Colombia, India (Chennai and Goa), Malawi, Senegal, and Uganda. Its major theme is the need to determine whether cases diagnosed in urban areas were imported from surrounding rural areas or resulted from transmission within the urban area. If infections are being acquired within urban areas, malaria control measures must be targeted within those urban areas to be effective. Conversely, if malaria cases are being imported from rural areas, control measures must be directed at vectors, breeding sites, and infected humans in those rural areas. Similar interventions must be directed differently if infections were acquired within urban areas. The hypothesis underlying the ICEMR approach to urban malaria is that optimal control of urban malaria depends on accurate epidemiologic and entomologic information about transmission. PMID:26259941

New Zealand veterinarians--demography, remuneration and vacancies.

PubMed

Jackson, R; Goodwin, K A; Perkins, N R; Roddick, J

2004-08-01

To determine levels of remuneration for veterinarians in New Zealand, to examine associations between putative explanatory factors and gross annual remuneration, and to quantify the type and prevalence of vacant positions. A postal survey to 486 identifiable clinical practices and 53 identifiable organisations that employ veterinarians was used to gather data for the 2-month period of December 2001 to January 2002. Data were produced for 972 veterinarians (367 females and 605 males) working in 325 clinical practices, and 299 veterinarians (88 females and 211 males) employed by 32 organisations. Median levels of gross annual remuneration for assistants, partners/ shareholders and sole owners working >/=5 days per week in clinical practice were NZ$60,000, $90,000 and $75,000, respectively, and for veterinarians in organisations, irrespective of number of days per week worked, was $68,000. Pay rates increased linearly as the number of years since graduation increased for all clinicians and with increasing age for veterinarians in organisations. Full-time assistants were likely to be paid more if the practice was rural rather than urban in location, if they were males, and if administrative duties were part of the job. The same factors, except for sex, were significant for remuneration for owners and partners/shareholders working full-time. Their remuneration tended to be higher if the practice was involved with either dairy or deer work but decreased as the number of animal species serviced increased and if they worked >5 days per week. Part-time female veterinarians were generally paid more than male counterparts. Male veterinarians working in organisations were generally paid about 8% more than their female colleagues. Veterinarians in organisations involved with administration at a head office were generally better paid than those without administrative duties. Pay rates were, on the whole, better in private organisations than in universities, state-owned enterprises, government-operated and other types of organisations About 50% of all services provided by clinical practices were directed to small animals, 27% to dairy cattle and about 10%, 6% and 3% to horses, sheep and beef cattle, and deer, respectively. About 31% of veterinarians worked solely with small animals but most had multiple species workloads. Of the 325 respondent practices, 98 reported vacancies for 119 veterinarians, of which 79 were full-time, 27 part-time and 12 locum positions. Of the 32 respondent organisations, seven reported vacancies for 16 mostly full-time positions. Farmer owned co-operative practices were less likely than privately owned practices to have full-time vacant positions. The only factor identified as influencing part-time vacancies in clinical practices was hourly pay rate. Vacancies occurred randomly across practices, irrespective of location, and there was no indication of greater demand for services for any particular species. The odds of a vacancy in organisations was lower for state-owned enterprises and private organisations than for government organisations (odds ratios (OR)=0.14 and 0.18, respectively). Relatively more females than males worked part-time and 23% of all assistants in clinical practice worked part-time. Sex made a significant difference to gross remuneration for full-time assistants in clinical practice and for veterinarians employed by private or government organisations. In both situations, males were generally better paid than females. Female part-time assistants and partners/shareholders or sole owners in clinical practice were generally better rewarded than their male counterparts. Sex had no effect on remuneration levels for owners/ partners working full-time in clinical practices. The study confirmed a serious shortage of veterinarians in New Zealand. The probability of a vacancy occurring in farmer owned co-operative ('club') practices was lower than in private practices. Vacancies were distributed randomly among rural, urban and rural/urban practices with no evidence of rural practices being more severely affected than urban or rural/urban practices.

Does increased emergency medical services prehospital time affect patient mortality in rural motor vehicle crashes? A statewide analysis.

PubMed

Gonzalez, Richard P; Cummings, Glenn R; Phelan, Herbert A; Mulekar, Madhuri S; Rodning, Charles B

2009-01-01

Fatality rates from rural vehicular trauma are almost double those found in urban settings. It has been suggested that increased prehospital time is a factor that adversely affects fatality rates in rural vehicular trauma. By linking and analyzing Alabama's statewide prehospital data, emergency medical services (EMS) prehospital time was assessed for rural and urban vehicular crashes. An imputational methodology permitted linkage of data from police motor vehicle crash (MVC) and EMS records. MVCs were defined as rural or urban by crash location using the United States Census Bureau criteria. Areas within Alabama that fell outside the Census Bureau definition of urban were defined as rural. Prehospital data were analyzed to determine EMS response time, scene time, and transport time in rural and urban settings. Over a 2-year period from January 2001 through December 2002, data were collected from EMS Patient Care Reports and police crash reports for the entire state of Alabama. By using an imputational methodology and join specifications, 45,763 police crash reports were linked to EMS Patient Care Reports. Of these, 34,341 (75%) were injured in rural settings and 11,422 (25%) were injured in urban settings. A total of 714 mortalities were identified, of which 611 (1.78%) occurred in rural settings and 103 (.90%) occurred in urban settings (P < .0001). When mortalities occurred, the mean EMS response time in rural settings was 10.67 minutes and 6.50 minutes in urban settings (P < .0001). When mortalities occurred, the mean EMS scene time in rural settings was 18.87 minutes and 10.83 minutes in urban settings (patients who were dead on scene and extrication patients were excluded from both settings) (P < .0001). When mortalities occurred, the mean EMS transport time in rural settings was 12.45 minutes and 7.43 minutes in urban settings (P < .0001). When mortalities occurred, the overall mean prehospital time in rural settings was 42.0 minutes and 24.8 minutes in urban settings (P < .0001). The mean EMS response time for rural MVCs with survivors was 8.54 minutes versus a mean of 10.67 minutes with mortalities (P < .0001). The mean EMS scene time for rural MVCs with survivors was 14.81 minutes versus 18.87 minutes with mortalities (patients who were dead on scene and extrication patients were excluded) (P = .0014). Based on this statewide analysis of MVCs, increased EMS prehospital time appears to be associated with higher mortality rates in rural settings.

Rural tobacco use across the United States: How rural and urban areas differ, broken down by census regions and divisions.

PubMed

Roberts, Megan E; Doogan, Nathan J; Kurti, Allison N; Redner, Ryan; Gaalema, Diann E; Stanton, Cassandra A; White, Thomas J; Higgins, Stephen T

2016-05-01

This project compared urban/rural differences in tobacco use, and examined how such differences vary across regions/divisions of the U.S. Using pooled 2012-2013 data from the National Survey on Drug Use and Health (NSDUH), we obtained weighted prevalence estimates for the use of cigarettes, menthol cigarettes, chewing tobacco, snuff, cigars, and pipes. NSDUH also provides information on participants' residence: rural vs. urban, and Census region and division. Overall, use of cigarettes, chew, and snuff were higher in rural, compared to urban areas. Across all tobacco products, urban/rural differences were particularly pronounced in certain divisions (e.g., the South Atlantic). Effects did not appear to be fully explained by differences in poverty. Going beyond previous research, these findings show that urban/rural differences vary across different types of tobacco products, as well as by division of the country. Results underscore the need for regulatory efforts that will reduce health disparities. Copyright © 2016 Elsevier Ltd. All rights reserved.

Rural Tobacco Use across the United States: How Rural and Urban Areas Differ, Broken Down by Census Regions and Divisions

PubMed Central

Roberts, Megan E.; Doogan, Nathan J.; Kurti, Allison N.; Redner, Ryan; Gaalema, Diann E.; Stanton, Cassandra A.; White, Thomas J.; Higgins, Stephen T.

2016-01-01

This project compared urban/rural differences in tobacco use, and examined how such differences vary across regions/divisions of the U.S. Using pooled 2012–2013 data from the National Survey on Drug Use and Health (NSDUH), we obtained weighted prevalence estimates for the use of cigarettes, menthol cigarettes, chewing tobacco, snuff, cigars, and pipes. NSDUH also provides information on participants’ residence: rural vs. urban, and Census region and division. Overall, use of cigarettes, chew, and snuff were higher in rural, compared to urban areas. Across all tobacco products, urban/rural differences were particularly pronounced in certain divisions (e.g., the South Atlantic). Effects did not appear to be fully explained by differences in poverty. Going beyond previous research, these findings show that urban/rural differences vary across different types of tobacco products, as well as by division of the country. Results underscore the need for regulatory efforts that will reduce health disparities. PMID:27107746

Temperature and earthworm effects on C and N dynamics in oak stands along an urban-rural land use gradient

Treesearch

R. V. Pouyat; P. M. Groffman; M. M. Carreiro; P. Bohlen; R. W. Parmelee

1996-01-01

In previous studies of an urban-rural land use gradient in the New York City metropolitan area, urban forest soils had higher heavy metal concentrations, soil temperatures, and abundances of earthworms than rural soils, while rural soils had higher abundances of fungi.

Cancer outcomes for Aboriginal and Torres Strait Islander Australians in rural and remote areas.

PubMed

Diaz, Abbey; Whop, Lisa J; Valery, Patricia C; Moore, Suzanne P; Cunningham, Joan; Garvey, Gail; Condon, John R

2015-02-01

To examine the association between residential remoteness and stage of cancer at diagnosis, treatment uptake, and survival within the Australian Indigenous population. Systematic review and matched retrospective cohort study. Australia. Systematic review: published papers that included a comparison of cancer stage at diagnosis, treatment uptake, mortality and/or survival for Indigenous people across remoteness categories were identified (n = 181). Fifteen papers (13 studies) were included in the review. Original analyses: new analyses were conducted using data from the Queensland Indigenous Cancer Study (QICS) comparing cancer stage at diagnosis, treatment uptake, and survival for Indigenous cancer patients living in rural/remote areas (n = 627, 66%) and urban areas (n = 329, 34%). Systematic review: Papers were included if there were related to stage of disease at diagnosis, treatment, mortality and survival of cancer. Restrictions were not placed on the outcome measures reported (e.g. standardised mortality ratios versus crude mortality rates). Original analyses: Odds ratios (OR, 95%CI) were used to compare stage of disease and treatment uptake between the two remoteness groups. Treatment uptake (treated/not treated) was analysed using logistic regression analysis. Survival was analysed using Cox proportional hazards regression. The final multivariate models included stage of cancer at diagnosis and area-level socioeconomic status (SEIFA). Existing evidence of variation in cancer outcomes for Indigenous people in remote compared with metropolitan areas is limited. While no previous studies have reported on differences in cancer stage and treatment uptake by remoteness within the Indigenous population, the available evidence suggests Indigenous cancer patients are less likely to survive their cancer the further they live from urban centres. New analysis of QICS data indicates that Indigenous cancer patients in rural/remote Queensland were less likely to be diagnosed with localised disease and less likely to receive treatment for their cancer compared to their urban counterparts. More research is needed to fully understand geographic differentials in cancer outcomes within the Indigenous population. Knowing how geographical location interacts with Indigenous status can help to identify ways of improving cancer outcomes for Indigenous Australians. © 2015 National Rural Health Alliance Inc.

Rural vs urban hospital performance in a 'competitive' public health service.

PubMed

Garcia-Lacalle, Javier; Martin, Emilio

2010-09-01

In some western countries, market-driven reforms to improve efficiency and quality have harmed the performance of some hospitals, occasionally leading to their closure, mostly in rural areas. This paper seeks to explore whether these reforms affect urban and rural hospitals differently in a European health service. Rural and urban hospital performance is compared taking into account their efficiency and perceived quality. The study is focused on the Andalusian Health Service (SAS) in Spain, which has implemented a freedom of hospital choice policy and a reimbursement system based on hospital performance. Data Envelopment Analysis, the Mann-Whitney U test and Multidimensional Scaling techniques are conducted for two years, 2003 and 2006. The results show that rural and urban hospitals perform similarly in the efficiency dimension, whereas rural hospitals perform significantly better than urban hospitals in the patient satisfaction dimension. When the two dimensions are considered jointly, some rural hospitals are found to be the best performers. As such, market-driven reforms do not necessary result in a difference in the performance of rural and urban hospitals. Copyright 2010 Elsevier Ltd. All rights reserved.

Rural–Urban Differences in Objective and Subjective Measures of Physical Activity: Findings From the National Health and Nutrition Examination Survey (NHANES) 2003–2006

PubMed Central

Wen, Ming; Kowaleski-Jones, Lori

2014-01-01

Introduction Lower levels of physical activity among rural relative to urban residents have been suggested as an important contributor to rural–urban health disparity; however, empirical evidence is sparse. Methods We examined rural–urban differences in 4 objective physical activity measures (2 intensity thresholds by 2 bout lengths) and 4 subjective measures (total, leisure, household, and transportation) in a nationally representative sample of participants in the National Health and Nutrition Examination Survey (NHANES) 2003–2006. The sample comprised 5,056 adults aged 20 to 75 years. Rural-Urban Commuting Area (RUCA) codes were matched with NHANES subjects to identify urban status and 2 types of rural status. Rural–urban and within–rural differences in physical activity were estimated without and with controls for demographic and socioeconomic variables. Results Rural residents were less active than urban residents in high-intensity long bout (2,020 counts per minute threshold and 10 miniutes or longer bout length) accelerometer-measured physical activity (42.5 ± 6.2 min/wk vs 55.9 ± 2.8 min/wk) but the difference disappeared with a lower-intensity threshold (760 counts per minute). Rural residents reported more total physical activity than urban residents (438.3 ± 35.3min/wk vs 371.2 ± 12.5 min/wk), with differences primarily attributable to household physical activity. Within rural areas, micropolitan residents were less active than residents in smaller rural areas. Controlling for other variables reduced the size of the differences. Conclusion The direction and significance of rural–urban difference in physical activity varied by the method of physical activity measurement, likely related to rural residents spending more time in low-intensity household physical activity but less time in high-intensity physical activity. Micropolitan residents were substantially less active than residents in smaller rural areas, indicating that physical activity did not vary unidirectionally with degree of urbanization. PMID:25144676

Metabolic Risk Factors of Type 2 Diabetes Mellitus and Correlated Glycemic Control/Complications: A Cross-Sectional Study between Rural and Urban Uygur Residents in Xinjiang Uygur Autonomous Region.

PubMed

Du, Guo-Li; Su, Yin-Xia; Yao, Hua; Zhu, Jun; Ma, Qi; Tuerdi, Ablikm; He, Xiao-Dong; Wang, Li; Wang, Zhi-Qiang; Xiao, Shan; Wang, Shu-Xia; Su, Li-Ping

2016-01-01

Diabetes is a major global public health problem driven by a high prevalence of metabolic risk factors. To describe the differences of metabolic risk factors of type 2 diabetes, as well as glycemic control and complicated diabetic complications between rural and urban Uygur residents in Xinjiang Uygur Autonomous Region of China. This comparative cross-sectional study, conducted among 2879 urban and 918 rural participants in Xinjiang, China, assessed the metabolic risk factors of diabetes and related complications differences between urban and rural settlements. Compared to rural areas, urban participants had higher education level and more average income, little physical activity, less triglycerides and higher HDL-c (p < 0.05 respectively). Differences in metabolic risk factors by urban/rural residence included overweight or obesity, triglycerides (≥1.71mmol/l), HDL-c (< 1.04 mmol/l), alcohol intake, and physical inactivity (p < 0.01 respectively). There was significant difference regarding the prevalence of HbA1c >8% (48.1% versus 54.5%, p = 0.019) between rural and urban diabetic participants. No significant difference in the prevalence of type 2 diabetic complications between urban and rural participants (74.9% versus 72.2%; p = 0.263) was detected. Compared to rural participants, the most prevalent modifiable risk factors associated with diabetic complications in urban participants were obesity (BMI ≥ 28 Kg/m2), HDL-c (< 1.04 mmol/l), physical inactivity and irregular eating habits (p = 0.035, p = 0.001, p < 0.001, and p = 0.013, respectively). Urban settlers were significantly more likely to have metabolic risk factors highlighting the need for public health efforts to improve health outcomes for these vulnerable populations. Diabetes related complications risk factors were prevalent amongst rural and urban diabetes settlers.

Myths, beliefs and perceptions about mental disorders and health-seeking behavior in Delhi, India

PubMed Central

Kishore, Jugal; Gupta, Avni; Jiloha, Ram Chander; Bantman, Patrick

2011-01-01

Objectives: To assess the myths, beliefs and perceptions about mental disorders and health-seeking behavior in general population and medical professionals of India. Materials and Methods: A cross-sectional study was carried out with a sample of 436 subjects (360 subjects from urban and rural communities of Delhi and 76 medical professionals working in different organizations in Delhi). A pre-tested questionnaire consisting items on perceptions, myths, and beliefs about causes, treatment, and health-seeking behavior for mental disorders was used. The collected data were statistically analyzed using computer software package Epi-info. Appropriate tests of significance were applied to detect any significant association. Results: The mental disorders were thought to be because of loss of semen or vaginal secretion (33.9% rural, 8.6% urban, 1.3% professionals), less sexual desire (23.7% rural, 18% urban), excessive masturbation (15.3% rural, 9.8% urban), God's punishment for their past sins (39.6% rural, 20.7% urban, 5.2% professionals), and polluted air (51.5% rural, 11.5% urban, 5.2% professionals). More people (37.7%) living in joint families than in nuclear families (26.5%) believed that sadness and unhappiness cause mental disorders. 34.8% of the rural subjects and 18% of the urban subjects believed that children do not get mental disorders, which means they have conception of adult-oriented mental disorders. 40.2% in rural areas, 33.3% in urban areas, and 7.9% professionals believed that mental illnesses are untreatable. Many believed that psychiatrists are eccentric (46.1% rural, 8.4% urban, 7.9% professionals), tend to know nothing, and do nothing (21.5% rural, 13.7% urban, 3.9% professionals), while 74.4% of rural subjects, 37.1% of urban subjects, and 17.6% professionals did not know that psychiatry is a branch of medicine. More people in rural areas than in urban area thought that keeping fasting or a faith healer can cure them from mental illnesses, whereas 11.8% of medical professionals believed the same. Most of the people reported that they liked to go to someone close who could listen to their problems, when they were sad and anxious. Only 15.6% of urban and 34.4% of the rural population reported that they would like to go to a psychiatrist when they or their family members are suffering from mental illness. Conclusion: It can be concluded from this study that the myths and misconceptions are significantly more prevalent in rural areas than in urban areas and among medical professionals, and the people need to be communicated to change their behavior and develop a positive attitude toward mental disorders so that health-seeking behavior can improve. PMID:22303041

The use of NOAA AVHRR data for assessment of the urban heat sland effect

USGS Publications Warehouse

Gallo, K.P.; McNab, A. L.; Karl, Thomas R.; Brown, Jesslyn F.; Hood, J. J.; Tarpley, J.D.

1993-01-01

A vegetation index and a radiative surface temperature were derived from satellite data acquired at approximately 1330 LST for each of 37 cities and for their respective nearby rural regions from 28 June through 8 August 1991. Urban–rural differences for the vegetation index and the surface temperatures were computed and then compared to observed urban–rural differences in minimum air temperatures. The purpose of these comparisons was to evaluate the use of satellite data to assess the influence of the urban environment on observed minimum air temperatures (the urban heat island effect). The temporal consistency of the data, from daily data to weekly, biweekly, and monthly intervals, was also evaluated. The satellite-derived normalized difference (ND) vegetation-index data, sampled over urban and rural regions composed of a variety of land surface environments, were linearly related to the difference in observed urban and rural minimum temperatures. The relationship between the ND index and observed differences in minimum temperature was improved when analyses were restricted by elevation differences between the sample locations and when biweekly or monthly intervals were utilized. The difference in the ND index between urban and rural regions appears to be an indicator of the difference in surface properties (evaporation and heat storage capacity) between the two environments that are responsible for differences in urban and rural minimum temperatures. The urban and rural differences in the ND index explain a greater amount of the variation observed in minimum temperature differences than past analyses that utilized urban population data. The use of satellite data may contribute to a globally consistent method for analysis of urban heat island bias.

Disparities in Prevalence of Cardiometablic Risk Factors in Rural, Urban-Poor, and Urban-Middle Class Women in India.

PubMed

Mohan, Indu; Gupta, Rajeev; Misra, Anoop; Sharma, Krishna Kumar; Agrawal, Aachu; Vikram, Naval K; Sharma, Vinita; Shrivastava, Usha; Pandey, Ravindra M

2016-01-01

Urbanization is an important determinant of cardiovascular disease (CVD) risk. To determine location-based differences in CVD risk factors in India we performed studies among women in rural, urban-poor and urban middle-class locations. Population-based cross-sectional studies in rural, urban-poor, and urban-middle class women (35-70 y) were performed at multiple sites. We evaluated 6853 women (rural 2616, 5 sites; urban-poor 2008, 4 sites; urban middle-class 2229, 11 sites) for socioeconomic, lifestyle, anthropometric and biochemical risk factors. Descriptive statistics are reported. Mean levels of body mass index (BMI), waist circumference, waist-hip ratio (WHR), systolic BP, fasting glucose and cholesterol in rural, urban-poor and urban-middle class women showed significantly increasing trends (ANOVAtrend, p <0.001). Age-adjusted prevalence of diabetes and risk factors among rural, urban-poor and urban-middle class women, respectively was, diabetes (2.2, 9.3, 17.7%), overweight BMI ≥25 kg/m2 (22.5, 45.6, 57.4%), waist >80 cm (28.3, 63.4, 61.9%), waist >90 cm (8.4, 31.4, 38.2%), waist hip ratio (WHR) >0.8 (60.4, 90.7, 88.5), WHR>0.9 (13.0, 44.3, 56.1%), hypertension (31.6, 48.2, 59.0%) and hypercholesterolemia (13.5, 27.7, 37.4%) (Mantel Haenszel X2 ptrend <0.01). Inverse trend was observed for tobacco use (41.6, 19.6, 9.4%). There was significant association of hypertension, hypercholesterolemia and diabetes with overweight and obesity (adjusted R2 0.89-0.99). There are significant location based differences in cardiometabolic risk factors in India. The urban-middle class women have the highest risk compared to urban-poor and rural.

Disparities in Prevalence of Cardiometablic Risk Factors in Rural, Urban-Poor, and Urban-Middle Class Women in India

PubMed Central

Mohan, Indu; Gupta, Rajeev; Misra, Anoop; Sharma, Krishna Kumar; Agrawal, Aachu; Vikram, Naval K.; Sharma, Vinita; Shrivastava, Usha; Pandey, Ravindra M.

2016-01-01

Objective Urbanization is an important determinant of cardiovascular disease (CVD) risk. To determine location-based differences in CVD risk factors in India we performed studies among women in rural, urban-poor and urban middle-class locations. Methods Population-based cross-sectional studies in rural, urban-poor, and urban-middle class women (35–70y) were performed at multiple sites. We evaluated 6853 women (rural 2616, 5 sites; urban-poor 2008, 4 sites; urban middle-class 2229, 11 sites) for socioeconomic, lifestyle, anthropometric and biochemical risk factors. Descriptive statistics are reported. Results Mean levels of body mass index (BMI), waist circumference, waist-hip ratio (WHR), systolic BP, fasting glucose and cholesterol in rural, urban-poor and urban-middle class women showed significantly increasing trends (ANOVAtrend, p <0.001). Age-adjusted prevalence of diabetes and risk factors among rural, urban-poor and urban-middle class women, respectively was, diabetes (2.2, 9.3, 17.7%), overweight BMI ≥25 kg/m2 (22.5, 45.6, 57.4%), waist >80 cm (28.3, 63.4, 61.9%), waist >90 cm (8.4, 31.4, 38.2%), waist hip ratio (WHR) >0.8 (60.4, 90.7, 88.5), WHR>0.9 (13.0, 44.3, 56.1%), hypertension (31.6, 48.2, 59.0%) and hypercholesterolemia (13.5, 27.7, 37.4%) (Mantel Haenszel X2 ptrend <0.01). Inverse trend was observed for tobacco use (41.6, 19.6, 9.4%). There was significant association of hypertension, hypercholesterolemia and diabetes with overweight and obesity (adjusted R2 0.89–0.99). Conclusions There are significant location based differences in cardiometabolic risk factors in India. The urban-middle class women have the highest risk compared to urban-poor and rural. PMID:26881429

Canine parvovirus in Australia: A comparative study of reported rural and urban cases.

PubMed

Zourkas, Elaine; Ward, Michael P; Kelman, Mark

2015-12-31

Canine parvovirus (CPV) is a highly contagious and often fatal disease reported worldwide. Outbreaks occur throughout Australia, and it has been suggested that disproportionally more CPV cases occur in rural locations. However, evidence to support this suggestion-and possible reasons for such a predisposition-has not existed until now. In this study a total of 4870 CPV cases reported from an Australian disease surveillance system between September 2009 and July 2014 were analysed. Australian postcodes were classified as rural or urban (based on human population density) and reported CPV cases were then categorised as rural or urban based on their reported home postcode. Parvovirus cases were predominately young (<12 months), entire, unvaccinated, mixed-breed dogs. More than twice as many of the reported cases were from a rural area (3321 cases) compared to an urban area (1549 cases). The overall case fatality rate was 47.2%; it was higher for those CPV cases reported from urban areas (50.6%) than rural areas (45.5%). A greater proportion of rural cases were younger, entire dogs compared to urban cases. The final multivariable model of CPV cases being reported from a rural area included age (<12 months) and vaccination status (never vaccinated) as significant predictors. Poor socioeconomic status might be a reason for the decision of rural owners not to vaccinate their dogs as readily as urban owners. The excess reporting of rural CPV cases compared to urban cases and the predictive risk factors identified in this study can be used by veterinarians to reduce the incidence of CPV by educating owners about the disease and promoting better vaccination programs in rural areas. This study also supports that the increased risk of CPV in rural areas may necessitate a need for increased vigilance around preventing CPV disease spread, additional care with puppies which are the most susceptible to this disease and tighter vaccination protocols, compared to urban areas. Copyright © 2015 Elsevier B.V. All rights reserved.

How rural and urban parents describe convenience in the context of school-based influenza vaccination: a qualitative study.

PubMed

Lind, Candace; Russell, Margaret L; Collins, Ramona; MacDonald, Judy; Frank, Christine J; Davis, Amy E

2015-01-22

Seasonal influenza vaccine uptake among school-age children has been low, particularly among rural children, even in jurisdictions in Canada where this immunization is publicly funded. Providing this vaccination at school may be convenient for parents and might contribute to increased vaccine uptake, particularly among rural children. We explore the construct of convenience as an advantage of school based influenza vaccination. We also explore for rural urban differences in this construct. Participants were parents of school-aged children from Alberta, Canada. We qualitatively analyzed focus group data from rural parents using a thematic template that emerged from prior work with urban parents. Both groups of parents had participated in focus groups to explore their perspectives on the acceptability of adding an annual influenza immunization to the immunization program that is currently delivered in Alberta schools. Data from within the theme of 'convenience' from both rural and urban parents were then further explored for sub-themes within convenience. Data were obtained from nine rural and nine urban focus groups. The template of themes that had arisen from prior analysis of the urban data applied to the rural data. Convenience was a third level theme under Advantages. Five fourth level themes emerged from within convenience. Four of the five sub-themes were common to both rural and urban participants: reduction of parental burden to schedule, reduction in parental lost time, decrease in parental stress and increase in physical access points for influenza immunization. The fifth subtheme, increases temporal access to influenza immunization, emerged uniquely from the rural data. Both rural and urban parents perceived that convenience would be an advantage of adding an annual influenza immunization to the vaccinations currently given to Alberta children at school. Improving temporal access to such immunization may be a more relevant aspect of convenience to rural than to urban parents.

Trends in childhood mortality in Kenya: the urban advantage has seemingly been wiped out.

PubMed

Kimani-Murage, E W; Fotso, J C; Egondi, T; Abuya, B; Elungata, P; Ziraba, A K; Kabiru, C W; Madise, N

2014-09-01

We describe trends in childhood mortality in Kenya, paying attention to the urban-rural and intra-urban differentials. We use data from the Kenya Demographic and Health Surveys (KDHS) collected between 1993 and 2008 and the Nairobi Urban Health and Demographic Surveillance System (NUHDSS) collected in two Nairobi slums between 2003 and 2010, to estimate infant mortality rate (IMR), child mortality rate (CMR) and under-five mortality rate (U5MR). Between 1993 and 2008, there was a downward trend in IMR, CMR and U5MR in both rural and urban areas. The decline was more rapid and statistically significant in rural areas but not in urban areas, hence the gap in urban-rural differentials narrowed over time. There was also a downward trend in childhood mortality in the slums between 2003 and 2010 from 83 to 57 for IMR, 33 to 24 for CMR, and 113 to 79 for U5MR, although the rates remained higher compared to those for rural and non-slum urban areas in Kenya. The narrowing gap between urban and rural areas may be attributed to the deplorable living conditions in urban slums. To reduce childhood mortality, extra emphasis is needed on the urban slums. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Palliative care costs in Canada: A descriptive comparison of studies of urban and rural patients near end of life.

PubMed

Dumont, Serge; Jacobs, Philip; Turcotte, Véronique; Turcotte, Stéphane; Johnston, Grace

2015-12-01

Significant gaps in the evidence base on costs in rural communities in Canada and elsewhere are reported in the literature, particularly regarding costs to families. However, it remains unclear whether the costs related to all resources used by palliative care patients in rural areas differ to those resources used in urban areas. The study aimed to compare both the costs that occurred over 6 months of participation in a palliative care program and the sharing of these costs in rural areas compared with those in urban areas. Data were drawn from two prior studies performed in Canada, employing a longitudinal, prospective design with repeated measures. The urban sample consisted of 125 patients and 127 informal caregivers. The rural sample consisted of 80 patients and 84 informal caregivers. Most patients in both samples had advanced cancer. The mean total cost per patient was CAD 26,652 in urban areas, while it was CAD 31,018 in rural areas. The family assumed 20.8% and 21.9% of costs in the rural and urban areas, respectively. The rural families faced more costs related to prescription medication, out-of-pocket costs, and transportation while the urban families faced more costs related to formal home care. Despite the fact that rural and urban families assumed a similar portion of costs, the distribution of these costs was somewhat different. Future studies would be needed to gain a better understanding of the dynamics of costs incurred by families taking care of a loved one at the end of life and the determinants of these costs in urban versus rural areas. © The Author(s) 2015.

Reported health, lifestyle and clinical manifestations associated with HIV status in people from rural and urban communities in the Free State Province, South Africa.

PubMed

Pienaar, Michélle; van Rooyen, Francois C; Walsh, Corinna M

2017-01-01

HIV infection impacts heavily on the infected individual's overall health status. To determine significant health, lifestyle (smoking and alcohol use) and independent clinical manifestations associated with HIV status in rural and urban communities. Adults aged between 25 and 64 years completed a questionnaire in a structured interview with each participant. Blood specimens were analysed in an accredited laboratory using standard techniques and controls. Anthropometric measurements were determined using standardised methods. Of the 567 rural participants, 97 (17.1%) were HIV-infected, and 172 (40.6%) of the 424 urban participants. More than half of HIV-infected rural participants used alcohol and more than 40% smoked. Median body mass index (BMI) of HIV-infected participants was lower than that of uninfected participants. Significantly more HIV-infected participants reported experiencing cough (rural), skin rash (urban), diarrhoea (rural and urban), vomiting (rural), loss of appetite (urban) and involuntary weight loss (rural). Significantly more HIV-uninfected participants reported diabetes mellitus (urban) and high blood pressure (rural and urban). In rural areas, HIV infection was positively associated with losing weight involuntarily (odds ratio 1.86), ever being diagnosed with tuberculosis (TB) (odds ratio 2.50) and being on TB treatment (odds ratio 3.29). In the urban sample, HIV infection was positively associated with having diarrhoea (odds ratio 2.04) and ever being diagnosed with TB (odds ratio 2.49). Involuntary weight loss and diarrhoea were most likely to predict the presence of HIV. In addition, present or past diagnosis of TB increased the odds of being HIV-infected. Information related to diarrhoea, weight loss and TB is easy to obtain from patients and should prompt healthcare workers to screen for HIV.

Analysis of Urban-Rural Land-Use Change during 1995-2006 and Its Policy Dimensional Driving Forces in Chongqing, China

PubMed Central

Long, Hualou; Wu, Xiuqin; Wang, Wenjie; Dong, Guihua

2008-01-01

This paper analyzes the urban-rural land-use change of Chongqing and its policy dimensional driving forces from 1995 to 2006, using high-resolution Landsat TM (Thematic Mapper) data of 1995, 2000 and 2006, and socio-economic data from both research institutes and government departments. The outcomes indicated that urban-rural land-use change in Chongqing can be characterized by two major trends: First, the non-agricultural land increased substantially from 1995 to 2006, thus causing agricultural land especially farmland to decrease continuously. Second, the aggregation index of urban settlements and rural settlements shows that local urban-rural development experienced a process of changing from aggregation (1995-2000) to decentralization (2000-2006). Chongqing is a special area getting immersed in many important policies, which include the establishment of the municipality directly under the Central Government, the building of Three Gorges Dam Project, the Western China Development Program and the Grain-for-Green Programme, and bring about tremendous influences on its land-use change. By analyzing Chongqing's land-use change and its policy driving forces, some implications for its new policy of ‘Urban-rural Integrated Reform’ are obtained. That is more attentions need to be paid to curbing excessive and idle rural housing and consolidating rural construction land, and to laying out a scientific land-use plan for its rural areas taking such rural land-use issues as farmland occupation and rural housing land management into accounts, so as to coordinate and balance the urban-rural development. PMID:27879729

Comparison of dietary habits in the urban and rural Croatian schoolchildren.

PubMed

Colić-Barić, Irena; Kajfez, Romana; Satalić, Zvonimir; Cvjetić, Selma

2004-06-01

Post-war socio-economic changes in Croatia probably affected dietary habits, and dietary data about schoolchildren after the war are missing. The aim of the study was to compare current nutrient intakes and dietary behavior between urban and rural schoolchildren in Croatia. A completely quantified Food Frequency Questionnaire was used. Subjects were 315 urban and 163 rural schoolchildren. Mean age was 12.5 and 12.6 years in the urban and rural area, respectively. Consumption of fast food, soft drinks and alcohol was more prevalent and more linked with dietary behavior in the urban than in the rural area. In both living areas protein intake was excessive (in the urban area 38.1% of subjects and in the rural 36.2% of subjects had protein intake higher than 200% RDA). Under 75% RDA/DRI in both living areas was observed for vitamin D, folate, calcium and selenium. Micronutrient intakes negatively correlated with age in both living areas, but were more pronounced in the urban area. The urban sample had more adequate energy and nutrient intakes which is consistent with prewar findings.

Seizures, cysticercosis and rural-to-urban migration: the PERU MIGRANT study.

PubMed

Gonzales, Isidro; Miranda, J Jaime; Rodriguez, Silvia; Vargas, Victor; Cjuno, Alfredo; Smeeth, Liam; Gonzalez, Armando E; Tsang, Victor C W; Gilman, Robert H; Garcia, Hector H

2015-04-01

To examine the prevalence of seizures, epilepsy and seropositivity to cysticercosis in rural villagers (cysticercosis-endemic setting), rural-to-urban migrants into a non-endemic urban shanty town and urban inhabitants of the same non-endemic shanty town. Three Peruvian populations (n = 985) originally recruited into a study about chronic diseases and migration were studied. These groups included rural inhabitants from an endemic region (n = 200), long-term rural-to-urban migrants (n = 589) and individuals living in the same urban setting (n = 196). Seizure disorders were detected by a survey, and a neurologist examined positive respondents. Serum samples from 981/985 individuals were processed for cysticercosis antibodies on immunoblot. Epilepsy prevalence (per 1000 people) was 15.3 in the urban group, 35.6 in migrants and 25 in rural inhabitants. A gradient in cysticercosis antibody seroprevalence was observed: urban 2%, migrant 13.5% and rural group 18% (P < 0.05). A similarly increasing pattern of higher seroprevalence was observed among migrants by age at migration. In rural villagers, there was strong evidence of an association between positive serology and having seizures (P = 0.011) but such an association was not observed in long-term migrants or in urban residents. In the entire study population, compared with seronegative participants, those with strong antibody reactions (≥ 4 antibody bands) were more likely to have epilepsy (P < 0.001). It is not only international migration that affects cysticercosis endemicity; internal migration can also affect patterns of endemicity within an endemic country. The neurological consequences of cysticercosis infection likely outlast the antibody response for years after rural-to-urban migration. © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

A prediction of the trend of population development in urban and rural areas in China.

PubMed

Hu, Y

1998-01-01

This study predicts trends in population growth, urbanization, and age structure in China. Data were obtained from the 1990 Census. Population totaled 1.22 billion at the end of 1996. The fertility model predicts future fertility by variant and parity; parameters are provided in a table. High, medium, and low fertility variants, respectively, are based on the total regressive fertility rates (TRFR) of 2.23, 1.9, and 1.6. The medium variant assumes 2 children in rural areas. The low variant is ideal and assumes no third parity in rural areas. Urbanization means an annual average increase of 0.5% after 1996 at pace I and 0.8% at pace II. Urban population will be 57.8% of total population by 2050. Under these three variants, population size in 2000 will be 898 million in rural and 403 million in urban areas, 869 million in rural and 400 million in urban areas, and 856 million in rural and 398 million in urban areas, respectively. Population will peak at 1.7 billion in 2050, at 1.48 billion in 2033, and at 1.38 billion in 2023, respectively. During the period 2000-2020, about 10-14 million rural migrants will move to urban areas; 10 million will move thereafter. The elderly aged over 60 years will reach 7% by 2000 and 20% by 2040. Rural population will age faster than urban population. The working age population will reach 775 million in 2000, peak at 868 million in 2016, and will always be over 60% of total population. School-age population will amount to over 300 million by 2030. Young population will always be more than 25% in rural areas, which is nearly 17 percentage points higher than in urban areas.

Examining Rural/Urban Differences in Prescription Opioid Misuse Among U.S. Adolescents

PubMed Central

Monnat, Shannon M.; Rigg, Khary K.

2015-01-01

Purpose This study examines differences in prescription opioid misuse (POM) among adolescents in rural, small urban and large urban areas of the US and identifies several individual, social, and community risk factors contributing to those differences. Methods We used nationally representative data from the 2011 and 2012 National Survey on Drug Use and Health (NSDUH) and estimated binary logistic regression and formal mediation models to assess past-year POM among 32,036 adolescents aged 12–17. Results Among adolescents, 6.8% of rural, 6.0% of small urban, and 5.3% of large urban engaged in past-year POM. Net of multiple risk and protective factors, rural adolescents have 35% greater odds and small urban adolescents have 21% greater odds of past-year POM compared to large urban adolescents. The difference between rural and small urban adolescents was not significant. Criminal activity, lower perceived substance use risk, and greater use of emergency medical treatment partially contribute to higher odds among rural adolescents, but they are also partially buffered by less peer substance use, less illicit drug access, and stronger religious beliefs. Conclusions Researchers, policy makers, and treatment providers must consider the complex array of individual, social, and community risk and protective factors to understand rural/urban differences in adolescent POM. Potential points of intervention to prevent POM in general and reduce rural disparities include early education about addiction risks, use of family drug courts to link criminal offenders to treatment, and access to non-emergency medical services to reduce rural residents’ reliance on emergency departments where opioid prescribing is more likely. PMID:26344571

Rural versus urban academic hospital mortality following stroke in Canada

PubMed Central

Turcotte, Stéphane; Légaré, France; Plant, Jeff; Poitras, Julien; Archambault, Patrick M.; Dupuis, Gilles

2018-01-01

Introduction Stroke is one of the leading causes of death in Canada. While stroke care has improved dramatically over the last decade, outcomes following stroke among patients treated in rural hospitals have not yet been reported in Canada. Objectives To describe variation in 30-day post-stroke in-hospital mortality rates between rural and urban academic hospitals in Canada. We also examined 24/7 in-hospital access to CT scanners and selected services in rural hospitals. Materials and methods We included Canadian Institute for Health Information (CIHI) data on adjusted 30-day in-hospital mortality following stroke from 2007 to 2011 for all acute care hospitals in Canada excluding Quebec and the Territories. We categorized rural hospitals as those located in rural small towns providing 24/7 emergency physician coverage with inpatient beds. Urban hospitals were academic centres designated as Level 1 or 2 trauma centres. We computed descriptive data on local access to a CT scanner and other services and compared mean 30-day adjusted post-stroke mortality rates for rural and urban hospitals to the overall Canadian rate. Results A total of 286 rural hospitals (3.4 million emergency department (ED) visits/year) and 24 urban hospitals (1.5 million ED visits/year) met inclusion criteria. From 2007 to 2011, 30-day in-hospital mortality rates following stroke were significantly higher in rural than in urban hospitals and higher than the Canadian average for every year except 2008 (rural average range = 18.26 to 21.04 and urban average range = 14.11 to 16.78). Only 11% of rural hospitals had a CT-scanner, 1% had MRI, 21% had in-hospital ICU, 94% had laboratory and 92% had basic x-ray facilities. Conclusion Rural hospitals in Canada had higher 30-day in-hospital mortality rates following stroke than urban academic hospitals and the Canadian average. Rural hospitals also have very limited local access to CT scanners and ICUs. These rural/urban discrepancies are cause for concern in the context of Canada’s universal health care system. PMID:29385173

Subjective well-being amongst migrant children in China: unravelling the roles of social support and identity integration.

PubMed

Ni, S; Chui, C H-K; Ji, X; Jordan, L; Chan, C L-W

2016-09-01

Migrant children refer to rural children who accompany one or both parents to urban area. Empirical evidence showed that compared with their urban counterparts, migrant children had poorer developmental, emotional and psychological health. A sample of 1306 migrant children were recruited to examine the characteristics of migrant children and investigate the effects of identity integration, support and socioeconomic factors (e.g. age, gender, type of school, family socioeconomic status, city type) on their subjective wellbeing. Children with higher levels of identity integration, social support, family socioeconomic status, who attended public school and who lived in the third-tiered city of Weihai demonstrated better subjective wellbeing. Social support remained a strong predictor for subjective wellbeing, despite a significant mediating effect of identity integration. These results highlight the need for policymakers and practitioners alike to address individual factors pertaining to psychological adjustments, as well as social determinants of subjective wellbeing in the context of migration. © 2016 John Wiley & Sons Ltd.

Prevalence of Overweight and Obesity among Children and Adolescents in Shandong, China: Urban-Rural Disparity.

PubMed

Zhang, Ying-Xiu; Wang, Zhao-Xia; Zhao, Jin-Shan; Chu, Zun-Hua

2016-08-01

The pattern of urban-rural disparity in childhood obesity varies across countries. The present study examined the change trend of urban-rural disparity in childhood overweight and obesity from 1985 to 2014 in Shandong, China. Data for this study were obtained from four cross-sectional surveys of school children carried out in 1985, 1995, 2005 and 2014 in Shandong Province, China. In this study, 39 943 students aged 7-18 years were included (14 458 in 1985, 7198 in 1995, 8568 in 2005 and 9719 in 2014). Height and weight of all subjects were measured; body mass index (BMI) was calculated from their height and weight. The BMI cutoff points recommended by the International Obesity Task Force were used to define overweight and obesity. The prevalence of overweight and obesity was increasing continuously both in urban and rural areas over the past 29 years (1985-2014). The prevalence of combined overweight and obesity was significantly higher in urban than in rural children and adolescents in 1985, 1995 and 2005 (p < 0.01). However, a rapid increase in the prevalence of combined overweight and obesity was observed in rural areas after 2005; as a result, the urban-rural disparity was getting narrower, and no significant urban-rural disparity was observed in 2014 (p > 0.05). The change trend of urban-rural disparity should be concerned in the future; policies and interventions focused on childhood overweight and obesity should pay attention to rural areas. © The Author [2016]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

[Prevalence of cardiovascular risk factors in urban and rural communities in the Wilaya of Tlemcen (Algeria): A comparative study].

PubMed

Boukli Hacène, L; Khelil, M-A; Chabane Sari, D; Meguenni, K; Meziane Tani, A

2017-08-01

In Algeria, few studies have been conducted to determine the prevalence of genetic and environmental risk factors of cardiovascular diseases as a function of residence. The objective of this study was therefore to determine the prevalence of cardiovascular risk factors according to sex and age in urban and rural communities in the Wilaya of Tlemcen (Algeria). A population survey was conducted on a representative sample of 864 individuals aged 20years and over, among inhabitants in urban and rural communes in the Wilaya of Tlemcen. Each subject answered the questionnaire on cardiovascular risk factors, underwent a physical examination and had a blood sample drawn. The prevalence of hypercholesterolemia was 6.6%, it was found to be higher in urban areas (8.4%) than in rural areas (4.6%). The prevalence of low HDL cholesterol levels was higher in urban (28.8%) than rural (23.9%) areas. The prevalence of family history of cardiovascular disease did not differ between the two sexes and between urban (15.7%) and rural (14.0%) areas. The prevalence of hypertension was higher in urban (28.0%) than in rural (16.8%) areas, and was highest among women aged 65 years or older in urban areas (67.3%) and in rural areas (66.6%). The prevalence of diabetes was higher among women living in urban areas (21.4%) compared with rural areas (15.4%). Obesity was much more frequent among women than among men in urban areas (24.7% in women and 9.5% in men) and in rural areas (28.3% in women and 8.3% in men). The prevalence of smoking was 45.8% for men and with no significant variations between urban areas and rural areas. The prevalence of cardiovascular risk factors according to sex and age in the two communes are high in two communes in the Wilaya of Tlemcen. However, the prevalence of hypertension, hypercholesterolemia and diabetes were higher in women in urban than in rural areas. This finding focuses attention on the need for measures to reduce the prevalence of these cardiovascular risk factors in these communities. Factors such as sex age and area of residence are indicators to consider when targeting interventions. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

A management-orientated comparative analysis of urban and rural anglers living in a metropolis (Berlin, Germany).

PubMed

Arlinghaus, Robert; Mehner, Thomas

2004-03-01

Increased efforts to analyze the human dimensions of anglers are necessary to improve freshwater fisheries management. This paper is a comparative analysis of urban and rural anglers living in a metropolis, based on n = 1061 anglers responding to a mail survey in the German capital of Berlin. More than two thirds of the anglers (71%) had spent most (>50%) of their effort outside the city borders of Berlin and thus were categorized as rural anglers. Compared to the rural anglers, urban anglers (>/=50% of total effort spent inside the city) were younger and less educated. Urban anglers were more avid and committed, less mobile, and more frequently fished from boats and during weekdays. Rural anglers were more experienced, fished for longer times per trip, fished more often at weekends and on holidays, were more often members of angling clubs, and more frequently caught higher valued fish species. The achievement and fish quantity aspects of the angling experience were more important for urban than for rural anglers. Concerning management options, urban anglers more frequently suggested constraining other stakeholders and reducing regulations, whereas rural anglers more often proposed improving physical access to angling sites. Future urban fishing programs should offer ease of access, connection to public transportation, moderate prices, and diverse piscivorous fish stocks. In contrast to rural fisheries, the provision of high ecological and aesthetical quality of the angling waters can be regarded as of minor importance in urban fisheries. Rural fisheries managers need to consider the needs of stakeholders living in Berlin to minimize impacts on the less degraded rural water bodies and potential user conflicts with resident anglers. Ecosystem-based management approaches should guide rural fisheries policy.

Exploring Diet Quality between Urban and Rural Dwelling Women of Reproductive Age

PubMed Central

Martin, Julie C.; Moran, Lisa J.; Teede, Helena J.; Ranasinha, Sanjeeva; Lombard, Catherine B.; Harrison, Cheryce L.

2017-01-01

Health disparities, including weight gain and obesity exist between urban and rural dwelling women. The primary aim was to compare diet quality in urban and rural women of reproductive age, and secondary analyses of the difference in macronutrient and micronutrient intake in urban and rural women, and the predictors of diet quality. Diet quality was assessed in urban (n = 149) and rural (n = 394) women by a modified version of the Dietary Guideline Index (DGI) energy, macronutrient and micronutrient intake from a food frequency questionnaire (FFQ) and predictors of diet quality. Diet quality did not significantly differ between urban and rural women (mean ± standard deviation (SD), 84.8 ± 15.9 vs. 83.9 ± 16.5, p = 0.264). Rural women reported a significantly higher intake of protein, fat, saturated fat, monounsaturated fat, cholesterol and iron and a higher score in the meat and meat alternatives component of the diet quality tool in comparison to urban women. In all women, a higher diet quality was associated with higher annual household income (>$Australian dollar (AUD) 80,000 vs. <$AUD80,000 p = 0.013) and working status (working fulltime/part-time vs. unemployed p = 0.043). Total diet quality did not differ in urban and rural women; however, a higher macronutrient consumption pattern was potentially related to a higher lean meat intake in rural women. Women who are unemployed and on a lower income are an important target group for future dietary interventions aiming to improve diet quality. PMID:28594351

Exploring Diet Quality between Urban and Rural Dwelling Women of Reproductive Age.

PubMed

Martin, Julie C; Moran, Lisa J; Teede, Helena J; Ranasinha, Sanjeeva; Lombard, Catherine B; Harrison, Cheryce L

2017-06-08

Health disparities, including weight gain and obesity exist between urban and rural dwelling women. The primary aim was to compare diet quality in urban and rural women of reproductive age, and secondary analyses of the difference in macronutrient and micronutrient intake in urban and rural women, and the predictors of diet quality. Diet quality was assessed in urban ( n = 149) and rural ( n = 394) women by a modified version of the Dietary Guideline Index (DGI) energy, macronutrient and micronutrient intake from a food frequency questionnaire (FFQ) and predictors of diet quality. Diet quality did not significantly differ between urban and rural women (mean ± standard deviation (SD), 84.8 ± 15.9 vs. 83.9 ± 16.5, p = 0.264). Rural women reported a significantly higher intake of protein, fat, saturated fat, monounsaturated fat, cholesterol and iron and a higher score in the meat and meat alternatives component of the diet quality tool in comparison to urban women. In all women, a higher diet quality was associated with higher annual household income (>$Australian dollar (AUD) 80,000 vs. <$AUD80,000 p = 0.013) and working status (working fulltime/part-time vs. unemployed p = 0.043). Total diet quality did not differ in urban and rural women; however, a higher macronutrient consumption pattern was potentially related to a higher lean meat intake in rural women. Women who are unemployed and on a lower income are an important target group for future dietary interventions aiming to improve diet quality.

Location and Lifestyle: The Comparative Explanatory Ability of Urbanism and Rurality

ERIC Educational Resources Information Center

Lowe, George D.; Peek, Charles W.

1974-01-01

The article focuses on 2 questions pivotal to the issue of rural-urban differences: 1) "Do attitudinal differences remain among the rural and urban residents independent of differences generated by other potent variables?"; and 2) "Will any increase in the predictive utility of rurality be generated by use of a composite definition (residence plus…

Working Memory Differences between Children Living in Rural and Urban Poverty

ERIC Educational Resources Information Center

Tine, Michele

2014-01-01

This study was designed to investigate if the working memory profiles of children living in rural poverty are distinct from the working memory profiles of children living in urban poverty. Verbal and visuospatial working memory tasks were administered to sixth-grade students living in low-income rural, low-income urban, high-income rural, and…

Current Use of E-Cigarettes and Conventional Cigarettes Among US High School Students in Urban and Rural Locations: 2014 National Youth Tobacco Survey.

PubMed

Noland, Melody; Rayens, Mary Kay; Wiggins, Amanda T; Huntington-Moskos, Luz; Rayens, Emily A; Howard, Tiffany; Hahn, Ellen J

2017-01-01

Adolescent tobacco use is higher in rural than in urban areas. While e-cigarette use is increasing rapidly among this age group, differences in prevalence between rural versus urban populations for this relatively novel product have not been explored. The purpose is to investigate whether location of school (rural-urban) is associated with e-cigarette use and dual use (defined as the use of both e-cigarettes and conventional cigarettes) among high school students. Cross-sectional survey obtained using a stratified, 3-stage cluster sample design. United States. A nationally representative sample of US high school students (N = 11 053) who completed the 2014 National Youth Tobacco Survey (NYTS); slightly more than half were urban (54%). The NYTS measures tobacco-related knowledge, attitudes, and use behavior and demographics of students in the United States. Weighted logistic regression assessed the relationships of urban-rural location with current e-cigarette use and dual use, adjusting for demographic factors, perceived risk, and social norms. There were clear differences in patterns of adolescent e-cigarette and cigarette use in rural versus urban areas. Social norms and perceptions may play a role in understanding these differences. Urban youth current cigarette smokers were nearly twice as likely as rural cigarette smokers to also use e-cigarettes. Reasons for urban-rural differences need to be taken into account when designing prevention programs and policy changes.

Buzz in Paris: flower production and plant-pollinator interactions in plants from contrasted urban and rural origins.

PubMed

Desaegher, James; Nadot, Sophie; Dajoz, Isabelle; Colas, Bruno

2017-12-01

Urbanisation, associated with habitat fragmentation, affects pollinator communities and insect foraging behaviour. These biotic changes are likely to select for modified traits in insect-pollinated plants from urban populations compared to rural populations. To test this hypothesis, we conducted an experiment involving four plant species commonly found in both urban and rural landscapes of the Île-de-France region (France): Cymbalaria muralis, Geranium robertianum, Geum urbanum and Prunella vulgaris. The four species were grown in four urban and four rural experimental sites in 2015. For each species and each experimental site, plants were grown from seeds collected in five urban and five rural locations. During flowering, we observed flower production and insect-flower interactions during 14 weeks and tested for the effects of experimental site location and plant origin on flower production and on the number of floral visits. The study species had various flower morphology and hence were visited by different floral visitors. The effect of experimental sites and seed origin also varied among study species. We found that (1) insect visits on P. vulgaris were more frequent in rural than in urban sites; (2) for C. muralis, the slope relating the number of pollinator visits to the number of flowers per individual was steeper in urban versus rural sites, suggesting a greater benefit in allocating resources to flower production in urban conditions; (3) as a likely consequence, C. muralis tended to produce more flowers in plants from urban versus rural origin.

Sociospatial distribution of access to facilities for moderate and vigorous intensity physical activity in Scotland by different modes of transport

PubMed Central

2012-01-01

Background People living in neighbourhoods of lower socioeconomic status have been shown to have higher rates of obesity and a lower likelihood of meeting physical activity recommendations than their more affluent counterparts. This study examines the sociospatial distribution of access to facilities for moderate or vigorous intensity physical activity in Scotland and whether such access differs by the mode of transport available and by Urban Rural Classification. Methods A database of all fixed physical activity facilities was obtained from the national agency for sport in Scotland. Facilities were categorised into light, moderate and vigorous intensity activity groupings before being mapped. Transport networks were created to assess the number of each type of facility accessible from the population weighted centroid of each small area in Scotland on foot, by bicycle, by car and by bus. Multilevel modelling was used to investigate the distribution of the number of accessible facilities by small area deprivation within urban, small town and rural areas separately, adjusting for population size and local authority. Results Prior to adjustment for Urban Rural Classification and local authority, the median number of accessible facilities for moderate or vigorous intensity activity increased with increasing deprivation from the most affluent or second most affluent quintile to the most deprived for all modes of transport. However, after adjustment, the modelling results suggest that those in more affluent areas have significantly higher access to moderate and vigorous intensity facilities by car than those living in more deprived areas. Conclusions The sociospatial distributions of access to facilities for both moderate intensity and vigorous intensity physical activity were similar. However, the results suggest that those living in the most affluent neighbourhoods have poorer access to facilities of either type that can be reached on foot, by bicycle or by bus than those living in less affluent areas. This poorer access from the most affluent areas appears to be reversed for those with access to a car. PMID:22568969

Dental Caries and its Socio-Behavioral Predictors- An Exploratory Cross-Sectional Study.

PubMed

Kumar, Santhosh; Tadakamadla, Jyothi; Duraiswamy, Prabu; Kulkarni, Suhas

To assess dental caries status and oral health related behavior of 12 year old school children in relation to urbanization and gender; to analyze the effect of socio-demographic and behavioral variables on dental caries experience. Study sample comprised 831, 12 year old school children in, India. Caries status was assessed by Decayed, missing, filled teeth (DMFT) index and a 16 item closed ended questionnaire was administered to children for assessing their oral health related knowledge, beliefs and behavior. Mean caries experience and prevalence was 1.94 and 64.9% respectively. Decay was the dominant component of DMFT. Greater proportion of female and urban children presented better oral health knowledge, beliefs and practices. Boys were more liable (OR=1.2, 95% CI=1.10-1.96) for having caries than girls. Children living in rural areas and whose parents were not professionals or semiprofessionals were more likely to experience caries. Children whose mothers were unskilled or house wives were more than twice likely to present caries (OR=2.14, 95% CI-2.03-2.45) than those children whose mothers were skilled or semi-skilled. Children of illiterate fathers and mothers were 1.09 (95% CI, 1.02-1.49) and 1.98 (95% CI, 1.13-1.99) times more likely to have dental caries than those children whose parents had greater than 10 years of education. Children, those who cleaned their teeth less than once a day presented an odds ratio of 1.36 (CI-1.17-1.86) also higher odds of dental caries was observed in children consuming sweets or soft drinks more than once a day. The prevalence and severity of dental caries was low among urban children and girls than their rural and boy counterparts. In general, oral health knowledge, beliefs and practices were low, predominantly in rural and male children. Caries experience was significantly associated with gender, location of residence, brushing frequency, frequency of consumption of soft drinks and sweets, parents' occupation and education.

Substance use among adolescent high school students in India: A survey of knowledge, attitude, and opinion

PubMed Central

Tsering, Dechenla; Pal, Ranabir; Dasgupta, Aparajita

2010-01-01

Background: Is knowledge regarding the consequences of substance use among adolescents enough to prevent them from initiating and continuing its use, is a question that needs to be clarified further? Objective: To assess the knowledge regarding harm of use and to obtain information about attitudes among high school students. Also, to discover the opinion of substance use held by users. Materials and Methods: This was a population based cross-sectional study conducted in two high schools of West Bengal, India, among 416 students, in classes VIII, IX, and X, with no interventions. Primary outcome measurements were substance use: knowledge regarding harm, attitude, and opinion. Following this proportions and the chi-square test were used for statistical analysis. Results: Out of 416 students, 52 (12.5%) used or abused any one of the substances irrespective of time and frequency in lifetime; 26 (15.1 %) were among the urban students and 26 (10.7 %) were among their rural counterparts. More than two-thirds (73.07%) of the respondents expressed a desire to quit substance use and 57.69% had tried to stop. ‘Easy availability’ and ‘relief from tension’ were the most frequent reasons for continuation of substance use. Level of knowledge on harmfulness of substance use among students was very high (urban — -84.6% and rural — 61.5%) and they stated media as the most frequent source of information. Users were successful in influencing their peers into taking up this habit (urban — 15.4% and rural — 26.9%). Conclusions: Inspite of being aware of the harmful effects of substance use, adolescents take up this habit. This requires comprehensive prevention and control programs in schools and the community, targeted toward adolescents and their parents and other family members. Effective measures are required to encourage shaping the attitude of school children toward self-confidence and adequacy, as also to prevent risk behavior among adolescents. PMID:21814448

Delays in accessing electroconvulsive therapy: a comparison between two urban and two rural populations in Australia.

PubMed

Johnston, Natalie E

2015-10-01

A comparison of the timing, rates and characteristics of electroconvulsive therapy use between urban and rural populations. The medical records of patients who received an acute course of electroconvulsive therapy at two rural and two urban psychiatric hospitals in New South Wales (NSW), Australia, in 2010 were reviewed retrospectively. Main outcome measures were the time from symptom onset, diagnosis and admission to commencing electroconvulsive therapy. Rates of use of electroconvulsive therapy were also compared between rural and urban hospitals using NSW statewide data. There was a significant delay in the time it took for rural patients to receive electroconvulsive therapy compared with urban patients when measured both from the time of symptom onset and from when they received a diagnosis. There were corresponding delays in the time taken for rural patients to be admitted to hospital compared with urban patients. There was no difference in the time it took to commence electroconvulsive therapy once a patient was admitted to hospital. NSW statewide urban-rural comparisons showed rates of electroconvulsive therapy treatment were significantly higher in urban hospitals. Patients in rural areas receive electroconvulsive therapy later in their acute illness due to delays in being admitted to hospital. The rate of use of electroconvulsive therapy also differs geographically. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Characteristics and career intentions of Scottish rural and urban GP registrars: cause for concern?

PubMed

Ross, S; Gillies, J C

1999-01-01

To investigate the differences between the characteristics and career intentions of GP registrars in urban and rural areas, and to make recommendations to reduce a potential work force crisis in rural practice. Postal survey. All general practices in Scotland. In February 1996, 40/196 (20%) of urban and 45/150 (30%) of rural GP registrar places available in Scotland, were vacant (chi 2 = 4.22, df = 1, p = 0.02). Postal questionnaires were sent to all 261 GP registrars in post. Of 235 respondents (90%), the majority wished to remain in general practice (63% of urban and 53% of rural registrars), but only 22% of urban and 18% of rural registrars intended to apply for principal posts immediately after training. Fewer urban (8%) than rural registrars (21%) stated an intention to go abroad to work after training. Rural registrars tended to want to work in rural areas, and vice versa. Part-time and job-sharing were attractive employment options for both groups, and more flexible career structures were favoured by over 80%. Though much more attention has been paid to recruitment in inner cities, the findings from this study suggest that in Scotland difficulties in finding principals may occur first in rural areas. As general practitioners have an extended role in rural areas, including that of emergency care, shortages could have a serious impact on patient care.

Winter Bird Assemblages in Rural and Urban Environments: A National Survey.

PubMed

Tryjanowski, Piotr; Sparks, Tim H; Biaduń, Waldemar; Brauze, Tomasz; Hetmański, Tomasz; Martyka, Rafał; Skórka, Piotr; Indykiewicz, Piotr; Myczko, Łukasz; Kunysz, Przemysław; Kawa, Piotr; Czyż, Stanisław; Czechowski, Paweł; Polakowski, Michał; Zduniak, Piotr; Jerzak, Leszek; Janiszewski, Tomasz; Goławski, Artur; Duduś, Leszek; Nowakowski, Jacek J; Wuczyński, Andrzej; Wysocki, Dariusz

2015-01-01

Urban development has a marked effect on the ecological and behavioural traits of many living organisms, including birds. In this paper, we analysed differences in the numbers of wintering birds between rural and urban areas in Poland. We also analysed species richness and abundance in relation to longitude, latitude, human population size, and landscape structure. All these parameters were analysed using modern statistical techniques incorporating species detectability. We counted birds in 156 squares (0.25 km2 each) in December 2012 and again in January 2013 in locations in and around 26 urban areas across Poland (in each urban area we surveyed 3 squares and 3 squares in nearby rural areas). The influence of twelve potential environmental variables on species abundance and richness was assessed with Generalized Linear Mixed Models, Principal Components and Detrended Correspondence Analyses. Totals of 72 bird species and 89,710 individual birds were recorded in this study. On average (± SE) 13.3 ± 0.3 species and 288 ± 14 individuals were recorded in each square in each survey. A formal comparison of rural and urban areas revealed that 27 species had a significant preference; 17 to rural areas and 10 to urban areas. Moreover, overall abundance in urban areas was more than double that of rural areas. There was almost a complete separation of rural and urban bird communities. Significantly more birds and more bird species were recorded in January compared to December. We conclude that differences between rural and urban areas in terms of winter conditions and the availability of resources are reflected in different bird communities in the two environments.

20 CFR 664.800 - How are the recipients of Youth Opportunity Grants selected?

Code of Federal Regulations, 2014 CFR

2014-04-01

... among urban and rural areas by taking into consideration such factors as the following: (1) The poverty rate in urban and rural communities; (2) The number of people in poverty in urban and rural communities...

20 CFR 664.800 - How are the recipients of Youth Opportunity Grants selected?

Code of Federal Regulations, 2013 CFR

2013-04-01

... among urban and rural areas by taking into consideration such factors as the following: (1) The poverty rate in urban and rural communities; (2) The number of people in poverty in urban and rural communities...

20 CFR 664.800 - How are the recipients of Youth Opportunity Grants selected?

Code of Federal Regulations, 2012 CFR

2012-04-01

... among urban and rural areas by taking into consideration such factors as the following: (1) The poverty rate in urban and rural communities; (2) The number of people in poverty in urban and rural communities...

20 CFR 664.800 - How are the recipients of Youth Opportunity Grants selected?

Code of Federal Regulations, 2011 CFR

2011-04-01

... among urban and rural areas by taking into consideration such factors as the following: (1) The poverty rate in urban and rural communities; (2) The number of people in poverty in urban and rural communities...

20 CFR 664.800 - How are the recipients of Youth Opportunity Grants selected?

Code of Federal Regulations, 2010 CFR

2010-04-01

... among urban and rural areas by taking into consideration such factors as the following: (1) The poverty rate in urban and rural communities; (2) The number of people in poverty in urban and rural communities...

Length of urban residence and obesity among within-country rural-to-urban Andean migrants.

PubMed

Antiporta, Daniel A; Smeeth, Liam; Gilman, Robert H; Miranda, J Jaime

2016-05-01

To evaluate the association between length of residence in an urban area and obesity among Peruvian rural-to-urban migrants. Cross-sectional database analysis of the migrant group from the PERU MIGRANT Study (2007). Exposure was length of urban residence, analysed as both a continuous (10-year units) and a categorical variable. Four skinfold site measurements (biceps, triceps, subscapular and suprailiac) were used to calculate body fat percentage and obesity (body fat percentage >25% males, >33% females). We used Poisson generalized linear models to estimate adjusted prevalence ratios and 95 % confidence intervals. Multicollinearity between age and length of urban residence was assessed using conditional numbers and correlation tests. A peri-urban shantytown in the south of Lima, Peru. Rural-to-urban migrants (n 526) living in Lima. Multivariable analyses showed that for each 10-year unit increase in residence in an urban area, rural-to-urban migrants had, on average, a 12 % (95 % CI 6, 18 %) higher prevalence of obesity. This association was also present when length of urban residence was analysed in categories. Sensitivity analyses, conducted with non-migrant groups, showed no evidence of an association between 10-year age units and obesity in rural (P=0·159) or urban populations (P=0·078). High correlation and a large conditional number between age and length of urban residence were found, suggesting a strong collinearity between both variables. Longer lengths of urban residence are related to increased obesity in rural-to-urban migrant populations; therefore, interventions to prevent obesity in urban areas may benefit from targeting migrant groups.

The nurse work environment, job satisfaction and turnover rates in rural and urban nursing units.

PubMed

Baernholdt, Marianne; Mark, Barbara A

2009-12-01

The aim of the present study was to determine whether there are differences in hospital characteristics, nursing unit characteristics, the nurse work environment, job satisfaction and turnover rates in rural and urban nursing units. Research in urban hospitals has found an association between the nurse work environment and job satisfaction and turnover rates, but this association has not been examined in rural hospitals. Rural and urban nursing units were compared in a national random sample of 97 United States hospitals (194 nursing units) with between 99 and 450 beds. Significant differences were found between hospital and nursing unit characteristics and the nurse work environment in rural and urban nursing units. Both nursing unit characteristics and the work environment were found to have a significant influence on nurse job satisfaction and turnover rates. Job satisfaction and turnover rates in rural and urban nursing units are associated with both nursing unit characteristics and the work environment. Both rural and urban hospitals can improve nurse job satisfaction and turnover rates by changing unit characteristics, such as creating better support services and a work environment that supports autonomous nursing practice. Rural hospitals can also improve the work environment by providing nurses with more educational opportunities.

Homicide in post-Soviet Belarus: urban-rural trends.

PubMed

Stickley, Andrew; Leinsalu, Mall; Razvodovsky, Yury E

2009-01-01

To investigate the occurrence of homicide in urban and rural regions of Belarus in the post-Soviet period. All-age male and female homicide mortality and population data were obtained for the years 1990, 1995, 2000 and 2005 for urban and rural regions of Belarus. These data were recalculated into three age categories and directly standardised. To assess relative changes in rural-urban homicide rates across time Poisson regression models were used to calculate rate ratios. Between 1990 and 1995 homicide rates rose sharply in urban and rural regions although the rise was greater in the former. Although there was little change in homicide rates in 2000, a notable divergence had occurred by 2005. While homicide rates rose slightly in rural areas, a large fall occurred in the rates of both men and women in urban areas. This resulted in significantly higher rural homicide rate ratios at the end of the study period. With some variations age-specific homicide rates followed this overall general pattern resulting in significantly higher homicide rate ratios in all rural groups aged 15 and above in 2005. It is probable that a combination of factors such as high levels of poverty, the effects of alcohol consumption, as well as the poor provision of emergency medical services underlie both the high levels of lethal violence and the growing rural-urban divergence in homicide rates in contemporary Belarus. Urgent action is now needed to address the deteriorating social and economic conditions underpinning violence, especially in rural regions.

Urbanization effects on soil nitrogen transformations and microbial biomass in the subtropics

Treesearch

Heather A. Enloe; B. Graeme Lockaby; Wayne C. Zipperer; Greg L. Somers

2015-01-01

As urbanization can involve multiple alterations to the soil environment, it is uncertain how urbanization effects soil nitrogen cycling. We established 22–0.04 ha plots in six different land cover types—rural slash pine (Pinus elliottii) plantations (n=3), rural natural pine forests (n=3), rural natural oak forests (n=4), urban pine forests (n=3), urban oak forests (n...

Urban Malaria: Understanding its Epidemiology, Ecology, and Transmission Across Seven Diverse ICEMR Network Sites.

PubMed

Wilson, Mark L; Krogstad, Donald J; Arinaitwe, Emmanuel; Arevalo-Herrera, Myriam; Chery, Laura; Ferreira, Marcelo U; Ndiaye, Daouda; Mathanga, Don P; Eapen, Alex

2015-09-01

A major public health question is whether urbanization will transform malaria from a rural to an urban disease. However, differences about definitions of urban settings, urban malaria, and whether malaria control should differ between rural and urban areas complicate both the analysis of available data and the development of intervention strategies. This report examines the approach of the International Centers of Excellence for Malaria Research (ICEMR) to urban malaria in Brazil, Colombia, India (Chennai and Goa), Malawi, Senegal, and Uganda. Its major theme is the need to determine whether cases diagnosed in urban areas were imported from surrounding rural areas or resulted from transmission within the urban area. If infections are being acquired within urban areas, malaria control measures must be targeted within those urban areas to be effective. Conversely, if malaria cases are being imported from rural areas, control measures must be directed at vectors, breeding sites, and infected humans in those rural areas. Similar interventions must be directed differently if infections were acquired within urban areas. The hypothesis underlying the ICEMR approach to urban malaria is that optimal control of urban malaria depends on accurate epidemiologic and entomologic information about transmission. © The American Society of Tropical Medicine and Hygiene.

Rural and urban married Asian immigrants in Taiwan: determinants of their physical and mental health.

PubMed

Chen, Walter; Shiao, Wen-Been; Lin, Blossom Yen-Ju; Lin, Cheng-Chieh

2013-12-01

Different geographical areas with unique social cultures or societies might influence immigrant health. This study examines whether health inequities and different social factors exist regarding the health of rural and urban married Asian immigrants. A survey was conducted on 419 rural and 582 urban married Asian immigrants in Taiwan in 2009. Whereas the descriptive results indicate a worse mental health status between rural and urban married Asian immigrants, rural married immigrants were as mentally healthy as urban ones when considering different social variables. An analysis of regional stratification found different social-determinant patterns on rural and urban married immigrants. Whereas social support is key for rural immigrant physical and mental health, acculturation (i.e., language proficiency), socioeconomics (i.e., working status), and family structure (the number of family members and children living in the family) are key to the mental health of urban married immigrants in addition to social support. This study verifies the key roles of social determinants on the subjective health of married Asian immigrants. Area-differential patterns on immigrant health might act as a reference for national authorities to (re)focus their attention toward more area-specific approaches for married Asian immigrants.

Urban-rural contrasts in fitness, physical activity, and sedentary behaviour in adolescents.

PubMed

Machado-Rodrigues, Aristides M; Coelho-E-Silva, Manuel J; Mota, Jorge; Padez, Cristina; Martins, Raul A; Cumming, Sean P; Riddoch, Chris; Malina, Robert M

2014-03-01

Research considering physical activity (PA), physical inactivity and health outcomes among urban and rural youth has produced equivocal findings. This study examined PA, physical inactivity, sedentary behaviours and cardiorespiratory fitness (CRF) in adolescents from urban and rural communities in the Portuguese Midlands. The sample included 362 adolescents (165 males, 197 females) of 13-16 years of age. CRF was assessed by the PACER test. A GT1M accelerometer was used to record 5 consecutive days of PA and time spent sedentary. Analyses of covariance (chronological age as co-variate) were performed to test the effect of the area of residence on sedentary behaviour, PA and CRF. Urban youth of both sexes spent less time in sedentary activities than rural youth. Urban males were more active than rural peers at the weekend, whereas urban females were significantly less active than rural females on week days and across all days assessed. Rural youth of both sexes had higher levels of CRF than urban youth. Area of residence was related to aerobic fitness, PA and time spent in sedentary behaviours among Portuguese youth. Interventions seeking to enhance health and active lifestyles in Portuguese youth should consider the potential impact of socio-geographic factors.

Rural-Urban Inequity in Unmet Obstetric Needs and Functionality of Emergency Obstetric Care Services in a Zambian District.

PubMed

Ng'anjo Phiri, Selia; Fylkesnes, Knut; Moland, Karen Marie; Byskov, Jens; Kiserud, Torvid

2016-01-01

Zambia has a high maternal mortality ratio, 398/100,000 live births. Few pregnant women access emergency obstetric care services to handle complications at childbirth. We aimed to assess the deficit in life-saving obstetric services in the rural and urban areas of Kapiri Mposhi district. A cross-sectional survey was conducted in 2011 as part of the 'Response to Accountable priority setting for Trust in health systems' (REACT) project. Data on all childbirths that occurred in emergency obstetric care facilities in 2010 were obtained retrospectively. Sources of information included registers from maternity ward admission, delivery and operation theatre, and case records. Data included age, parity, mode of delivery, obstetric complications, and outcome of mother and the newborn. An approach using estimated major obstetric interventions expected but not done in health facilities was used to assess deficit of life-saving interventions in urban and rural areas. A total of 2114 urban and 1226 rural childbirths occurring in emergency obstetric care facilities (excluding abortions) were analysed. Facility childbirth constituted 81% of expected births in urban and 16% in rural areas. Based on the reference estimate that 1.4% of childbearing women were expected to need major obstetric intervention, unmet obstetric need was 77 of 106 women, thus 73% (95% CI 71-75%) in rural areas whereas urban areas had no deficit. Major obstetric interventions for absolute maternal indications were higher in urban 2.1% (95% CI 1.60-2.71%) than in rural areas 0.4% (95% CI 0.27-0.55%), with an urban to rural rate ratio of 5.5 (95% CI 3.55-8.76). Women in rural areas had deficient obstetric care. The likelihood of under-going a life-saving intervention was 5.5 times higher for women in urban than rural areas. Targeting rural women with life-saving services could substantially reduce this inequity and preventable deaths.

[Fertility in rural and urban areas of Mexico].

PubMed

Garcia Y Garma, I O

1989-01-01

Data from 6 fertility surveys conducted in Mexico between 1969-87 were used to compare rural and urban fertility and to determine whether a significant level of contraceptive usage could be achieved in rural areas despite their lack of socioeconomic development. Age-specific marital fertility rates were calculated for the 4 national-level and 2 rural fertility surveys. The index of fertility control developed by Coale and Trussel was calculated for rural, urban, and all areas. The marital total fertility rate in rural areas declined from 10.6 in 1970 to 7.4 in 1982, a decline of 2.5% annually. From 1982-87 the annual rate of decline in rural fertility slowed to 1.6%, reaching 6.8 children in 1987. The urban marital total fertility rate declined from 7.72 in 1976 to 5.03 in 1987, while the marital total fertility rate for Mexico as a whole declined from 9.04 in 1976 to 5.85 in 1987. The indices of fertility control showed slowly increasing use of contraception in rural areas starting from the very low level of 1969. The urban index of fertility control showed some contraceptive use for all age groups in all surveys. The increases in contraceptive usage were considerable in rural areas from 1976-82 and much less marked in urban areas. From 1982-87 the inverse was observed and the fertility decline in urban areas was more marked. The condition of natural fertility found in rural areas in 1969 subsequently disappeared. Over time, fertility decline and use of contraception have intensified. Contraception is widely practiced in urban areas and is continuing to become more prevalent. The rural fertility decline in 1976-82 suggests that at least sometimes increases in fertility control are more important in rural areas than in urban areas. The theory of modernization, which holds that fertility decline in developed countries is attributable to factors associated with the process of modernization, thus comes into question. However, it is probable that a sustained fertility decline in the most depressed rural areas will be achieved only with substantial socioeconomic change.

Factors influencing specialist outreach and support services to rural populations in the Eden and Central Karoo districts of the Western Cape.

PubMed

Schoevers, Johan; Jenkins, Louis

2015-04-21

Access to health care often depends on where one lives. Rural populations have significantly poorer health outcomes than their urban counterparts. Specialist outreach to rural communities is one way of improving access to care. A multifaceted style of outreach improves access and health outcomes, whilst a shifted outpatients style only improves access. In principle, stakeholders agree that specialist outreach and support (O&S) to rural populations is necessary. In practice, however, factors influence whether or not O&S reaches its goals, affecting sustainability.Aim and setting: Our aim was to better understand factors associated with the success or failure of specialist O&S to rural populations in the Eden and Central Karoo districts in the Western Cape. An anonymous parallel three-stage Delphi process was followed to obtain consensus in a specialist and district hospital panel. Twenty eight specialist and 31 district hospital experts were invited, with response rates of 60.7%-71.4% and 58.1%-74.2% respectively across the three rounds. Relationships, communication and planning were found to be factors feeding into a service delivery versus capacity building tension, which affects the efficiency of O&S. The success of the O&S programme is dependent on a site-specific model that is acceptable to both the outreaching specialists and the hosting district hospital. Good communication, constructive feedback and improved planning may improve relationships and efficiency, which might lead to a more sustainable and mutually beneficial O&S system.

Traditional values of virginity and sexual behaviour in rural Ethiopian youth: results from a cross-sectional study

PubMed Central

Molla, Mitike; Berhane, Yemane; Lindtjørn, Bernt

2008-01-01

Background Delaying sexual initiation has been promoted as one of the methods of decreasing risks of HIV among young people. In traditional countries, such as Ethiopia, retaining virginity until marriage is the norm. However, no one has examined the impact of this traditional norm on sexual behaviour and risk of HIV in marriage. This study examined the effect of virginity norm on having sex before marriage and sexual behaviour after marriage among rural Ethiopian youth. Methods We did a cross-sectional survey in 9 rural and 1 urban area using a probabilistic sample of 3,743 youth, 15–24 years of age. Univariate analysis was used to assess associations between virginity norm and gender stratified by area, and between sexual behaviour and marital status. We applied Kaplan-Meier and Cox regression analysis to estimate age at sexual debut and assessed the predictors of premarital sex among the never-married using SPSS. Results We found that maintaining virginity is still a way of securing marriage for girls, especially in rural areas; the odds of belief and intention to marry a virgin among boys was 3–4 times higher among rural young males. As age increased, the likelihood of remaining a virgin decreased. There was no significant difference between married and unmarried young people in terms of number of partners and visiting commercial sex workers. Married men were twice more likely to have multiple sexual partners than their female counterparts. A Cox regression show that those who did not believe in traditional values of preserving virginity (adjusted hazard ratio [AHR] = 2.91 [1.92–4.40]), alcohol drinkers (AHR = 2.91 [1.97–4.29]), Khat chewers (AHR = 2.36 [1.45–3.85]), literates (AHR = 18.01 [4.34–74.42]), and the older age group (AHR = 1.85 [1.19–2.91]) were more likely to have premarital sex than their counterparts. Conclusion Although virginity norms help delay age at sexual debut among rural Ethiopian youth, and thus reduces vulnerability to sexually transmitted infections and HIV infection, vulnerability among females may increase after marriage due to unprotected multiple risky sexual behaviours by spouses. The use of preventive services, such as VCT before marriage and condom use in marriage should be part of the HIV/AIDS prevention and control strategies. PMID:18184425

Labor migration and risk aversion in less developed countries.

PubMed

Katz, E; Stark, O

1986-01-01

"In this paper we question the pioneering work of Todaro, which states that rural-to-urban labor migration in less developed countries (LDCs) is an individual response to a higher urban expected income. We demonstrate that rural-to-urban labor migration is perfectly rational even if urban expected income is lower than rural income. We achieve this under a set of fairly stringent conditions: an individual decision-making entity, a one-period planning horizon, and global risk aversion. We obtain the result that a small chance of reaping a high reward is sufficient to trigger rural-to-urban labor migration." excerpt

Urban and rural variations in morbidity and mortality in Northern Ireland

PubMed Central

O'Reilly, Gareth; O' Reilly, Dermot; Rosato, Michael; Connolly, Sheelah

2007-01-01

Background From a public health perspective and for the appropriate allocation of resources it is important to understand the differences in health between areas. This paper examines the variations in morbidity and mortality between urban and rural areas. Methods This is a cohort study looking at morbidity levels of the population of Northern Ireland at the time of the 2001 census, and subsequent mortality over the following four years. Individual characteristics including demographic and socio-economic factors were as recorded on census forms. The urban-rural nature of residence was based on census areas (average population c1900) classified into eight settlement bands, ranging from cities to rural settlements with populations of less than 1000. Results The study shows that neither tenure nor car availability are unbiased measures of deprivation in the urban-rural context. There is no indication that social class is biased. There was an increasing gradient of poorer health from rural to urban areas, where mortality rates were about 22% (95% Confidence Intervals 19%–25%) higher than the most rural areas. Differences in death rates between rural and city areas were evident for most of the major causes of death but were greatest for respiratory disease and lung cancer. Conversely, death rates in the most rural areas were higher in children and adults aged less than 20. Conclusion Urban areas appear less healthy than the more rural areas and the association with respiratory disease and lung cancer suggests that pollution may be a factor. Rural areas however, have higher death rates amongst younger people, something which requires further research. There is also a need for additional indicators of deprivation that have equal meaning in urban and rural areas. PMID:17594471

Participation in productive activities and health outcomes among older adults in urban China.

PubMed

Li, Yawen; Xu, Ling; Chi, Iris; Guo, Ping

2014-10-01

This study examined whether participating in productive activities was associated with better health outcomes among older adults in urban China, including analysis of potential gender differences. Using a sample of 10,016 urban Chinese adults aged 60 years or older from the 2006 Sample Survey of the Aged Population in Urban/Rural China, we regressed measures of self-rated health, functional health, and depression on productive activities (paid employment, helping with family, and volunteering), controlling for sociodemographic variables. Those who provided assistance to family members or volunteered had significantly lower levels of depression and better functional and self-rated health than their counterparts. Older adults with paid job, providing family assistance, or volunteering reported significantly lower levels of depression and better functional and self-rated health than those without those activities. However, only older men with paid employment reported significantly less depression, and the effect of family assistance on functional health also differed by gender. As research increasingly demonstrates the role of productive activities in maintaining health among older adults, our findings can help practitioners or policy makers strategically select or develop health programs to promote productive activities among older adults in urban China. © The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Chilling out in "Cosmopolitan Country": Urban/Rural Hybridity and the Construction of Daylesford as a "Lesbian and Gay Rural Idyll"

ERIC Educational Resources Information Center

Gorman-Murray, Andrew; Waitt, Gordon; Gibson, Chris

2012-01-01

This paper advances scholarship on "lesbian and gay rural idylls". A growing literature examines how "lesbian and gay rural idylls" are not only produced in opposition to the urban, but are themselves urban constructs. We extend these contentions by exploring the processes of idyllisation suffusing lesbian and gay festival…

A Rural-Urban Comparison in Emergency Department Visits for U.S. Children with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Zhang, Wanqing; Mason, Ashley E.; Boyd, Brian; Sikich, Linmarie; Baranek, Grace

2017-01-01

We examined rural-urban differences in emergency department visits, and child and clinical characteristics associated with visits for U.S. children aged 3-17 years with autism spectrum disorder (ASD). Rural children with ASD were twice more likely to have emergency department visits in urban hospitals than rural children without ASD. The children…

Differential effectiveness of depression disease management for rural and urban primary care patients.

PubMed

Adams, Scott J; Xu, Stanley; Dong, Fran; Fortney, John; Rost, Kathryn

2006-01-01

Federally qualified health centers across the country are adopting depression disease management programs following federally mandated training; however, little is known about the relative effectiveness of depression disease management in rural versus urban patient populations. To explore whether a depression disease management program has a comparable impact on clinical outcomes over 2 years in patients treated in rural and urban primary care practices and whether the impact is mediated by receiving evidence-based care (antidepressant medication and specialty care counseling). A preplanned secondary analysis was conducted in a consecutively sampled cohort of 479 depressed primary care patients recruited from 12 practices in 10 states across the country participating in the Quality Enhancement for Strategic Teaming study. Depression disease management improved the mental health status of urban patients over 18 months but not rural patients. Effects were not mediated by antidepressant medication or specialty care counseling in urban or rural patients. Depression disease management appears to improve clinical outcomes in urban but not rural patients. Because these programs compete for scarce resources, health care organizations interested in delivering depression disease management to rural populations need to advocate for programs whose clinical effectiveness has been demonstrated for rural residents.

Spatial-temporal change of land surface temperature across 285 cities in China: An urban-rural contrast perspective.

PubMed

Peng, Jian; Ma, Jing; Liu, Qianyuan; Liu, Yanxu; Hu, Yi'na; Li, Yingru; Yue, Yuemin

2018-09-01

As an important theme in global climate change and urban sustainable development, the changes of land surface temperature (LST) and surface urban heat island (SUHI) have been more and more focused by urban ecologists. This study used land-use data to identify the urban-rural areas in 285 cities in China and comparatively analyzed LST in urban-rural areas with the perspective of spatial-temporal dynamics heterogeneity. The results showed that, 98.9% of the cities exhibited SUHI effect in summer nighttime and the effect was stronger in northern cities than that in southern cities. In 2010, the mean SUHI intensity was the largest in summer daytime, with 4.6% of the cities having extreme SUHI of over 4°C. From 2001 to 2010, the nighttime LST of most cities increased more quickly in urban areas compared with rural areas, with an increasing tendency of the urban-rural LST difference. The difference in the urban- rural LST change rate was concentrated in the range of 0-0.1°C/year for 68.0% of cities in winter and 70.8% of cities in summer. For the higher LST increasing in urban areas compared with rural areas, there were more cities in summer than winter, indicating that the summer nighttime was the key temporal period for SUHI management. Based on the change slope of urban-rural LST, cities were clustered into four types and the vital and major zones for urban thermal environment management were identified in China. The vital zone included cities in Hunan, Hubei and other central rising provinces as well as the Beibu Gulf of Guangxi Province. The major zone included most of the cities in Central Plain Urban Agglomeration, Yangtze River Delta and Pearl River Delta. These results can provide scientific basis for SUHI adaptation in China. Copyright © 2018 Elsevier B.V. All rights reserved.

Gaseous pollutants on rural and urban nursery schools in Northern Portugal.

PubMed

Nunes, R A O; Branco, P T B S; Alvim-Ferraz, M C M; Martins, F G; Sousa, S I V

2016-01-01

Indoor air quality in nursery schools is different from other schools and this has been largely ignored, particularly in rural areas. Urban and rural nursery schools have different environmental characteristics whose knowledge needs improvement. Thus, this study aimed to evaluate continuously the concentrations of CO2, CO, NO2, O3, CH2O and total VOC in three rural nursery schools and one urban, being the only one comparing urban and rural nurseries with continuous measurements, thus considering occupation and non-occupation periods. Regarding CO2, urban nursery recorded higher concentrations (739-2328 mg m(-3)) than rural nurseries (653-1078 mg m(-3)). The influence of outdoor air was the main source of CO, NO2 and O3 indoor concentrations. CO and NO2 concentrations were higher in the urban nursery and O3 concentrations were higher in rural ones. CH2O and TVOC concentrations seemed to be related to internal sources, such as furniture and flooring finishing and cleaning products. Copyright © 2015 Elsevier Ltd. All rights reserved.

Employment outcome for people with schizophrenia in rural v. urban China: population-based study

PubMed Central

Yang, Lawrence H.; Phillips, Michael R.; Li, Xianyun; Yu, Gary; Zhang, Jingxuan; Shi, Qichang; Song, Zhiqiang; Ding, Zhijie; Pang, Shutao; Susser, Ezra

2013-01-01

Background Although outcomes among people with schizophrenia differ by social context, this has rarely been examined across rural v. urban settings. For individuals with schizophrenia, employment is widely recognised as a critical ingredient of social integration. Aims To compare employment for people with schizophrenia in rural v. urban settings in China. Method In a large community-based study in four provinces representing 12% of China’s population, we identified 393 people with schizophrenia (112 never treated). We used adjusted Poisson regression models to compare employment for those living in rural (n = 297) v. urban (n = 96) settings. Results Although rural and urban residents had similar impairments due to symptoms, rural residents were three times more likely to be employed (adjusted relative risk 3.27, 95% CI 2.11–5.07, P<0.001). Conclusions People with schizophrenia have greater opportunities to use their capacities for productive work in rural than urban settings in China. Contextual mechanisms that may explain this result offer a useful focus for future research. PMID:23258768

Supportive care needs of women with breast cancer in rural Scotland.

PubMed

Hubbard, Gill; Venning, Christine; Walker, Alison; Scanlon, Karen; Kyle, Richard G

2015-06-01

The aim of this study was to identify the supportive care needs and unmet needs of women with breast cancer (BC) in rural Scotland. In 2013, a survey of supportive care needs of rural women with BC was conducted using the short-form Supportive Care Needs Survey (SCNS-SF34). Semi-structured interviews were subsequently conducted with a purpose sample of questionnaire respondents. Forty-four women with BC completed the survey and ten were interviewed. Over half of participants reported at least one moderate to high unmet need (56.8 %, n = 25), a tenth reported low needs (11.4 %, n = 5), and around a third reported no unmet needs for all 34 items (31.8 %, n = 14). The most prevalent moderate to high needs were 'being informed about cancer in remission' (31.8 %, n = 14), 'fears about the cancer spreading' (27.3 %, n = 12), 'being adequately informed about the benefits and side-effects of treatment' and 'concerns about the worries of those close to you' (both 25.0 %, n = 11). Interviews highlighted the following unmet needs: information about treatment and side effects, overview of care, fear of recurrence, impact on family and distance from support. Rural women with BC report similar unmet needs to their urban counterparts. Fear of recurrence is a key unmet need that should be addressed for all women with BC. However, they also report unique unmet needs because of rural location. Thus, it is critical that cancer services address the additional unmet needs of rural women with BC and, in particular, needs relating to distance from services.

Urban-rural disparities in child nutrition-related health outcomes in China: The role of hukou policy.

PubMed

Liu, Hong; Rizzo, John A; Fang, Hai

2015-11-23

Hukou is the household registration system in China that determines eligibility for various welfare benefits, such as health care, education, housing, and employment. The hukou system may lead to nutritional and health disparities in China. We aim at examining the role of the hukou system in affecting urban-rural disparities in child nutrition, and disentangling the institutional effect of hukou from the effect of urban/rural residence on child nutrition-related health outcomes. This study uses data from the China Health and Nutrition Survey 1993-2009 with a sample of 9616 children under the age of 18. We compute height-for-age z-score and weight-for-age z-score for children. We use both descriptive statistics and multiple regression techniques to study the levels and significance of the association between child nutrition-related health outcomes and hukou type. Children with urban hukou have 0.25 (P < 0.01) higher height z-scores and 0.15 (P < 0.01) higher weight z-scores than children with rural hukou, and this difference by urban vs. rural hukou status is larger than the difference in height and weight (0.23 and 0.09, respectively) by urban vs. rural residence. Controlling for place of residence, children with urban hukou had 0.18 higher height z-scores and 0.17 (P < 0.01) higher weight z-scores than children with rural hukou. The hukou system exacerbates urban-rural disparities in child nutrition-related health outcomes independent of the well-known disparity stemming from urban-rural residence. Fortunately, however, child health disparities due to hukou have been declining since 2000.

Adolescent Tobacco Use in Urban Versus Rural Areas of the United States: The Influence of Tobacco Control Policy Environments.

PubMed

Pesko, Michael F; Robarts, Adam M T

2017-07-01

Adults and adolescents who reside in rural areas of the United States are traditionally more likely to be tobacco users. This urban-rural disparity remains largely unexplained and, more recently, it is unclear what impact the emergence of electronic cigarettes (e-cigarettes) has had on adolescent tobacco use in urban and rural areas. Our objective is to evaluate the influence of sociodemographics and tobacco control policy environments on adolescent tobacco use in urban versus rural areas, as well as to identify the effect of e-cigarettes on traditional patterns of urban-rural tobacco use. This study analyzes repeated cross-sectional data from the National Youth Tobacco Survey for the years 2011-2014. We estimate the associations between rural residence, cigarette taxes, tobacco advertisement exposure, and ease of access to tobacco with six tobacco use outcomes: current (past 30-day) use of cigarettes, e-cigarettes, cigars, smokeless tobacco, multiple tobacco products, and any tobacco. E-cigarette use among urban youths aged 11-17 years in the United States increased from .82% in 2011 to 8.62% in 2014 (p < .001). Tobacco advertisement exposure was significantly positively associated with all current tobacco use outcomes (p < .001) except for e-cigarettes. Our predictors account for approximately 40% of the difference in urban-rural cigarette use. Sociodemographics, cigarette taxes, and tobacco advertisement exposure are significant predictors of adolescent tobacco use in the United States but do not entirely explain urban-rural disparities. In addition, e-cigarettes appear to be rapidly changing traditional patterns of tobacco use, particularly in urban areas. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Prevalence and risk factors of HIV-1 and HIV-2 infection in urban and rural areas in Tamil Nadu, India.

PubMed

Solomon, S; Kumarasamy, N; Ganesh, A K; Amalraj, R E

1998-02-01

We aim to study the factors associated with the prevalence of HIV-1 and HIV-2 infection in the urban and rural areas of Tamil Nadu, India. The population of Tamil Nadu is approximately 60 million. Between April 94 and March 95, 992 samples from 5 representative urban centres and 1071 samples from 5 representative rural centres were collected and studied. A questionnaire was administered privately and it preceded collection of each sample. Samples were screened using ELISA and antibodies to HIV-1 and HIV-2 were confirmed using Western blot. The study was anonymous and unlinked. The prevalence of HIV infection in urban and rural areas was 7.2% (95% CI=6.1 to 8.31%); HIV-1 antibodies were found in 7.4% (95% CI=5.8 to 9.2%) of urban and 7.0% (95% CI=5.6 to 8.7%) of rural population; HIV-2 antibodies were found in 0.8% of urban and 0.3% of rural population. Heterosexual transmission, more so among those with multiple partner sex, was the main mode; higher prevalence of HIV infection among divorced/single individuals both in urban (21.1%) and rural (26.1%) was found. HIV infection among housewives stood at 4.1% (urban) and 3.8% (rural). The strength of association between STDs and HIV was observed to be greater in rural subjects (OR=8.89; 95% CI=5.11 to 15.57) than in urban subjects (OR=1.9; 95% CI=1.14 to 3.18). The prevalence of condom use was found to be less than 2% in the study subjects. HIV-2 is not as widely prevalent in Tamil Nadu as HIV-1. In our study the most common risk factors for HIV infection that emerged were (a) having multiple sexual partners, and (b) history of STDs or Venereal Disease Research Laboratory (VDRL) reactivity. Mobility of individuals between urban and rural areas has furthered the dissemination of HIV infection. Low condom usage among study subjects questions the effectiveness of the existing AIDS awareness and education programme. The study indicates the importance of placing equal emphasis on HIV prevention in rural India. HIV infection among housewives in urban and rural areas is indicative of gender inequalities and the importance of empowering women to prevent infection from spouse.

Oviposition ecology and species composition of Aedes spp. and Aedes aegypti dynamics in variously urbanized settings in arbovirus foci in southeastern Côte d'Ivoire.

PubMed

Zahouli, Julien B Z; Utzinger, Jürg; Adja, Maurice A; Müller, Pie; Malone, David; Tano, Yao; Koudou, Benjamin G

2016-09-29

Aedes mosquito-transmitted outbreaks of dengue and yellow fever have been reported from rural and urban parts of Côte d'Ivoire. The present study aimed at assessing Aedes spp. oviposition ecology in variously urbanized settings within arbovirus foci in southeastern Côte d'Ivoire. Aedes spp. eggs were sampled using a standard ovitrap method from January 2013 to April 2014 in different ecosystems of rural, suburban and urban areas. Emerged larvae were reared until the adult stage for species identification. Aedes spp. oviposition ecology significantly varied from rural-to-urban areas and according to the ecozones and the seasons. Species richness of Aedes spp. gradually decreased from rural (eight species) to suburban (three species) and urban (one species) areas. Conversely, emerged adult Aedes spp. mean numbers were higher in the urban (1.97 Aedes/ovitrap/week), followed by the suburban (1.44 Aedes/ovitrap/week) and rural (0.89 Aedes/ovitrap/week) areas. Aedes aegypti was the only species in the urban setting (100 %), and was also the predominant species in suburban (85.5 %) and rural (63.3 %) areas. The highest Ae. aegypti mean number was observed in the urban (1.97 Ae. aegypti/ovitrap/week), followed by the suburban (1.20 Ae. aegypti/ovitrap/week) and rural (0.57 Ae. aegypti/ovitrap/week) areas. Aedes africanus (9.4 %), Ae. dendrophilus (8.0 %), Ae. metallicus (1.3 %) in the rural, and Ae. vittatus (6.5 %) and Ae. metallicus (1.2 %) in the suburban areas each represented more than 1 % of the total Aedes fauna. In all areas, Aedes species richness and abundance were higher in the peridomestic zones and during the rainy season, with stronger variations in species richness in the rural and in abundance in the urban areas. Besides, the highest Culex quinquefasciatus abundance was found in the urban areas, while Eretmapodites chrysogaster was restricted to the rural areas. Urbanization correlates with a substantially higher abundance in Aedes mosquitoes and a regression of the Aedes wild species towards a unique presence of Ae. aegypti in urban areas. Aedes wild species serve as bridge vectors of arboviruses in rural areas, while Ae. aegypti amplifies arbovirus transmission in urban areas. Our results have important ramifications for dengue and yellow fever vector control and surveillance strategies in arbovirus foci in southeastern Côte d'Ivoire.

[Inequality in the prevalence of intestinal parasitic infections among schoolchildren from urban and rural schools].

PubMed

Barra, Marco; Bustos, Luis; Ossa, Ximena

2016-07-01

Parasitic infections in children reflect social inequalities throughout the world, especially in urban and rural territories. To assess inequalities in the prevalence of infections by protozoa and intestinal helminths and associated factors in children of different geographical areas from the commune of Puerto Montt. Cross-sectional study carried out in 103 students from one urban and two rural schools in the commune of Puerto Montt. A socio-demographic survey was applied and the presence parasitic infections was evaluated in serial stool samples. The prevalence of Protozoan and intestinal helminthic infections were 37.5 and 68.1% in urban and rural areas respectively. A regression analysis showed that the differences between rural and urban children, disappear when the results are adjusted by family income and the quality of sewage disposal. In urban children, the prevalence of parasitic infections increases along with the decrease in family income. Income and sanitary conditions rather than being or urban or rural origin explain the variations in rates of childhood parasitic infections. Infections with protozoa and intestinal helminths are an indicator of social inequality in health.

Rural and urban breastfeeding initiation trends in low-income women in North Carolina from 2003 to 2007.

PubMed

Lynch, Suzanne; Bethel, Jeffrey; Chowdhury, Najmul; Moore, Justin B

2012-05-01

Breastfeeding has extensive health benefits for both infants and mothers. Despite these benefits, a significant number of women, disproportionately low-income women, do not initiate breastfeeding. Previous research has also demonstrated that breastfeeding prevalence varies by urbanicity level. The objective was to examine race/ethnicity and urbanicity trends in breastfeeding initiation among low-income women in North Carolina from 2003 to 2007. Breastfeeding initiation data from the North Carolina Pregnancy Nutrition Surveillance System were utilized, with responses from 240,054 women over the 5-year period. Overall, 65.4% of women in mixed-urban counties and 62.1% of women in urban counties initiated breastfeeding compared to only 49.8% of women in rural counties. The disparity between rural and urban counties widened over time, with urban and mixed-urban counties making significantly greater gains in breastfeeding initiation than rural counties. Hispanic and non-Hispanic white women had 6.17 (95% confidence interval [CI], 5.99-6.36) and 1.4 (95% CI, 1.46-1.53) times the odds of initiating breastfeeding as non-Hispanic blacks, respectively. Finally, stratified multivariate regression models identified that the association between race/ethnicity and breastfeeding varied by urbanicity level. The current study provides a clearer picture of rural and urban breastfeeding trends within North Carolina and has implications for states with similar racial/ethnic and urbanicity levels. The research determined that women in rural areas, particularly non-Hispanic blacks, are less likely to initiate breastfeeding. Increased emphasis should be placed on developing breastfeeding interventions for rural communities, particularly targeting the non-Hispanic black population.

What role can the rural pipeline play in the recruitment and retention of rural allied health professionals?

PubMed

Durey, Angela; Haigh, Margaret; Katzenellenbogen, Judith M

2015-01-01

People living in rural areas have poorer health than their urban counterparts with higher morbidity and mortality rates and lower life expectancy. Challenges attracting health professionals to work in rural locations in Australia and elsewhere have been well- documented. In response, the idea of a rural pipeline emerged in the medical literature as a career pathway for doctors, conceptualised as a career continuum starting at school and ending in a committed, appropriately trained and supported rural doctor. This article draws on the literature to consider how the concept of a rural pipeline can be used to enhance recruitment and retention of allied health professionals (AHPs) in Australia. The complexity of the issue is taken into account, acknowledging the diverse professional, organisational and social needs within and between AHPs and their different career pathways. With this in mind, the rural pipeline is adapted and extended to focus on AHPs who enter at any stage of their career to work in rural areas. Barriers to recruitment and retention require multifaceted strategies to encourage and support AHPs at various stages along the pipeline to enter, and remain in, rural practice. Findings from the literature identify discrete themes within and between AHPs about factors influencing their rural recruitment and retention choices and include career stage at entry to rural practice, age, gender, social context, professional support, organisational environment and public-private practice mix in service delivery. These findings underscored the development of an extended rural pipeline adapted to specifically target AHPs. This flexible framework of entry to rural practice can be applied at any stage of their career and includes suggestions of strategies to support retention. Evidence from studies of rural AHPs suggests a flexible approach to recruitment and retention is needed that takes into account the complexity of the issue. The extended rural pipeline adapted to AHPs avoids a one-size-fits-all approach. Instead, it offers a more nuanced approach that addresses the diversity within and between professions and reflects the different stages at which AHPs enter rural practice that can inform recruitment and retention strategies that better meet their needs.

Dental myths, oral hygiene methods and nicotine habits in an ageing rural population: an Indian study.

PubMed

Singh, Saumyendra V; Akbar, Zafar; Tripathi, Arvind; Chandra, Suresh; Tripathi, Anurag

2013-01-01

Though, increased emphasis is being given on spreading dental care facilities and awareness in Indian villages, the target population is unfortunately less literate and is not financially equipped compared to their urban counterparts. The rural aged additionally may have to face problems like desertion by the educated youth to follow better opportunities in cities, disease, and lack of mobility. The present study strived to evaluate dental myths, oral hygiene methods, and tobacco habits awareness in a rural ageing population in the perspective of a changing India. The study area consisted of a group of ten villages, situated in district Lucknow, Uttar Pradesh, India. The subjects were questioned about dental myths, tobacco habits, and oral hygiene methods and then divided into groups on the basis of age, sex, and educational status. The number of sound teeth in each subject was also counted. Mean-values, standard deviation, Chi-square test and P values were used to make inter-group comparisons. Forty percent of the subjects considered oral hygiene unnecessary, 60.8% of the population was relying on simple mouth rinsing for maintaining oral hygiene, 48% had either the habit of smoking and chewing tobacco or both and 81% of the subjects had one dental myth or the other. We concluded that the rural aged is a deprived lot and a targeted program to infuse scientific dental practices in them is necessary.

Uninsured Hospitalizations: Rural and Urban Differences

ERIC Educational Resources Information Center

Zhang, Wanqing; Mueller, Keith J.; Chen, Li-Wu

2008-01-01

Context: Few studies have examined hospitalization patterns among the uninsured, especially from the perspective of rural and urban differences. Purpose: To examine whether the patterns of uninsured hospitalizations differ in rural and urban hospitals and to identify the most prevalent and costly diagnoses among uninsured hospitalizations.…

Using a DEA Management Tool through a Nonparametric Approach: An Examination of Urban-Rural Effects on Thai School Efficiency

ERIC Educational Resources Information Center

Kantabutra, Sangchan

2009-01-01

This paper examines urban-rural effects on public upper-secondary school efficiency in northern Thailand. In the study, efficiency was measured by a nonparametric technique, data envelopment analysis (DEA). Urban-rural effects were examined through a Mann-Whitney nonparametric statistical test. Results indicate that urban schools appear to have…

''I Eat to Be Happy, to Be Strong, and to Live.'' Perceptions of Rural and Urban Adolescents in Cameroon, Africa

ERIC Educational Resources Information Center

Dapi, Leonie N.; Omoloko, Cecile; Janlert, Urban; Dahlgren, Lars; Haglin, Lena

2007-01-01

Objective: To investigate factors influencing rural and urban adolescents' food perceptions during a time of nutritional transition in Cameroon, Africa. Design: Qualitative in-depth interviews. Settings: Yaounde urban and Bandja rural areas. Participants: Fifteen adolescents 12 to 15 years old purposely selected from schools in urban and rural…

Social vulnerability and environmental change along urban-rural interfaces

Treesearch

John Schelhas; Sarah Hitchner; Cassandra Johnson

2012-01-01

As the world becomes increasingly urbanized and interconnected, the distinction between urban and rural areas is diminishing. Creation of new urban–rural interface areas causes immediate changes in local natural and social environments, and theseareas are also susceptible to both short-term and long-term environmental changes. Different groups of people...

Stigmatization experienced by rural-to-urban migrant workers in China: findings from a qualitative study.

PubMed

Li, Xiaoming; Zhang, Liying; Fang, Xiaoyi; Xiong, Qing; Chen, Xinguang; Lin, Danhua; Mathur, Ambika; Stanton, Bonita

2007-12-01

Global literature has suggested a potential negative impact of social stigma on both physical and mental health among those who are being stigmatized. However, limited data are available regarding the form of stigma and stigmatization against rural-to-urban migrant workers in developing countries, including China. This study, employing qualitative data collected from focus group discussions and in-depth individual interviews with rural-to-urban migrants in Beijing, China, was designed to understand the forms and context of stigmatization against rural migrant workers. The data in the current study show that rural-to-urban migrant workers in China had experienced various forms of stigmatization including labelling, stereotyping, separation, status loss and discrimination. Stigmatization occurred through different contexts of migrant workers' lives in urban destinations, including employment seeking, workplace benefits, and access to health and other public services. The current study is a necessary first step to assess the potential impact of stigmatization on both the physical and psychological well-being of rural-to-urban migrant workers.

Rural Villagers and Urban Residents Exposure to Poultry in China

PubMed Central

Shi, Ying; Liao, Qiaohong; Zhou, Hang; Zhou, Lei; Li, Leilei; Wu, Jiabing; Zhang, Shunxiang; Yu, Zhangda; Wu, Xiaomin; Ma, Hanwu; Lu, Jianhua; Cowling, Benjamin J.; Yu, Hongjie

2014-01-01

Patterns of poultry exposure in rural and urban areas in China have not been systematically evaluated and compared. The objective of our study is to investigate patterns in human exposure to poultry in rural and urban China. We conducted a two-stage household-based clustered survey on population exposure to live/sick/dead poultry in Xiuning and Shenzhen. Half of the rural households (51%) in Xiuning raised poultry, mostly (78%) free-range. Around half of those households (40%) allowed poultry to stay in their living areas. One quarter of villagers reported having contact with sick or dead poultry. In Shenzhen, 37% urban residents visited live poultry markets. Among these, 40% purchased live poultry and 16% touched the poultry or cages during purchase. Our findings indicated that human exposure to poultry was different in rural and urban areas in China. This discrepancy could contribute to the observed differences in epidemiologic characteristics between urban and rural cases of influenza A(H7N9) and A(H5N1) virus infection. PMID:24769673

Comparison between motorcyclist’ violation behavior and accidents in urban and rural area in Indonesia: A comparative study

NASA Astrophysics Data System (ADS)

Rahmawati, N.; Widyanti, A.

2017-12-01

Some studies stated that the main factor related to the accident was driving behavior. This study aims to explore the differences between motorcyclist” behaviour and repetitive violation behaviour in two different area, urban and rural area in Indonesia. Respondents were selected based on convenience sampling method in Bandung as a representative of urban area and Kulon Progo as a representative of rural area. They were asked to fill in a questionnaire about driving behaviour, consists of 10 dimensions or 51 questions with Likert scales ranging from 1 (very often) to 6 (never). The results of this study shows that the motorcyclists’ behavior differ significantly between rural and urban area. Motorcyclists in the urban area (Bandung) are more committed to violations than in rural area (Kulon Progo). This result is not in line with previous studies in Australia and United States which stated that motorcyclists in rural area more frequently speeding than in urban area. Implications of the result are discussed.

Climate change as a migration driver from rural and urban Mexico

NASA Astrophysics Data System (ADS)

Nawrotzki, Raphael J.; Hunter, Lori M.; Runfola, Daniel M.; Riosmena, Fernando

2015-11-01

Studies investigating migration as a response to climate variability have largely focused on rural locations to the exclusion of urban areas. This lack of urban focus is unfortunate given the sheer numbers of urban residents and continuing high levels of urbanization. To begin filling this empirical gap, this study investigates climate change impacts on US-bound migration from rural and urban Mexico, 1986-1999. We employ geostatistical interpolation methods to construct two climate change indices, capturing warm and wet spell duration, based on daily temperature and precipitation readings for 214 weather stations across Mexico. In combination with detailed migration histories obtained from the Mexican Migration Project, we model the influence of climate change on household-level migration from 68 rural and 49 urban municipalities. Results from multilevel event-history models reveal that a temperature warming and excessive precipitation significantly increased international migration during the study period. However, climate change impacts on international migration is only observed for rural areas. Interactions reveal a causal pathway in which temperature (but not precipitation) influences migration patterns through employment in the agricultural sector. As such, climate-related international migration may decline with continued urbanization and the resulting reductions in direct dependence of households on rural agriculture.

Climate Change as Migration Driver from Rural and Urban Mexico.

PubMed

Nawrotzki, Raphael J; Hunter, Lori M; Runfola, Daniel M; Riosmena, Fernando

2015-11-01

Studies investigating migration as a response to climate variability have largely focused on rural locations to the exclusion of urban areas. This lack of urban focus is unfortunate given the sheer numbers of urban residents and continuing high levels of urbanization. To begin filling this empirical gap, this study investigates climate change impacts on U.S.-bound migration from rural and urban Mexico, 1986-1999. We employ geostatistical interpolation methods to construct two climate change indices, capturing warm and wet spell duration, based on daily temperature and precipitation readings for 214 weather stations across Mexico. In combination with detailed migration histories obtained from the Mexican Migration Project, we model the influence of climate change on household-level migration from 68 rural and 49 urban municipalities. Results from multilevel event-history models reveal that a temperature warming and excessive precipitation significantly increased international migration during the study period. However, climate change impacts on international migration is only observed for rural areas. Interactions reveal a causal pathway in which temperature (but not precipitation) influences migration patterns through employment in the agricultural sector. As such, climate-related international migration may decline with continued urbanization and the resulting reductions in direct dependence of households on rural agriculture.

Perceived Ease of Access to Alcohol, Tobacco, and Other Substances in Rural and Urban US Students

PubMed Central

Warren, Jacob C.; Smalley, K. Bryant; Barefoot, K. Nikki

2015-01-01

Introduction Ease of access to substances has been shown to have a direct and significant relationship with substance use for school-aged children. Previous research involving rural samples of middle and high school students reveals that perceived ease of access to substances is a significant predictor of recent use among rural adolescents; however, it is unclear if perceived access to substances varies between rural and urban areas. The purpose of the current study was to examine rural-urban differences in perceived ease of access to alcohol, smoking and chewing tobacco, marijuana, and seven other substances in order to better inform and promote future substance use prevention and programming efforts in rural areas. Methods Data were analyzed from the 2013 Georgia Student Health Survey II, administered in all public and interested private/charter schools in the state of Georgia. A total of 513,909 students (18.2% rural) indicated their perceived ease of access to 11 substances on a 4-point Likert-type scale. Rural-urban differences were investigated using chi-square analysis. Results In general, it appeared the rural-urban differences fell along legal/illicit lines. For middle school students, a significant difference in perceived ease of access was found for each substance, with rural students reporting greater access to smoking tobacco, chewing tobacco, and steroids, and urban students reporting greater access to alcohol, marijuana, cocaine, inhalants, ecstasy, methamphetamine, hallucinogens, and prescription drugs. Rural high school students reported higher access to alcohol, smoking tobacco, chewing tobacco, and steroids, with urban students reporting higher access to marijuana, cocaine, inhalants, ecstasy, and hallucinogens. Perceptions of ease of access more than doubled for each substance in both geographies between middle and high school. Conclusions In summary, the current study found multiple and fairly consistent differences between rural and urban students’ perceived ease of access to a variety of substances, with rural students reporting higher levels of access to legal substances and urban students reporting higher levels of access predominantly to illicit substances. Most troubling were the high levels of perceived access to substances, however, particularly in high school students, with more than half even of rural students reporting at least somewhat easy access to marijuana, and more than 60% of both rural and urban high school students reporting easy access to alcohol. Future research should investigate ways to decrease the perceptions of access to substances in order to prevent use and abuse. PMID:26518286

Comparison of positive allergy skin tests among asthmatic children from rural and urban areas living within small geographic area.

PubMed

Bibi, Haim; Shoseyov, David; Feigenbaum, David; Nir, Pnina; Shiachi, Rosa; Scharff, Shimon; Peled, Ronit

2002-04-01

Evidence of increased asthma and allergic response among urban versus rural residents has been reported. To evaluate the prevalence of allergic response among asthmatic children from urban and rural areas living within close proximity. In all, 448 asthmatic children from urban (363) and rural (85) areas were studied. The study group consisted of 234 9-year-olds and 214 12-year-olds. A health questionnaire was completed on each child who subsequently underwent allergic skin prick tests (SPTs). There was significantly more positive SPT response to house-dust mite, mold, cat, and cypress among asthmatic children from urban areas compared with children living in rural areas: 58.3% versus 37.6%, 46.1% versus 31.8%, 17.45 versus 5.9%, and 26.2% versus 15.3%, respectively. Positive SPT for indoor allergens were significantly greater among asthmatic urban residents than asthmatic rural residents: 63.3% versus 45.5%, respectively (P < 0.02). Positive SPT response to all the allergens checked was higher among the 12-year-old age group when compared with the 9-year-olds, 34.6% versus 22.7%, respectively (P = 0.05). Allergic response measured by SPT is significantly more common among asthmatic children from urban areas as opposed to rural, even though both areas are within small distance of one another. Further, asthmatic children living in urban areas demonstrated more allergic response to both indoor and outdoor allergens. The allergic response tends to increase with increased age in both urban and rural asthmatic children.

Seasonal variability of aerosols and their characteristics in urban and rural locations of Delhi-NCR

NASA Astrophysics Data System (ADS)

Bhardwaj, Purnima; Pandey, Alok Kumar; Kumar, Krishan; Jain, V. K.

2017-10-01

Present study shows the seasonal variation of the Aerosol Optical Depth (AOD) and aerosols characteristics in an urban and rural environment over Delhi-NCR. Aerosol sampling was carried out using a Mini-Volume sampler at an urban and rural location in Delhi-NCR. A relatively higher PM2.5 (particulate matter of size < 2.5 μm) concentrations were observed at the urban sampling site than the rural one in the summer as well as winter season. PM2.5 samples were further analyzed by Scanning Electron Microscopy (SEM) and Energy Dispersive X-Ray Spectroscopy (EDX) in order to understand the morphology and elemental composition of the PM2.5 aerosols. Summer SEM results showed the dominance of fluffy agglomerate (soot) in urban area whereas the rural area was relatively clean. The winter season SEM results showed the presence of aggregates of smaller particles at urban site whereas flaky, round and irregular shaped particles were observed at the rural site. EDX analysis showed the presence of elements such as C, Cu, Zn, Ga and Fe (representative elements) in varying concentrations at both the urban and rural sampling locations. NASA's Aqua satellite MODIS sensor AOD data for summer and winter seasons have been used to study the spatial distributions of aerosols over the study region. AOD was found to be relatively higher in urban area as compared to the rural area in both the summer and winter seasons indicating the contribution of high amount of anthropogenic aerosols in the urban atmosphere.

Winter Bird Assemblages in Rural and Urban Environments: A National Survey

PubMed Central

Tryjanowski, Piotr; Sparks, Tim H.; Biaduń, Waldemar; Brauze, Tomasz; Hetmański, Tomasz; Martyka, Rafał; Skórka, Piotr; Indykiewicz, Piotr; Myczko, Łukasz; Kunysz, Przemysław; Kawa, Piotr; Czyż, Stanisław; Czechowski, Paweł; Polakowski, Michał; Zduniak, Piotr; Jerzak, Leszek; Janiszewski, Tomasz; Goławski, Artur; Duduś, Leszek; Nowakowski, Jacek J.; Wuczyński, Andrzej; Wysocki, Dariusz

2015-01-01

Urban development has a marked effect on the ecological and behavioural traits of many living organisms, including birds. In this paper, we analysed differences in the numbers of wintering birds between rural and urban areas in Poland. We also analysed species richness and abundance in relation to longitude, latitude, human population size, and landscape structure. All these parameters were analysed using modern statistical techniques incorporating species detectability. We counted birds in 156 squares (0.25 km2 each) in December 2012 and again in January 2013 in locations in and around 26 urban areas across Poland (in each urban area we surveyed 3 squares and 3 squares in nearby rural areas). The influence of twelve potential environmental variables on species abundance and richness was assessed with Generalized Linear Mixed Models, Principal Components and Detrended Correspondence Analyses. Totals of 72 bird species and 89,710 individual birds were recorded in this study. On average (±SE) 13.3 ± 0.3 species and 288 ± 14 individuals were recorded in each square in each survey. A formal comparison of rural and urban areas revealed that 27 species had a significant preference; 17 to rural areas and 10 to urban areas. Moreover, overall abundance in urban areas was more than double that of rural areas. There was almost a complete separation of rural and urban bird communities. Significantly more birds and more bird species were recorded in January compared to December. We conclude that differences between rural and urban areas in terms of winter conditions and the availability of resources are reflected in different bird communities in the two environments. PMID:26086819

The "rule of halves" does not apply in Peru: awareness, treatment, and control of hypertension and diabetes in rural, urban, and rural-to-urban migrants.

PubMed

Lerner, Alana G; Bernabe-Ortiz, Antonio; Gilman, Robert H; Smeeth, Liam; Miranda, J Jaime

2013-06-01

To determine the awareness, treatment, and control of hypertension and diabetes by migration status. Cross-sectional study, secondary analyses of the PERU MIGRANT study. Rural, rural-to-urban migrants, and urban participants. Awareness, treatment, and control of hypertension and diabetes mellitus were calculated using weights to account for participant's group size. Of 205 of the 987 (weighted prevalence 24.1%, 95% confidence interval: 21.1%-27.1%) participants identified as hypertensive, 48.3% were aware of their diagnosis, 40% of them were receiving treatment, and 30.4% of those receiving treatment were controlled. Diabetes was present in 33 of the 987 (weighted prevalence 4.6%, 95% confidence interval: 3.1%-6%), and diabetes awareness, treatment, and control were 71.1%, 40.6%, and 7.7%, respectively. Suboptimal control rates, defined as those not meeting blood pressure or glycaemia targets among those with the condition, were 95.1% for hypertension and 97% for diabetes. Higher awareness, treatment, and control rates, for both hypertension and diabetes, were observed in rural-to-urban migrants and urban participants compared with rural participants. However, treatment rates were much lower among migrants compared with the urban group. These results identify major unmet needs in awareness, treatment, and control of hypertension and diabetes. Particular challenges are lack of awareness of both hypertension and diabetes in rural areas, and poor levels of treatment and control among people who have migrated from rural into urban areas.

Risk of several cancers is higher in urban areas after adjusting for socioeconomic status. Results from a two-country population-based study of 18 common cancers.

PubMed

Sharp, Linda; Donnelly, David; Hegarty, Avril; Carsin, Anne-Elie; Deady, Sandra; McCluskey, Neil; Gavin, Anna; Comber, Harry

2014-06-01

Some studies suggest that there are urban-rural variations in cancer incidence but whether these simply reflect urban-rural socioeconomic variation is unclear. We investigated whether there were urban-rural variations in the incidence of 18 cancers, after adjusting for socioeconomic status. Cancers diagnosed between 1995 and 2007 were extracted from the population-based National Cancer Registry Ireland and Northern Ireland Cancer Registry and categorised by urban-rural status, based on population density of area of residence at diagnosis (rural <1 person per hectare, intermediate 1-15 people per hectare, urban >15 people per hectare). Relative risks (RR) were calculated by negative binomial regression, adjusting for age, country and three area-based markers of socioeconomic status. Risks were significantly higher in both sexes in urban than rural residents with head and neck (males RR urban vs. rural = 1.53, 95 % CI 1.42-1.64; females RR = 1.29, 95 % CI 1.15-1.45), esophageal (males 1.21, 1.11-1.31; females 1.21, 1.08-1.35), stomach (males 1.36, 1.27-1.46; females 1.19, 1.08-1.30), colorectal (males 1.14, 1.09-1.18; females 1.04, 1.00-1.09), lung (males 1.54, 1.47-1.61; females 1.74, 1.65-1.84), non-melanoma skin (males 1.13, 1.10-1.17; females 1.23, 1.19-1.27) and bladder (males 1.30, 1.21-1.39; females 1.31, 1.17-1.46) cancers. Risks of breast, cervical, kidney and brain cancer were significantly higher in females in urban areas. Prostate cancer risk was higher in rural areas (0.94, 0.90-0.97). Other cancers showed no significant urban-rural differences. After adjusting for socioeconomic variation, urban-rural differences were evident for 12 of 18 cancers. Variations in healthcare utilization and known risk factors likely explain some of the observed associations. Explanations for others are unclear and, in the interests of equity, warrant further investigation.

Urbanicity and lifestyle risk factors for cardiometabolic diseases in rural Uganda: a cross-sectional study.

PubMed

Riha, Johanna; Karabarinde, Alex; Ssenyomo, Gerald; Allender, Steven; Asiki, Gershim; Kamali, Anatoli; Young, Elizabeth H; Sandhu, Manjinder S; Seeley, Janet

2014-07-01

Urban living is associated with unhealthy lifestyles that can increase the risk of cardiometabolic diseases. In sub-Saharan Africa (SSA), where the majority of people live in rural areas, it is still unclear if there is a corresponding increase in unhealthy lifestyles as rural areas adopt urban characteristics. This study examines the distribution of urban characteristics across rural communities in Uganda and their associations with lifestyle risk factors for chronic diseases. Using data collected in 2011, we examined cross-sectional associations between urbanicity and lifestyle risk factors in rural communities in Uganda, with 7,340 participants aged 13 y and above across 25 villages. Urbanicity was defined according to a multi-component scale, and Poisson regression models were used to examine associations between urbanicity and lifestyle risk factors by quartile of urbanicity. Despite all of the villages not having paved roads and running water, there was marked variation in levels of urbanicity across the villages, largely attributable to differences in economic activity, civil infrastructure, and availability of educational and healthcare services. In regression models, after adjustment for clustering and potential confounders including socioeconomic status, increasing urbanicity was associated with an increase in lifestyle risk factors such as physical inactivity (risk ratio [RR]: 1.19; 95% CI: 1.14, 1.24), low fruit and vegetable consumption (RR: 1.17; 95% CI: 1.10, 1.23), and high body mass index (RR: 1.48; 95% CI: 1.24, 1.77). This study indicates that even across rural communities in SSA, increasing urbanicity is associated with a higher prevalence of lifestyle risk factors for cardiometabolic diseases. This finding highlights the need to consider the health impact of urbanization in rural areas across SSA. Please see later in the article for the Editors' Summary.

Trends in childhood mortality in Kenya: The urban advantage has seemingly been wiped out

PubMed Central

Kimani-Murage, E.W.; Fotso, J.C.; Egondi, T.; Abuya, B.; Elungata, P.; Ziraba, A.K.; Kabiru, C.W.; Madise, N.

2014-01-01

Background We describe trends in childhood mortality in Kenya, paying attention to the urban–rural and intra-urban differentials. Methods We use data from the Kenya Demographic and Health Surveys (KDHS) collected between 1993 and 2008 and the Nairobi Urban Health and Demographic Surveillance System (NUHDSS) collected in two Nairobi slums between 2003 and 2010, to estimate infant mortality rate (IMR), child mortality rate (CMR) and under-five mortality rate (U5MR). Results Between 1993 and 2008, there was a downward trend in IMR, CMR and U5MR in both rural and urban areas. The decline was more rapid and statistically significant in rural areas but not in urban areas, hence the gap in urban–rural differentials narrowed over time. There was also a downward trend in childhood mortality in the slums between 2003 and 2010 from 83 to 57 for IMR, 33 to 24 for CMR, and 113 to 79 for U5MR, although the rates remained higher compared to those for rural and non-slum urban areas in Kenya. Conclusions The narrowing gap between urban and rural areas may be attributed to the deplorable living conditions in urban slums. To reduce childhood mortality, extra emphasis is needed on the urban slums. PMID:25024120

Links between fear of humans, stress and survival support a non-random distribution of birds among urban and rural habitats

PubMed Central

Rebolo-Ifrán, Natalia; Carrete, Martina; Sanz-Aguilar, Ana; Rodríguez-Martínez, Sol; Cabezas, Sonia; Marchant, Tracy A.; Bortolotti, Gary R.; Tella, José L.

2015-01-01

Urban endocrine ecology aims to understand how organisms cope with new sources of stress and maintain allostatic load to thrive in an increasingly urbanized world. Recent research efforts have yielded controversial results based on short-term measures of stress, without exploring its fitness effects. We measured feather corticosterone (CORTf, reflecting the duration and amplitude of glucocorticoid secretion over several weeks) and subsequent annual survival in urban and rural burrowing owls. This species shows high individual consistency in fear of humans (i.e., flight initiation distance, FID), allowing us to hypothesize that individuals distribute among habitats according to their tolerance to human disturbance. FIDs were shorter in urban than in rural birds, but CORTf levels did not differ, nor were correlated to FIDs. Survival was twice as high in urban as in rural birds and links with CORTf varied between habitats: while a quadratic relationship supports stabilizing selection in urban birds, high predation rates may have masked CORTf-survival relationship in rural ones. These results evidence that urban life does not constitute an additional source of stress for urban individuals, as shown by their near identical CORTf values compared with rural conspecifics supporting the non-random distribution of individuals among habitats according to their behavioural phenotypes. PMID:26348294

Links between fear of humans, stress and survival support a non-random distribution of birds among urban and rural habitats.

PubMed

Rebolo-Ifrán, Natalia; Carrete, Martina; Sanz-Aguilar, Ana; Rodríguez-Martínez, Sol; Cabezas, Sonia; Marchant, Tracy A; Bortolotti, Gary R; Tella, José L

2015-09-08

Urban endocrine ecology aims to understand how organisms cope with new sources of stress and maintain allostatic load to thrive in an increasingly urbanized world. Recent research efforts have yielded controversial results based on short-term measures of stress, without exploring its fitness effects. We measured feather corticosterone (CORTf, reflecting the duration and amplitude of glucocorticoid secretion over several weeks) and subsequent annual survival in urban and rural burrowing owls. This species shows high individual consistency in fear of humans (i.e., flight initiation distance, FID), allowing us to hypothesize that individuals distribute among habitats according to their tolerance to human disturbance. FIDs were shorter in urban than in rural birds, but CORTf levels did not differ, nor were correlated to FIDs. Survival was twice as high in urban as in rural birds and links with CORTf varied between habitats: while a quadratic relationship supports stabilizing selection in urban birds, high predation rates may have masked CORTf-survival relationship in rural ones. These results evidence that urban life does not constitute an additional source of stress for urban individuals, as shown by their near identical CORTf values compared with rural conspecifics supporting the non-random distribution of individuals among habitats according to their behavioural phenotypes.

[Rural-urban population redistribution between 1970 and 1980 (a micro-regional analysis)].

PubMed

Costa, M A

1982-01-01

Changes in rural-urban population distribution in Brazil from 1970 to 1980 are analyzed using census data. Trends examined include spatial redistribution throughout the country, rapid urbanization, the decline in the size of the rural population in the state of Parana, agricultural expansion in the northern and central-western regions, and the increase of the rural population within metropolitan areas. (summary in ENG)

Association between salt and hypertension in rural and urban populations of low to middle income countries: a systematic review and meta-analysis of population based studies.

PubMed

Subasinghe, Asvini K; Arabshahi, Simin; Busingye, Doreen; Evans, Roger G; Walker, Karen Z; Riddell, Michaela A; Thrift, Amanda G

2016-01-01

The prevalence of hypertension, the greatest contributor to mortality globally, is increasing in low-and-middle income countries (LMICs). In urban regions of LMICs, excessive salt intake is associated with increased risk of hypertension. We aimed to determine whether this is the case in rural regions as well. We performed a meta-analysis of studies in rural and urban areas of LMICs in which the association of salt and hypertension were assessed using multivariable models. We identified 18 studies with a total of 134,916 participants. The prevalence of high salt intake ranged from 21.3% to 89.5% in rural and urban populations. When salt was analysed as a continuous variable, a greater impact of salt on hypertension was found in urban (n=4) (pooled effect size (ES) 1.42, 95% CI 1.19, 1.69) than in rural populations (n=4) (pooled ES 1.07, 95% CI 1.04, 1.10, p for difference <0.001). In studies where salt was analysed continuously, a greater impact of salt on hypertension was observed in lean rural populations (BMI <23 kg/m2) than in non-lean rural populations (BMI >=23 kg/m2, p for difference <0.001). The prevalence of high salt intake is similar in rural and urban regions. Excessive salt intake has a greater impact on the prevalence of hypertension in urban than rural regions. BMI appears to modify the relationship between salt and hypertension in rural populations.

[Obesity, body morphology, and blood pressure in urban and rural population groups of Yucatan].

PubMed

Arroyo, Pedro; Fernández, Victoria; Loría, Alvar; Pardío, Jeannette; Laviada, Hugo; Vargas-Ancona, Lizardo; Ward, Ryk

2007-01-01

To characterize body morphology and blood pressure of adults of the Mexican state of Yucatan. Rural-urban differences in weight, height, waist, and hip circumferences, and blood pressure were analyzed in 313 urban and 271 rural subjects. No rural-urban differences in prevalence of obesity and overweight were found. Hypertension was marginally higher in urban subjects. Rural abnormal waist circumference was higher in young men and young women. Comparison with two national surveys and a survey in the aboriginal population (rural mixtecos) showed similar prevalence of obesity as ENSA-2000 and higher than mixtecos and ENEC-1993. Abnormal waist circumference was intermediate between ENSANUT-2006 and mixtecos and hypertension was intermediate between ENEC and mixtecos. The Maya and mestizo population of Yucatan showed a high prevalence of obesity and abnormal waist circumference not accompanied by a comparable higher hypertension frequency. This finding requires further confirmation.

Rural AIDS Diagnoses in Florida: Changing Demographics and Factors Associated With Survival

PubMed Central

Trepka, Mary Jo; Niyonsenga, Theophile; Maddox, Lorene M.; Lieb, Spencer

2012-01-01

Purpose To compare demographic characteristics and predictors of survival of rural residents diagnosed with acquired immunodeficiency syndrome (AIDS) with those of urban residents. Methods Florida surveillance data for people diagnosed with AIDS during 1993–2007 were merged with 2000 Census data using ZIP code tabulation areas (ZCTA). Rural status was classified based on the ZCTA’s rural-urban commuting area classification. Survival rates were compared between rural and urban areas using survival curves and Cox proportional hazards models controlling for demographic, clinical, and area-level socioeconomic and health care access factors. Findings Of the 73,590 people diagnosed with AIDS, 1,991 (2.7%) resided in rural areas. People in the most recent rural cohorts were more likely than those in earlier cohorts to be female, non-Hispanic black, older, and have a reported transmission mode of heterosexual sex. There were no statistically significant differences in the 3-, 5-, or 10-year survival rates between rural and urban residents. Older age at the time of diagnosis, diagnosis during the 1993–1995 period, other/unknown transmission mode, and lower CD4 count/percent categories were associated with lower survival in both rural and urban areas. In urban areas only, being non-Hispanic black or Hispanic, being US born, more poverty, less community social support, and lower physician density were also associated with lower survival. Conclusions In rural Florida, the demographic characteristics of people diagnosed with AIDS have been changing, which may necessitate modifications in the delivery of AIDS-related services. Rural residents diagnosed with AIDS did not have a significant survival disadvantage relative to urban residents. PMID:23802929

Short-term outcome and differences between rural and urban trauma patients treated by mobile intensive care units in Northern Finland: a retrospective analysis.

PubMed

Raatiniemi, Lasse; Liisanantti, Janne; Niemi, Suvi; Nal, Heini; Ohtonen, Pasi; Antikainen, Harri; Martikainen, Matti; Alahuhta, Seppo

2015-11-05

Emergency medical services are an important part of trauma care, but data comparing urban and rural areas is needed. We compared 30-day mortality and length of intensive care unit (ICU) stay for trauma patients injured in rural and urban municipalities and collected basic data on trauma care in Northern Finland. We examined data from all trauma patients treated by the Finnish Helicopter Emergency Medical Services in 2012 and 2013. Only patients surviving to hospital were included in the analysis but all pre-hospital deaths were recorded. All data was retrieved from the national Helicopter Emergency Medical Services database, medical records, and the Finnish Causes of Death Registry. Patients were defined as urban or rural depending on the type of municipality where the injury occurred. A total of 472 patients were included. Age and Injury Severity Score did not differ between rural and urban patients. The pre-hospital time intervals and distances to trauma centers were longer for rural patients and a larger proportion of urban patients had intentional injuries (23.5% vs. 9.3%, P <0.001). The 30-day mortality for severely injured patients (Injury Severity Score >15) was 23.9% in urban and 13.3% in rural municipalities. In the multivariate regression analysis the odds ratio (OR) for 30-day mortality was 2.8 (95% confidence interval 1.0 to 7.9, P = 0.05) in urban municipalities. There was no difference in the length of ICU stay or scores. Twenty patients died on scene or during transportation and 56 missions were aborted because of pre-hospital death. The severely injured urban trauma patients had a trend toward higher 30-day mortality compared with patients injured in rural areas but the length of ICU stay was similar. However, more pre-hospital deaths occurred in rural municipalities. The time before mobile ICU arrival appears to be critical for trauma patients' survival, especially in rural areas.

[Comparative analysis of four kinds of vitamin B of milk of lactating mothers and maternal and infant nutritional status in Chinese urban and rural areas].

PubMed

Liu, Huihui; Han, Xiuxia; Liu, Liegang; Jiang, Dianchen; Yi, Mingji; Zheng, Yanfeng; Ma, Aiguo

2014-05-01

To understand the nutritional level of lactating mothers and infant by detecting the content of the vitamin B1, vitamin B2, vitamin B6, nicotinic of milk of urban and rural areas and to provide the basis for improving vitamin nutritional status of lactating women and their babies. Totally 92 pairs of breastfeeding healthy mothers and their children in Shandong Province were selected. 34 pairs were in a urban area and 58 pairs were in a rural area. Collect the milk of selected lactating mothers and the urine of the lactating mothers and their children. Detect the content of vitamin B1, vitamin B2, vitamin B6, nicotinic of milk of lactating mothers and the content of vitamin B1, vitamin B2, nicotinic of urine of lactating mothers and their children. The content of vitamin B2, vitamin B6 and niacin of milk of urban lactating mothers were significantly higher than that of rural lactating mothers. The results of detection showed the vitamin B2 of milk of urban lactating mothers was 149.77 microg/100 g, which was significantly higher than that of rural women in 85.09 microg/100 g (P < 0.05). Vitamin B6 and niacin contents were 15.29 microg/100 g, 40.83 microg/100 g, which were also higher than that in rural lactating milk (6.69 microg/100 g and 24.48 microg/100 g) (All values P < 0.05). However, vitamin B1 of milk of urban and rural lactating mothers were 5.54 microg/100 g and 4.80 microg/100 g respectively, which had no significant difference. Urine analysis showed vitamin B2 and niacin of urban mothers and children were significantly higher than that in rural area (P < 0.05). But the level of vitamin B1 of rural children was higher than that of urban children (P < 0.05). There was no significant difference in the vitamin B1 between urban and rural mothers. The insufficient percentages of vitamin B1, vitamin B2. niacin in urban mothers was 23.5%, 32.3% and 17.6%, and that in rural mothers were 29.3%, 82.8% and 53.4%. The deficiency percentage of vitamin B1, vitamin B2, niacin in urban children were 2.9%, 2.9% and 11.8%, and that in rural children were 5.1%, 51.8% and 25.8%. The insufficient percentage of vitamin B1 in urban and rural mothers was high and the content of vitamin B1 of milk was low. While the insufficient percentage of vitamin B2, niacin of rural lactating mothers and children were higher than that of urban mothers and children.

Comparison of indicators of the use of insulin and oral diabetes medication in a Polish population of patients in urban and rural areas in the years 2008, 2011 and 2012.

PubMed

Śliwczyński, Andrzej; Brzozowska, Melania; Czeleko, Tomasz; Karnafel, Waldemar; Sierocka, Aleksandra; Iltchev, Petre; Marczak, Michał

2014-01-01

Diabetes is one of the 10 most important chronic diseases in the world. According to the data of the International Diabetes Federation, in Poland 9% of the population between the ages of 20-79 suffer from diabetes. The aim of this study was to investigate the differences in the prevalence of diabetes in urban and rural areas in Poland, and the preparation of a model describing the phenomenon. Differences between urban and rural areas were studied for the occurrence of patients treated with diabetes per 100,000 inhabitants, the number of patients, structure of treatment per the used products, and the costs of reimbursement of treatment products between 2008-2012. Urban and rural cases were compared using zip codes. The basis for classifying a patient as being an inhabitant of an urban or rural area was an urban zip code of the declared place of residence. Differences were observed both between various areas of Poland, as well as depending on whether the declared place of residence of the patient was urban or rural. Differences between urban and rural areas within the studied period have increased. The difference in the prevalence of diabetes among the inhabitants of Podlaskie, Śląskie or Świętokrzyskie provinces is striking. Differences between urban and rural areas which depend on morbidity and detection of patients in the earlier phase of illness, the structures of medical technologies used in the treatment process, the number of purchased pharmaceuticals, enable better monitoring of effectiveness and quality of politics on prevention and treatment of chronic diseases. It is important for the creation of a health policy to devise a system of indicators, which will enable a decrease in the existing differences between regions, and between the urban and rural areas within the provinces.

Demographic and Geographical Characteristics of Pediatric Trauma in Scotland

DTIC Science & Technology

2013-01-01

the 8-fold Scottish Urban/ Rural Classifi- cation [20], which is based on settlement size and drive time to major conurbations. Social deprivation was...distribution, but with some exceptions. Scotland has an eccentrically distributed population, with 69.5% living in urban areas ( Scottish urban/ rural ...high rate of mortality and prehospital death. Acta Anaesthesiol Scand 2003;47:153-6. [20] Scottish Government: Scottish government urban/ rural

All Rural Places Are Not Created Equal: Revisiting the Rural Mortality Penalty in the United States

PubMed Central

2014-01-01

Objectives. I investigated mortality disparities between urban and rural areas by measuring disparities in urban US areas compared with 6 rural classifications, ranging from suburban to remote locales. Methods. Data from the Compressed Mortality File, National Center for Health Statistics, from 1968 to 2007, was used to calculate age-adjusted mortality rates for all rural and urban regions by year. Criteria measuring disparity between regions included excess deaths, annual rate of change in mortality, and proportion of excess deaths by population size. I used multivariable analysis to test for differences in determinants across regions. Results. The rural mortality penalty existed in all rural classifications, but the degree of disparity varied considerably. Rural–urban continuum code 6 was highly disadvantaged, and rural–urban continuum code 9 displayed a favorable mortality profile. Population, socioeconomic, and health care determinants of mortality varied across regions. Conclusions. A 2-decade long trend in mortality disparities existed in all rural classifications, but the penalty was not distributed evenly. This constitutes an important public health problem. Research should target the slow rates of improvement in mortality in the rural United States as an area of concern. PMID:25211763

Rural-Urban Differences in Environmental Concern in Canada

ERIC Educational Resources Information Center

Huddart-Kennedy, Emily; Beckley, Thomas M.; McFarlane, Bonita L.; Nadeau, Solange

2009-01-01

Distinctions between rural and urban populations are well documented in environmental sociology literature. Rural and urban places may exert different influences on participation in environmentally supportive behavior (ESB) as well as on other forms of environmental concern (EC). The influence of these distinct geographies may be due to present…

Predicting Children's Asthma Hospitalizations: Rural and Urban Differences in Texas

ERIC Educational Resources Information Center

Grineski, Sara E.

2009-01-01

Asthma is the number one chronic health condition facing children today; however, little is known about rural-urban inequalities in asthma. This "area effects on health" study examines rural-urban differences in childhood asthma hospitalizations within the state of Texas using negative binomial regression models. Effects associated with…

Rural-Urban Comparison of Female Educational Aspirations in South-Western Nigeria.

ERIC Educational Resources Information Center

Akande, Bolanle E.

1987-01-01

Examines the issue of equality of opportunity and social mobility in terms of differences between urban and rural young people in South-Western Nigeria, focusing particularly on those handicaps associated with female disadvantage. Reports results of interviews with 359 rural and urban female secondary school students. (JHZ)

Rural-Urban Differences in Scholastic Performance in College.

ERIC Educational Resources Information Center

Feller, Barbara A.

The study examined: (1) the effects of rural-urban background and social class on scholastic performance in college, and (2) the rural-urban differences in scholastic performance when controlled for social class, sex, and measured intelligence. Data originally collected by students' self-reports and administrative records for panel-designed…

Rural and Urban Teaching Experiences: Narrative Expressions

ERIC Educational Resources Information Center

Preston, Jane P.

2012-01-01

This qualitative exploration of rural and urban teaching experiences encapsulates the experiences of 8 Western Canadian teachers. A literature review outlines the benefits and challenges of rural and urban education. Stemming from narrative inquiry data, I present the study's results in the form of two composite stories, which depict the lived…

Rural-to-urban migration, kinship networks, and fertility among the Igbo in Nigeria

PubMed Central

Smith, Daniel Jordan

2013-01-01

Like many African rural-to-urban migrants, Igbo-speaking migrants to cities in Nigeria maintain close ties to their places of origin. ‘Home people’ constitute a vital core of most migrants’ social networks. The institution of kinship enables migrants to negotiate Nigeria’s clientelistic political economy. In this context, dichotomous distinctions between rural and urban can be inappropriate analytical concepts because kinship obligations and community ties that extend across rural and urban space create a continuous social field. This paper presents ethnographic data to suggest that fertility behavior in contemporary Igbo-speaking Nigeria cannot be understood without taking into account the ways in which rural and urban social and demographic regimes are mutually implicated and dialectically constituted (anthropological demography; migration; kinship; reproductive behavior; Nigeria). PMID:24426181

The impact of rural-urban migration on child survival.

PubMed

Brockerhoff, M

1994-10-01

Large rural-urban child mortality differentials in many developing countries suggest that rural families can improve their children's survival chances by leaving the countryside and settling in towns and cities. This study uses data from Demographic and Health Surveys in 17 countries to assess the impact of maternal rural-urban migration on the survival chances of children under age two in the late 1970s and 1980s. Results show that, before migration, children of migrant women had similar or slightly higher mortality risks than children of women who remained in the village. In the two-year period surrounding their mother's migration, their chances of dying increased sharply as a result of accompanying their mothers or being left behind, to levels well above those of rural and urban non-migrant children. Children born after migrants had settled in the urban area, however, gradually experienced much better survival chances than children of rural non-migrants, as well as lower mortality risks than migrants' children born in rural areas before migration. The study concludes that many disadvantaged urban children would probably have been much worse off had their mothers remained in the village, and that millions of children's lives may have been saved in the 1980s as a result of mothers moving to urban areas.

Functional independence of residents in urban and rural long-term care facilities in Taiwan.

PubMed

Lin, Kwan-Hwa; Wu, Shiao-Chi; Hsiung, Chia-Ling; Hu, Ming-Hsia; Hsieh, Ching-Lin; Lin, Jau-Hong; Kuo, Mei-Ying

2004-02-04

To compare the score of functional independence measure (FIM) between urban and rural residents living in long-term care facilities (LTCF) in Taiwan. A total of 437 subjects in 112 licensed LTCF in Taiwan were randomly selected by stratification strategy. Physical therapists interviewed the subjects in nursing homes (NH) and intermediate care facilities (ICF) to obtain the basic data, and the FIM score. (1) There was no significant difference in basic demographic data between urban and rural LTC subjects. (2) Most of the subjects in urban and rural LTCF were males, less than 80 years old, single/widowed, having multiple diseases, using more than one assistive devices, and having social welfare financial support. (3) Motor abilities (eating, grooming, and transfer) and cognition (comprehension, social interaction and problem solving) in rural LTCF subjects were significantly (p < 0.05) higher than those in urban areas as revealed by the FIM assessment. (4) The median of FIM total score of rural LTCF subjects was 90.5, which was significantly (p < 0.05) higher than that of urban LTCF subjects (median = 76). Some of the functional performance of subjects in rural long-term care institutions is better than those in urban areas. Our results may provide guidelines for the manpower and equipment supply estimation.

A cross-sectional survey of Aedes aegypti immature abundance in urban and rural household containers in central Colombia.

PubMed

Overgaard, Hans J; Olano, Víctor Alberto; Jaramillo, Juan Felipe; Matiz, María Inés; Sarmiento, Diana; Stenström, Thor Axel; Alexander, Neal

2017-07-27

Aedes aegypti, the major vector of dengue, breeds in domestic water containers. The development of immature mosquitoes in such containers is influenced by various environmental, ecological and socioeconomic factors. Urban and rural disparities in water storage practices and water source supply may affect mosquito immature abundance and, potentially, dengue risk. We evaluated the effect of water and container characteristics on A. aegypti immature abundance in urban and rural areas. Data were collected in the wet season of 2011 in central Colombia from 36 urban and 35 rural containers, which were either mosquito-positive or negative. Immature mosquitoes were identified to species. Data on water and container characteristics were collected from all containers. A total of 1452 Aedes pupae and larvae were collected of which 81% were A. aegypti and 19% A. fluviatilis. Aedes aegypti immatures were found in both urban and rural sites. However, the mean number of A. aegypti pupae was five times higher in containers in the urban sites compared to those in the rural sites. One of the important factors associated with A. aegypti infestation was frequency of container washing. Monthly-washed or never-washed containers were both about four times more likely to be infested than those washed every week. There were no significant differences between urban and rural sites in frequency of washing containers. Aedes aegypti immature infestation was positively associated with total dissolved solids, but negatively associated with dissolved oxygen. Water temperature, total dissolved solids, ammonia, nitrate, and organic matter were significantly higher in urban than in rural containers, which might explain urban-rural differences in breeding of A. aegypti. However, many of these factors vary substantially between studies and in their degree of association with vector breeding, therefore they may not be reliable indices for vector control interventions. Although containers in urban areas were more likely to be infested with A. aegypti, rural containers still provide suitable habitats for A. aegypti. Containers that are washed more frequent are less likely to produce A. aegypti. These results highlight the importance of container washing as an effective vector control tool in both urban and rural areas. In addition, alternative designs of the highly productive washbasins should continue to be explored. To control diseases such as dengue, Zika and chikungunya, effective vector breeding site control must be implemented in addition to other interventions.

Prevalence of self-reported asthma in urban and rural areas of Turkey.

PubMed

Ekici, Aydanur; Ekici, Mehmet; Kocyigit, Pinar; Karlidag, Ali

2012-06-01

The risk factors for asthma in rural and urban population of Turkey are not well known. In this study we examined the effects of risk factors on the prevalence of asthma in adults living in rural and urban areas using data from a representative sample. Parents and grandparents of students from 20 randomly selected primary schools in urban and rural areas of Kirikkale, Turkey, were asked about respiratory diseases using the respiratory questionnaire, which were returned to us by their children. Out of 13,225 parents and grandparents of primary school students 12,270 returned the questionnaires, for an overall response rate of 92.7%. The prevalence of asthma was more common in adults living in rural areas than in urban areas (10.8% vs. 6.2%, p < .0001, respectively). Asthma was more prevalent in women exposed to biomass smoke than those who were not exposed to it in rural areas (14.8% vs. 6.6%, p = .0001, respectively). Frequent childhood respiratory infections were more common in adults living in rural areas than in urban areas (18.2% vs. 10.9%, p < .0001, respectively). Exposure to biomass smoke and frequent childhood respiratory infections were associated with an increased risk of asthma, after adjusting for possible confounding factors in the logistic model for rural subjects. Chronic rhinitis (p = .0001) and frequent childhood respiratory infections (p = .0001) were associated with an increased risk of asthma, after adjusting for possible confounding factors in the logistic model for urban subjects. The prevalence of asthma in adults living in the rural areas of the Kirikkale Region in Central Turkey was significantly higher than that in the urban population. Exposure to biomass smoke and childhood respiratory infections were more common in adults living in rural areas. The higher rate of asthma in adults living in rural areas may be due to a higher frequency of childhood respiratory infections and exposure to biomass smoke.

The extent of shifts in vegetation phenology between rural and urban areas within a human-dominated region.

PubMed

Dallimer, Martin; Tang, Zhiyao; Gaston, Kevin J; Davies, Zoe G

2016-04-01

Urbanization is one of the major environmental challenges facing the world today. One of its particularly pressing effects is alterations to local and regional climate through, for example, the Urban Heat Island. Such changes in conditions are likely to have an impact on the phenology of urban vegetation, which will have knock-on implications for the role that urban green infrastructure can play in delivering multiple ecosystem services. Here, in a human-dominated region, we undertake an explicit comparison of vegetation phenology between urban and rural zones. Using satellite-derived MODIS-EVI data from the first decade of the 20th century, we extract metrics of vegetation phenology (date of start of growing season, date of end of growing season, and length of season) for Britain's 15 largest cities and their rural surrounds. On average, urban areas experienced a growing season 8.8 days longer than surrounding rural zones. As would be expected, there was a significant decline in growing season length with latitude (by 3.4 and 2.4 days/degree latitude in rural and urban areas respectively). Although there is considerable variability in how phenology in urban and rural areas differs across our study cities, we found no evidence that built urban form influences the start, end, or length of the growing season. However, the difference in the length of the growing season between rural and urban areas was significantly negatively associated with the mean disposable household income for a city. Vegetation in urban areas deliver many ecosystem services such as temperature mitigation, pollution removal, carbon uptake and storage, the provision of amenity value for humans and habitat for biodiversity. Given the rapid pace of urbanization and ongoing climate change, understanding how vegetation phenology will alter in the future is important if we wish to be able to manage urban greenspaces effectively.

Song convergence in multiple urban populations of silvereyes (Zosterops lateralis)

PubMed Central

Potvin, Dominique A; Parris, Kirsten M

2012-01-01

Recent studies have revealed differences between urban and rural vocalizations of numerous bird species. These differences include frequency shifts, amplitude shifts, altered song speed, and selective meme use. If particular memes sung by urban populations are adapted to the urban soundscape, “urban-typical” calls, memes, or repertoires should be consistently used in multiple urban populations of the same species, regardless of geographic location. We tested whether songs or contact calls of silvereyes (Zosterops lateralis) might be subject to such convergent cultural evolution by comparing syllable repertoires of geographically dispersed urban and rural population pairs throughout southeastern Australia. Despite frequency and tempo differences between urban and rural calls, call repertoires were similar between habitat types. However, certain song syllables were used more frequently by birds from urban than rural populations. Partial redundancy analysis revealed that both geographic location and habitat characteristics were important predictors of syllable repertoire composition. These findings suggest convergent cultural evolution: urban populations modify both song and call syllables from their local repertoire in response to noise. PMID:22957198

Song convergence in multiple urban populations of silvereyes (Zosterops lateralis).

PubMed

Potvin, Dominique A; Parris, Kirsten M

2012-08-01

Recent studies have revealed differences between urban and rural vocalizations of numerous bird species. These differences include frequency shifts, amplitude shifts, altered song speed, and selective meme use. If particular memes sung by urban populations are adapted to the urban soundscape, "urban-typical" calls, memes, or repertoires should be consistently used in multiple urban populations of the same species, regardless of geographic location. We tested whether songs or contact calls of silvereyes (Zosterops lateralis) might be subject to such convergent cultural evolution by comparing syllable repertoires of geographically dispersed urban and rural population pairs throughout southeastern Australia. Despite frequency and tempo differences between urban and rural calls, call repertoires were similar between habitat types. However, certain song syllables were used more frequently by birds from urban than rural populations. Partial redundancy analysis revealed that both geographic location and habitat characteristics were important predictors of syllable repertoire composition. These findings suggest convergent cultural evolution: urban populations modify both song and call syllables from their local repertoire in response to noise.

Urban-Rural Comparisons in Hospital Admission, Treatments, and Outcomes for ST-Segment-Elevation Myocardial Infarction in China From 2001 to 2011: A Retrospective Analysis From the China PEACE Study (Patient-Centered Evaluative Assessment of Cardiac Events).

PubMed

Li, Xi; Murugiah, Karthik; Li, Jing; Masoudi, Frederick A; Chan, Paul S; Hu, Shuang; Spertus, John A; Wang, Yongfei; Downing, Nicholas S; Krumholz, Harlan M; Jiang, Lixin

2017-11-01

In response to urban-rural disparities in healthcare resources, China recently launched a healthcare reform with a focus on improving rural care during the past decade. However, nationally representative studies comparing medical care and patient outcomes between urban and rural areas in China during this period are not available. We created a nationally representative sample of patients in China admitted for ST-segment-elevation myocardial infarction in 2001, 2006, and 2011, using a 2-stage random sampling design in 2 urban and 3 rural strata. In China, evidence-based treatments were provided less often in 2001 in rural hospitals, which had lower volume and less availability of advanced cardiac facilities. However, these differences diminished by 2011 for reperfusion therapy (54% in urban versus 57% in rural; P =0.1) and reversed for angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (66% versus 68%; P =0.04) and early β-blockers (56% versus 60%; P =0.01). The risk-adjusted rate of in-hospital death or withdrawal from treatment was not significantly different between urban and rural hospitals in any study year, with an adjusted odds ratio of 1.13 (0.77-1.65) in 2001, 0.99 (0.77-1.27) in 2006, and 0.94 (0.74-1.19) in 2011. Although urban-rural disparities in evidence-based treatment for myocardial infarction in China have largely been eliminated, substantial gaps in quality of care persist in both settings. In addition, urban hospitals providing more resource-intensive care did not achieve better outcomes. URL: https://www.clinicaltrials.gov. Unique identifier: NCT01624883. © 2017 American Heart Association, Inc.

Organophosphate esters and phthalate esters in human hair from rural and urban areas, Chongqing, China: Concentrations, composition profiles and sources in comparison to street dust.

PubMed

He, Ming-Jing; Lu, Jun-Feng; Ma, Jing-Ye; Wang, Huan; Du, Xiao-Fan

2018-06-01

Human hair and street dust from rural and urban areas in Chongqing were collected to analyze Organophosphate esters (OPEs) and phthalate esters (PAEs). Concentrations of OPEs in urban hair were significantly higher than those in rural hair, whereas PAEs concentrations in rural hair were significantly higher than those in urban hair. Different composition patterns of OPEs were observed in rural and urban hair, where tris (2-chloroisopropyl) phosphate (TCIPP), tris (butyl) phosphate (TNBP) and triphenyl phosphate (TPHP) were the dominating analogues in rural hair, accounting for 62.1% of the OPEs burden, and tris (methylphenyl) phosphate (TMPP) exhibited a high contribution in urban hair, responsible for 51.3% of total OPEs, which differed from the composition profiles in corresponding street dust. Analogous composition patterns of PAEs were found in hair of both areas. Di-(2-ethylhexyl) phthalate (DEHP), dibutyl phthalate (DNBP), diisobutyl phthalate (DIBP) and diethyl phthalate (DEP) were the most abundant analogues in hair samples, while DEHP was the predominant analogue in dust samples. No clear tendency was obtained between the increasing ages and the concentrations of both compounds. Most OPEs and PAEs congeners showed significantly positive correlation with one another in rural hair. On the contrary, different correlation patterns were observed in urban hair for OPEs and PAEs, indicating multiple or additional sources existed in urban areas. Significant correlations of OPEs and PAEs were found between hair and corresponding street dust samples, but poor correlations of OPEs and PAEs were observed between rural hair and rural indoor dust, suggesting that street dust may be a predominant exogenous source for human exposure to OPEs and PAEs in this area. Copyright © 2018 Elsevier Ltd. All rights reserved.

Widening rural-urban disparities in all-cause mortality and mortality from major causes of death in the USA, 1969-2009.

PubMed

Singh, Gopal K; Siahpush, Mohammad

2014-04-01

This study examined trends in rural-urban disparities in all-cause and cause-specific mortality in the USA between 1969 and 2009. A rural-urban continuum measure was linked to county-level mortality data. Age-adjusted death rates were calculated by sex, race, cause-of-death, area-poverty, and urbanization level for 13 time periods between 1969 and 2009. Cause-of-death decomposition and log-linear and Poisson regression were used to analyze rural-urban differentials. Mortality rates increased with increasing levels of rurality overall and for non-Hispanic whites, blacks, and American Indians/Alaska Natives. Despite the declining mortality trends, mortality risks for both males and females and for blacks and whites have been increasingly higher in non-metropolitan than metropolitan areas, particularly since 1990. In 2005-2009, mortality rates varied from 391.9 per 100,000 population for Asians/Pacific Islanders in rural areas to 1,063.2 for blacks in small-urban towns. Poverty gradients were steeper in rural areas, which maintained higher mortality than urban areas after adjustment for poverty level. Poor blacks in non-metropolitan areas experienced two to three times higher all-cause and premature mortality risks than affluent blacks and whites in metropolitan areas. Disparities widened over time; excess mortality from all causes combined and from several major causes of death in non-metropolitan areas was greater in 2005-2009 than in 1990-1992. Causes of death contributing most to the increasing rural-urban disparity and higher rural mortality include heart disease, unintentional injuries, COPD, lung cancer, stroke, suicide, diabetes, nephritis, pneumonia/influenza, cirrhosis, and Alzheimer's disease. Residents in metropolitan areas experienced larger mortality reductions during the past four decades than non-metropolitan residents, contributing to the widening gap.

The effect on cardiovascular risk factors of migration from rural to urban areas in Peru: PERU MIGRANT Study

PubMed Central

Miranda, J Jaime; Gilman, Robert H; García, Héctor H; Smeeth, Liam

2009-01-01

Background Mass-migration observed in Peru from the 1970s occurred because of the need to escape from politically motivated violence and work related reasons. The majority of the migrant population, mostly Andean peasants from the mountainous areas, tends to settle in clusters in certain parts of the capital and their rural environment could not be more different than the urban one. Because the key driver for migration was not the usual economic and work-related reasons, the selection effects whereby migrants differ from non-migrants are likely to be less prominent in Peru. Thus the Peruvian context offers a unique opportunity to test the effects of migration. Methods/Design The PERU MIGRANT (PEru's Rural to Urban MIGRANTs) study was designed to investigate the magnitude of differences between rural-to-urban migrant and non-migrant groups in specific CVD risk factors. For this, three groups were selected: Rural, people who have always have lived in a rural environment; Rural-urban, people who migrated from rural to urban areas; and, Urban, people who have always lived in a urban environment. Discussion Overall response rate at enrolment was 73.2% and overall response rate at completion of the study was 61.6%. A rejection form was obtained in 282/323 people who refused to take part in the study (87.3%). Refusals did not differ by sex in rural and migrant groups, but 70% of refusals in the urban group were males. In terms of age, most refusals were observed in the oldest age-group (>60 years old) in all study groups. The final total sample size achieved was 98.9% of the target sample size (989/1000). Of these, 52.8% (522/989) were females. Final size of the rural, migrant and urban study groups were 201, 589 and 199 urban people, respectively. Migrant's average age at first migration and years lived in an urban environment were 14.4 years (IQR 10–17) and 32 years (IQR 25–39), respectively. This paper describes the PERU MIGRANT study design together with a critical analysis of the potential for bias and confounding in migrant studies, and strategies for reducing these problems. A discussion of the potential advantages provided by the case of migration in Peru to the field of migration and health is also presented. PMID:19505331

Urban-rural differences in the gene expression profiles of Ghanaian children.

PubMed

Amoah, A S; Obeng, B B; May, L; Kruize, Y C; Larbi, I A; Kabesch, M; Wilson, M D; Hartgers, F C; Boakye, D A; Yazdanbakhsh, M

2014-01-01

Recent studies indicate that urbanization is having a pronounced effect on disease patterns in developing countries. To understand the immunological basis of this, we examined mRNA expression in whole blood of genes involved in immune activation and regulation in 151 children aged 5-13 years attending rural, urban low socioeconomic status (SES) and urban high-SES schools in Ghana. Samples were also collected to detect helminth and malaria infections. Marked differences in gene expression were observed between the rural and urban areas as well as within the urban area. The expression of both interleukin (IL)-10 and programmed cell death protein 1 increased significantly across the schools from urban high SES to urban low SES to rural (P-trend <0.001). Although IL-10 gene expression was significantly elevated in the rural compared with the urban schools (P<0.001), this was not associated with parasitic infection. Significant differences in the expression of toll-like receptors (TLRs) and their signaling genes were seen between the two urban schools. Genetic differences could not fully account for the gene expression profiles in the different groups as shown by analysis of IL-10, TLR-2 and TLR-4 gene polymorphisms. Immune gene expression patterns are strongly influenced by environmental determinants and may underlie the effects of urbanization seen on health outcomes.

Do wild-caught urban house sparrows show desensitized stress responses to a novel stressor?

PubMed

Salleh Hudin, Noraine; Teyssier, Aimeric; Aerts, Johan; Fairhurst, Graham D; Strubbe, Diederik; White, Joël; De Neve, Liesbeth; Lens, Luc

2018-04-09

While urbanisation exposes individuals to novel challenges, urban areas may also constitute stable environments in which seasonal fluctuations are buffered. Baseline and stress-induced plasma corticosterone levels are often found to be similar in urban and rural populations. Here we aimed to disentangle two possible mechanisms underlying such pattern: (i) urban environments are no more stressful or urban birds have a better ability to habituate to stressors; or (ii) urban birds developed desensitized stress responses. We exposed wild-caught urban and rural house sparrows ( Passer domesticus ) to combined captivity and diet treatments (urban vs rural diet) and measured corticosterone levels (cort f ) both in natural tail feathers and in regrown homologous ones. Urban and rural house sparrows showed similar cort f levels in the wild and in response to novel stressors caused by the experiment, supporting the growing notion that urban environments are no more stressful during the non-breeding season than are rural ones. Still, juveniles and males originating from urban populations showed the highest cort f levels in regrown feathers. We did not find evidence that cort f was consistent within individuals across moults. Our study stresses the need for incorporating both intrinsic and environmental factors for the interpretation of variation in cort f between populations. © 2018. Published by The Company of Biologists Ltd.

Medicaid Expansion Under the Affordable Care Act and Insurance Coverage in Rural and Urban Areas.

PubMed

Soni, Aparna; Hendryx, Michael; Simon, Kosali

2017-04-01

To analyze the differential rural-urban impacts of the Affordable Care Act Medicaid expansion on low-income childless adults' health insurance coverage. Using data from the American Community Survey years 2011-2015, we conducted a difference-in-differences regression analysis to test for changes in the probability of low-income childless adults having insurance in states that expanded Medicaid versus states that did not expand, in rural versus urban areas. Analyses employed survey weights, adjusted for covariates, and included a set of falsification tests as well as sensitivity analyses. Medicaid expansion under the Affordable Care Act increased the probability of Medicaid coverage for targeted populations in rural and urban areas, with a significantly greater increase in rural areas (P < .05), but some of these gains were offset by reductions in individual purchased insurance among rural populations (P < .01). Falsification tests showed that the insurance increases were specific to low-income childless adults, as expected, and were largely insignificant for other populations. The Medicaid expansion increased the probability of having "any insurance" for the pooled urban and rural low-income populations, and it specifically increased Medicaid coverage more in rural versus urban populations. There was some evidence that the expansion was accompanied by some shifting from individual purchased insurance to Medicaid in rural areas, and there is a need for future work to understand the implications of this shift on expenditures, access to care and utilization. © 2017 National Rural Health Association.

Timing and Impact of Hearing Healthcare in Adult Cochlear Implant Recipients: A Rural-Urban Comparison

PubMed Central

Hixon, Brian; Chan, Stephen; Adkins, Margaret; Shinn, Jennifer B.; Bush, Matthew L.

2016-01-01

Objective The purpose of this study is to compare the timing and impact of hearing healthcare of rural and urban adults with severe hearing loss who use cochlear implants (CI). Study Design Cross-sectional questionnaire study Setting Tertiary referral center Patients Adult cochlear implant recipients. Main Outcome Measures Data collected included county of residence, socioeconomic information, impact of hearing loss on education/employment, and timing of hearing loss treatment. The benefits obtained from cochlear implantation were also evaluated. Results There were 91 participants (32 from urban counties, 26 from moderately rural counties, and 33 for extremely rural counties). Rural participants have a longer commute time to the CI center (p<0.001), lower income (p<0.001) and higher percentage of Medicaid coverage (p=0.004). Compared with urban-metro participants, rural participants with gradually progressive hearing loss had a greater time interval from the onset of hearing loss to obtaining hearing aid amplification (10 years versus 5 years, p=0.04). There was also a greater time interval from onset of hearing loss to the time of cochlear implantation in rural participants (p=0.04). Reported job loss was higher in rural participants than in urban participants (p=0.05). Both groups reported comparable benefit from cochlear implantation. Conclusions Rural CI recipients differ from urban residents in socioeconomic characteristics and may be delayed in timely treatment of hearing loss. Further efforts to expand access to hearing healthcare services may benefit rural adult patients. PMID:27636389

Timing and Impact of Hearing Healthcare in Adult Cochlear Implant Recipients: A Rural-Urban Comparison.

PubMed

Hixon, Brian; Chan, Stephen; Adkins, Margaret; Shinn, Jennifer B; Bush, Matthew L

2016-10-01

The purpose of this study is to compare the timing and impact of hearing healthcare of rural and urban adults with severe hearing loss who use cochlear implants (CI). Cross-sectional questionnaire study. Tertiary referral center. Adult cochlear implant recipients. Data collected included county of residence, socioeconomic information, impact of hearing loss on education/employment, and timing of hearing loss treatment. The benefits obtained from cochlear implantation were also evaluated. There were 91 participants (32 from urban counties, 26 from moderately rural counties, and 33 for extremely rural counties). Rural participants have a longer commute time to the CI center (p < 0.001), lower income (p < 0.001), and higher percentage of Medicaid coverage (p = 0.004). Compared with urban-metro participants, rural participants with gradually progressive hearing loss had a greater time interval from the onset of hearing loss to obtaining hearing aid amplification (10 yr versus 5 yr, p = 0.04). There was also a greater time interval from onset of hearing loss to the time of cochlear implantation in rural participants (p = 0.04). Reported job loss was higher in rural participants than in urban participants (p = 0.05). Both groups reported comparable benefit from cochlear implantation. Rural CI recipients differ from urban residents in socioeconomic characteristics and may be delayed in timely treatment of hearing loss. Further efforts to expand access to hearing healthcare services may benefit rural adult patients.

Intersection of Living in a Rural Versus Urban Area and Race/Ethnicity in Explaining Access to Health Care in the United States.

PubMed

Caldwell, Julia T; Ford, Chandra L; Wallace, Steven P; Wang, May C; Takahashi, Lois M

2016-08-01

To examine whether living in a rural versus urban area differentially exposes populations to social conditions associated with disparities in access to health care. We linked Medical Expenditure Panel Survey (2005-2010) data to geographic data from the American Community Survey (2005-2009) and Area Health Resource File (2010). We categorized census tracts as rural and urban by using the Rural-Urban Commuting Area Codes. Respondent sample sizes ranged from 49 839 to 105 306. Outcomes were access to a usual source of health care, cholesterol screening, cervical screening, dental visit within recommended intervals, and health care needs met. African Americans in rural areas had lower odds of cholesterol screening (odds ratio[OR] = 0.37; 95% confidence interval[CI] = 0.25, 0.57) and cervical screening (OR = 0.48; 95% CI = 0.29, 0.80) than African Americans in urban areas. Whites had fewer screenings and dental visits in rural versus urban areas. There were mixed results for which racial/ethnic group had better access. Rural status confers additional disadvantage for most of the health care use measures, independently of poverty and health care supply.

Rural-Urban Differences in Consumer Governance at Community Health Centers

PubMed Central

Wright, David Bradley

2017-01-01

Context Community health centers (CHCs) are primary care clinics that serve mostly low-income patients in rural and urban areas. They are required to be governed by a consumer majority. What little is known about the structure and function of these boards in practice, suggests that CHC boards in rural areas may look and act differently than CHC boards in urban areas. Purpose To identify differences in the structure and function of consumer governance at CHCs in rural and urban areas. Methods Semi-structured telephone interviews were conducted with 30 CHC board members from 14 different states. Questions focused on board members’ perceptions of board composition and the role of consumers on the board. Findings CHCs in rural areas are more likely to have representative boards, are better able to convey confidence in the organization, and are better able to assess community needs than CHCs in urban areas. However, CHCs in rural areas often have problems achieving objective decision-making, and may have fewer means for objectively evaluating quality of care due to the lack of patient board member anonymity. Conclusions Consumer governance is implemented differently in rural and urban communities, and the advantages and disadvantages in each setting are unique. PMID:23551642

Association of long-term PM2.5 exposure with mortality using different air pollution exposure models: impacts in rural and urban California.

PubMed

Garcia, Cynthia A; Yap, Poh-Sin; Park, Hye-Youn; Weller, Barbara L

2016-01-01

Most PM2.5-associated mortality studies are not conducted in rural areas where mortality rates may differ when population characteristics, health care access, and PM2.5 composition differ. PM2.5-associated mortality was investigated in the elderly residing in rural-urban zip codes. Exposure (2000-2006) was estimated using different models and Poisson regression was performed using 2006 mortality data. PM2.5 models estimated comparable exposures, although subtle differences were observed in rate ratios (RR) within areas by health outcomes. Cardiovascular disease (CVD), ischemic heart disease (IHD), and cardiopulmonary disease (CPD), mortality was significantly associated with rural, urban, and statewide chronic PM2.5 exposures. We observed larger effect sizes in RRs for CVD, CPD, and all-cause (AC) with similar sizes for IHD mortality in rural areas compared to urban areas. PM2.5 was significantly associated with AC mortality in rural areas and statewide; however, in urban areas, only the most restrictive exposure model showed an association. Given the results seen, future mortality studies should consider adjusting for differences with rural-urban variables.

Cumulative Causation of Rural Migration and Initial Peri-Urbanization in China.

PubMed

Hao, Lingxin

2012-01-01

This paper posits that rural migration feeds the high demand for cheap labor in peri-urbanization, which is driven by globalization, flows of foreign capital, and entrepreneurial local governments. While the gravity model and push/pull perspective ignore the dynamics of migratory course, we use the cumulative causation of migration theory to conceptualize social expectations for outmigration and social resources from migrant networks in destinations. Four major findings are drawn from this demographic analysis based on micro data from China's 2000 Census. First, the expectation of outmigration significantly increases outmigration, and this effect is independent of push factors. Second, foreign direct investment (FDI) contributes to attracting rural labor migrants from other provinces to peri-urban areas as it does to cities. Third, social resources from migrant networks play an important role in attracting rural labor migrants to both city and noncity destinations. Fourth, the importance of wage differentials declines in gravitating rural labor migrants to peri-urban areas. These findings provide tentative evidence that rural labor migration is indispensable during initial peri-urbanization. Infused with flows of FDI and entrepreneurial local governments, rural migration has created a favorable initial condition for peri-urbanization.

Cumulative Causation of Rural Migration and Initial Peri-Urbanization in China*

PubMed Central

Hao, Lingxin

2014-01-01

This paper posits that rural migration feeds the high demand for cheap labor in peri-urbanization, which is driven by globalization, flows of foreign capital, and entrepreneurial local governments. While the gravity model and push/pull perspective ignore the dynamics of migratory course, we use the cumulative causation of migration theory to conceptualize social expectations for outmigration and social resources from migrant networks in destinations. Four major findings are drawn from this demographic analysis based on micro data from China’s 2000 Census. First, the expectation of outmigration significantly increases outmigration, and this effect is independent of push factors. Second, foreign direct investment (FDI) contributes to attracting rural labor migrants from other provinces to peri-urban areas as it does to cities. Third, social resources from migrant networks play an important role in attracting rural labor migrants to both city and noncity destinations. Fourth, the importance of wage differentials declines in gravitating rural labor migrants to peri-urban areas. These findings provide tentative evidence that rural labor migration is indispensable during initial peri-urbanization. Infused with flows of FDI and entrepreneurial local governments, rural migration has created a favorable initial condition for peri-urbanization. PMID:25525564

Marginalization and health service coverage among indigenous, rural, and urban populations: a public health problem in Mexico.

PubMed

Roldán, José; Álvarez, Marsela; Carrasco, María; Guarneros, Noé; Ledesma, José; Cuchillo-Hilario, Mario; Chávez, Adolfo

2017-12-01

  Marginalization is a significant issue in Mexico, involving a lack of access to health services with differential impacts on Indigenous, rural and urban populations. The objective of this study was to understand Mexico’s public health problem across three population areas, Indigenous, rural and urban, in relation to degree of marginalization and health service coverage.   The sampling universe of the study consisted of 107 458 geographic locations in the country. The study was retrospective, comparative and confirmatory. The study applied analysis of variance, parametric and non-parametric, correlation and correspondence analyses.   Significant differences were identified between the Indigenous, rural and urban populations with respect to their level of marginalization and access to health services. The most affected area was Indigenous, followed by rural areas. The sector that was least affected was urban.   Although health coverage is highly concentrated in urban areas in Mexico, shortages are mostly concentrated in rural areas where Indigenous groups represent the extreme end of marginalization and access to medical coverage. Inadequate access to health services in the Indigenous and rural populations throws the gravity of the public health problem into relief.

Assessment of dietary habits and nutritional status of depressive patients, depending on place of residence.

PubMed

Stefanska, Ewa; Wendołowicz, Agnieszka; Cwalina, Urszula; Kowzan, Urszula; Konarzewska, Beata; Szulc, Agata; Ostrowska, Lucyna

2017-12-23

An increased incidence of depressive disorders observed in recent years in the Polish and world population is a serious health problem. The aim of the study was to compare dietary habits and nutritional status of patients with recurrent depressive disorders, depending on their place of residence. Their impact on selected metabolic parameters was also considered. The study group comprised 96 women and 84 men reporting to the Outpatient Mental Health Clinic at the Department of Psychiatry, Medical University of Bialystok in north-eastern Poland. The average age of the women was 46.7±11.7 years, and of men 47.0±11.3 years. In the quantitative assessmentof diets, 24-hour food recall interviews were conducted. Assessment of the nutritional status of the respondents consisted of anthropometric measurements, body composition analysis and biochemical parameters. It was show that the diets of female urban inhabitants were characterized by a significantly lower energy value and total fat content, compared to their rural counterparts. The food rations of men living in the city had a significantly higher energy value, protein content and total FAT, compared to rural residents. It was also noted that urban residents of both genders were characterized by a lower percentage of body fat, both visceral and subcutaneous (women), and a higher water content than rural residents. The study showed dietary errors in all compared groups, regardless of place of residence, which was reflected in the nutritional status of the respondents. The results also indicated that during the declared change in dietary habits, the treatment of depressive patients should include dietary instructions in order to ensure an optimum supply of nutrients.

High prevalence and low awareness, treatment and control of hypertension in Asian Indian women.

PubMed

Gupta, R; Pandey, R M; Misra, A; Agrawal, A; Misra, P; Dey, S; Rao, S; Menon, V U; Kamalamma, N; Vasantha Devi, K P; Revathi, K; Vikram, N K; Sharma, V; Guptha, S

2012-10-01

Hypertension is an important public health problem in India. To determine its prevalence, awareness, treatment and control among women, we performed a nationwide study. Population-based studies among women aged 35-70 years were performed in four urban and five rural locations. Stratified sampling was performed and we enrolled 4608 (rural 2604 and urban 2004) of the targeted 8000 (57%). Demographic details, medical history, diet, physical activity, anthropometry and blood pressure (BP) were recorded. Descriptive statistics are reported. Logistic regression was performed to determine the association of hypertension and its awareness, treatment and control with socioeconomic factors. Age-adjusted prevalence of hypertension (known or BP≥140/≥90 mm Hg) was observed in 1672 women (39.2%) (rural 746, 31.5%; urban 926, 48.2%). Significant determinants of hypertension were urban location, greater literacy, high dietary fat, low fibre intake, obesity and truncal obesity (P<0.01). Hypertension awareness was noted in 727 women (42.8%), more in urban (529, 56.8%) than in rural (198, 24.6%). Of these, 38.6% of the women were on treatment (urban 35.7, rural 46.5) and of those treated, controlled blood pressure (<140 and <90 mm Hg) was observed in 21.5% (urban 28.3 vs 10.2). Among hypertensive subjects, treatment was noted in 18.3% (rural 13.1, urban 22.5) and control in 3.9% (rural 1.3, urban 5.9). A significant determinant of low awareness, treatment and control was rural location (multivariate-adjusted P<0.05). There is a high prevalence of hypertension in middle-aged Asian Indian women. Very low awareness, treatment and control status are observed.

A comparative clinical survey of the prevalence of refractive errors and eye diseases in urban and rural school children.

PubMed

Uzma, Nazia; Kumar, B Santhosh; Khaja Mohinuddin Salar, B M; Zafar, Mohammed Atheshm; Reddy, V Devender

2009-06-01

To assess the prevalence of refractive error and common ocular diseases in school-aged children in urban and rural populations in and around Hyderabad, India. Population-based, cross-sectional study. A total of 3314 school children, 1789 from urban areas and 1525 from rural areas. The examination included visual acuity measurements, retinoscopy and autorefraction under cycloplegia, examination of the anterior segment and external eye, and ocular motility evaluation. In the urban group the prevalence of uncorrected presenting and best-corrected visual impairment (< or = 20/40 in the better eye) was 9.8%, which dropped to 7.1% with presenting vision and was further reduced to 1.1% with best-corrected visual acuity. Uncorrected visual acuity in the rural group was 6.6%, which dropped to 3.3% with presenting vision and was further reduced to 2.5% with best-corrected visual acuity. The prevalence of refractive error was greater (25.2%) in the urban than the rural group (8%). Myopia measured with autorefraction was observed in 51.4% of urban children and 16.7% in rural children. Increased literacy rate, duration of study hours, and older age of the child were found to have contributed more to the prevalence of myopia in the urban group. Hyperopia with autorefraction was found to be 3.3% in the urban and 3.1% in the rural group. Hyperopia was associated with younger age in the study group. Trachoma was the leading cause of ocular morbidity in the rural group (3.5%) compared with the urban group (0.16%). Night blindness was reported in 3.2% of children in the rural group and 0.33% in the urban group. Vitamin A deficiency, low socio-economic status, and poor personal and environmental hygienic practice were found to have a positive correlation with ocular morbidity among rural group children. Provision of health education, periodic visual screening programs, and primary eye care by trained health care personnel in the elementary schools will prevent the prevalence of refractive errors and common ocular diseases in school children.

Are associations between the perceived home and neighbourhood environment and children's physical activity and sedentary behaviour moderated by urban/rural location?

PubMed

Salmon, Jo; Veitch, Jenny; Abbott, Gavin; ChinAPaw, Mai; Brug, Johannes J; teVelde, Saskia J; Cleland, Verity; Hume, Clare; Crawford, David; Ball, Kylie

2013-11-01

Associations between parental perceived home and neighbourhood environments and children's physical activity (PA), and sedentary time (ST) and screen time and moderating effects according to urban/rural location were examined. Data were collected (2007-2008) from a cohort of women (aged 18-45 years) and their children (5-12 years) participating in the Resilience for Eating and Activity Despite Inequality (READI) study. A total of 613 children (47% boys; mean age 9.4±2.2 years) and their mothers were included in the study. Urban children had higher screen time than rural children. Mothers in rural areas reported greater access to physical activity equipment in the home, higher levels of descriptive norms for physical activity, greater knowledge of the neighbourhood, a stronger social network, and higher personal safety than urban mothers. There were five significant interactions between the home and neighbourhood environment and PA/ST according to urban/rural location. Among urban children, the importance of doing PA together as a family was positively associated with ST. Interventions targeting PA and ST may need to target different factors according to urban/rural location. © 2013 Elsevier Ltd. All rights reserved.

Differences in the Fitness Levels of Urban and Rural Middle School Students in Croatia

ERIC Educational Resources Information Center

Novak, Dario; Bernstein, Eve R.; Podnar, Hrvoje; Vozzolo, Yolanda

2015-01-01

Background: It is known that suburban youth are more fit than urban youth in Croatia. Method: Differences (p < 0.05) in fitness levels and motor abilities of 9,164 (F = 4,671, M = 4,493) Croatian children (age range: 11-14 years) from urban (F = 1,380, M = 1,268), mixed rural-urban (F = 274, M = 289), and rural (F = 3017, M = 2936) areas were…

Extent of telehealth use in rural and urban hospitals.

PubMed

Ward, Marcia M; Ullrich, Fred; Mueller, Keith

2014-01-01

Key Findings. Data from 4,727 hospitals in the 2013 HIMSS Analytics database yielded these findings: (1) Two-thirds (66.0% of rural defined as nonmetropolitan and 68.0% of urban) had no telehealth services or were only in the process of implementing a telehealth application. One-third (34.0%rural and 32.0% urban) had at least one telehealth application currently in use. (2) Among hospitals with "live and operational" telehealth services, 61.4% indicated only a single department/program with an operational telehealth service, and 38.6% indicated two or more departments/programs with operational telehealth services. Rural hospitals were significantly less likely to have multiple services (35.2%) than were urban hospitals (42.1%) (3) Hospitals that were more likely to have implemented at least one telehealth service were academic medical centers, not-for-profit institutions, hospitals belonging to integrated delivery systems, and larger institutions (in terms of FTEs but not licensed beds). Rural and urban hospitals did not differ significantly in overall telehealth implementation rates. (4) Urban and rural hospitals did differ in the department where telehealth was implemented. Urban hospitals were more likely than rural hospitals to have operational telehealth implementations in cardiology/stroke/heart attack programs (7.4% vs. 6.2%), neurology (4.4% vs. 2.1%), and obstetrics/gynecology/NICU/pediatrics (3.8% vs. 2.5%). In contrast, rural hospitals were more likely than urban hospital to have operational telehealth implementations in radiology departments (17.7% vs. 13.9%) and in emergency/trauma care (8.8% vs. 6.3%).

Urban-rural differences in physical activity in Belgian adults and the importance of psychosocial factors.

PubMed

Dyck, Delfien Van; Cardon, Greet; Deforche, Benedicte; De Bourdeaudhuij, Ilse

2011-02-01

Recent research in urban planning and public health has drawn attention to the associations between urban form and physical activity in adults. Because little is known on the urban-rural differences in physical activity, the main aims of the present study were to examine differences in physical activity between urban and rural adults and to investigate the moderating effects of the physical environment on the relationship between psychosocial factors and physical activity. In Flanders, Belgium, five rural and five urban neighborhoods were selected. A sample of 350 adults (20-65 years of age; 35 adults per neighborhood) participated in the study. Participants wore a pedometer for 7 days, and self-reported physical activity and psychosocial data were also collected. Results showed that urban adults took more steps/day and reported more walking and cycling for transport in the neighborhood, more recreational walking in the neighborhood, and more walking for transportation outside the neighborhood than rural adults. Rural adults reported more recreational cycling in the neighborhoods. The physical environment was a significant moderator of the associations between several psychosocial factors (modeling from family, self-efficacy, and perceived barriers) and physical activity. In rural participants, adults with psychosocial scores above average were more physically active, whereas there were no differences in physical activity according to psychosocial factors in urban participants. These results are promising and plead for the development of multidimensional interventions, targeting specific population subgroups. In rural environments, where changing the environment would be a very challenging task, interventions focusing on modifiable psychosocial constructs could possibly be effective.