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.

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.

Childhood asthma and allergies in urban, semiurban, and rural residential sectors in Chile.

PubMed

Kausel, Leonie; Boneberger, Anja; Calvo, Mario; Radon, Katja

2013-01-01

While rural living protects from asthma and allergies in many countries, results are conflicting in Latin America. We studied the prevalence of asthma and asthma symptoms in children from urban, semiurban, and rural sectors in south Chile. A cross-sectional questionnaire study was conducted in semiurban and rural sectors in the province of Valdivia (n = 559) using the ISAAC (International Study of Asthma and Allergies in Childhood) questionnaire. Results were compared to prevalence in urban Valdivia (n = 3105) by using data from ISAAC III study. Odds ratios (+95% confidence intervals) were calculated. No statistical significant differences were found for asthma ever and eczema symptoms stratified by residential sector, but a gradient could be shown for current asthma and rhinoconjunctivitis symptoms with urban living having highest and rural living having lowest prevalence. Rural living was inversely associated in a statistical significant way with current asthma (OR: 0.4; 95% CI: 0.2-0.9) and rhinoconjunctivitis symptoms (OR: 0.3; 95% CI: 0.2-0.7) in logistic regression analyses. Rural living seems to protect from asthma and respiratory allergies also in Chile, a South American country facing epidemiological transition. These data would be improved by clinical studies of allergic symptoms observed in studied sectors.

Rural and Urban Living in Persons with Spinal Cord Injury and Comparing Environmental Barriers, Their Health, and Quality-of-Life Outcomes.

PubMed

Glennie, R Andrew; Batke, Juliet; Fallah, Nader; Cheng, Christiana L; Rivers, Carly S; Noonan, Vanessa K; Dvorak, Marcel F; Fisher, Charles G; Kwon, Brian K; Street, John T

2017-10-15

There is worldwide geographic variation in the epidemiology of traumatic spinal cord injury (tSCI). The aim of this study was to determine whether environmental barriers, health status, and quality-of-life outcomes differ between patients with tSCI living in rural or urban settings, and whether patients move from rural to urban settings after tSCI. A cohort review of the Rick Hansen SCI Registry (RHSCIR) was undertaken from 2004 to 2012 for one province in Canada. Rural/urban setting was determined using postal codes. Outcomes data at 1 year in the community included the Short Form-36 Version 2 (SF36v2™), Life Satisfaction Questionnaire, Craig Hospital Inventory of Environmental Factors-Short Form (CHIEF-SF), Functional Independent Measure ® Instrument, and SCI Health Questionnaire. Statistical methodologies used were t test, Mann-Whitney U test, and Fisher's exact or χ 2 test. In the analysis, 338 RHSCIR participants were included; 65 lived in a rural setting and 273 in an urban setting. Of the original patients residing in a rural area at discharge,10 moved to an urban area by 1 year. Those who moved from a rural to urban area reported a lower SF-36v2™ Mental Component Score (MCS; p = 0.04) and a higher incidence of depression at 1 year (p = 0.04). Urban patients also reported a higher incidence of depression (p = 0.02) and a lower CHIEF-SF total score (p = 0.01) indicating fewer environmental barriers. No significant differences were found in other outcomes. Results suggest that although the patient outcomes are similar, some patients move from rural to urban settings after tSCI. Future efforts should target screening mental health problems early, especially in urban settings.

Rural and Urban Living in Persons with Spinal Cord Injury and Comparing Environmental Barriers, Their Health, and Quality-of-Life Outcomes

PubMed Central

Batke, Juliet; Fallah, Nader; Cheng, Christiana L.; Rivers, Carly S.; Noonan, Vanessa K.; Dvorak, Marcel F.; Fisher, Charles G.; Kwon, Brian K.; Street, John T.

2017-01-01

Abstract There is worldwide geographic variation in the epidemiology of traumatic spinal cord injury (tSCI). The aim of this study was to determine whether environmental barriers, health status, and quality-of-life outcomes differ between patients with tSCI living in rural or urban settings, and whether patients move from rural to urban settings after tSCI. A cohort review of the Rick Hansen SCI Registry (RHSCIR) was undertaken from 2004 to 2012 for one province in Canada. Rural/urban setting was determined using postal codes. Outcomes data at 1 year in the community included the Short Form-36 Version 2 (SF36v2™), Life Satisfaction Questionnaire, Craig Hospital Inventory of Environmental Factors-Short Form (CHIEF-SF), Functional Independent Measure® Instrument, and SCI Health Questionnaire. Statistical methodologies used were t test, Mann-Whitney U test, and Fisher's exact or χ2 test. In the analysis, 338 RHSCIR participants were included; 65 lived in a rural setting and 273 in an urban setting. Of the original patients residing in a rural area at discharge,10 moved to an urban area by 1 year. Those who moved from a rural to urban area reported a lower SF-36v2™ Mental Component Score (MCS; p = 0.04) and a higher incidence of depression at 1 year (p = 0.04). Urban patients also reported a higher incidence of depression (p = 0.02) and a lower CHIEF-SF total score (p = 0.01) indicating fewer environmental barriers. No significant differences were found in other outcomes. Results suggest that although the patient outcomes are similar, some patients move from rural to urban settings after tSCI. Future efforts should target screening mental health problems early, especially in urban settings. PMID:28462633

Do urban environments increase the risk of anxiety, depression and psychosis? An epidemiological study.

PubMed

McKenzie, Karen; Murray, Aja; Booth, Tom

2013-09-25

The present study aimed to investigate whether there is an association between type of living environment (urban versus rural) and anxiety, depression and psychosis in the Scottish population. Data were obtained from the Scottish Neighbourhood Statistics database on Scottish Index of Multiple Deprivation and urban-rural classifications for 6505 data zones across Scotland. Multiple regression was used to test the association between prescriptions for psychotropic medication for anxiety, depression and psychosis, and type of living environment according to urban-rural classification, controlling for a range of socio-economic factors. Urban-rural classification significantly predicted poorer mental health both before (β=-.29) and after (β=-.20) controlling for a large number of socio-economic variables, with more urban areas having higher rates of prescription for psychotropic medication for anxiety, depression and psychosis. The current study focussed on macro-level variables and did not include individual level data. As such, the study did not include data on individual diagnoses, but instead used drug prescriptions for anxiety, depression and psychosis as a proxy for level of affective disorders within data zones. More urban living environments in Scotland are associated with higher rates of prescription for psychotropic medication for anxiety, depression and psychosis. © 2013 Elsevier B.V. All rights reserved.

The relative contribution of immigration or local increase for persistence of urban schistosomiasis in Salvador, Bahia, Brazil.

PubMed

Blanton, Ronald E; Barbosa, Lúcio M; Reis, Eliana A; Carmo, Theomira M; Dos Santos, Cláudio R A; Costa, Jackson M; Aminu, Peace T; Blank, Walter A; Reis, Renato Barbosa; Guimarães, Isabel C; Silva, Luciano K; Reis, Mitermayer G

2015-03-01

Urbanization is increasing across the globe, and diseases once considered rural can now be found in urban areas due to the migration of populations from rural endemic areas, local transmission within the city, or a combination of factors. We investigated the epidemiologic characteristics of urban immigrants and natives living in a neighborhood of Salvador, Brazil where there is a focus of transmission of Schistosoma mansoni. In a cross-sectional study, all inhabitants from 3 sections of the community were interviewed and examined. In order to determine the degree of parasite differentiation between immigrants and the native born, S. mansoni eggs from stools were genotyped for 15 microsatellite markers. The area received migrants from all over the state, but most infected children had never been outside of the city, and infected snails were present at water contact sites. Other epidemiologic features suggested immigration contributed little to the presence of infection. The intensity and prevalence of infection were the same for immigrants and natives when adjusted for age, and length of immigrant residence in the community was positively associated with prevalence of infection. The population structure of the parasites also supported that the contribution from immigration was small, since the host-to-host differentiation was no greater in the urban parasite population than a rural population with little distant immigration, and there had been little differentiation in the urban population over the past 7 years. Public health efforts should focus on eliminating local transmission, and once eliminated, reintroduction from distant migration is unlikely.

Cardiovascular risk factor burden in Africa and the Middle East: the Africa Middle East Cardiovascular Epidemiological (ACE) study.

PubMed

Alsheikh-Ali, Alawi A; Omar, Mohamed I; Raal, Frederick J; Rashed, Wafa; Hamoui, Omar; Kane, Abdoul; Alami, Mohamed; Abreu, Paula; Mashhoud, Walid M

2014-01-01

Increased urbanization in the developing world parallels a rising burden of chronic diseases. Developing countries account for ∼ 80% of global cardiovascular (CV) deaths, but contribute a paucity of systematic epidemiological data on CV risk factors. To estimate the prevalence of CV risk factors in rural and urban cohorts attending general practice clinics in the Africa and Middle East (AfME) region. In a cross-sectional epidemiological study, the presence of CV risk factors (hypertension, diabetes mellitus (diabetes), dyslipidemia, obesity, smoking and abdominal obesity) were evaluated in stable adult outpatients attending general practice primary care clinics. A rural population was defined as isolated (>50 km or lack of easy access to commuter transportation) from urban centers. 4,378 outpatients were systematically recruited from 94 clinics across 14 AfME countries. Mean age was 46 ± 14 years and 52% of outpatients were female. A high prevalence of dyslipidemia (70%) and abdominal obesity (68%) were observed, followed by hypertension (43%) and diabetes (25%). The vast majority of outpatients (92%) had at least one modifiable CV risk factor, many (74%) had more than one, and half (53%) had 3 or more. These findings were observed in both genders and across urban and rural centers. Among outpatients with pre-existing hypertension or dyslipidemia, many were not at their target blood pressure or LDL-cholesterol goals. Cardiovascular risk factors are highly prevalent among relatively young, stable outpatients attending general practice clinics across AfME. The findings support opportunistic screening for CV risk factors whenever outpatients visit a general practitioner and provide an opportunity for early identification and management of CV risk factors, including lifestyle interventions.

Cardiovascular Risk Factor Burden in Africa and the Middle East: The Africa Middle East Cardiovascular Epidemiological (ACE) Study

PubMed Central

Alsheikh-Ali, Alawi A.; Omar, Mohamed I.; Raal, Frederick J.; Rashed, Wafa; Hamoui, Omar; Kane, Abdoul; Alami, Mohamed; Abreu, Paula; Mashhoud, Walid M.

2014-01-01

Background Increased urbanization in the developing world parallels a rising burden of chronic diseases. Developing countries account for ∼80% of global cardiovascular (CV) deaths, but contribute a paucity of systematic epidemiological data on CV risk factors. Objective To estimate the prevalence of CV risk factors in rural and urban cohorts attending general practice clinics in the Africa and Middle East (AfME) region. Methods In a cross-sectional epidemiological study, the presence of CV risk factors (hypertension, diabetes mellitus (diabetes), dyslipidemia, obesity, smoking and abdominal obesity) were evaluated in stable adult outpatients attending general practice primary care clinics. A rural population was defined as isolated (>50 km or lack of easy access to commuter transportation) from urban centers. Results 4,378 outpatients were systematically recruited from 94 clinics across 14 AfME countries. Mean age was 46±14 years and 52% of outpatients were female. A high prevalence of dyslipidemia (70%) and abdominal obesity (68%) were observed, followed by hypertension (43%) and diabetes (25%). The vast majority of outpatients (92%) had at least one modifiable CV risk factor, many (74%) had more than one, and half (53%) had 3 or more. These findings were observed in both genders and across urban and rural centers. Among outpatients with pre-existing hypertension or dyslipidemia, many were not at their target blood pressure or LDL-cholesterol goals. Conclusion Cardiovascular risk factors are highly prevalent among relatively young, stable outpatients attending general practice clinics across AfME. The findings support opportunistic screening for CV risk factors whenever outpatients visit a general practitioner and provide an opportunity for early identification and management of CV risk factors, including lifestyle interventions. PMID:25090638

Social and Environmental Factors and Their Influence on Drug Use Vulnerability and Resiliency in Rural Populations

ERIC Educational Resources Information Center

Dew, Brian; Elifson, Kirk; Dozier, Michael

2007-01-01

Findings from recent epidemiological investigations indicate that substance use in rural America has increased to the point where it nearly equals, if not exceeds, the rates found in suburban and urban areas. Although previous research has examined factors that have influenced use patterns, little attention has been devoted to the social and…

Anthropometric differences among natives of Abuja living in urban and rural communities: correlations with other cardiovascular risk factors.

PubMed

Adediran, Olufemi Sola; Adebayo, Philip Babatunde; Akintunde, Adeseye Abiodun

2013-03-27

There is an increase of obesity and other cardiovascular risk factors worldwide, but especially in developing countries where multifaceted transitions are occurring. There is need for more evidence for the cardio-metabolic effect of changing lifestyles and urbanization in Nigeria. This study aimed at defining rural-urban differences in anthropometric parameters in two Nigerian communities of the same ancestral origin and to determine the cardiovascular risk correlates of these anthropometric measurements. This was a cross-sectional epidemiological study using stratified cluster sampling method. We studied 335 and 332 urban and rural dwellers respectively. A complete cardiovascular profile as well as anthropometric measurements was compared between the two populations. All anthropometric indices considered in this study (weight, BMI, waist circumference, waist circumference/height ratio, abdominal height; biceps, triceps, sub-scapular, abdominal, superior iliac skinfold thicknesses) were significantly higher in urban than in the rural population (p = <0.001). Overweight, obesity and hypertension were significantly prevalent among the urban population (p = <0.001) while there was no significant difference in the prevalence of dyslipidaemia (p = 0.096) and diabetes (p = 0.083) between the two cohorts. Females tend to have a higher chance of obesity than males although there was no gender difference in waist circumference and central skin fold thickness in the rural population. Age was the significant predictor of systolic blood pressure among the rural (R(2) = 0.157, β = 0.258, p = 0.016) and urban female population (R(2) = 0.201, β = 0.351, p = <0.001) while Abdominal height (R(2) = 0.16, β = 0.281, p = 0.001) and waist circumference (R(2) = 0.064 β = 0.064, p = .003) were predictors of systolic blood pressure in urban and rural men respectively. Anthropometric indices were significantly higher among the urban than the rural populations. Cardiovascular risks were equally more prevalent among the urban population. Appropriate health education and lifestyle modification strategies may reduce the increased burden of cardiovascular risk factors associated with rural-urban migration.

Distinct clinical characteristics and helminth co-infections in adult tuberculosis patients from urban compared to rural Tanzania.

PubMed

Sikalengo, George; Hella, Jerry; Mhimbira, Francis; Rutaihwa, Liliana K; Bani, Farida; Ndege, Robert; Sasamalo, Mohamed; Kamwela, Lujeko; Said, Khadija; Mhalu, Grace; Mlacha, Yeromin; Hatz, Christoph; Knopp, Stefanie; Gagneux, Sébastien; Reither, Klaus; Utzinger, Jürg; Tanner, Marcel; Letang, Emilio; Weisser, Maja; Fenner, Lukas

2018-03-24

Differences in rural and urban settings could account for distinct characteristics in the epidemiology of tuberculosis (TB). We comparatively studied epidemiological features of TB and helminth co-infections in adult patients from rural and urban settings of Tanzania. Adult patients (≥ 18 years) with microbiologically confirmed pulmonary TB were consecutively enrolled into two cohorts in Dar es Salaam, with ~ 4.4 million inhabitants (urban), and Ifakara in the sparsely populated Kilombero District with ~ 400 000 inhabitants (rural). Clinical data were obtained at recruitment. Stool and urine samples were subjected to diagnose helminthiases using Kato-Katz, Baermann, urine filtration, and circulating cathodic antigen tests. Differences between groups were assessed by χ 2 , Fisher's exact, and Wilcoxon rank sum tests. Logistic regression models were used to determine associations. Between August 2015 and February 2017, 668 patients were enrolled, 460 (68.9%) at the urban and 208 (31.1%) at the rural site. Median patient age was 35 years (interquartile range [IQR]: 27-41.5 years), and 454 (68%) were males. Patients from the rural setting were older (median age 37 years vs. 34 years, P = 0.003), had a lower median body mass index (17.5 kg/m 2 vs. 18.5 kg/m 2 , P <  0.001), a higher proportion of recurrent TB cases (9% vs. 1%, P <  0.001), and in HIV/TB co-infected patients a lower median CD4 cell counts (147 cells/μl vs. 249 cells/μl, P = 0.02) compared to those from urban Tanzania. There was no significant difference in frequencies of HIV infection, diabetes mellitus, and haemoglobin concentration levels between the two settings. The overall prevalence of helminth co-infections was 22.9% (95% confidence interval [CI]: 20.4-27.0%). The significantly higher prevalence of helminth infections at the urban site (25.7% vs. 17.3%, P = 0.018) was predominantly driven by Strongyloides stercoralis (17.0% vs. 4.8%, P <  0.001) and Schistosoma mansoni infection (4.1% vs. 16.4%, P <  0.001). Recurrent TB was associated with living in a rural setting (adjusted odds ratio [aOR]: 3.97, 95% CI: 1.16-13.67) and increasing age (aOR: 1.06, 95% CI: 1.02-1.10). Clinical characteristics and helminth co-infections pattern differ in TB patients in urban and rural Tanzania. The differences underline the need for setting-specific, tailored public health interventions to improve clinical management of TB and comorbidities.

An epidemiological study to determine the prevalence and risk assessment of gingivitis in 5-, 12- and 15-year-old children of rural and urban area of Panchkula (Haryana).

PubMed

Kaur, Avninder; Gupta, Nidhi; Baweja, Devinder Kaur; Simratvir, Mauli

2014-01-01

The aim and objective of the present study was to determine the prevalence and severity of gingivitis and evaluate the factors associated with gingivitis in children residing in rural and urban areas of Panchkula. The present study was carried out on a sample of 1269 school children, aged 5, 12 and 15 years, randomly selected from the rural and the urban schools of Panchkula and gingival index was recorded as devised by Loe and Silness (1963) to assess the severity of gingivitis. A standardized questionnaire was self prepared, which was filled by the examiner prior to the clinical examination. The data were subjected to SPSS, version 13, and statistically analyzed using Chi test, F test, ANOVA test. In the age group of 5 years, the children affected with gingivitis in the rural and the urban areas were 67 and 33%, respectively, which was statistically highly significant (P = 0.0001). In the age group of 12 years, the children affected with gingivitis in the rural and the urban areas were 94 and 92%, respectively (P = 0.537), whereas in 15-year olds, the children affected with gingivitis in the rural and the urban areas were 98 and 64%, respectively (P = 0.0001). The children who brushed once a day had higher prevalence of gingivitis as compared to children who brushed more than once per day in all the age groups. The results showed that the percentage of children affected with gingivitis was significantly higher in the rural areas in 5- and 15-year-old children, but this trend was not seen in 12-year age group, reflecting the lack of awareness in rural areas.

Landing periodicity of Aedes aegypti with implications for dengue transmission in Trinidad, West Indies.

PubMed

Chadee, D D; Martinez, R

2000-12-01

The diel landing/biting periodicity of the Trinidad strain of Aedes aegypti (L.) was monitored using human-bait during January-August 1999. Hourly light intensities were measured both indoors and outdoors at both urban and rural sites. The periodicity of females was diurnal and nocturnal, with 90% arriving during daylight and twilight and 10% during the night. The pattern of landing was trimodal, with consistent peaks at 0700 h, 1100 h and 1700 h. The diel periodicities at indoor and outdoor urban sites were virtually identical. In contrast, the periodicities in rural areas differed, with no nocturnal activities being recorded at indoor and outdoor sites. At both urban and rural sites, larger numbers of adults were collected outside than inside houses. A significant correlation between light intensities and mosquito landing patterns was observed. The implications of the changing landing patterns of Ae. aegypti within urban areas are discussed in light of the epidemiology and control of dengue fever in Trinidad.

Comparative evaluation of MRSA nasal colonization epidemiology in the urban and rural secondary school community of Kurdistan, Iraq.

PubMed

Hussein, Nawfal R; Basharat, Zarrin; Muhammed, Ary H; Al-Dabbagh, Samim A

2015-01-01

To study the nasal carriage rate of Staphylococcus aureus (S. aureus) (including methicillin-resistant strains) in secondary school community of the urban and rural districts of the Kurdistan region of Iraq, a cross-sectional population based survey was carried out in the city Duhok and rural areas of Amedya, Akre and Zakho. Nasal swabs were obtained from nostrils of 509 students aged 14-23 years. Resistance to methicillin was assessed by Kirby-Bauer disk diffusion and agar dilution assay. Vancomycin sensitivity was also tested on Muller-Hinton agar. It was found that the frequency of overall S. aureus nasal carriage (SANC) was 17.75% (90/509, CI95, 14.58-21.42%). In urban areas, the carriage rate was 20.59% (49/239, CI95, 15.64-26.29%), whereas it was 15.24% (41/270, CI95, 11.17-20.10%) in rural districts. The frequency of methicillin-resistant S. aureus (MRSA) among the isolated strains was found to be 2.04% (1/49) and 21.95% (9/41) in urban and rural areas respectively. It was found that in urban residents, the odd ratio (OR) of acquiring SANC was 1.44 (CI95, 0.91-2.27%) and risk ratio (RR) was at least 1.35 (CI95, 0.92-1.96%) while OR decreased to 0.12 (CI95, 0.01-0.96%) for MRSA carriage. Hence, the S. aureus carriage rate was higher in urban districts compared to rural areas while more MRSA were found in rural areas compared to urban districts. All studied strains were sensitive to vancomycin. This study provided baseline information for S. aureus nasal colonization in the region. Also, it showed that living in rural areas increased the odds of MRSA colonization. More attention should be paid to control MRSA colonization in rural communities.

Comparative Evaluation of MRSA Nasal Colonization Epidemiology in the Urban and Rural Secondary School Community of Kurdistan, Iraq

PubMed Central

Hussein, Nawfal R.; Basharat, Zarrin; Muhammed, Ary H.; Al-Dabbagh, Samim A.

2015-01-01

Background To study the nasal carriage rate of Staphylococcus aureus (S. aureus) (including methicillin-resistant strains) in secondary school community of the urban and rural districts of the Kurdistan region of Iraq, a cross-sectional population based survey was carried out in the city Duhok and rural areas of Amedya, Akre and Zakho. Methods Nasal swabs were obtained from nostrils of 509 students aged 14-23 years. Resistance to methicillin was assessed by Kirby-Bauer disk diffusion and agar dilution assay. Vancomycin sensitivity was also tested on Muller-Hinton agar. Results It was found that the frequency of overall S. aureus nasal carriage (SANC) was 17.75% (90/509, CI95, 14.58–21.42%). In urban areas, the carriage rate was 20.59% (49/239, CI95, 15.64–26.29%), whereas it was 15.24% (41/270, CI95, 11.17–20.10%) in rural districts. The frequency of methicillin-resistant S. aureus (MRSA) among the isolated strains was found to be 2.04% (1/49) and 21.95% (9/41) in urban and rural areas respectively. It was found that in urban residents, the odd ratio (OR) of acquiring SANC was 1.44 (CI95, 0.91-2.27%) and risk ratio (RR) was at least 1.35 (CI95, 0.92-1.96%) while OR decreased to 0.12 (CI95, 0.01-0.96%) for MRSA carriage. Hence, the S. aureus carriage rate was higher in urban districts compared to rural areas while more MRSA were found in rural areas compared to urban districts. All studied strains were sensitive to vancomycin. Conclusion This study provided baseline information for S. aureus nasal colonization in the region. Also, it showed that living in rural areas increased the odds of MRSA colonization. More attention should be paid to control MRSA colonization in rural communities. PMID:25932644

Prevalence and diversity of human pathogenic rickettsiae in urban versus rural habitats, Hungary.

PubMed

Szekeres, Sándor; Docters van Leeuwen, Arieke; Rigó, Krisztina; Jablonszky, Mónika; Majoros, Gábor; Sprong, Hein; Földvári, Gábor

2016-02-01

Tick-borne rickettsioses belong to the important emerging infectious diseases worldwide. We investigated the potential human exposure to rickettsiae by determining their presence in questing ticks collected in an urban park of Budapest and a popular hunting and recreational forest area in southern Hungary. Differences were found in the infectious risk between the two habitats. Rickettsia monacensis and Rickettsia helvetica were identified with sequencing in questing Ixodes ricinus, the only ticks species collected in the city park. Female I. ricinus had a particularly high prevalence of R. helvetica (45%). Tick community was more diverse in the rural habitat with Dermacentor reticulatus ticks having especially high percentage (58%) of Rickettsia raoultii infection. We conclude that despite the distinct eco-epidemiological traits, the risk (hazard and exposure) of acquiring human pathogenic rickettsial infections in both the urban and the rural study sites exists.

THE EPIDEMIOLOGY OF CHEMICAL CONTAMINANTS OF DRINKING WATER

EPA Science Inventory

A number of chemical contaminants have been identified in drinking water. These contaminants reach drinking water supplies from various sources, including municipal and industrial discharges, urban and rural run-off, natural geological formations, drinking water distrib...

Association of ambient air quality with children's lung function in urban and rural Iran.

PubMed

Asgari, M M; DuBois, A; Asgari, M; Gent, J; Beckett, W S

1998-01-01

During the summer of 1994, a cross-sectional epidemiological study, in which the pulmonary function of children in Tehran was compared with pulmonary function in children in a rural town in Iran, was conducted. Four hundred children aged 5-11 y were studied. Daytime ambient nitrogen dioxide, sulfur dioxide, and particulate matter were measured with portable devices, which were placed in the children's neighborhoods on the days of study. Levels of these ambient substances were markedly higher in urban Tehran than in rural areas. Children's parents were questioned about home environmental exposures (including heating source and environmental tobacco smoke) and the children's respiratory symptoms. Pulmonary function was assessed, both by spirometry and peak expiratory flow meter. Forced expiratory volume in 1 s and forced vital capacity-as a percentage of predicted for age, sex and height-were significantly lower in urban children than in rural children. Both measurements evidenced significant reverse correlations with levels of sulfur dioxide, nitrogen dioxide, and particulate matter. Differences in spirometric lung function were not explained by nutritional status, as assessed by height and weight for age, or by home environmental exposures. Reported airway symptoms (i.e., cough, phlegm, and wheeze) were higher among rural children, whereas reported physician diagnosis of bronchitis and asthma were higher among urban children. The association between higher pollutant concentrations and reduced pulmonary function in this urban-rural comparison suggests that there is an effect of urban air pollution on short-term lung function and/or lung growth and development during the preadolescent years.

Association of ambient air quality with children`s lung function in urban and rural Iran

DOE Office of Scientific and Technical Information (OSTI.GOV)

Asgari, M.M.; Dubois, A.; Beckett, W.S.

During the summer of 1994, a cross-sectional epidemiological study, in which the pulmonary function of children in Tehran was compared with pulmonary function in children in a rural town in Iran, was conducted. Four hundred children aged 5--11 y were studied. Daytime ambient nitrogen dioxide, sulfur dioxide, and particulate matter were measured with portable devices, which were placed in the children`s neighborhoods on the days of study. Levels of these ambient substances were markedly higher in urban Tehran than in rural areas. Children`s parents were questioned about home environmental exposures (including heating source and environmental tobacco smoke) and the children`smore » respiratory symptoms. Pulmonary function was assessed, both by spirometry and peak expiratory flow meter. Forced expiratory volume in 1 s and forced vital capacity--as a percentage of predicted for age, sex and height--were significantly lower in urban children than in rural children. Both measurements evidenced significant reverse correlations with levels of sulfur dioxide, nitrogen dioxide, and particulate matter. Differences in spirometric lung function were not explained by nutritional status, as assessed by height and weight for age, or by home environmental exposures. Reported airway symptoms were higher among rural children, whereas reported physician diagnosis of bronchitis and asthma were higher among urban children. The association between higher pollutant concentrations and reduced pulmonary function in this urban-rural comparison suggests that there is an effect of urban air pollution on short-term lung function and/or lung growth and development during the preadolescent years.« less

Low prevalence of methicillin-resistant Staphylococcus aureus nasal carriage in urban and rural community settings in Bolivia and Peru.

PubMed

Bartoloni, Alessandro; Pallecchi, Lucia; Fernandez, Connie; Mantella, Antonia; Riccobono, Eleonora; Magnelli, Donata; Mannini, Dario; Strohmeyer, Marianne; Bartalesi, Filippo; Segundo, Higinio; Monasterio, Joaquin; Rodriguez, Hugo; Cabezas, César; Gotuzzo, Eduardo; Rossolini, Gian Maria

2013-05-01

To investigate the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) nasal carriage in rural and urban community settings of Bolivia and Peru. MRSA nasal carriage was investigated in 585 individuals living in rural and urban areas of Bolivia and Peru (one urban area, one small rural village, and two native communities, one of which was highly isolated). MRSA isolates were subjected to molecular analysis for the detection of virulence genes, characterization of the staphylococcal cassette chromosome mec (SCCmec), and genotyping (multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE)). An overall very low prevalence of MRSA nasal carriage was observed (0.5%), with MRSA carriers being detected only in a small rural village of the Bolivian Chaco. The three MRSA isolates showed the characteristics of community-associated MRSA (being susceptible to all non-beta-lactam antibiotics and harboring the SCCmec type IV), were clonally related, and belonged to ST1649. This study provides an insight into the epidemiology of MRSA in community settings of Bolivia and Peru. Reliable, time-saving, and low-cost methods should be implemented to encourage continued surveillance of MRSA dissemination in resource-limited countries. Copyright © 2012 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Explaining differences in education-related inequalities in health between urban and rural areas in Mongolia.

PubMed

Dorjdagva, Javkhlanbayar; Batbaatar, Enkhjargal; Dorjsuren, Bayarsaikhan; Kauhanen, Jussi

2015-12-22

After the socioeconomic transition in 1990, Mongolia has been experiencing demographic and epidemiologic transitions; however, there is lack of evidence on socioeconomic-related inequality in health across the country. The aim of this paper is to evaluate the education-related inequalities in adult population health in urban and rural areas of Mongolia in 2007/2008. This paper used a nationwide cross-sectional data, the Household Socio-Economic Survey 2007/2008, collected by the National Statistical Office. We employed the Erreygers' concentration index to assess the degree of education-related inequality in adult health in urban and rural areas. Our results suggest that a lower education level was associated with poor self-reported health. The concentration indices of physical limitation and chronic disease were significantly less than zero in both areas. On the other hand, ill-health was concentrated among the less educated groups. The decomposition results show education, economic activity status and income were the main contributors to education-related inequalities in physical limitation and chronic disease removing age-sex related contributions. Improving accessibility and quality of education, especially for the lower socioeconomic groups may reduce socioeconomic-related inequality in health in both rural and urban areas of Mongolia.

Does the design and implementation of proven innovations for delivering basic primary health care services in rural communities fit the urban setting: the case of Ghana’s Community-based Health Planning and Services (CHPS)

PubMed Central

2014-01-01

Background Rapid urban population growth is of global concern as it is accompanied with several new health challenges. The urban poor who reside in informal settlements are more vulnerable to these health challenges. Lack of formal government public health facilities for the provision of health care is also a common phenomenon among communities inhabited by the urban poor. To help ameliorate this situation, an innovative urban primary health system was introduced in urban Ghana, based on the milestones model developed with the rural Community-Based Health Planning and Services (CHPS) system. This paper provides an overview of innovative experiences adapted while addressing these urban health issues, including the process of deriving constructive lessons needed to inform discourse on the design and implementation of the sustainable Community-Based Health Planning and Services (CHPS) model as a response to urban health challenges in Southern Ghana. Methods This research was conducted during the six-month pilot of the urban CHPS programme in two selected areas acting as the intervention and control arms of the design. Daily routine data were collected based on milestones initially delineated for the rural CHPS model in the control communities whilst in the intervention communities, some modifications were made to the rural milestones. Results The findings from the implementation activities revealed that many of the best practices derived from the rural CHPS experiment could not be transplanted to poor urban settlements due to the unique organizational structures and epidemiological characteristics found in the urban context. For example, constructing Community Health Compounds and residential facilities within zones, a central component to the rural CHPS strategy, proved inappropriate for the urban sector. Night and weekend home visit schedules were initiated to better accommodate urban residents and increase coverage. The breadth of the disease burden of the urban residents also requires a broader expertise and training of the CHOs. Conclusions Access to improved urban health services remains a challenge. However, current policy guidelines for the implementation of a primary health model based on rural experiences and experimental design requires careful review and modifications to meet the needs of the urban settings. PMID:24690310

Does the design and implementation of proven innovations for delivering basic primary health care services in rural communities fit the urban setting: the case of Ghana's Community-based Health Planning and Services (CHPS).

PubMed

Adongo, Philip Baba; Phillips, James F; Aikins, Moses; Arhin, Doris Afua; Schmitt, Margaret; Nwameme, Adanna U; Tabong, Philip Teg-Nefaah; Binka, Fred N

2014-04-01

Rapid urban population growth is of global concern as it is accompanied with several new health challenges. The urban poor who reside in informal settlements are more vulnerable to these health challenges. Lack of formal government public health facilities for the provision of health care is also a common phenomenon among communities inhabited by the urban poor. To help ameliorate this situation, an innovative urban primary health system was introduced in urban Ghana, based on the milestones model developed with the rural Community-Based Health Planning and Services (CHPS) system. This paper provides an overview of innovative experiences adapted while addressing these urban health issues, including the process of deriving constructive lessons needed to inform discourse on the design and implementation of the sustainable Community-Based Health Planning and Services (CHPS) model as a response to urban health challenges in Southern Ghana. This research was conducted during the six-month pilot of the urban CHPS programme in two selected areas acting as the intervention and control arms of the design. Daily routine data were collected based on milestones initially delineated for the rural CHPS model in the control communities whilst in the intervention communities, some modifications were made to the rural milestones. The findings from the implementation activities revealed that many of the best practices derived from the rural CHPS experiment could not be transplanted to poor urban settlements due to the unique organizational structures and epidemiological characteristics found in the urban context. For example, constructing Community Health Compounds and residential facilities within zones, a central component to the rural CHPS strategy, proved inappropriate for the urban sector. Night and weekend home visit schedules were initiated to better accommodate urban residents and increase coverage. The breadth of the disease burden of the urban residents also requires a broader expertise and training of the CHOs. Access to improved urban health services remains a challenge. However, current policy guidelines for the implementation of a primary health model based on rural experiences and experimental design requires careful review and modifications to meet the needs of the urban settings.

Determining risk for severe leptospirosis by molecular analysis of environmental surface waters for pathogenic Leptospira.

PubMed

Ganoza, Christian A; Matthias, Michael A; Collins-Richards, Devon; Brouwer, Kimberly C; Cunningham, Calaveras B; Segura, Eddy R; Gilman, Robert H; Gotuzzo, Eduardo; Vinetz, Joseph M

2006-08-01

Although previous data indicate that the overall incidence of human leptospirosis in the Peruvian Amazon is similar in urban and rural sites, severe leptospirosis has been observed only in the urban context. As a potential explanation for this epidemiological observation, we tested the hypothesis that concentrations of more virulent Leptospira would be higher in urban than in rural environmental surface waters. A quantitative real-time PCR assay was used to compare levels of Leptospira in urban and rural environmental surface waters in sites in the Peruvian Amazon region of Iquitos. Molecular taxonomic analysis of a 1,200-bp segment of the leptospiral 16S ribosomal RNA gene was used to identify Leptospira to the species level. Pathogenic Leptospira species were found only in urban slum water sources (Fisher's exact test; p = 0.013). The concentration of pathogen-related Leptospira was higher in urban than rural water sources (approximately 10(3) leptospires/ml versus 0.5 x 10(2) leptospires/ml; F = 8.406, p < 0.05). Identical 16S rRNA gene sequences from Leptospira interrogans serovar Icterohaemorrhagiae were found in urban slum market area gutter water and in human isolates, suggesting a specific mode of transmission from rats to humans. In a prospective, population-based study of patients presenting with acute febrile illness, isolation of L. interrogans-related leptospires from humans was significantly associated with urban acquisition (75% of urban isolates); human isolates of other leptospiral species were associated with rural acquisition (78% of rural isolates) (chi-square analysis; p < 0.01). This distribution of human leptospiral isolates mirrored the distribution of leptospiral 16S ribosomal gene sequences in urban and rural water sources. Our findings data support the hypothesis that urban severe leptospirosis in the Peruvian Amazon is associated with higher concentrations of more pathogenic leptospires at sites of exposure and transmission. This combined quantitative and molecular taxonomical risk assessment of environmental surface waters is globally applicable for assessing risk for leptospiral infection and severe disease in leptospirosis-endemic regions.

Determining Risk for Severe Leptospirosis by Molecular Analysis of Environmental Surface Waters for Pathogenic Leptospira

PubMed Central

Collins-Richards, Devon; Brouwer, Kimberly C; Cunningham, Calaveras B; Segura, Eddy R; Gilman, Robert H; Gotuzzo, Eduardo; Vinetz, Joseph M

2006-01-01

Background Although previous data indicate that the overall incidence of human leptospirosis in the Peruvian Amazon is similar in urban and rural sites, severe leptospirosis has been observed only in the urban context. As a potential explanation for this epidemiological observation, we tested the hypothesis that concentrations of more virulent Leptospira would be higher in urban than in rural environmental surface waters. Methods and Findings A quantitative real-time PCR assay was used to compare levels of Leptospira in urban and rural environmental surface waters in sites in the Peruvian Amazon region of Iquitos. Molecular taxonomic analysis of a 1,200-bp segment of the leptospiral 16S ribosomal RNA gene was used to identify Leptospira to the species level. Pathogenic Leptospira species were found only in urban slum water sources (Fisher's exact test; p = 0.013). The concentration of pathogen-related Leptospira was higher in urban than rural water sources (~103 leptospires/ml versus 0.5 × 102 leptospires/ml; F = 8.406, p < 0.05). Identical 16S rRNA gene sequences from Leptospira interrogans serovar Icterohaemorrhagiae were found in urban slum market area gutter water and in human isolates, suggesting a specific mode of transmission from rats to humans. In a prospective, population-based study of patients presenting with acute febrile illness, isolation of L. interrogans-related leptospires from humans was significantly associated with urban acquisition (75% of urban isolates); human isolates of other leptospiral species were associated with rural acquisition (78% of rural isolates) (chi-square analysis; p < 0.01). This distribution of human leptospiral isolates mirrored the distribution of leptospiral 16S ribosomal gene sequences in urban and rural water sources. Conclusions Our findings data support the hypothesis that urban severe leptospirosis in the Peruvian Amazon is associated with higher concentrations of more pathogenic leptospires at sites of exposure and transmission. This combined quantitative and molecular taxonomical risk assessment of environmental surface waters is globally applicable for assessing risk for leptospiral infection and severe disease in leptospirosis-endemic regions. PMID:16933963

Rural-urban differentials of premature mortality burden in south-west China.

PubMed

Cai, Le; Chongsuvivatwong, Virasakdi

2006-10-14

Yunnan province is located in south western China and is one of the poorest provinces of the country. This study examines the premature mortality burden from common causes of deaths among an urban region, suburban region and rural region of Kunming, the capital of Yunnan. Years of life lost (YLL) rate per 1,000 and mortality rate per 100,000 were calculated from medical death certificates in 2003 and broken down by cause of death, age and gender among urban, suburban and rural regions. YLL was calculated without age-weighting and discounting rate. Rates were age-adjusted to the combined population of three regions. However, 3% discounting rate and a standard age-weighting function were included in the sensitivity analysis. Non-communicable diseases contributed the most YLL in all three regions. The rural region had about 50% higher premature mortality burden compared to the other two regions. YLL from infectious diseases and perinatal problems was still a major problem in the rural region. Among non-communicable diseases, YLL from stroke was the highest in the urban/suburban regions; COPD followed as the second and was the highest in the rural region. Mortality burden from injuries was however higher in the rural region than the other two regions, especially for men. Self-inflicted injuries were between 2-8 times more serious among women. The use of either mortality rate or YLL gives a similar conclusion regarding the order of priority. Reanalysis with age-weighting and 3% discounting rate gave similar results. Urban south western China has already engaged in epidemiological pattern of developed countries. The rural region is additionally burdened by diseases of poverty and injury on top of the non-communicable diseases.

Differences in patterns of high-risk human papillomavirus infection between urban and rural low-resource settings: cross-sectional findings from Mali.

PubMed

Schluterman, Nicholas H; Sow, Samba O; Traore, Cheick B; Bakarou, Kamate; Dembelé, Rokiatou; Sacko, Founé; Gravitt, Patti E; Tracy, J Kathleen

2013-02-06

The burden of cervical cancer is disproportionately high in low-resource settings. With limited implementation of human papillomavirus (HPV) vaccines on the horizon in the developing world, reliable data on the epidemiology of high-risk HPV (HR-HPV) infection in distinct geographic populations is essential to planners of vaccination programs. The purpose of this study was to determine whether urban patterns of HR-HPV occurrence can be generalized to rural areas of the same developing country, using data from Mali, West Africa, as an example. Urban and rural women in Mali participated in a structured interview and clinician exam, with collection of cervical samples for HPV DNA testing, to determine HR-HPV prevalence and correlates of infection. Correlates were assessed using bivariate analysis and logistic regression. A total of 414 women (n=202 urban women; n=212 rural women) were recruited across both settings. The prevalence of HR-HPV infection in rural women was nearly twice that observed in urban women (23% v. 12%). Earlier age of sexual debut and fewer pregnancies were associated with HR-HPV infection among urban women, but not rural women. Twenty-six percent of urban women who had sexual intercourse by age 14 had an HR-HPV infection, compared to only 9% of those who had later sexual debut (p<0.01). Overall, age, income, and polygamy did not appear to have a relationship with HR-HPV infection. Compared to urban women, rural women were significantly more likely to be infected with high-risk HPV. The patterns and risk factors of HR-HPV infection may be different between geographic areas, even within the same developing country. The high prevalence in both groups suggests that nearly all rural women and most urban women in Mali will be infected with HR-HPV during their lifetime, so the effects of risk factors may not be statistically apparent. To control HPV and cervical cancer in West Africa and the rest of the developing world, planners should prioritize vaccination in high-burden areas.

Modeling the hepatitis A epidemiological transition in Brazil and Mexico

PubMed Central

Van Effelterre, Thierry; Guignard, Adrienne; Marano, Cinzia; Rojas, Rosalba; Jacobsen, Kathryn H.

2017-01-01

ABSTRACT Background: Many low- to middle-income countries have completed or are in the process of transitioning from high or intermediate to low endemicity for hepatitis A virus (HAV). Because the risk of severe hepatitis A disease increases with age at infection, decreased incidence that leaves older children and adults susceptible to HAV infection may actually increase the population-level burden of disease from HAV. Mathematical models can be helpful for projecting future epidemiological profiles for HAV. Methods: An age-specific deterministic, dynamic compartmental transmission model with stratification by setting (rural versus urban) was calibrated with country-specific data on demography, urbanization, and seroprevalence of anti-HAV antibodies. HAV transmission was modeled as a function of setting-specific access to safe water. The model was then used to project various HAV-related epidemiological outcomes in Brazil and in Mexico from 1950 to 2050. Results: The projected epidemiological outcomes were qualitatively similar in the 2 countries. The age at the midpoint of population immunity (AMPI) increased considerably and the mean age of symptomatic HAV cases shifted from childhood to early adulthood. The projected overall incidence rate of HAV infections decreased by about two thirds as safe water access improved. However, the incidence rate of symptomatic HAV infections remained roughly the same over the projection period. The incidence rates of HAV infections (all and symptomatic alone) were projected to become similar in rural and urban settings in the next decades. Conclusion: This model featuring population age structure, urbanization and access to safe water as key contributors to the epidemiological transition for HAV was previously validated with data from Thailand and fits equally well with data from Latin American countries. Assuming no introduction of a vaccination program over the projection period, both Brazil and Mexico were projected to experience a continued decrease in HAV incidence rates without any substantial decrease in the incidence rates of symptomatic HAV infections. PMID:28481680

Modeling the hepatitis A epidemiological transition in Brazil and Mexico.

PubMed

Van Effelterre, Thierry; Guignard, Adrienne; Marano, Cinzia; Rojas, Rosalba; Jacobsen, Kathryn H

2017-08-03

Many low- to middle-income countries have completed or are in the process of transitioning from high or intermediate to low endemicity for hepatitis A virus (HAV). Because the risk of severe hepatitis A disease increases with age at infection, decreased incidence that leaves older children and adults susceptible to HAV infection may actually increase the population-level burden of disease from HAV. Mathematical models can be helpful for projecting future epidemiological profiles for HAV. An age-specific deterministic, dynamic compartmental transmission model with stratification by setting (rural versus urban) was calibrated with country-specific data on demography, urbanization, and seroprevalence of anti-HAV antibodies. HAV transmission was modeled as a function of setting-specific access to safe water. The model was then used to project various HAV-related epidemiological outcomes in Brazil and in Mexico from 1950 to 2050. The projected epidemiological outcomes were qualitatively similar in the 2 countries. The age at the midpoint of population immunity (AMPI) increased considerably and the mean age of symptomatic HAV cases shifted from childhood to early adulthood. The projected overall incidence rate of HAV infections decreased by about two thirds as safe water access improved. However, the incidence rate of symptomatic HAV infections remained roughly the same over the projection period. The incidence rates of HAV infections (all and symptomatic alone) were projected to become similar in rural and urban settings in the next decades. This model featuring population age structure, urbanization and access to safe water as key contributors to the epidemiological transition for HAV was previously validated with data from Thailand and fits equally well with data from Latin American countries. Assuming no introduction of a vaccination program over the projection period, both Brazil and Mexico were projected to experience a continued decrease in HAV incidence rates without any substantial decrease in the incidence rates of symptomatic HAV infections.

Prevalence of obesity and body size perceptions in urban and rural Senegal: new insight on the epidemiological transition in West Africa.

PubMed

Macia, Enguerran; Cohen, Emmanuel; Gueye, Lamine; Boetsch, Gilles; Duboz, Priscilla

The objectives of this study were to assess the prevalence of obesity in Dakar and in Tessekere, a rural municipality in northern Senegal, and to compare ideal body size between these populations. A cross-sectional survey was carried out in 2015 on a representative sample of 1 000 adults, aged 20 years and older in Dakar, and 500 adults of the same age in Tessekere. The prevalence of obesity and overweight was higher in Dakar than in Tessekere. However, overweight and obesity rates of young women living in this rural area were close to those of young women in Dakar. At a body mass index of 27.5 kg/m 2 , less than 40% of the men in Dakar and Tessekere found themselves too fat, compared to 50% of urban women and 30% of rural women. This study explains how and why obesity is becoming a rural health problem in Senegal.

Estimating the burden of injury in urban and rural Sudan in 2008.

PubMed

Abdalla, Safa; Ahmed, Suad; Swareldahab, Zeinab; Bhalla, Kavi

2017-06-01

Sudan has been undergoing demographic and social changes that could have a tangible impact on population injury rates. However, reliable estimates of injury epidemiology are lacking. We aimed to estimate injury incidence and mortality in urban and rural Sudan, using existing data sources. We used the 2008 national census mortality data with mortuary data to construct unintentional and intentional injury mortality estimates in urban and rural areas. We estimated incidence of non-fatal injuries using the Sudan Household Health Survey 2010. Uncertainty analysis was carried out to construct 95% uncertainty intervals (UIs) for the final estimates. Overall injury death rate was estimated at 109 (95% UI 83-142) per 100 000 per year, 94 (66-129) per 100 000 in urban populations and 117 (95% UI 86-157) per 100 000 in rural populations. Injuries accounted for 12% of all male deaths and 6% of all female deaths, but more than half of the deaths among young men aged 20-34 years. Urban injury rates were higher among males but lower among females than rural injury rates. Road traffic injuries were the major cause of fatal injury in urban Sudan, but other causes accounted for the majority of non-fatal injuries nationally. Road traffic injuries should remain a priority for the country but better data are needed for rural Sudan. To that end, investment in existing data collection systems is essential. Our method can be applied in other countries with a similar data availability pattern. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Temporal trends of main reproductive characteristics in ten urban and rural regions of China: the China Kadoorie biobank study of 300 000 women.

PubMed

Lewington, Sarah; Li, LiMing; Murugasen, Serini; Hong, Lai-san; Yang, Ling; Guo, Yu; Bian, Zheng; Collins, Rory; Chen, Junshi; He, Hui; Wu, Ming; He, Tianyou; Ren, Xiaolan; Meng, Jinhuai; Peto, Richard; Chen, Zhengming

2014-08-01

Chinese women's reproductive patterns have changed significantly over the past several decades. However, relatively little is known about the pace and characteristics of these changes either overall or by region and socioeconomic status. We examined the cross-sectional data from the China Kadoorie Biobank cohort study that recruited 300 000 women born between 1930 and 1974 (mean age: 51 years) from 10 socially diverse urban and rural regions of China. Temporal trends in several self-reported reproductive characteristics, and effect modification of these trends by area and education (as a surrogate for socioeconomic status), were examined. The overall mean age at menarche was 15.4 (standard deviation 1.9) years, but decreased steadily over the 45 birth cohorts from 16.1 to 14.3 years, except for an anomalous increase of ∼1 year for women exposed to the 1958-61 famine in early adolescence. Similarly large changes were seen for other characteristics: mean parity fell (urban: 4.9 to 1.1; rural: 5.9 to 1.4); mean age at first birth increased (urban: 19.0 to 25.9 years; rural: 18.3 to 23.8 years); and birth spacing increased after 1980 to over 5 years. Breastfeeding declined after 1950 in urban and, after 1980, in rural women; and 68% of urban and 48% of rural women experienced a terminated pregnancy. Mean age at menopause increased from 47.9 to 49.3 years. There have been striking changes in reproductive factors over time and between areas among these Chinese women. Their effects on major chronic diseases should be investigated. © The Author 2014. Published by Oxford University Press on behalf of the International Epidemiological Association.

Comparison of healthy lifestyle behaviors among individuals with and without cardiovascular diseases from urban and rural areas in China: A cross-sectional study.

PubMed

Wang, Chuangshi; Li, Wei; Yin, Lu; Bo, Jian; Peng, Yaguang; Wang, Yang

2017-01-01

The study aimed to explore the gap of prevalence of healthy lifestyle behaviors including smoking cessation, quitting drinking, physical activity and healthy eating between Chinese adults with and without cardiovascular diseases (CVDs). This study is a cross-sectional component of Prospective Urban Rural Epidemiology (PURE)-China study, which recruited ~46,000 participants from 70 rural and 45 urban communities between 2005 and 2009. Participants were divided into disease (with CVDs) and control (without any diseases) groups. The adjusted rates were estimated for different strata by the generalized, linear mixed-effects model, including community as a random effect with additional adjustment for age, sex, education and income. Among 40,490 participants, <10% had all four healthy lifestyle behaviors (disease group versus control group: urban areas: 7.8% versus 8.1%; rural areas: 3.4% versus 3.2%). The rates of smoking cessation and quitting drinking were significantly higher in disease group for both urban and rural residents (P<0.001). In urban areas, higher rates were observed in all other three healthy lifestyle behaviors except physical activity in low-income regions (P<0.05). Similarly, the higher trends were observed for stopping smoking and drinking while opposite trends for healthy eating among rural residents from low-income regions (P<0.05). Our study showed that the prevalence of adopting all four behaviors was low among Chinese adults. Individuals with CVDs were more likely to follow healthy lifestyle behaviors, but it still indicated a large gap between the actual and ideal adoption of healthy lifestyle behaviors, which called for the promotion of population-wide strategies to modify lifestyle behaviors in addition to individual health-care intervention strategies.

Comparison of healthy lifestyle behaviors among individuals with and without cardiovascular diseases from urban and rural areas in China: A cross-sectional study

PubMed Central

Wang, Chuangshi; Yin, Lu; Bo, Jian; Peng, Yaguang; Wang, Yang

2017-01-01

Introduction The study aimed to explore the gap of prevalence of healthy lifestyle behaviors including smoking cessation, quitting drinking, physical activity and healthy eating between Chinese adults with and without cardiovascular diseases (CVDs). Methods This study is a cross-sectional component of Prospective Urban Rural Epidemiology (PURE)-China study, which recruited ~46,000 participants from 70 rural and 45 urban communities between 2005 and 2009. Participants were divided into disease (with CVDs) and control (without any diseases) groups. The adjusted rates were estimated for different strata by the generalized, linear mixed-effects model, including community as a random effect with additional adjustment for age, sex, education and income. Results Among 40,490 participants, <10% had all four healthy lifestyle behaviors (disease group versus control group: urban areas: 7.8% versus 8.1%; rural areas: 3.4% versus 3.2%). The rates of smoking cessation and quitting drinking were significantly higher in disease group for both urban and rural residents (P<0.001). In urban areas, higher rates were observed in all other three healthy lifestyle behaviors except physical activity in low-income regions (P<0.05). Similarly, the higher trends were observed for stopping smoking and drinking while opposite trends for healthy eating among rural residents from low-income regions (P<0.05). Conclusions Our study showed that the prevalence of adopting all four behaviors was low among Chinese adults. Individuals with CVDs were more likely to follow healthy lifestyle behaviors, but it still indicated a large gap between the actual and ideal adoption of healthy lifestyle behaviors, which called for the promotion of population-wide strategies to modify lifestyle behaviors in addition to individual health-care intervention strategies. PMID:28771516

Urbanization of black South African women may increase risk of low bone mass due to low vitamin D status, low calcium intake, and high bone turnover.

PubMed

Kruger, Marlena C; Kruger, Iolanthé M; Wentzel-Viljoen, Edelweiss; Kruger, Annamarie

2011-10-01

Globally, rural to urban migration is accompanied by changes in dietary patterns and lifestyle that have serious health implications, including development of low bone mass. We hypothesized that serum 25 (OH) vitamin D3 (25[OH]D3) levels will be lower, bone turnover higher, and nutrition inadequate in urban postmenopausal black women, increasing risk for low bone mass. We aimed to assess the prevalence of risk factors for low bone mass in 1261 black women from rural and urban areas in the North West Province of South Africa (Prospective Urban and Rural Epidemiology-South Africa project). Fasting blood samples were taken; and participants were interviewed to complete questionnaires on self-reported diseases, fractures, and dietary intakes. Bone health markers were assessed in a subgroup of 658 women older than 45 years. Specific lifestyle risk factors identified were inactivity, smoking, injectable progestin contraception use, and high alcohol consumption. Dietary risk factors identified were low calcium and high animal protein, phosphorous, and sodium intakes. The 25(OH)D3 and C-terminal telopeptide (CTX) levels were significantly higher in the rural vs the urban women older than 50 years. Parathyroid hormone (PTH) levels increased with age in both groups. The 25(OH)D levels were inversely correlated with CTX and PTH in rural women. In urban women, PTH and CTX were correlated while dietary calcium was inversely correlated with CTX and PTH with 25(OH)D3. The combination of low dietary calcium (<230 mg/d), marginally insufficient 25(OH)D3 status, and raised PTH may result in increased bone resorption. Further research is required to assess bone health and fracture risk in black African women. Copyright © 2011 Elsevier Inc. All rights reserved.

Lessons learned during active epidemiological surveillance of Ebola and Marburg viral hemorrhagic fever epidemics in Africa.

PubMed

Allaranga, Yokouide; Kone, Mamadou Lamine; Formenty, Pierre; Libama, Francois; Boumandouki, Paul; Woodfill, Celia J I; Sow, Idrissa; Duale, Sambe; Alemu, Wondimagegnehu; Yada, Adamou

2010-03-01

To review epidemiological surveillance approaches used during Ebola and Marburg hemorrhagic fever epidemics in Africa in the past fifteen years. Overall, 26 hemorrhagic epidemic outbreaks have been registered in 12 countries; 18 caused by the Ebola virus and eight by the Marburg virus. About 2551 cases have been reported, among which 268 were health workers (9,3%). Based on articles and epidemic management reports, this review analyses surveillance approaches, route of introduction of the virus into the population (urban and rural), the collaboration between the human health sector and the wildlife sector and factors that have affected epidemic management. Several factors affecting the epidemiological surveillance during Ebola and Marburg viruses hemorrhagic epidemics have been observed. During epidemics in rural settings, outbreak investigations have shown multiple introductions of the virus into the human population through wildlife. In contrast, during epidemics in urban settings a single introduction of the virus in the community was responsible for the epidemic. Active surveillance is key to containing outbreaks of Ebola and Marburg viruses Collaboration with those in charge of the conservation of wildlife is essential for the early detection of viral hemorrhagic fever epidemics. Hemorrhagic fever epidemics caused by Ebola and Marburg viruses are occurring more and more frequently in Sub-Saharan Africa and only an adapted epidemiological surveillance system will allow for early detection and effective response.

Impact of anxiety and depressive symptoms on perceptions of stigma in persons living with HIV disease in rural versus urban North Carolina.

PubMed

Costelloe, Stephanie; Kemppainen, Jeanne; Brion, John; MacKain, Sally; Reid, Paula; Frampton, Art; Rigsbee, Elizabeth

2015-01-01

This analysis examined the relationships between HIV-related stigma, depression, and anxiety in rural and urban sites. Participants were HIV-positive urban (n = 100) and rural (n = 100) adult residents of a US southern state, drawn from a sample for a larger international study of self-esteem and self-compassion. Measures included demographic and health information, the HIV Stigma Scale, the Center for Epidemiology Studies Depression Scale (CES-D), and the Symptom Checklist 90 Revised (SCL-R-90) anxiety scale. Independent sample t-tests showed no significant differences between urban/rural groups on measures of HIV-related stigma, anxiety, or depression, except that rural participants reported greater disclosure concerns (t = 2.11, df = 196, p = .036). Both groups indicated high levels of depression and anxiety relative to published norms and clinically relevant cut-off scores. Hierarchical regression analyses were conducted for the HIV Stigma Scale including its four subscales and total stigma scores. Block 1 (control) contained health and demographic variables known to predict HIV-related stigma. Block 2 included the CES-D and the SCL-R-90, and Block 3 was urban/rural location. Mental health symptom scores contributed a significant amount to explained variance in total stigma scores (5.5%, FΔ = 6.020, p < .01), personalized stigma (4.8%, FΔ = 5.035, p < .01), negative self-image (9.7%, FΔ = 12.289, p < .001), and concern with public attitudes (4.9%, FΔ = 5.228, p < .01), but not disclosure concerns. Urban/rural location made significant additional contributions to the variance for total stigma (1.7%, FΔ = 3.899, p < .05), disclosure concerns (2.6%, FΔ = 5.446, p < .05), and concern with public attitudes (1.9%, FΔ = 4.169, p < .05) but not personalized stigma or negative self-image. Depression scores consistently and significantly predicted perceived stigma total and subscale scores. Findings suggest that mental health symptoms and urban/rural location play important roles in perceived stigma, and treatment implications are presented.

Influence of Urbanicity and County Characteristics on the Association between Ozone and Asthma Emergency Department Visits in North Carolina

EPA Science Inventory

Background: Air pollution epidemiology studies, often conducted in large metropolitan areas due to proximity to regulatory monitors, are limited in their ability to examine potential associations between air pollution exposures and health effects in rural locations. Methods: In a...

A rural/urban comparison of privacy and confidentiality concerns associated with providing sensitive location information in epidemiologic research involving persons who use drugs.

PubMed

Rudolph, Abby E; Young, April M; Havens, Jennifer R

2017-11-01

Analyses that link contextual factors with individual-level data can improve our understanding of the "risk environment"; however, the accuracy of information provided by participants about locations where illegal/stigmatized behaviors occur may be influenced by privacy/confidentiality concerns that may vary by setting and/or data collection approach. We recruited thirty-five persons who use drugs from a rural Appalachian town and a Mid-Atlantic city to participate in in-depth interviews. Through thematic analyses, we identified and compared privacy/confidentiality concerns associated with two survey methods that (1) collect self-reported addresses/cross-streets and (2) use an interactive web-based map to find/confirm locations in rural and urban settings. Concerns differed more by setting than between methods. For example, (1) rural participants valued interviewer rapport and protections provided by the Certificate of Confidentiality more; (2) locations considered to be sensitive differed in rural (i.e., others' homes) and urban (i.e., where drugs were used) settings; and (3) urban participants were more likely to view providing cross-streets as an acceptable alternative to providing exact addresses for sensitive locations and to prefer the web-based map approach. Rural-urban differences in privacy/confidentiality concerns reflect contextual differences (i.e., where drugs are used/purchased, population density, and prior drug-related arrests). Strategies to alleviate concerns include: (1) obtain a Certificate of Confidentiality, (2) collect geographic data at the scale necessary for proposed analyses, and (3) permit participants to provide intersections/landmarks in close proximity to actual locations rather than exact addresses or to skip questions where providing an intersection/landmark would not obfuscate the actual address. Copyright © 2017 Elsevier Ltd. All rights reserved.

Psychosocial factors and obesity in 17 high-, middle- and low-income countries: the Prospective Urban Rural Epidemiologic study.

PubMed

Rosengren, A; Teo, K; Rangarajan, S; Kabali, C; Khumalo, I; Kutty, V R; Gupta, R; Yusuf, R; Iqbal, R; Ismail, N; Altuntas, Y; Kelishadi, R; Diaz, R; Avezum, A; Chifamba, J; Zatonska, K; Wei, L; Liao, X; Lopez-Jaramillo, P; Yusufali, A; Seron, P; Lear, S A; Yusuf, S

2015-08-01

Psychosocial stress has been proposed to contribute to obesity, particularly abdominal, or central obesity, through chronic activation of the neuroendocrine systems. However, these putative relationships are complex and dependent on country and cultural context. We investigated the association between psychosocial factors and general and abdominal obesity in the Prospective Urban Rural Epidemiologic study. This observational, cross-sectional study enrolled 151 966 individuals aged 35-70 years from 628 urban and rural communities in 17 high-, middle- and low-income countries. Data were collected for 125 290 individuals regarding education, anthropometrics, hypertension/diabetes, tobacco/alcohol use, diet and psychosocial factors (self-perceived stress and depression). After standardization for age, sex, country income and urban/rural location, the proportion with obesity (body mass index ≥30 kg m(-)(2)) increased from 15.7% in 40 831 individuals with no stress to 20.5% in 7720 individuals with permanent stress, with corresponding proportions for ethnicity- and sex-specific central obesity of 48.6% and 53.5%, respectively (P<0.0001 for both). Associations between stress and hypertension/diabetes tended to be inverse. Estimating the total effect of permanent stress with age, sex, physical activity, education and region as confounders, no relationship between stress and obesity persisted (adjusted prevalence ratio (PR) for obesity 1.04 (95% confidence interval: 0.99-1.10)). There was no relationship between ethnicity- and sex-specific central obesity (adjusted PR 1.00 (0.97-1.02)). Stratification by region yielded inconsistent associations. Depression was weakly but independently linked to obesity (PR 1.08 (1.04-1.12)), and very marginally to abdominal obesity (PR 1.01 (1.00-1.03)). Although individuals with permanent stress tended to be slightly more obese, there was no overall independent effect and no evidence that abdominal obesity or its consequences (hypertension, diabetes) increased with higher levels of stress or depression. This study does not support a causal link between psychosocial factors and abdominal obesity.

[Emergence of Microsporum audouinii and Trichophyton tonsurans as causative organisms of tinea capitis in the Dominican Republic].

PubMed

Arenas, R; Torres, E; Amaya, M; Rivera, E R; Espinal, A; Polanco, M; Fernández, R; Isa-Isa, R

2010-05-01

Tinea capitis affects mainly children. The frequency and causative organism vary from region to region. To provide epidemiological and mycological data on tinea capitis collected in urban and rural areas of the Dominican Republic. Samples were obtained from 118 patients with tinea capitis. Sixty-three of these were from 2 schools in urban areas of the Dominican capital Santo Domingo (53%) and 55 were from rural schools on the border with Haiti (47%). The study included 84 boys (71. 18%) and 34 girls (28. 81%). The urban sample comprised mainly boys (84. 12%). The most represented age ranges were 6 to 8 years (47. 45%), 3 to 5 years (24. 59%), and 9 to 11 years (16. 94%). Microsporum audouinii (39. 68%), Trichophyton tonsurans (23. 80%), Microsporum canis (19. 04%), and Trichophyton violaceum (1. 58%) were isolated from children in urban areas, whereas T. tonsurans (87%) and Trichophyton mentagrophytes (2%) were isolated from those in rural areas. Overall, T. tonsurans (61. 16%), M. audouinii (24. 27%), and M canis (11. 65%) were the most frequently isolated causative organisms, whereas T. violaceum and T. mentagrophytes were rarely reported. In urban areas of the Dominican Republic, tinea capitis was found mainly in boys, but in rural areas it was evenly distributed among boys and girls. The emergence of M. audouinii and an increase in T. tonsurans were found while M. canis continued to be present at lower frequencies. On the rural border with Haiti, there was a significant predominance of T. tonsurans.

Communicable diseases in rural and remote Australia: the need for improved understanding and action.

PubMed

Quinn, Emma K; Massey, Peter D; Speare, Rick

2015-01-01

Rural and remote communities of Australia, particularly those including Aboriginal people, experience greater morbidity and mortality across a range of health outcomes compared to urban communities. Previous national data have demonstrated that rural and remote communities experience a disproportionate burden of communicable diseases compared to their urban counterparts. This systematic review was undertaken to describe the types of research that have explored the epidemiology of communicable diseases in rural and remote communities in Australia, with particular reference to the social determinants of health. We conducted a keyword search of several databases (EMBASE, MEDLINE/PubMed, RURAL, Aboriginal and Torres Strait Islander Health Database, Web of Science Core Collection, and Google and Google Scholar websites) for peer-reviewed and grey literature that described or analysed the epidemiology of communicable diseases in rural and/or remote communities of Australia from 2004 to 2013. Exclusion criteria were applied to keep the review focused on rural and/or remote communities and the population-level epidemiological analysis of communicable diseases. From 2287 retrieved articles, a total of 50 remained after applying exclusion criteria. The majority of included articles were descriptive studies (41/50). Seven of the total 50 articles contained analytical studies; one systematic literature review and one experimental study were also identified. Due to the diversity of approaches in measuring disease burden, we performed a narrative synthesis of the articles according to the review objectives. Most of the articles investigated the disease burden in remote (n=37/50) and Aboriginal communities only (n=21/50). The studies highlighted a high prevalence or incidence of skin, eye and respiratory infections for remote Aboriginal communities, particularly children over the past decade. There was emerging evidence to suggest that housing and social conditions play an important role in determining the risk of skin, ear, respiratory and gastrointestinal infections in children. Other health service and sociocultural factors were also discussed by authors as influencing the epidemiology of communicable diseases in rural and remote communities. This systematic review identified several communicable diseases that continue to cause considerable morbidity in remote Aboriginal communities, including skin, eye and respiratory infections, particularly for children. Overall there is a substantial amount of descriptive epidemiology published, but few analytical or experimental studies. Despite a lack of empirical investigation into the social determinants of the burden of communicable disease, there is emerging evidence that has demonstrated a significant association between housing conditions and skin, ear, respiratory and gastrointestinal infections in children. There is also growing recognition of other social and environmental factors that can influence the burden of diseases in rural and remote communities. Further investment into higher quality community-based research that addresses the social determinants of communicable diseases in remote communities is warranted. The lack of research investigating zoonoses and tropical diseases was noted.

The rural-to-urban migrant population in China: gloomy prospects for tuberculosis control.

PubMed

Tobe, Ruoyan Gai; Xu, Lingzhong; Song, Peipei; Huang, Yong

2011-12-01

The migrant population is a population with a high risk of tuberculosis (TB) infection and transmission. Globally, migration is likely to have a significant impact on TB epidemiology, particularly in countries that receive substantial numbers of migrants from countries with a high infection burden. China, a country with the world's second highest TB burden, faces a considerable increase in the number of rural-to-urban migrants. This population has a significant impact on urban TB epidemics and is specifically targeted by national guidelines for TB control. TB control among the migrant population has had relatively poor outcomes. Barriers to detection and treatment have both financial and non-financial aspects, such as the "migratory" nature of the migrant population, their marginalized working and living environment, poor financial status, little awareness of TB, inadequate referral to TB dispensaries, and potential social stigma in the workplace. Currently, the free TB treatment policy has limited ability to relieve the financial burden on most migrant TB patients as would allow optimal outcomes of TB detection and treatment. Universal health insurance coverage and fostering of personnel in community-based primary health care for the rural-to- urban migrant population represent two pillars of successful TB control.

[Changes in the epidemiological pattern of malaria in a rural area of the middle Rio Negro, Brazilian Amazon: a retrospective analysis].

PubMed

Suárez-Mutis, Martha Cecilia; Coura, José Rodrigues

2007-04-01

A retrospective study on reported malaria cases in the municipality (county) of Barcelos, Amazonas State, Brazil, was performed from 1992 to 2004, emphasizing the high endemic area along the Padauiri, an affluent of the Rio Negro. 16,795 cases were reported, 10,318 (61.4%) from the rural area and 6,477 (38.6%) from the urban area. Mean annual parasite index for the period was 136.7 per 1,000 inhabitants in the urban area and 613.6 per 1,000 in the rural area of Barcelos and 708.9 per 1,000 in the Padauiri area. In the latter area, two periods were considered: one epidemic, from 1992 to 1998, and the other post-epidemic, from 1999 to 2004. Comparing the two periods, the male/female ratio changed from 1.8 to 1.14, mean patient age from 17.9 to 14.8, proportion of Plasmodium falciparum cases from 51.9% to 23.7%, proportion of slides with low P. falciparum parasite density from 35.3% to 44.9%, and proportion of P. vivax from 24% to 35% (all these differences were statistically significant, with p < 0.05). The changes in the epidemiological pattern of malaria in the Padauiri area will be further elucidated through prospective studies.

Epidemiology of dental caries among adolescents in Tamil Nadu, India.

PubMed

Veerasamy, Arthi; Kirk, Ray; Gage, Jeffrey

2016-06-01

Economic and dietary changes in the Indian state of Tamil Nadu have led to compromised oral health status of the adolescent population. Adequate epidemiological data are not available to address the prevention or treatment needs in this region of India. The aim of this study was to measure the prevalence and severity of dental caries among adolescents of Tamil Nadu, a southern state of India. The study sample included 974 adolescent school students (12-15 years of age) from both rural and urban areas of Tamil Nadu, India. The decayed, missing and filled teeth (DMFT) index of these students was measured using the World Health Organization oral health survey method, in a quantitative cross-sectional study. The oral health survey indicated that the prevalence of dental caries among adolescents in rural and urban areas of Tamil Nadu was 61.4%, with an average DMFT score of 2.03. Multiple regression analyses indicated factors such as gender, mother's education, type of school and caste as significant predictors of dental caries. Female gender, Scheduled Caste and Tribes attending public schools in rural areas were identified as the more vulnerable populations to be affected by dental caries. Oral health policies should be targeted to these adolescent populations in the Tamil Nadu region. © 2016 FDI World Dental Federation.

Otitis media in indonesian urban and rural school children.

PubMed

Anggraeni, Ratna; Hartanto, Widya W; Djelantik, Bulantrisna; Ghanie, Abla; Utama, Denny S; Setiawan, Eka P; Lukman, Erica; Hardiningsih, Chintriany; Asmuni, Suprihati; Budiarti, Rery; Rahardjo, Sutji Pratiwi; Djamin, Riskiana; Mulyani, Tri; Mutyara, Kuswandewi; Carosone-Link, Phyllis; Kartasasmita, Cissy B; Simões, Eric A F

2014-10-01

Although the epidemiology of otitis media is well-known in industrialized countries, the extent of otitis media in developing Asian countries, especially in south East Asia is not well studied. To define the burden of otitis media and its sequelae in children 6-15 years of age, we enrolled elementary and junior high school children in 6 areas in rural and urban Indonesia. Randomly selected schools and classrooms were selected. All children were administered a questionnaire and had ear examinations, pneumatic otoscopy and screening audiometry. Children with any abnormality on examination or with a relevant history underwent diagnostic audiometry and tympanometry, if indicated. Of the 7005 children studied, 116 had chronic suppurative otitis media (CSOM), 30 had acute otitis media and 26 had otitis media with effusion. 2.7% of rural children had CSOM compared with 0.7% of urban children (P < 0.0001). The rates per 1000 of CSOM in rural Bali and Bandung were significantly higher (75 and 25, respectively) than in the rest of Indonesia (P < 0.05). In rural Bali, the rate per 1000 children of inactive CSOM was 63 in 6- to 9-year-old children, compared with 37 in children aged 13-15 years. Concomitantly, the rates of tympanosclerosis were 7 and 26/1000, respectively, in these age groups. In Indonesia, the prevalence of CSOM is relatively high with most disease occurring in rural areas. The high rates in rural Bali with early progression to tympanosclerosis suggest a significant burden of potentially vaccine preventable illness.

Socio-Economic Inequality of Chronic Non-Communicable Diseases in Bangladesh.

PubMed

Biswas, Tuhin; Islam, Md Saimul; Linton, Natalie; Rawal, Lal B

2016-01-01

Chronic non-communicable diseases (NCDs) are a major public health challenge, and undermine social and economic development in much of the developing world, including Bangladesh. Epidemiologic evidence on the socioeconomic status (SES)-related pattern of NCDs remains limited in Bangladesh. This study assessed the relationship between three chronic NCDs and SES among the Bangladeshi population, paying particular attention to the differences between urban and rural areas. Data from the 2011 Bangladesh Demographic and Health Survey were used for this study. Using a concentration index (CI), we measured relative inequality across pre-diabetes, diabetes, pre-hypertension, hypertension, and BMI (underweight, normal weight, and overweight/obese) in urban and rural areas in Bangladesh. A CI and its associated curve can be used to identify whether socioeconomic inequality exists for a given health variable. In addition, we estimated the health achievement index, integrating mean coverage and the distribution of coverage by rural and urban populations. Socioeconomic inequalities were observed across diseases and risk factors. Using CI, significant inequalities observed for pre-hypertension (CI = 0.09, p = 0.001), hypertension (CI = 0.10, p = 0.001), pre-diabetes (CI = -0.01, p = 0.005), diabetes (CI = 0.19, p<0.001), and overweight/obesity (CI = 0.45, p<0.001). In contrast to the high prevalence of the chronic health conditions among the urban richest, a significant difference in CI was observed for pre-hypertension (CI = -0.20, p = 0.001), hypertension (CI = -0.20, p = 0.005), pre-diabetes (CI = -0.15, p = 0.005), diabetes (CI = -0.26, p = 0.004) and overweight/obesity (CI = 0.25, p = 0.004) were observed more among the low wealth quintiles of rural population. In the same vein, the poorest rural households had more co-morbidities compared to the richest rural households (p = 0.003), and prevalence of co-morbidities was much higher for the richest urban households compared to the poorest urban households. On the other hand in rural the "disachievement" of health indicators is more noticeable than the urban ones. The findings indicate the high burden of selected NCDs among the low wealth quintile populations in rural areas and wealthy populations in urban areas. Particular attentions may be necessary to address the problem of NCDs among these groups.

Socio-Economic Inequality of Chronic Non-Communicable Diseases in Bangladesh

PubMed Central

Biswas, Tuhin; Islam, Md. Saimul; Linton, Natalie; Rawal, Lal B.

2016-01-01

Introduction Chronic non-communicable diseases (NCDs) are a major public health challenge, and undermine social and economic development in much of the developing world, including Bangladesh. Epidemiologic evidence on the socioeconomic status (SES)-related pattern of NCDs remains limited in Bangladesh. This study assessed the relationship between three chronic NCDs and SES among the Bangladeshi population, paying particular attention to the differences between urban and rural areas. Materials and Method Data from the 2011 Bangladesh Demographic and Health Survey were used for this study. Using a concentration index (CI), we measured relative inequality across pre-diabetes, diabetes, pre-hypertension, hypertension, and BMI (underweight, normal weight, and overweight/obese) in urban and rural areas in Bangladesh. A CI and its associated curve can be used to identify whether socioeconomic inequality exists for a given health variable. In addition, we estimated the health achievement index, integrating mean coverage and the distribution of coverage by rural and urban populations. Results Socioeconomic inequalities were observed across diseases and risk factors. Using CI, significant inequalities observed for pre-hypertension (CI = 0.09, p = 0.001), hypertension (CI = 0.10, p = 0.001), pre-diabetes (CI = -0.01, p = 0.005), diabetes (CI = 0.19, p<0.001), and overweight/obesity (CI = 0.45, p<0.001). In contrast to the high prevalence of the chronic health conditions among the urban richest, a significant difference in CI was observed for pre-hypertension (CI = -0.20, p = 0.001), hypertension (CI = -0.20, p = 0.005), pre-diabetes (CI = -0.15, p = 0.005), diabetes (CI = -0.26, p = 0.004) and overweight/obesity (CI = 0.25, p = 0.004) were observed more among the low wealth quintiles of rural population. In the same vein, the poorest rural households had more co-morbidities compared to the richest rural households (p = 0.003), and prevalence of co-morbidities was much higher for the richest urban households compared to the poorest urban households. On the other hand in rural the “disachievement” of health indicators is more noticeable than the urban ones. Conclusion The findings indicate the high burden of selected NCDs among the low wealth quintile populations in rural areas and wealthy populations in urban areas. Particular attentions may be necessary to address the problem of NCDs among these groups. PMID:27902760

Cardiovascular disease risk factors and socioeconomic variables in a nation undergoing epidemiologic transition.

PubMed

Rasiah, Rajah; Yusoff, Khalid; Mohammadreza, Amiri; Manikam, Rishya; Tumin, Makmor; Chandrasekaran, Sankara Kumar; Khademi, Shabnam; Bakar, Najmin Abu

2013-09-25

Cardiovascular disease (CVD) related deaths is not only the prime cause of mortality in the world, it has also continued to increase in the low and middle income countries. Hence, this study examines the relationship between CVD risk factors and socioeconomic variables in Malaysia, which is a rapidly growing middle income nation undergoing epidemiologic transition. Using data from 11,959 adults aged 30 years and above, and living in urban and rural areas between 2007 and 2010, this study attempts to examine the prevalence of CVD risk factors, and the association between these factors, and socioeconomic and demographic variables in Malaysia. The socioeconomic and demographic, and anthropometric data was obtained with blood pressure and fasting venous blood for glucose and lipids through a community-based survey. The association between CVD risk factors, and education and income was mixed. There was a negative association between smoking and hypertension, and education and income. The association between diabetes, hypercholesterolemia and being overweight with education and income was not clear. More men than women smoked in all education and income groups. The remaining consistent results show that the relationship between smoking, and education and income was obvious and inverse among Malays, others, rural women, Western Peninsular Malaysia (WPM) and Eastern Peninsular Malaysia (EPM). Urban men showed higher prevalence of being overweight than rural men in all education and income categories. Except for those with no education more rural men smoked than urban men. Also, Malay men in all education and income categories showed the highest prevalence of smoking among the ethnic groups. The association between CVD risk factors and socioeconomic variables should be considered when formulating programmes to reduce morbidity and mortality rates in low and middle income countries. While general awareness programmes should be targeted at all, specific ones should be focused on vulnerable groups, such as, men and rural inhabitants for smoking, Malays for hypertension and hypercholesterolemia, and Indians and Malays, and respondents from EPM for diabetes.

Measurement error in time-series analysis: a simulation study comparing modelled and monitored data.

PubMed

Butland, Barbara K; Armstrong, Ben; Atkinson, Richard W; Wilkinson, Paul; Heal, Mathew R; Doherty, Ruth M; Vieno, Massimo

2013-11-13

Assessing health effects from background exposure to air pollution is often hampered by the sparseness of pollution monitoring networks. However, regional atmospheric chemistry-transport models (CTMs) can provide pollution data with national coverage at fine geographical and temporal resolution. We used statistical simulation to compare the impact on epidemiological time-series analysis of additive measurement error in sparse monitor data as opposed to geographically and temporally complete model data. Statistical simulations were based on a theoretical area of 4 regions each consisting of twenty-five 5 km × 5 km grid-squares. In the context of a 3-year Poisson regression time-series analysis of the association between mortality and a single pollutant, we compared the error impact of using daily grid-specific model data as opposed to daily regional average monitor data. We investigated how this comparison was affected if we changed the number of grids per region containing a monitor. To inform simulations, estimates (e.g. of pollutant means) were obtained from observed monitor data for 2003-2006 for national network sites across the UK and corresponding model data that were generated by the EMEP-WRF CTM. Average within-site correlations between observed monitor and model data were 0.73 and 0.76 for rural and urban daily maximum 8-hour ozone respectively, and 0.67 and 0.61 for rural and urban loge(daily 1-hour maximum NO2). When regional averages were based on 5 or 10 monitors per region, health effect estimates exhibited little bias. However, with only 1 monitor per region, the regression coefficient in our time-series analysis was attenuated by an estimated 6% for urban background ozone, 13% for rural ozone, 29% for urban background loge(NO2) and 38% for rural loge(NO2). For grid-specific model data the corresponding figures were 19%, 22%, 54% and 44% respectively, i.e. similar for rural loge(NO2) but more marked for urban loge(NO2). Even if correlations between model and monitor data appear reasonably strong, additive classical measurement error in model data may lead to appreciable bias in health effect estimates. As process-based air pollution models become more widely used in epidemiological time-series analysis, assessments of error impact that include statistical simulation may be useful.

Tobacco consumption and positive mental health: an epidemiological study from a positive psychology perspective.

PubMed

Bazo-Alvarez, Juan Carlos; Peralta-Alvarez, Frank; Bernabé-Ortiz, Antonio; Alvarado, Germán F; Miranda, J Jaime

2016-05-04

Positive mental health (PMH) is much more than the absence of mental illnesses. For example, PMH explains that to be happy or resilient can drive us to live a full life, giving us a perception of well-being and robustness against everyday problems. Moreover, PMH can help people to avoid risky behaviours like tobacco consumption (TC). Our hypothesis was that PMH is negatively associated with TC, and this association differs across rural, urban and migrant populations. A cross-sectional study was conducted using the PERU MIGRANT Study's dataset, including rural population from the Peruvian highlands (n = 201), urban population from the capital city Lima (n = 199) and migrants who were born in highlands but had to migrated because of terrorism (n = 589). We used an adapted version of the 12-item Global Health Questionnaire to measure PMH. The outcome was TC, measured as lifetime and recent TC. Log-Poisson robust regression, performed with a Maximum Likelihood method, was used to estimate crude prevalence ratios (PR) and 95 % confidence intervals (95%CI), adjusted by sex, age, family income and education which were the confounders. The modelling procedure included the use of LR Test, Akaike information criteria (AIC) and Bayesian information criteria (BIC). Cumulative occurrence of tobacco use (lifetime TC) was 61.7 % in the rural group, 78 % in the urban group and 76.2 % in rural-to-urban migrants. Recent TC was 35.3 % in the rural group, 30.7 % in the urban group and 20.5 % in rural-to-urban migrants. After adjusting for confounders, there was evidence of a negative association between PMH and lifetime TC in the rural group (PR = 0.93; 95%CI: 0.87-0.99), and a positive association between PMH and recent TC in migrants (PR = 1.1; 95%CI: 1.0-1.3). PMH was negatively associated with TC in rural participants only. Urbans exhibited just a similar trend, while migrants exhibited the opposite one. This evidence represents the first step in the route of knowing the potential of PMH for fighting against TC. For rural populations, this study supplies new information that could support decisions about prevention programmes and psychotherapy for smoking cessation. However, more research in the topic is needed.

Epidemiology and population structure of Staphylococcus aureus in various population groups from a rural and semi urban area in Gabon, Central Africa.

PubMed

Ateba Ngoa, Ulysse; Schaumburg, Frieder; Adegnika, Ayola Akim; Kösters, Katrin; Möller, Tina; Fernandes, Jose Francisco; Alabi, Abraham; Issifou, Saadou; Becker, Karsten; Grobusch, Martin Peter; Kremsner, Peter Gottfried; Lell, Bertrand

2012-10-01

Little data is available on the epidemiology of Staphylococcus aureus in Africa. In the present study we aim at characterizing the population structure of S. aureus in healthy subjects from a rural and a semi-urban area in Lambaréné, Gabon as well as in hospital staff and inpatients. In total, 500 subjects were screened for S. aureus colonization of the nares, axillae and inguinal region. Overall, 146 (29%) were positive. We found 46 different spa types. The most frequent spa types were t084 (35%) and the agr II was the most prevalent subtype of the accessory gene regulator (56%, n=82). Five isolates (3%) were methicillin resistant S. aureus (MRSA). Carriage rates of S. aureus in Gabon are comparable to developed countries. MRSA is for the first time described and could pose a significant health threat in this region with limited access to microbiological laboratory facilities and to adequate antimicrobial agents. Copyright © 2012 Elsevier B.V. All rights reserved.

Epidemiology of soil-transmitted helminths, Schistosoma mansoni, and haematocrit values among schoolchildren in Ethiopia.

PubMed

Abera, Bayeh; Alem, Genetu; Yimer, Mulat; Herrador, Zaida

2013-03-14

This study aimed to determine the prevalence of intestinal helminths, risk factors and haematocrit values among primary schoolchildren. Across-sectional study was conducted in 12 primary schools in March 2011. Stool samples were randomly selected from 778 children and were microscopically examined using Kato-Katz and formal-ether concentration methods. Haematocrit values were measured using heparinized capillary tubes. The overall prevalence of intestinal helminths was 51.5% (rural = 68.3%, urban = 36.2%). Hookworm spp., Schistosoma mansoni and Schistosoma stercoralis were more prevalent in rural schools, whereas Hymenolepis nana was higher in urban schools (p = 0.0001). With regard to haematocrit, 34% of rural and 21.7% of urban schoolchildren had haematocrit values below the median (40.5%) (p=0.001). Hookworm spp. and S. mansoni infected children had lower haematocrit values than non-infected children (p = 0.001). Lack of footwear was positively associated with intestinal helminths infection in rural schools [OR = 2.5 (95% CI: 1.5-4.1)], and having dirty fingernails and untrimmed fingernails were positively associated with the prevalence of intestinal helminths in urban samples [OR = 1.58 (95% CI: 1.03-2.5)]. The prevalence of soil-transmitted helminths and S. mansoni differs by geographical area of the schools and social determinants. Primary school de-worming and health education on proper hygiene are recommended.

Parasitic diseases and urban development.

PubMed Central

Mott, K. E.; Desjeux, P.; Moncayo, A.; Ranque, P.; de Raadt, P.

1990-01-01

The distribution and epidemiology of parasitic diseases in both urban and periurban areas of endemic countries have been changing as development progresses. The following different scenarios involving Chagas disease, lymphatic filariasis, leishmaniasis and schistosomiasis are discussed: (1) infected persons entering nonendemic urban areas without vectors; (2) infected persons entering nonendemic urban areas with vectors; (3) infected persons entering endemic urban areas; (4) non-infected persons entering endemic urban areas; (5) urbanization or domestication of natural zoonotic foci; and (6) vectors entering nonendemic urban areas. Cultural and social habits from the rural areas, such as type of house construction and domestic water usage, are adopted by migrants to urban areas and increase the risk of disease transmission which adversely affects employment in urban populations. As the urban health services must deal with the rise in parasitic diseases, appropriate control strategies for the urban setting must be developed and implemented. PMID:2127380

Prevalence of childhood obesity and overweight in Bangladesh: findings from a countrywide epidemiological study

PubMed Central

2014-01-01

Background Obesity has been declared an epidemic in many high income countries. In low income countries, the coexistence of obesity and underweight makes the situation more grievous. The priority is to explore the overall pictures of body weight status in low income countries and countries that are in transitional phase. Through this country wide cross sectional study we would like to capture the current body weight status among the school aged children, both in urban and rural areas in Bangladesh. Methods We conducted a countrywide cross sectional study, from June to September 2009. By random sampling, we selected 10,135 students from 6 to 15 years from both the urban and rural schools. We categorized the students into overweight, obese and underweight by using the values for age and sex at +1SD, +2SD and −2 SD of Z scores of BMI respectively. Results We observed among 6 to 15 year olds from both the urban and rural areas 3.5% were obese, 9.5% were overweight and 17.6% were underweight. The proportion of obese and overweight students were greater among the students from urban schools (5.6%, 10.6%) compared to the students from rural schools (1.2%, 8.6%) (RD = 4.3, 95% CI = 3.6, 5.0; RD = 2.0, 95% CI = 0.1, 3.1). The proportion of underweight students were lower in the urban schools (16.1%) compared to the rural schools (19.2%) (RD = −3.1; 95% CI = −4.6, −1.6) Conclusions The rate of obesity and overweight is alarming among school aged children in Bangladesh. Overweight and underweight are coexisting which needs special attention to minimize the dual burden. PMID:24690395

Epidemiology and molecular analysis of hepatitis A, B and C in a semi-urban and rural area of Crete.

PubMed

Drositis, I; Bertsias, A; Lionis, C; Kouroumalis, E

2013-12-01

An observational seroepidemiological study was carried out in a well-defined primary-care district on the island of Crete in order to determine the recent endemicity of viral hepatitis in Cretan-population. The setting consisted of a semi-urban group and a remote & rural group. Serum samples were collected from 876 subjects (437 males, 439 females) aged 15 years or above. Subjects were randomly selected from the permanent population of the area that consisted of 5705 individuals. The aim was to measure the prevalence of selected viral-hepatitis markers. Hepatitis B surface-antigen (HBsAg) was found positive in twenty-nine individuals, (3.3%). Antibodies to hepatitis B virus core-antigen (HBcAb) were detected in 287 subjects (32.8%) and antibodies to hepatitis C virus (anti-HCV) were detected in nineteen subjects (2.2%). Seropositivities for the semi-urban group were: 3.4%, 19.1%, 2.1% and 3.2%, 48.8%, 2.2% in remote & rural group respectively. Virtually, all subjects >45 years old were seropositive for antibodies to hepatitis A, whereas approximately 80% of those in the 15-44 age-group were found to be seropositive. A threefold increase in the HBV exposure and carrier proportion was found in Cretan native-population and in rural-areas compared to older studies carried out in other rural-populations of the island. It is still unknown whether the recent economic crisis or the demographic changes in Cretan-population contributed to these findings. HCV endemicity remains relatively constant, however an alteration of hepatitis C genotypes was observed. Exposure to HAV was found to be higher in remote and rural areas compared to semi-urban areas. © 2013.

How federal health-care policies interface with urban and rural areas: a comparison of three systems.

PubMed

Baracskay, Daniel

2012-01-01

Global public health policies span national borders and affect multitudes of people. The spread of infectious disease has neither political nor economic boundaries, and when elevated to a status of pandemic proportions, immediate action is required. In federal systems of government, the national level leads the policy formation and implementation process, but also collaborates with supranational organisations as part of the global health network. Likewise, the national level of government cooperates with sub-national governments located in both urban and rural areas. Rural areas, particularly in less developed countries, tend to have higher poverty rates and lack the benefits of proper medical facilities, communication modes and technology to prevent the spread of disease. From the perspective of epidemiological surveillance and intervention, this article will examine federal health policies in three federal systems: Australia, Malaysia and the USA. Using the theoretical foundations of collaborative federalism, this article specifically examines how collaborative arrangements and interactions among governmental and non-governmental actors help to address the inherent discrepancies that exist between policy implementation and reactions to outbreaks in urban and rural areas. This is considered in the context of the recent H1N1 influenza pandemic, which spread significantly across the globe in 2009 and is now in what has been termed the 'post-pandemic era'.

Cocaine, MDMA and methamphetamine residues in wastewater: Consumption trends (2009-2015) in South East Queensland, Australia.

PubMed

Lai, Foon Yin; O'Brien, Jake W; Thai, Phong K; Hall, Wayne; Chan, Gary; Bruno, Raimondo; Ort, Christoph; Prichard, Jeremy; Carter, Steve; Anuj, Shalona; Kirkbride, K Paul; Gartner, Coral; Humphries, Melissa; Mueller, Jochen F

2016-10-15

Wastewater analysis, or wastewater-based epidemiology, has become a common tool to monitor trends of illicit drug consumption around the world. In this study, we examined trends in cocaine, 3,4-methylenedioxymethamphetamine (MDMA) and methamphetamine consumption by measuring their residues in wastewater from two wastewater treatment plants in Australia (specifically, an urban and a rural catchment, both in South East Queensland) between 2009 and 2015. With direct injection of the samples, target analytes were identified and quantified using liquid chromatography-mass spectrometry. Cocaine and MDMA residues and metabolites were mainly quantifiable in the urban catchment while methamphetamine residues were consistently detected in both urban and rural catchments. There was no consistent trend in the population normalised mass loads observed for cocaine and MDMA at the urban site between 2009 and 2015. In contrast, there was a five-fold increase in methamphetamine consumption over this period in this catchment. For methamphetamine consumption, the rural area showed a very similar trend as the urban catchment starting at a lower baseline. The observed increase in per capita loads of methamphetamine via wastewater analysis over the past six years in South East Queensland provides objective evidence for increased methamphetamine consumption in the Australian population while the use of other illicit stimulants remained relatively stable. Copyright © 2016 Elsevier B.V. All rights reserved.

Secular trend of the leading causes of death in China from 2003 to 2013.

PubMed

Ren, Yongcheng; Zhang, Ming; Luo, Xinping; Zhao, Jingzhi; Yin, Lei; Pang, Chao; Feng, Tianping; Wang, Shu; Wang, Bingyuan; Zhang, Hongyan; Yang, Xiangyu; Hu, Dongsheng

2017-06-01

To analyze the epidemiological characteristics and secular trends of the leading causes of death in China. Data on the leading causes of death was collected from the Statistical Yearbook of China. Data for 11 years, from 2003 to 2013, was analyzed by regression analysis and chi-square test. The top 3 causes of death from 2009 to 2013 were cancer, cerebrovascular disease, and cardiopathy, with the role of cardiopathy increasing over time (P<0.01). The proportion of deaths related to cardio-cerebrovascular diseases in urban and rural areas increased to 41.9% and 44.8%, respectively, in 2013, and was significantly higher than that for cancer, 25.5% and 22.4% (both P<0.01). Injury and poisoning in urban or rural areas represented the fifth leading cause of death. In 2006, endocrine, nutritional, and metabolic diseases were the sixth main cause of death, with 3.3% in urban areas. The role of genito-urinary, respiratory, and digestive system diseases in urban areas and genito-urinary system diseases in rural areas decreased during this period (all P<0.05). Cancer, cerebrovascular disease, and cardiopathy accounted for more than 67% of all deaths from 2007 to 2013 in China, and significantly increased in proportion from 2003 to 2013.

Urban transmission of schistosomiasis: new epidemiological situation in the forest area of Pernambuco.

PubMed

Gomes, Elainne Christine de Souza; Mesquita, Millena Carla da Silva; Rehn, Vitorina Nerivânia Covello; Nascimento, Wheverton Ricardo Correia do; Loyo, Rodrigo; Barbosa, Constança Simões

2016-01-01

Schistosomiasis is considered an endemic disease in Vitória de Santo Antão, Pernambuco, a district which has presented both high incidence and prevalence of it for decades. Poor environmental conditions lead to contamination of water sources in rural areas, which are used by the population during daily activities, resulting in typical transmission. Recently, there has been evidence of vector snails in urban areas, which could set a new model for schistosomiasis transmission in this district. To identify the new epidemiological situation for the urban transmission of schistosomiasis in Vitória de Santo Antão, Pernambuco. A malacological survey was conducted in all water sources in the city limits to investigate schistosomiasis vector snails (Biomphalaria spp.). The collected snails were examined for taxonomic identification and Schistosoma mansoni infection. All breeding sites were georeferenced to build risk maps through the TrackMaker PRO program and ArcGIS software. We identified 22 Biomphalaria straminea breeding sites and collected 1,704 snails. One of these breeding sites was identified as a source of transmission and seven as potential sources of transmission. The designed maps identified two risk areas of urban transmission of schistosomiasis and expansion areas for breeding sites, establishing an increased risk of transmission to the population. This study verified the existence of a new epidemiological situation in which the possibility of the urban transmission of the disease was confirmed.

Malaria prevalence in Bata district, Equatorial Guinea: a cross-sectional study.

PubMed

Ncogo, Policarpo; Herrador, Zaida; Romay-Barja, Maria; García-Carrasco, Emely; Nseng, Gloria; Berzosa, Pedro; Santana-Morales, Maria A; Riloha, Matilde; Aparicio, Pilar; Valladares, Basilio; Benito, Agustín

2015-11-16

Malaria has traditionally been a leading public health problem in Equatorial Guinea. After completion, in September 2011, of the integrated set of interventions against malaria launched by the Global Fund Malaria Programme in the mainland area, the epidemiological situation of malaria remains unknown. The aim of this study was to investigate the prevalence rate of malaria and associated factors based on the rapid diagnosis test (RDT) in Bata district, in order to provide evidence that will reinforce the National Malaria Control Programme. From June to August 2013, a representative cross sectional survey using a multistage, stratified, cluster-selected sample was carried out in urban zones and rural villages from Bata district. Data on socio-demographic, health status and malaria-related behaviours was collected. Malaria diagnosis was performed by RDT. Bivariate and multivariable statistical methods were employed to assess malaria prevalence and its association with different factors. Prevalence of malaria was higher in rural settings (58.9 %; CI 95 % 55.2-62.5 %) than in the sampled urban communities (33.9 %; CI 95 % 31.1-36.9 %). Presence of anaemia was also high, especially in rural sites (89.6 vs. 82.8 %, p < 0.001). The analyses show that a positive RDT result was significantly associated with age group, the most affected age range being 13 months-14 years old. Other significant covariates were ethnic group (only in urban sites), number of adults living in the house (only in rural villages) previous history of fever, anaemia (only in urban sites) and sleeping under a bed net. Moreover, those who never slept under a bed net were two times more likely to have malaria. The prevalence of malaria was high in Bata district, especially in rural villages. The National Programme to fight malaria in Equatorial Guinea should take into account the differences found between rural and urban communities and age groups to target appropriately those worst affected. The findings of this study will assist in planning and undertaking regional policy and other preventive initiatives.

Epidemiology of adulthood drowning deaths in Bangladesh: Findings from a nationwide health and injury survey

PubMed Central

Hossain, Mohammad Jahangir; Biswas, Animesh; Mashreky, Saidur Rahman; Rahman, Fazlur; Rahman, Aminur

2017-01-01

Background: Annual global death due to drowning accounts for 372,000 lives, 90% of which occur in low and middle income countries. Life in Bangladesh exposes adults and children to may water bodies for daily household needs, and as a result drowning is common. In Bangladesh, due to lack of systemic data collection, drowning among adults is unknown; most research is focused on childhood drowning. The aim of the present study was to explore the epidemiology of adulthood drowning deaths in Bangladesh. Methodology: A nationwide cross-sectional survey was conducted from January to December in 2003 among 171,366 rural and urban households, with a sample of 819,429 individuals to determine the epidemiology of adulthood drowning in Bangladesh.   Results:  Annual fatal drowning incidence among adults was 5.85/100,000 individuals. Of these, 71.4% were male and 28.6% were female (RR 2.39). In total, 90% of the fatalities were from rural areas. Rural populations were also found to have a 8.58 times higher risk of drowning than those in urban areas. About 95% of drowning occurred in natural water bodies. About 61.6% of the deaths occurred at the scene followed by 33.5% at the home. Of the drowning fatalities, 67% took place in water bodies within 100 meters of the household. Among the drowning fatalities 78.4% occurred in daylight between 7.00 and 18.00. Over 97% of the victims were from poor socio economic conditions with a monthly income tk. 6,000 ($94) or less. Only 25.5% of incidences were reported to the police station. Conclusions: Every year a significant number of adults die due to drowning in Bangladesh.  Populations living in rural areas, especially men, were the main victims of drowning. This survey finding might help policy makers and scientists to understand the drowning scenario among adults in Bangladesh. PMID:28529716

Epidemiology of adulthood drowning deaths in Bangladesh: Findings from a nationwide health and injury survey.

PubMed

Hossain, Mohammad Jahangir; Biswas, Animesh; Mashreky, Saidur Rahman; Rahman, Fazlur; Rahman, Aminur

2017-01-01

Background: Annual global death due to drowning accounts for 372,000 lives, 90% of which occur in low and middle income countries. Life in Bangladesh exposes adults and children to may water bodies for daily household needs, and as a result drowning is common. In Bangladesh, due to lack of systemic data collection, drowning among adults is unknown; most research is focused on childhood drowning. The aim of the present study was to explore the epidemiology of adulthood drowning deaths in Bangladesh. Methodology: A nationwide cross-sectional survey was conducted from January to December in 2003 among 171,366 rural and urban households, with a sample of 819,429 individuals to determine the epidemiology of adulthood drowning in Bangladesh.   Results:   Annual fatal drowning incidence among adults was 5.85/100,000 individuals. Of these, 71.4% were male and 28.6% were female (RR 2.39). In total, 90% of the fatalities were from rural areas. Rural populations were also found to have a 8.58 times higher risk of drowning than those in urban areas. About 95% of drowning occurred in natural water bodies. About 61.6% of the deaths occurred at the scene followed by 33.5% at the home. Of the drowning fatalities, 67% took place in water bodies within 100 meters of the household. Among the drowning fatalities 78.4% occurred in daylight between 7.00 and 18.00. Over 97% of the victims were from poor socio economic conditions with a monthly income tk. 6,000 ($94) or less. Only 25.5% of incidences were reported to the police station. Conclusions: Every year a significant number of adults die due to drowning in Bangladesh.  Populations living in rural areas, especially men, were the main victims of drowning. This survey finding might help policy makers and scientists to understand the drowning scenario among adults in Bangladesh.

Cardiovascular Diseases and Risk-Factor Burden in Urban and Rural Communities in High-, Middle-, and Low-Income Regions of China: A Large Community-Based Epidemiological Study.

PubMed

Yan, Ruohua; Li, Wei; Yin, Lu; Wang, Yang; Bo, Jian

2017-02-06

Most cardiovascular diseases occur in low- and middle-income regions of the world, but the socioeconomic distribution within China remains unclear. Our study aims to investigate whether the prevalence of cardiovascular diseases differs among high-, middle-, and low-income regions of China and to explore the reasons for the disparities. We enrolled 46 285 individuals from 115 urban and rural communities in 12 provinces across China between 2005 and 2009. We recorded their medical histories of cardiovascular diseases and calculated the INTERHEART Risk Score for the assessment of cardiovascular risk-factor burden, with higher scores indicating greater burden. The mean INTERHEART Risk Score was higher in high- and middle-income regions than in low-income regions (9.47, 9.48, and 8.58, respectively, P<0.0001). By contrast, the prevalence of total cardiovascular disease (stroke, ischemic heart disease, and other heart diseases that led to hospitalization) was lower in high- and middle-income regions than in low-income regions (7.46%, 7.42%, and 8.36%, respectively, P trend =0.0064). In high- and middle-income regions, urban communities have higher INTERHEART Risk Score and higher prevalent rate than rural communities. In low-income regions, however, the prevalence of total cardiovascular disease was similar between urban and rural areas despite the significantly higher INTERHEART Risk Score for urban settings. We detected an inverse trend between risk-factor burden and cardiovascular disease prevalence in urban and rural communities in high-, middle-, and low-income regions of China. Such asymmetry may be attributed to the interregional differences in residents' awareness, quality of healthcare, and availability and affordability of medical services. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Oral health status of rural-urban migrant children in South China.

PubMed

Gao, Xiao-Li; McGrath, Colman; Lin, Huan-Cai

2011-01-01

In China, there is a massive rural-urban migration and the children of migrants are often unregistered residents (a 'floating population'). This pilot study aimed to profile the oral health of migrant children in South China's principal city of migration and identify its socio-demographic/behavioural determinants. An epidemiological survey was conducted in an area of Guangzhou among 5-year-old migrant children (n = 138) who received oral examinations according to the World Health Organization criteria. Parents' oral health knowledge/attitude, child practices, and impact of children's oral health on their quality-of-life (QoL) were assessed. The caries rate and mean (SD) dmft were 86% and 5.17 (4.16), respectively, higher than those national statistics for both rural and urban areas (P < 0.05). Oral hygiene was satisfactory (DI-S < 1.0) in 3% of children. Oral health impacts on QoL were considerable; 60% reported one or more impacts. 58% variance in 'dmft' was explained by 'non-local-born', 'low-educated parents', 'bedtime feeding', 'parental unawareness of fluoride's effect and importance of teeth', and 'poor oral hygiene' (all P < 0.05). 'Non-local-born' and 'dmft' indicated poor oral health-related QoL (both P < 0.05), accounting for 32% of variance. Oral health is poor among rural-urban migrant children and requires effective interventions in targeted sub-groups. © 2010 The Authors. International Journal of Paediatric Dentistry © 2010 BSPD, IAPD and Blackwell Publishing Ltd.

Psychosocial factors and obesity in 17 high-, middle- and low-income countries: the Prospective Urban Rural Epidemiologic study

PubMed Central

Rosengren, A; Teo, K; Rangarajan, S; Kabali, C; Khumalo, I; Kutty, V R; Gupta, R; Yusuf, R; Iqbal, R; Ismail, N; Altuntas, Y; Kelishadi, R; Diaz, R; Avezum, A; Chifamba, J; Zatonska, K; Wei, L; Liao, X; Lopez-Jaramillo, P; Yusufali, A; Seron, P; Lear, S A; Yusuf, S

2015-01-01

Background/Objectives: Psychosocial stress has been proposed to contribute to obesity, particularly abdominal, or central obesity, through chronic activation of the neuroendocrine systems. However, these putative relationships are complex and dependent on country and cultural context. We investigated the association between psychosocial factors and general and abdominal obesity in the Prospective Urban Rural Epidemiologic study. Subjects/Methods: This observational, cross-sectional study enrolled 151 966 individuals aged 35–70 years from 628 urban and rural communities in 17 high-, middle- and low-income countries. Data were collected for 125 290 individuals regarding education, anthropometrics, hypertension/diabetes, tobacco/alcohol use, diet and psychosocial factors (self-perceived stress and depression). Results: After standardization for age, sex, country income and urban/rural location, the proportion with obesity (body mass index ⩾30 kg m−2) increased from 15.7% in 40 831 individuals with no stress to 20.5% in 7720 individuals with permanent stress, with corresponding proportions for ethnicity- and sex-specific central obesity of 48.6% and 53.5%, respectively (P<0.0001 for both). Associations between stress and hypertension/diabetes tended to be inverse. Estimating the total effect of permanent stress with age, sex, physical activity, education and region as confounders, no relationship between stress and obesity persisted (adjusted prevalence ratio (PR) for obesity 1.04 (95% confidence interval: 0.99–1.10)). There was no relationship between ethnicity- and sex-specific central obesity (adjusted PR 1.00 (0.97–1.02)). Stratification by region yielded inconsistent associations. Depression was weakly but independently linked to obesity (PR 1.08 (1.04–1.12)), and very marginally to abdominal obesity (PR 1.01 (1.00–1.03)). Conclusions: Although individuals with permanent stress tended to be slightly more obese, there was no overall independent effect and no evidence that abdominal obesity or its consequences (hypertension, diabetes) increased with higher levels of stress or depression. This study does not support a causal link between psychosocial factors and abdominal obesity. PMID:25869608

[A serological survey of the infection by Echinococcus sp. in the municipality of Sena Madureira, AC].

PubMed

Pastore, Ricardo; Vitali, Lúcia H; Macedo, Vanize de Oliveira; Prata, Aluízio

2003-01-01

A serological inquiry was performed in the municipality of Sena Madureira, Acre State, Brazil, to evaluate the individual contact with Echinococcus sp. The participants were recruited from two distinct populations: residents in the urban and rural areas, the latter distributed among riverside communities of the region. A total of 1,064 individuals were evaluated: 851 from the urban zone and 213 from the rural area. The study was divided into two phases: a serological screening, in which the blood samples were collected and then sent to the Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (Serology Laboratory), Ribeirão Preto, SP, Brazil, for the serological test by counterimmunoelectrophoresis technique; and secondly an epidemiological inquiry for evaluating the individuals and their dwelling conditions and customs. Comparing the results of serological tests, the prevalence in the rural area was 6% against 3.5% in the urban area. The overall prevalence was 4%. The possibility of the existence of another intermediate host in the life cycle of Echinococcus vogeli was analyzed and the findings indicated the domestic pig as being the most probable.

Measured radiofrequency exposure during various mobile-phone use scenarios.

PubMed

Kelsh, Michael A; Shum, Mona; Sheppard, Asher R; McNeely, Mark; Kuster, Niels; Lau, Edmund; Weidling, Ryan; Fordyce, Tiffani; Kühn, Sven; Sulser, Christof

2011-01-01

Epidemiologic studies of mobile phone users have relied on self reporting or billing records to assess exposure. Herein, we report quantitative measurements of mobile-phone power output as a function of phone technology, environmental terrain, and handset design. Radiofrequency (RF) output data were collected using software-modified phones that recorded power control settings, coupled with a mobile system that recorded and analyzed RF fields measured in a phantom head placed in a vehicle. Data collected from three distinct routes (urban, suburban, and rural) were summarized as averages of peak levels and overall averages of RF power output, and were analyzed using analysis of variance methods. Technology was the strongest predictor of RF power output. The older analog technology produced the highest RF levels, whereas CDMA had the lowest, with GSM and TDMA showing similar intermediate levels. We observed generally higher RF power output in rural areas. There was good correlation between average power control settings in the software-modified phones and power measurements in the phantoms. Our findings suggest that phone technology, and to a lesser extent, degree of urbanization, are the two stronger influences on RF power output. Software-modified phones should be useful for improving epidemiologic exposure assessment.

Community-based epidemiological study of epilepsy in the Qena governorate in Upper Egypt, a door-to-door survey.

PubMed

Fawi, Gharib; Khedr, Eman M; El-Fetoh, Noha Abo; Thabit, Mohamed N; Abbass, Mohamed A; Zaki, Ahmad F

2015-07-01

The aim of this study is to estimate the epidemiological features of epilepsy in a representative governorate of Upper Egypt. A door-to-door community-based survey study was performed using a sample of 10 areas among various districts of the Qena governorate in Upper Egypt. Six were classified as rural areas, and the remaining four were classified as urban areas, with a total population of 8027 inhabitants. The population was screened using an epilepsy-screening questionnaire. Positive cases with suspected epilepsy were referred to Qena University Hospital to be further evaluated by a qualified neurologist and for further investigations, such as neuroimaging and electroencephalography. One hundred patients had a confirmed diagnosis of epilepsy, with a lifetime prevalence of 12.46/1000. The active prevalence rate of epilepsy was 2.12/1000, while the incidence rate was 123/100000. Seventy-six percent of the patients had idiopathic epilepsies, while 24% had symptomatic epilepsy. Generalized epilepsies were more common (70.1%) than partial epilepsy (26.3%), meanwhile epilepsies with mixed seizure types were 2.6%. The most common seizure type was generalized tonic clonic seizures (51.8%). The age-specific prevalence rate of epilepsy was much higher in infancy and early childhood (62.5 and 37.04/1000, respectively), which regressed steadily with age. Idiopathic epilepsies were significantly more common in urban areas than in rural areas (P=0.01), while symptomatic epilepsies were more common in rural areas than in urban areas (P<0.005). Upper Egypt is characterized by a relatively high incidence and prevalence of epilepsy and epilepsy-related medical service, and more cultural education should be directed to those areas in Egypt. Copyright © 2015 Elsevier B.V. All rights reserved.

Prevalence, incidence, and epidemiological features of poliomyelitis in the Yemen Arab Republic.

PubMed

Hajar, M M; Zeid, A S; Saif, M A; Parvez, M A; Steinglass, R C; Crain, S

1983-01-01

There is a lack of reliable information on the extent of the poliomyelitis problem in developing countries, although the disease is thought to be more of a threat in urban than in rural areas. The Expanded Programme on Immunization (EPI) began operations in Yemen in 1977, and it was considered appropriate to try to establish the prevalence of residual paralysis due to poliomyelitis in children aged 5-13 years, in order to estimate the annual incidence of clinical cases of the disease, and to determine the epidemiological features of poliomyelitis in the country. The data thus obtained would provide a basis for assessing the impact of the immunization programme on the incidence of poliomyelitis.The results of the survey showed a prevalence of lameness due to poliomyelitis of 4.0 per 1000 children. The estimated annual incidence of the disease is thus 18.6 per 100 000 of the general population, or approximately 1088 cases each year, with an estimated 163 deaths. An estimated 5000 children aged 5-13 years are lame as a result of poliomyelitis. There was no significant difference in the incidence of the disease in rural and urban areas. The median age of onset was 1.92 years in the urban setting and 1.29 years in the rural setting, with more than half of all cases occurring before the age of 2 years. Immunization efforts should therefore be directed towards infants aged under 2 years. Although a national disease notification system was established in 1976, 95% of the clinical cases discovered during the survey had not been reported. This underlines the importance of special surveys in gathering the data necessary to evaluate the effectiveness of the immunization programme.

Use of Bead-Based Serologic Assay to Evaluate Chikungunya Virus Epidemic, Haiti.

PubMed

Rogier, Eric W; Moss, Delynn M; Mace, Kimberly E; Chang, Michelle; Jean, Samuel E; Bullard, Stevan M; Lammie, Patrick J; Lemoine, Jean Frantz; Udhayakumar, Venkatachalam

2018-06-01

The index case of chikungunya virus (CHIKV) in Haiti was reported during early 2014; the vector, the pervasive Aedes aegypti mosquito, promoted rapid spread throughout the country. During December 2014-February 2015, we collected blood samples from 4,438 persons at 154 sites (62 urban, 92 rural) throughout Haiti and measured CHIKV IgG by using a multiplex bead assay. Overall CHIKV seroprevalence was 57.9%; differences between rural (mean 44.9%) and urban (mean 78.4%) areas were pronounced. Logistic modeling identified the urban environment as a strong predictor of CHIKV exposure (adjusted odds ratio 3.34, 95% CI 2.38-4.69), and geographic elevation provided a strong negative correlation. We observed no correlation between age and antibody positivity or titer. Our findings demonstrated through serologic testing the recent and rapid dissemination of the arbovirus throughout the country. These results show the utility of serologic data to conduct epidemiologic studies of quickly spreading mosquitoborne arboviruses.

Consequences of smoke inhalation in the 'Epidemiology of Allergic Diseases in Poland' project (ECAP).

PubMed

Stankiewicz-Choroszucha, Bożenna L; Wawrzyniak, Zbigniew M; Lipiec, Agnieszka; Piekarska, Barbara; Kapalczynski, Wojciech J; Samoliński, Bolesław K

2011-01-01

This paper presents a risk assessment of individuals with respiratory allergies who are exposed to active and passive tobacco smoke (environmental tobacco smoke or ETS). Smoking tobacco and ETS is a serious environmental hazard known to be harmful to human health. This analysis is based on the results of the Epidemiology of Allergic Diseases in Poland (ECAP) study, which was conducted from 2006-2008 on a sample of approximately 22,500 respondents in 9 areas of Poland, both urban and rural. Data collection was based on individual interviews and a questionnaire employing Computer Assisted Personal Interviewing technology (CAPI). 46.8% of respondents declared themselves as smokers, defined as those who smoke and have done so for at least one year. In this group, 41.5% of respondents were female and 54.3% were male. While differences between various areas of Poland were demonstrated, they did not necessarily correlate with urbanization. Rural Zamość reported 41.4% of smokers while metropolitan Poznań had 41.9% of smokers. These statistics can be contrasted against other urban areas such as Katowice and Gdansk, which had 51.8% and 52.3% of smokers, respectively (n = 9376). 29.6% of rural women reported smoking, while this percentage was higher among urban women, ranging from 36.3% in Poznań to 49.5% in Gdańsk. However, the highest percentage of smokers was among males in Zamość at 56.1%. This percentage was higher than the overall average in this study. The largest percentages of active smoking occurred among laborers, craftsmen, miners, drivers, farmers and fishermen, the self-employed and gardeners. This quantitative assessment of the prevalence of smoking underlines the importance of the consequences of this habit as they relate to asthma and respiratory allergies. The findings demonstrate smoking as a serious social problem associated with allergic diseases, and a habit that differs between place of residence and work environment.

Cardiovascular disease risk factors and socioeconomic variables in a nation undergoing epidemiologic transition

PubMed Central

2013-01-01

Background Cardiovascular disease (CVD) related deaths is not only the prime cause of mortality in the world, it has also continued to increase in the low and middle income countries. Hence, this study examines the relationship between CVD risk factors and socioeconomic variables in Malaysia, which is a rapidly growing middle income nation undergoing epidemiologic transition. Methods Using data from 11,959 adults aged 30 years and above, and living in urban and rural areas between 2007 and 2010, this study attempts to examine the prevalence of CVD risk factors, and the association between these factors, and socioeconomic and demographic variables in Malaysia. The socioeconomic and demographic, and anthropometric data was obtained with blood pressure and fasting venous blood for glucose and lipids through a community-based survey. Results The association between CVD risk factors, and education and income was mixed. There was a negative association between smoking and hypertension, and education and income. The association between diabetes, hypercholesterolemia and being overweight with education and income was not clear. More men than women smoked in all education and income groups. The remaining consistent results show that the relationship between smoking, and education and income was obvious and inverse among Malays, others, rural women, Western Peninsular Malaysia (WPM) and Eastern Peninsular Malaysia (EPM). Urban men showed higher prevalence of being overweight than rural men in all education and income categories. Except for those with no education more rural men smoked than urban men. Also, Malay men in all education and income categories showed the highest prevalence of smoking among the ethnic groups. Conclusions The association between CVD risk factors and socioeconomic variables should be considered when formulating programmes to reduce morbidity and mortality rates in low and middle income countries. While general awareness programmes should be targeted at all, specific ones should be focused on vulnerable groups, such as, men and rural inhabitants for smoking, Malays for hypertension and hypercholesterolemia, and Indians and Malays, and respondents from EPM for diabetes. PMID:24066906

Health financing and integration of urban and rural residents' basic medical insurance systems in China.

PubMed

Zhu, Kun; Zhang, Luying; Yuan, Shasha; Zhang, Xiaojuan; Zhang, Zhiruo

2017-11-07

China is in the process of integrating the new cooperative medical scheme (NCMS) and the urban residents' basic medical insurance system (URBMI) into the urban and rural residents' basic medical insurance system (URRBMI). However, how to integrate the financing policies of NCMS and URBMI has not been described in detail. This paper attempts to illustrate the differences between the financing mechanisms of NCMS and URBMI, to analyze financing inequity between urban and rural residents and to identify financing mechanisms for integrating urban and rural residents' medical insurance systems. Financing data for NCMS and URBMI (from 2008 to 2015) was collected from the China health statistics yearbook, the China health and family planning statistics yearbook, the National Handbook of NCMS Information, the China human resources and social security statistics yearbook, and the China social security yearbook. "Ability to pay" was introduced to measure inequity in health financing. Individual contributions to NCMS and URBMI as a function of per capita disposable income was used to analyze equity in health financing between rural and urban residents. URBMI had a financing mechanism that was similar to that used by NCMS in that public finance accounted for more than three quarters of the pooling funds. The scale of financing for NCMS was less than 5% of the per capita net income of rural residents and less than 2% of the per capita disposable income of urban residents for URBMI. Individual contributions to the NCMS and URBMI funds were less than 1% of their disposable and net incomes. Inequity in health financing between urban and rural residents in China was not improved as expected with the introduction of NCMS and URBMI. The role of the central government and local governments in financing NCMS and URBMI was oscillating in the past decade. The scale of financing for URRBMI is insufficient for the increasing demands for medical services from the insured. The pooling fund should be increased so that it can better adjust to China's rapidly aging population and epidemiological transitions as well as protect the insured from poverty due to illness. Individual contributions to the URBMI and NCMS funds were small in terms of contributors' incomes. The role of the central government and local governments in financing URRBMI was not clearly identified. Individual contributions to the URRBMI fund should be increased to ensure the sustainable development of URRBMI. Compulsory enrollment should be required so that URRBMI improves the social medical insurance system in China.

Intentional injuries in young Ohio children: is there urban/rural variation?

PubMed

Anderson, Brit L; Pomerantz, Wendy J; Gittelman, Michael A

2014-09-01

Intentional injuries are the third leading cause of death in children 1 year to 4 years of age. The epidemiology of these injuries based on urban/rural geography and economic variables has not been clearly established. The study purposes are (1) to determine the rate of severe intentional injuries in children younger than 5 years in urban versus rural Ohio counties and (2) to determine if poverty within counties is associated with intentional injury rate. Demographic and injury data on children younger than 5 years who experienced intentional injuries, from January 1, 2003, to December 31, 2011, were extracted retrospectively from the Ohio Trauma Acute Care Registry. We calculated injury rates using the county of residence and US census data. We assigned each county to an urbanization level based on population density (A, most urban; D, most rural). Mean income and percentage of families with children younger than 5 years living below poverty in Ohio counties were obtained from the US census. Rates are per 100,000 children younger than 5 years per year. A total of 984 patients were included; the overall injury rate was 15.9. The mean age was 0.66 years (SD, 1.02 years); 583 (59.2%) were male and 655 (66.6%) were white. One hundred twenty-nine (13.1%) died. Injury rates by urbanization level were as follows: A, 16.5; B, 10.7; C, 18.7; and D, 15.2 (p = 0.285). There were significant associations between county injury rate and mean income (p = 0.05) and percentage of families with children younger than 5 years living below poverty (p = 0.04). We found no association between intentional injury rate and urbanization level in young Ohio children. However, we did find an association between county mean income and percentage of families living below poverty, with intentional injury rate suggesting that financial hardship may be an important risk factor of these injuries.

Rural–urban variations in age at menarche, adult height, leg-length and abdominal adiposity in black South African women in transitioning South Africa

PubMed Central

2018-01-01

Abstract Background: The pre-pubertal socioeconomic environment may be an important determinant of age at menarche, adult height, body proportions and adiposity: traits closely linked to adolescent and adult health. Aims: This study explored differences in age at menarche, adult height, relative leg-length and waist circumference between rural and urban black South African young adult women, who are at different stages of the nutrition and epidemiologic transitions. Subjects and methods: We compared 18–23 year-old black South African women, 482 urban-dwelling from Soweto and 509 from the rural Mpumalanga province. Age at menarche, obstetric history and household socio-demographic and economic information were recorded using interview-administered questionnaires. Height, sitting-height, hip and waist circumference were measured using standardised techniques. Results: Urban and rural black South African women differed in their age at menarche (at ages 12.7 and 14.5 years, respectively). In urban women, a one-year increase in age at menarche was associated with a 0.65 cm and 0.16% increase in height and relative leg-length ratio, respectively. In both settings, earlier age at menarche and shorter relative leg-length were independently associated with an increase in waist circumference. Conclusions: In black South African women, the earlier onset of puberty, and consequently an earlier growth cessation process, may lead to central fat mass accumulation in adulthood. PMID:29557678

High Leptospira Diversity in Animals and Humans Complicates the Search for Common Reservoirs of Human Disease in Rural Ecuador.

PubMed

Barragan, Veronica; Chiriboga, Jorge; Miller, Erin; Olivas, Sonora; Birdsell, Dawn; Hepp, Crystal; Hornstra, Heidie; Schupp, James M; Morales, Melba; Gonzalez, Manuel; Reyes, Soraya; de la Cruz, Carmen; Keim, Paul; Hartskeerl, Rudy; Trueba, Gabriel; Pearson, Talima

2016-09-01

Leptospirosis is a zoonotic disease responsible for high morbidity around the world, especially in tropical and low income countries. Rats are thought to be the main vector of human leptospirosis in urban settings. However, differences between urban and low-income rural communities provide additional insights into the epidemiology of the disease. Our study was conducted in two low-income rural communities near the coast of Ecuador. We detected and characterized infectious leptospira DNA in a wide variety of samples using new real time quantitative PCR assays and amplicon sequencing. We detected infectious leptospira in a high percentage of febrile patients (14.7%). In contrast to previous studies on leptospirosis risk factors, higher positivity was not found in rats (3.0%) but rather in cows (35.8%) and pigs (21.1%). Six leptospira species were identified (L. borgpetersenii, L kirschnerii, L santarosai, L. interrogans, L noguchii, and an intermediate species within the L. licerasiae and L. wolffii clade) and no significant differences in the species of leptospira present in each animal species was detected (χ2 = 9.89, adj.p-value = 0.27). A large portion of the world's human population lives in low-income, rural communities, however, there is limited information about leptospirosis transmission dynamics in these settings. In these areas, exposure to peridomestic livestock is particularly common and high prevalence of infectious leptospira in cows and pigs suggest that they may be the most important reservoir for human transmission. Genotyping clinical samples show that multiple species of leptospira are involved in human disease. As these genotypes were also detected in samples from a variety of animals, genotype data must be used in conjunction with epidemiological data to provide evidence of transmission and the importance of different potential leptospirosis reservoirs.

Assessing global risk factors for non-fatal injuries from road traffic accidents and falls in adults aged 35-70 years in 17 countries: a cross-sectional analysis of the Prospective Urban Rural Epidemiological (PURE) study.

PubMed

Raina, Parminder; Sohel, Nazmul; Oremus, Mark; Shannon, Harry; Mony, Prem; Kumar, Rajesh; Li, Wei; Wang, Yang; Wang, Xingyu; Yusoff, Khalid; Yusuf, Rita; Iqbal, Romaina; Szuba, Andrzej; Oguz, Aytekin; Rosengren, Annika; Kruger, Annamarie; Chifamba, Jephat; Mohammadifard, Noushin; Darwish, Ebtihal Ahmad; Dagenais, Gilles; Diaz, Rafael; Avezum, Alvaro; Lopez-Jaramillo, Patricio; Seron, Pamela; Rangarajan, Sumathy; Teo, Koon; Yusuf, Salim

2016-04-01

To assess risk factors associated with non-fatal injuries (NFIs) from road traffic accidents (RTAs) or falls. Our study included 151 609 participants from the Prospective Urban Rural Epidemiological study. Participants reported whether they experienced injuries within the past 12 months that limited normal activities. Additional questions elicited data on risk factors. We employed multivariable logistic regression to analyse data. Overall, 5979 participants (3.9% of 151 609) reported at least one NFI. Total number of NFIs was 6300: 1428 were caused by RTAs (22.7%), 1948 by falls (30.9%) and 2924 by other causes (46.4%). Married/common law status was associated with fewer falls, but not with RTA. Age 65-70 years was associated with fewer RTAs, but more falls; age 55-64 years was associated with more falls. Male versus female was associated with more RTAs and fewer falls. In lower-middle-income countries, rural residence was associated with more RTAs and falls; in low-income countries, rural residence was associated with fewer RTAs. Previous alcohol use was associated with more RTAs and falls; current alcohol use was associated with more falls. Education was not associated with either NFI type. This study of persons aged 35-70 years found that some risk factors for NFI differ according to whether the injury is related to RTA or falls. Policymakers may use these differences to guide the design of prevention policies for RTA-related or fall-related NFI. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Geographical location and age affects the incidence of parasitic infestations in school children.

PubMed

Rayan, Paran; Verghese, Susan; McDonnell, Pauline Ann

2010-01-01

Environmental factors affect the dissemination and distribution of intestinal parasites in human communities. To comprehend the prevalence of parasitic infestation and to examine whether geographical location and age also influence the prevalence of infection, fecal samples from 195 school children (rural = 95; male = 39; female = 56) (urban = 100; male = 60; female = 40) of five age groups ranging from 5 to 11 years in two different socio-economic zones (rural and urban) were screened for specific intestinal parasites using standard histological techniques. Percentage incidences of parasitic species found in fecal wet mounts and concentrates in rural children were Entamoeba coli (25.3%), Giardia lamblia (17.9%), Blastocystis hominis (14.7%), Entamoeba histolytica (4.2%), Iodamoeba butschlii (1.1%), Hymenolepis nana (1.1%) and Ascaris lumbricoides (1.1%). Whereas the percentage incidences among urban children were E. coli (26%), A. lumbricoides (21%), B. hominis (18%), G. lamblia (14%), T. trichiura (8%), I. butschlii (4%) and A. duodenale (1%). Such findings may be related to dietary differences, living conditions and the greater use of natural anti-helminthic medicinal plants in rural communities. These results are important for both epidemiological data collection and for correlating dietary differences to intestinal parasitic diseases. We chose to investigate whether geographical location and age affect the prevalence and distribution of intestinal parasites among school children from two separate regions (rural and urban) in areas surrounding, Chennai, Tamil Nadu, India. A study of the prevalence of parasitic infestations was undertaken among primary school children, in rural and urban communities around Chennai, Tamil Nadu, India. Faecal sample collection, direct microscopic techniques, macroscopic examination and concentration techniques for identifying the parasites. Percentage incidences of parasitic species found in faecal wet mounts and concentrates were done instead of statistical analyses. Both macroscopic and microscopic examinations of faecal samples revealed that the overall percentage prevalence of parasite species encountered in rural children were Entamoeba coli (25.3%), G. lamblia (17.9%), B. hominis (14.7%), Entamoeba histolytica (4.2%), I. butschlii (1.1%), H. nana (1.1%), Ascaris lumbricoides (1.1%). The prevalence among urban children were E. coli (26%), A. lumbricoides (21%), B. hominis (18%), G. lamblia (14%), T. trichiura (8%), I. butschlii (4%) and A. duodenale (1%). Overall, comparative significant differences were noted between rural and urban children for E. histolytica (4.2 vs. 14%), G. lamblia (17.9 vs. 14%), A. lumbricoides (1.1 vs. 21%) and T. trichiura (0 vs. 8%), with the major difference being the much higher occurrence of A. lumbricoides and T. trichiura infections in urban children. One of the greatest challenges for healthcare professionals is the prevention and treatment of protozoal and helminthic parasitic infections. From our study we conclude that the prevalence of different pathogenic species of amoeba such as Entamoeba histolytica (4.2 vs. 0%) and G. lamblia (17.9 vs. 14%), (P value was equal to 1) was significantly higher among rural children compared to children from urban areas. In contrast, the prevalence of nematodes such as A. lumbricoides (21% vs. 1.1%), T. trichiura (8% vs. 0%) and A. duodenale (1%) was also significantly higher among rural children.

Air pollution from household solid fuel combustion in India: an overview of exposure and health related information to inform health research priorities.

PubMed

Balakrishnan, Kalpana; Ramaswamy, Padmavathi; Sambandam, Sankar; Thangavel, Gurusamy; Ghosh, Santu; Johnson, Priscilla; Mukhopadhyay, Krishnendu; Venugopal, Vidhya; Thanasekaraan, Vijayalakshmi

2011-01-01

Environmental and occupational risk factors contribute to nearly 40% of the national burden of disease in India, with air pollution in the indoor and outdoor environment ranking amongst leading risk factors. It is now recognized that the health burden from air pollution exposures that primarily occur in the rural indoors, from pollutants released during the incomplete combustion of solid fuels in households, may rival or even exceed the burden attributable to urban outdoor exposures. Few environmental epidemiological efforts have been devoted to this setting, however. We provide an overview of important available information on exposures and health effects related to household solid fuel use in India, with a view to inform health research priorities for household air pollution and facilitate being able to address air pollution within an integrated rural-urban framework in the future.

Hospitalizations for heat-stress illness varies between rural and urban areas: an analysis of Illinois data, 1987-2014.

PubMed

Jagai, Jyotsna S; Grossman, Elena; Navon, Livia; Sambanis, Apostolis; Dorevitch, Samuel

2017-04-07

The disease burden due to heat-stress illness (HSI), which can result in significant morbidity and mortality, is expected to increase as the climate continues to warm. In the United States (U.S.) much of what is known about HSI epidemiology is from analyses of urban heat waves. There is limited research addressing whether HSI hospitalization risk varies between urban and rural areas, nor is much known about additional diagnoses of patients hospitalized for HSI. Hospitalizations in Illinois for HSI (ICD-9-CM codes 992.x or E900) in the months of May through September from 1987 to 2014 (n = 8667) were examined. Age-adjusted mean monthly hospitalization rates were calculated for each county using U.S. Census population data. Counties were categorized into five urban-rural strata using Rural Urban Continuum Codes (RUCC) (RUCC1, most urbanized to RUCC5, thinly populated). Average maximum monthly temperature (°C) was calculated for each county using daily data. Multi-level linear regression models were used, with county as the fixed effect and temperature as random effect, to model monthly hospitalization rates, adjusting for the percent of county population below the poverty line, percent of population that is Non-Hispanic Black, and percent of the population that is Hispanic. All analyses were stratified by county RUCC. Additional diagnoses of patients hospitalized for HSI and charges for hospitalization were summarized. Highest rates of HSI hospitalizations were seen in the most rural, thinly populated stratum (mean annual summer hospitalization rate of 1.16 hospitalizations per 100,000 population in the thinly populated strata vs. 0.45 per 100,000 in the metropolitan urban strata). A one-degree Celsius increase in maximum monthly average temperature was associated with a 0.34 increase in HSI hospitalization rate per 100,000 population in the thinly populated counties compared with 0.02 per 100,000 in highly urbanized counties. The most common additional diagnoses of patients hospitalized with HSI were dehydration, electrolyte abnormalities, and acute renal disorders. Total and mean hospital charges for HSI cases were $167.7 million and $20,500 (in 2014 US dollars). Elevated temperatures appear to have different impacts on HSI hospitalization rates as function of urbanization. The most rural and the most urbanized counties of Illinois had the largest increases in monthly hospitalization rates for HSI per unit increase in the average monthly maximum temperature. This suggests that vulnerability of communities to heat is complex and strategies to reduce HSI may need to be tailored to the degree of urbanization of a county.

Added sugar intake in South Africa: findings from the Adult Prospective Urban and Rural Epidemiology cohort study.

PubMed

Vorster, Hester H; Kruger, Annamarie; Wentzel-Viljoen, Edelweiss; Kruger, H Salome; Margetts, Barrie M

2014-06-01

Obesity and other noncommunicable disease (NCD) risk factors are increasing in low- and middle-income countries. There are few data on the association between increased added sugar intake and NCD risk in these countries. We assessed the relation between added sugar intake and NCD risk factors in an African cohort study. Added sugars were defined as all monosaccharides and disaccharides added to foods and beverages during processing, cooking, and at the table. We conducted a 5-y follow-up of a cohort of 2010 urban and rural men and women aged 30-70 y of age at recruitment in 2005 from the North West Province in South Africa. Added sugar intake, particularly in rural areas, has increased rapidly in the past 5 y. In rural areas, the proportion of adults who consumed sucrose-sweetened beverages approximately doubled (for men, from 25% to 56%; for women, from 33% to 63%) in the past 5 y. After adjustment, subjects who consumed more added sugars (≥10% energy from added sugars) compared with those who consumed less added sugars had a higher waist circumference [mean difference (95% CI): 1.07 cm (0.35, 1.79 cm)] and body mass index (in kg/m²) [0.43 (0.12, 0.74)] and lower HDL cholesterol [-0.08 mmol/L (-0.14, 0.002 mmol/L)]. This cohort showed dramatic increases in added sugars and sucrose-sweetened beverage consumption in both urban and rural areas. Increased consumption was associated with increased NCD risk factors. In addition, the study showed that the nutrition transition has reached a remote rural area in South Africa. Urgent action is needed to address these trends. © 2014 American Society for Nutrition.

[Urbanization of Chagas disease in Peru: experiences in prevention and control].

PubMed

Náquira, César

2014-04-01

In Peru, Chagas disease has an epidemiological significance in three macro-regions, one of them is the southern macro-region formed by the departments of Arequipa, Moquegua and Tacna. In 1965 a successful control was performed by house spraying insecticides, however, the persistence of the vector made it necessary for a second control plan that was implemented in 2000 and followed the guidelines of CONAL Plan, based on the elimination of Triatoma infestans and screening in blood banks.This plan was successful in Tacna and Moquegua, therefore these departments were considered free of vectorial transmission by the Pan American Health Organization. A ssimilar situation has not been achieved in the department of Arequipa because of the presence, among other factors, of rural migration to the city, in this way the urbanization of Chagas disease is a new epidemiological scenario of which we need to know more.

[The effect of contraception on fertility in the border region of Chiapas, Mexico].

PubMed

Nazar-Beutelspacher, A; Halperin-Frisch, D; Salvatierra-Izaba, B

1996-01-01

To estimate the effect of contraception on fertility in the border region of Chiapas, Mexico. In 1994 an epidemiological cross-sectional study was carried out on a representative sample of 1,560 non-indigenous women between ages 15 and 49 in the border region of Chiapas. The prevalence of contraception practices and the total fertility rates (TFR) were obtained and stratified by rural, intermediate and urban communities. TFR were compared between women who had never used contraceptives and those who had used them. The estimated TFR was 3.67 and varied from 4.14 in rural areas to 3.36 in urban areas. There were no differences in the TFR (3.74 and 3.88) nor in the average live births (3.47 and 3.48) between women who had never used contraceptives and those who had used them. The major effect of contraception on fertility was observed in rural areas. Factors which influence the small impact of contraception on fertility include the late use of these methods and the early age of first union among users.

Absence of convincing evidence of Coxiella burnetii infection in Chile: a cross-sectional serosurvey among healthy adults in four different regions.

PubMed

Weitzel, Thomas; López, Javier; Acosta-Jamett, Gerardo; Edouard, Sophie; Parola, Philippe; Abarca, Katia

2016-10-06

Coxiella burnetii is an important zoonotic pathogen of global distribution. Still, in most parts of South America including Chile, systematic epidemiological data are lacking. The presented study aims to determine the seroprevalence of Coxiella burnetii antibodies in healthy adults of four different regions in Chile. A cross-sectional study was performed, which included healthy adults living in rural and urban areas of four cities located in different regions in northern, central, and southern Chile. In urban sectors, households were chosen by double stratified random sampling, while in rural areas convenience sampling was performed. Serum specimens were taken and screened for the presence of IgG antibodies against C. burnetii phase II antigen using a commercial ELISA kit. Positive and indeterminate results were confirmed by a reference laboratory using indirect immunofluorescence assay (IFA). A total of 1112 individuals were included. Of those, 8 were positive by ELISA, but only one sample was confirmed using IFA. Statistical analysis for population freedom from disease revealed a high probability that C. burnetii was absent in our study population. Our work provides the first epidemiological data on human Q fever in Chile indicating either a very low endemicity or the absence of this pathogen in the studied areas.

Epidemiological analysis, detection, and comparison of space-time patterns of Beijing hand-foot-mouth disease (2008-2012).

PubMed

Wang, Jiaojiao; Cao, Zhidong; Zeng, Daniel Dajun; Wang, Quanyi; Wang, Xiaoli; Qian, Haikun

2014-01-01

Hand, foot, and mouth disease (HFMD) mostly affects the health of infants and preschool children. Many studies of HFMD in different regions have been published. However, the epidemiological characteristics and space-time patterns of individual-level HFMD cases in a major city such as Beijing are unknown. The objective of this study was to investigate epidemiological features and identify high relative risk space-time HFMD clusters at a fine spatial scale. Detailed information on age, occupation, pathogen and gender was used to analyze the epidemiological features of HFMD epidemics. Data on individual-level HFMD cases were examined using Local Indicators of Spatial Association (LISA) analysis to identify the spatial autocorrelation of HFMD incidence. Spatial filtering combined with scan statistics methods were used to detect HFMD clusters. A total of 157,707 HFMD cases (60.25% were male, 39.75% were female) reported in Beijing from 2008 to 2012 included 1465 severe cases and 33 fatal cases. The annual average incidence rate was 164.3 per 100,000 (ranged from 104.2 in 2008 to 231.5 in 2010). Male incidence was higher than female incidence for the 0 to 14-year age group, and 93.88% were nursery children or lived at home. Areas at a higher relative risk were mainly located in the urban-rural transition zones (the percentage of the population at risk ranged from 33.89% in 2011 to 39.58% in 2012) showing High-High positive spatial association for HFMD incidence. The most likely space-time cluster was located in the mid-east part of the Fangshan district, southwest of Beijing. The spatial-time patterns of Beijing HFMD (2008-2012) showed relatively steady. The population at risk were mainly distributed in the urban-rural transition zones. Epidemiological features of Beijing HFMD were generally consistent with the previous research. The findings generated computational insights useful for disease surveillance, risk assessment and early warning.

An Epidemiological Study of Malnutrition Among Under Five Children of Rural and Urban Haryana.

PubMed

Yadav, Sachin Singh; Yadav, Shweta Tomar; Mishra, Prabhaker; Mittal, Anshu; Kumar, Randhir; Singh, Jagjeet

2016-02-01

A child is future of nation. Malnutrition is a big public health problem in India as it can be attributed for more than half (54 percent) of all under five mortality in India. To assess prevalence of malnutrition among urban and rural population of Haryana using newly developed WHO growth standards. A community based cross-sectional survey was conducted in children of 3-60 months age living in the urban and rural field practice areas of Department of Community Medicine MMIMSR, Mullana, Ambala during January 2012 to December 2012. Seven hundred and fifty children, aged 3-60 months, were studied for nutritional status, socio-demographic measures were obtained from structured questionnaire and followed by anthropometric assessment using standards methods. Z score for Anthropometric data was calculated by WHO Anthro 2010 software (beta version). Descriptive statistics as well as simple proportion were calculated with SPSS 20. We found that 41.3% children were underweight and 14% were severe underweight. Female children were more nutritionally deprived than males. Among sociodemographic factors maternal educational and working status as well as SES class and rural background of family had greater impact on nutritional status of child. We found that almost half of our under five children are underweight, girl child being affected more. For attainment of best possible nutrition and growth in children, targeted short-term strategies addressing underlying risk factors and more long-term poverty alleviation strategies may be needed.

Comparative epidemiology of human infections with avian influenza A H7N9 and H5N1 viruses in China: a population-based study of laboratory-confirmed cases.

PubMed

Cowling, Benjamin J; Jin, Lianmei; Lau, Eric H Y; Liao, Qiaohong; Wu, Peng; Jiang, Hui; Tsang, Tim K; Zheng, Jiandong; Fang, Vicky J; Chang, Zhaorui; Ni, Michael Y; Zhang, Qian; Ip, Dennis K M; Yu, Jianxing; Li, Yu; Wang, Liping; Tu, Wenxiao; Meng, Ling; Wu, Joseph T; Luo, Huiming; Li, Qun; Shu, Yuelong; Li, Zhongjie; Feng, Zijian; Yang, Weizhong; Wang, Yu; Leung, Gabriel M; Yu, Hongjie

2013-07-13

The novel influenza A H7N9 virus emerged recently in mainland China, whereas the influenza A H5N1 virus has infected people in China since 2003. Both infections are thought to be mainly zoonotic. We aimed to compare the epidemiological characteristics of the complete series of laboratory-confirmed cases of both viruses in mainland China so far. An integrated database was constructed with information about demographic, epidemiological, and clinical variables of laboratory-confirmed cases of H7N9 (130 patients) and H5N1 (43 patients) that were reported to the Chinese Centre for Disease Control and Prevention until May 24, 2013. We described disease occurrence by age, sex, and geography, and estimated key epidemiological variables. We used survival analysis techniques to estimate the following distributions: infection to onset, onset to admission, onset to laboratory confirmation, admission to death, and admission to discharge. The median age of the 130 individuals with confirmed infection with H7N9 was 62 years and of the 43 with H5N1 was 26 years. In urban areas, 74% of cases of both viruses were in men, whereas in rural areas the proportions of the viruses in men were 62% for H7N9 and 33% for H5N1. 75% of patients infected with H7N9 and 71% of those with H5N1 reported recent exposure to poultry. The mean incubation period of H7N9 was 3·1 days and of H5N1 was 3·3 days. On average, 21 contacts were traced for each case of H7N9 in urban areas and 18 in rural areas, compared with 90 and 63 for H5N1. The fatality risk on admission to hospital was 36% (95% CI 26-45) for H7N9 and 70% (56-83%) for H5N1. The sex ratios in urban compared with rural cases are consistent with exposure to poultry driving the risk of infection--a higher risk in men was only recorded in urban areas but not in rural areas, and the increased risk for men was of a similar magnitude for H7N9 and H5N1. However, the difference in susceptibility to serious illness with the two different viruses remains unexplained, since most cases of H7N9 were in older adults whereas most cases of H5N1 were in younger people. A limitation of our study is that we compared laboratory-confirmed cases of H7N9 and H5N1 infection, and some infections might not have been ascertained. Ministry of Science and Technology, China; Research Fund for the Control of Infectious Disease and University Grants Committee, Hong Kong Special Administrative Region, China; and the US National Institutes of Health. Copyright © 2013 Elsevier Ltd. All rights reserved.

County-level cumulative environmental quality associated with cancer incidence.

PubMed

Jagai, Jyotsna S; Messer, Lynne C; Rappazzo, Kristen M; Gray, Christine L; Grabich, Shannon C; Lobdell, Danelle T

2017-08-01

Individual environmental exposures are associated with cancer development; however, environmental exposures occur simultaneously. The Environmental Quality Index (EQI) is a county-level measure of cumulative environmental exposures that occur in 5 domains. The EQI was linked to county-level annual age-adjusted cancer incidence rates from the Surveillance, Epidemiology, and End Results (SEER) Program state cancer profiles. All-site cancer and the top 3 site-specific cancers for male and female subjects were considered. Incident rate differences (IRDs; annual rate difference per 100,000 persons) and 95% confidence intervals (CIs) were estimated using fixed-slope, random intercept multilevel linear regression models. Associations were assessed with domain-specific indices and analyses were stratified by rural/urban status. Comparing the highest quintile/poorest environmental quality with the lowest quintile/best environmental quality for overall EQI, all-site county-level cancer incidence rate was positively associated with poor environmental quality overall (IRD, 38.55; 95% CI, 29.57-47.53) and for male (IRD, 32.60; 95% CI, 16.28-48.91) and female (IRD, 30.34; 95% CI, 20.47-40.21) subjects, indicating a potential increase in cancer incidence with decreasing environmental quality. Rural/urban stratified models demonstrated positive associations comparing the highest with the lowest quintiles for all strata, except the thinly populated/rural stratum and in the metropolitan/urbanized stratum. Prostate and breast cancer demonstrated the strongest positive associations with poor environmental quality. We observed strong positive associations between the EQI and all-site cancer incidence rates, and associations differed by rural/urban status and environmental domain. Research focusing on single environmental exposures in cancer development may not address the broader environmental context in which cancers develop, and future research should address cumulative environmental exposures. Cancer 2017;123:2901-8. © 2017 American Cancer Society. © 2017 American Cancer Society.

Mortality from and incidence of pesticide poisoning in South Korea: findings from National Death and Health Utilization Data between 2006 and 2010.

PubMed

Cha, Eun Shil; Khang, Young-Ho; Lee, Won Jin

2014-01-01

Pesticide poisoning has been recognized as an important public health issue around the world. The objectives of this study were to report nationally representative figures on mortality from and the incidence of pesticide poisoning in South Korea and to describe their epidemiologic characteristics. We calculated the age-standardized rates of mortality from and the incidence of pesticide poisoning in South Korea by gender and region from 2006 through 2010 using registered death data obtained from Statistics Korea and national healthcare utilization data obtained from the National Health Insurance Review and Assessment Service of South Korea. During the study period of 2006 through 2010, a total of 16,161 deaths and 45,291 patients related to pesticide poisoning were identified, marking respective mortality and incidence rates of 5.35 and 15.37 per 100,000 population. Intentional self-poisoning was identified as the major cause of death due to pesticides (85.9%) and accounted for 20.8% of all recorded suicides. The rates of mortality due to and incidence of pesticide poisoning were higher in rural than in urban areas, and this rural-urban discrepancy was more pronounced for mortality than for incidence. Both the rate of mortality due to pesticide poisoning and its incidence rate increased with age and were higher among men than women. This study provides the magnitude and epidemiologic characteristics for mortality from and the incidence of pesticide poisoning at the national level, and strongly suggests the need for further efforts to prevent pesticide self-poisonings, especially in rural areas in South Korea.

Recent transmission of Mycobacterium tuberculosis in China: the implication of molecular epidemiology for tuberculosis control.

PubMed

Yang, Chongguang; Gao, Qian

2018-02-01

Tuberculosis (TB) has remained an ongoing concern in China. The national scale-up of the Directly Observed Treatment, Short Course (DOTS) program has accelerated the fight against TB in China. Nevertheless, many challenges still remain, including the spread of drug-resistant strains, high disease burden in rural areas, and enormous rural-to-urban migrations. Whether incident active TB represents recent transmission or endogenous reactivation has helped to prioritize the strategies for TB control. Evidence from molecular epidemiology studies has delineated the recent transmission of Mycobacterium tuberculosis (M. tuberculosis) strains in many settings. However, the transmission patterns of TB in most areas of China are still not clear. Studies carried out to date could not capture the real burden of recent transmission of the disease in China because of the retrospective study design, incomplete sampling, and use of low-resolution genotyping methods. We reviewed the implementations of molecular epidemiology of TB in China, the estimated disease burden due to recent transmission of M. tuberculosis strains, the primary transmission of drug-resistant TB, and the evaluation of a feasible genotyping method of M. tuberculosis strains in circulation.

Nationwide community survey of tuberculosis epidemiology in Saudi Arabia.

PubMed

al-Kassimi, F A; Abdullah, A K; al-Hajjaj, M S; al-Orainey, I O; Bamgboye, E A; Chowdhury, M N

1993-08-01

In the first nationwide community-based survey of the epidemiology of tuberculosis in Saudi Arabia, 7721 subjects were screened in the 5 provinces (using an equal proportional allocation formula) for 2 parameters: (1) prevalence of positive Mantoux test in non BCG vaccinated subjects; (2) prevalence of bacillary cases on sputum culture. The prevalence of positive Mantoux reaction in children aged 5-14 years was 6% +/- 1.8; higher in urban areas (10%), and lower in rural areas (2%), thus classifying Saudi Arabia among the middle prevalence countries. These relatively good results (by Third World standards) could reflect the rise of the standard of living and wide availability of free treatment for active cases with a lowered risk of infection in the community. This view is supported by the fact that in our survey, only one subject grew Mycobacterium tuberculosis in the sputum. However, there were foci of high prevalence of Mantoux reaction in the urban communities in the Western province (20% +/- 8.7 urban; 1% +/- 1.9 rural). The problem may be caused by the fact that the province receives every year over a million pilgrims, some of whom are known to settle illegally and escape the usual screening for tuberculosis imposed on foreign labourers. In conclusion, even in the absence of an enforceable national programme for the eradication of tuberculosis, the economic standard and wide availability of free treatment for active cases has resulted in relatively low rates of prevalence of tuberculin sensitivity in children. The foci of high prevalence in the Western Province require special screening arrangements.

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.

Knowledge and causal attributions for mental disorders in HIV-positive children and adolescents: results from rural and urban Uganda.

PubMed

Nalukenge, W; Martin, F; Seeley, J; Kinyanda, E

2018-05-02

Increasing availability of antiretroviral treatment (ART) has led HIV to be considered a chronic disease, shifting attention to focus on quality of life including mental wellbeing. We investigated knowledge and causal attributions for mental disorders in HIV-positive children and adolescents in rural and urban Uganda. This qualitative study was nested in an epidemiological mental health study among HIV-positive children and adolescents aged 5-17 years in rural and urban Uganda. In-depth interviews were conducted with caregivers of HIV-positive children (5-11 years) and adolescents (12-17 years) in HIV care. Interviews were audio recorded with permission from participants and written consent and assent sought before study procedures. Thirty eight participants (19 caregivers, 19 children/adolescents) were interviewed. Age range of caregivers was 28-69 years; majority were female (17). Caregivers had little knowledge on mental disorders ;only 3 related the vignette to a mental problem  and attributed it to: improper upbringing, violence, poverty and bereavement. Five adolescents identified vignettes as portraying mental disorders caused by: ill-health of parents, bereavement, child abuse, discrimination, HIV and poverty. Caregivers are not knowledgeable about behavioural and emotional challenges in HIV-positive children/adolescents. Mental health literacy programmes at HIV care clinics are essential to enhance treatment-seeking for mental health.

The impact of urbanization and population density on childhood Plasmodium falciparum parasite prevalence rates in Africa.

PubMed

Kabaria, Caroline W; Gilbert, Marius; Noor, Abdisalan M; Snow, Robert W; Linard, Catherine

2017-01-26

Although malaria has been traditionally regarded as less of a problem in urban areas compared to neighbouring rural areas, the risk of malaria infection continues to exist in densely populated, urban areas of Africa. Despite the recognition that urbanization influences the epidemiology of malaria, there is little consensus on urbanization relevant for malaria parasite mapping. Previous studies examining the relationship between urbanization and malaria transmission have used products defining urbanization at global/continental scales developed in the early 2000s, that overestimate actual urban extents while the population estimates are over 15 years old and estimated at administrative unit level. This study sought to discriminate an urbanization definition that is most relevant for malaria parasite mapping using individual level malaria infection data obtained from nationally representative household-based surveys. Boosted regression tree (BRT) modelling was used to determine the effect of urbanization on malaria transmission and if this effect varied with urbanization definition. In addition, the most recent high resolution population distribution data was used to determine whether population density had significant effect on malaria parasite prevalence and if so, could population density replace urban classifications in modelling malaria transmission patterns. The risk of malaria infection was shown to decline from rural areas through peri-urban settlements to urban central areas. Population density was found to be an important predictor of malaria risk. The final boosted regression trees (BRT) model with urbanization and population density gave the best model fit (Tukey test p value <0.05) compared to the models with urbanization only. Given the challenges in uniformly classifying urban areas across different countries, population density provides a reliable metric to adjust for the patterns of malaria risk in densely populated urban areas. Future malaria risk models can, therefore, be improved by including both population density and urbanization which have both been shown to have significant impact on malaria risk in this study.

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

Influence of Urbanicity and County Characteristics on the ...

EPA Pesticide Factsheets

Background: Air pollution epidemiology studies, often conducted in large metropolitan areas due to proximity to regulatory monitors, are limited in their ability to examine potential associations between air pollution exposures and health effects in rural locations. Methods: In a time-stratified case-crossover framework, we examined associations between asthma emergency department (ED) visits in North Carolina (2006-2008) collected by a surveillance system, and short-term ozone exposures using predicted concentrations from the Community Multiscale Air Quality (CMAQ) model. Associations were estimated by county groupings based on four urbanicity classifications (representative of county size and urban proximity) and county health. Results: Ozone was associated with asthma ED visits in all-year and warm season (April-October) analyses [Odds Ratio (OR) =1.019; 95% CI: 0.998, 1.040; OR=1.020; 95% CI: 0.997, 1.044, respectively, for a 20 ppb increase in lag 0-2 days ozone]. The association was strongest in Less Urbanized counties, with no evidence of a positive association in Rural counties. Associations were similar when adjusted for fine particulate matter in copolluant models. Associations were stronger for children (5-17 years of age) compared with other age groups, and for individuals living in counties with poorer health status compared with counties that had the highest health rankings, although estimated associations for these subgroups were imprecise. Conclu

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.

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.

Cardiovascular epidemiological transition in a rural habitat of Nigeria: the case of mangu local government area.

PubMed

Okeahialam, B N; Ogbonna, C; Otokwula, A E; Joseph, D E; Chuhwak, E K; Isiguzoro, I O

2012-01-01

Epidemiological transition is at various stages in different places. The true situation in sub-Saharan Africa (SSA) is largely unknown. Having studied this rural habitat 17 years ago, we returned there to study several cardiovascular disease (CVD) risk factors to see if any change had occurred. The communities studied in 1991 as part of the national CVD survey were returned to in 2008 and re-studied descriptively in a cross-sectional manner. All adults 15 years and above, apart from demographic and personal data had blood pressure (BP) and some blood indices determined. Over the period, some changes occurred. The mean (SD) age increased from 34.1(16.9) to 45.5(18.2) years suggesting an ageing population. More people in 2008 than 1991 lived most of their last 5 years in the urban areas suggesting some influence of urbanisation. Significantly fewer people smoked and drank after 17 years. However mean (SD) of Body Mass Index rose [20.7(2.8) to 23.7(4.5) kg/m²], as well as SBP and DBP. Prevalence of hypertension rose from 7.4% to 20.9%. Both total and HDL cholesterol rose, although atherogenic index dropped. Mean (SD) blood sugar interestingly dropped from 5.0(2.9) to 4.6(1.0) mmol/l. Epidemiological transition is evident in this rural SSA habitat, and proactive steps to stem the tide and curb the consequences of CVD should be instituted.

High Leptospira Diversity in Animals and Humans Complicates the Search for Common Reservoirs of Human Disease in Rural Ecuador

PubMed Central

Chiriboga, Jorge; Miller, Erin; Olivas, Sonora; Birdsell, Dawn; Hepp, Crystal; Hornstra, Heidie; Schupp, James M.; Morales, Melba; Gonzalez, Manuel; Reyes, Soraya; de la Cruz, Carmen; Keim, Paul; Hartskeerl, Rudy; Trueba, Gabriel; Pearson, Talima

2016-01-01

Background Leptospirosis is a zoonotic disease responsible for high morbidity around the world, especially in tropical and low income countries. Rats are thought to be the main vector of human leptospirosis in urban settings. However, differences between urban and low-income rural communities provide additional insights into the epidemiology of the disease. Methodology/Principal findings Our study was conducted in two low-income rural communities near the coast of Ecuador. We detected and characterized infectious leptospira DNA in a wide variety of samples using new real time quantitative PCR assays and amplicon sequencing. We detected infectious leptospira in a high percentage of febrile patients (14.7%). In contrast to previous studies on leptospirosis risk factors, higher positivity was not found in rats (3.0%) but rather in cows (35.8%) and pigs (21.1%). Six leptospira species were identified (L. borgpetersenii, L kirschnerii, L santarosai, L. interrogans, L noguchii, and an intermediate species within the L. licerasiae and L. wolffii clade) and no significant differences in the species of leptospira present in each animal species was detected (χ2 = 9.89, adj.p-value = 0.27). Conclusions/Significance A large portion of the world’s human population lives in low-income, rural communities, however, there is limited information about leptospirosis transmission dynamics in these settings. In these areas, exposure to peridomestic livestock is particularly common and high prevalence of infectious leptospira in cows and pigs suggest that they may be the most important reservoir for human transmission. Genotyping clinical samples show that multiple species of leptospira are involved in human disease. As these genotypes were also detected in samples from a variety of animals, genotype data must be used in conjunction with epidemiological data to provide evidence of transmission and the importance of different potential leptospirosis reservoirs. PMID:27622673

Urban air pollution, poverty, violence and health--Neurological and immunological aspects as mediating factors.

PubMed

Kristiansson, Marianne; Sörman, Karolina; Tekwe, Carmen; Calderón-Garcidueñas, Lilian

2015-07-01

Rapid rural-urban migration has created overcrowded areas characterized by concentrated poverty and increases in indoor and outdoor air pollutants. These "hotspots" constitute an increased risk of violence and disease outbreaks. We hypothesize that the effects of poverty and associated air pollution-related stress on impaired cognitive skills are mediated by inflammatory cytokines. A research framework is proposed, encompassing (i) an epidemiological investigation of associations between poverty, high concentrations of air pollutants, violence and health, (ii) a longitudinal follow-up of working memory capacities and inflammatory markers, and (iii) intervention programs aiming to strengthen employability and decreased exposures to toxic air pollutants. Copyright © 2015 Elsevier Inc. All rights reserved.

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.…

Mortality from and Incidence of Pesticide Poisoning in South Korea: Findings from National Death and Health Utilization Data between 2006 and 2010

PubMed Central

Cha, Eun Shil; Khang, Young-Ho; Lee, Won Jin

2014-01-01

Pesticide poisoning has been recognized as an important public health issue around the world. The objectives of this study were to report nationally representative figures on mortality from and the incidence of pesticide poisoning in South Korea and to describe their epidemiologic characteristics. We calculated the age-standardized rates of mortality from and the incidence of pesticide poisoning in South Korea by gender and region from 2006 through 2010 using registered death data obtained from Statistics Korea and national healthcare utilization data obtained from the National Health Insurance Review and Assessment Service of South Korea. During the study period of 2006 through 2010, a total of 16,161 deaths and 45,291 patients related to pesticide poisoning were identified, marking respective mortality and incidence rates of 5.35 and 15.37 per 100,000 population. Intentional self-poisoning was identified as the major cause of death due to pesticides (85.9%) and accounted for 20.8% of all recorded suicides. The rates of mortality due to and incidence of pesticide poisoning were higher in rural than in urban areas, and this rural-urban discrepancy was more pronounced for mortality than for incidence. Both the rate of mortality due to pesticide poisoning and its incidence rate increased with age and were higher among men than women. This study provides the magnitude and epidemiologic characteristics for mortality from and the incidence of pesticide poisoning at the national level, and strongly suggests the need for further efforts to prevent pesticide self-poisonings, especially in rural areas in South Korea. PMID:24743877

[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.

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.

Demography, maternal health and the epidemiology of malaria and other major infectious diseases in the rural department Tsamba-Magotsi, Ngounie Province, in central African Gabon.

PubMed

Manego, R Zoleko; Mombo-Ngoma, G; Witte, M; Held, J; Gmeiner, M; Gebru, T; Tazemda, B; Mischlinger, J; Groger, M; Lell, B; Adegnika, A A; Agnandji, S T; Kremsner, P G; Mordmüller, B; Ramharter, M; Matsiegui, P B

2017-01-28

Sub-Saharan Africa is undergoing an epidemiological transition from a predominance of infectious diseases to non-communicable and lifestyle related conditions. However, the pace of this transition and the pattern of disease epidemiology are uneven between affluent urban and rural poor populations. To address this question for a remote rural region located in the central African rainforest region of Gabon, this study was conducted to assess reasons for health care attendance and to characterize the epidemiology of malaria and other major infectious diseases for the department of Tsamba Magotsi. Major causes for health care attendance were collected from local hospital records. Cross sectional population based surveys were performed for the assessment of local malaria epidemiology. Pregnant women attending antenatal care services were surveyed as a sentinel population for the characterization of chronic viral and parasitic infections in the community. Infectious diseases were responsible for 71% (7469) of a total of 10,580 consultations at the formal health care sector in 2010. Overall, malaria - defined by clinical syndrome - remained the most frequent cause for health care attendance. A cross sectional malaria survey in 840 asymptomatic individuals residing in Tsamba Magotsi resulted in a Plasmodium spp. infection prevalence of 37%. The infection rate in 2-10 year old asymptomatic children - a standard measure for malaria endemicity - was 46% (100 of 217) with P. falciparum as predominant species (79%). Infection with other plasmodial species (P. ovale and P. malariae) presented most commonly as coinfections (23.2%). Prevalence of HIV, HBV, and syphilis were 6.2, 7.3, and 2.5%, respectively, in cross-sectional assessments of antenatal care visits of pregnant women. Urogenital schistosomiasis and the filarial pathogens Loa loa and Mansonella perstans are highly prevalent chronic parasitic infections affecting the local population. Despite major improvements in the accessibility of Tsamba Magotsi over the past decade the epidemiological transition does not appear to have majorly changed on the spectrum of diseases in this rural Gabonese population. The high prevalence of Plasmodium infection indicates a high burden of malaria related morbidity. Infectious diseases remain one of the most important health issues and further research activities in the field of tropical medicine and infectious diseases could help improve health care for the local population.

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.

Differences in late-stage diagnosis, treatment, and colorectal cancer-related death between rural and urban African Americans and whites in Georgia.

PubMed

Hines, Robert B; Markossian, Talar W

2012-01-01

Disparities in health outcomes due to a diagnosis of colorectal cancer (CRC) have been reported for a number of demographic groups. This study was conducted to examine the outcomes of late-stage diagnosis, treatment, and cancer-related death according to race and geographic residency status (rural vs urban). This study utilized cross-sectional and follow-up data from the Surveillance, Epidemiology, and End Results (SEER) Program for all incident colon and rectal tumors diagnosed for the Atlanta and Rural Georgia Cancer Registries for the years 1992-2007. Compared to whites, African Americans had a 40% increased odds (OR, 1.40; 95% CI, 1.30-1.51) of late-stage diagnosis, a 50% decreased odds (OR, 0.50; 95% CI, 0.37-0.68) of having surgery for colon cancer, and a 67% decreased odds (OR, 0.33; 95% CI, 0.25-0.44) of receiving surgery for rectal cancer. Rural residence was not associated with late stage at diagnosis or receipt of treatment. African Americans had a slightly increased risk of death from colon cancer (HR, 1.11; 95% CI, 1.00-1.24) and a larger increased risk of death due to rectal cancer (HR, 1.24; 95% CI, 1.14-1.35). Rural residents experienced a 15% increased risk of death (HR, 1.15; 95% CI, 1.01-1.32) due to colon cancer. Further investigations should target African Americans and rural residents to gain insight into the etiologic mechanisms responsible for the poorer CRC outcomes experienced by these 2 segments of the population. © 2011 National Rural Health Association.

Social and cultural features of cholera and shigellosis in peri-urban and rural communities of Zanzibar

PubMed Central

2010-01-01

Background Responding to the high burden of cholera in developing countries, the WHO now considers vaccination as a supplement to the provision of safe drinking water and improved sanitation in the strategy for cholera control in endemic settings. Cultural concepts of illness affect many aspects of public health. In the first step of a two-step strategy to examine determinants of cholera vaccine acceptance, this study identified social and cultural features of diarrhoeal illness for cholera control in endemic communities. Methods A cultural epidemiological study with locally adapted vignette-based interviews was conducted in two cholera-endemic communities of Zanzibar. A random sample of unaffected peri-urban (n = 179) and rural (n = 177) adults was interviewed to study community ideas of cholera and shigellosis, considering categories of distress, perceived causes, and help-seeking behaviour. Results Cholera was recognised by 88%. Symptoms of dehydration were most prominent in reports at the peri-urban site. Interference with work leading to strain on household finances was frequently emphasised. Dirty environment was the most prominent perceived cause, followed by unsafe drinking water and germ-carrying flies. Causes unrelated to the biomedical basis of cholera were reported more often by rural respondents. Rural women had more difficulty (20%) to identify a cause than men (7.1%, p = 0.016). Peri-urban self treatment emphasised rehydration; the rural community preferred herbal treatment and antibiotics. Shigellosis was recognised by 70%. Fewer regarded it as very serious compared with cholera (76% vs. 97%, p < 0.001) and regarded it as less likely to be fatal (48% vs. 78%, p < 0.001). More respondents could not explain causes of shigellosis (23%) compared with cholera (7.3%, p < 0.001). Community respondents less frequently identified dehydration and contagiousness for shigellosis. Government facilities were preferred healthcare providers for both conditions. Conclusions This study clarified local views of cholera and shigellosis relevant for diarrhoeal disease control in Zanzibar. The finding that rural women were less likely than men to specify causes of cholera suggests more attention to them is required. Better health education is needed for cholera in rural areas and for shigellosis in general. This study also identified variables for subsequent analysis of social and cultural determinants of cholera vaccine acceptance. PMID:21110853

Epidemiology and genetic characterization of HIV-1 isolates in the general population of Djibouti (Horn of Africa).

PubMed

Maslin, Jérôme; Rogier, Christophe; Berger, Franck; Khamil, Mohamed Ali; Mattera, Didier; Grandadam, Marc; Caron, Mélanie; Nicand, Elizabeth

2005-06-01

During a national survey in 2002 in Djibouti, serum samples were collected using a valid sampling scheme from 2423 Djiboutians representing the general population of urban and rural districts. The HIV-1 seroprevalence was 2%. The HIV-1 polymerase gene from 53 untreated patients was amplified. Phylogenetic analysis of 34 isolates revealed a majority of subtype C (73%) as well as other subtypes, including CRF02_AG recombinants (18%), subtype D (6%), and subtype A (3%).

Serum uric acid concentrations in a Xhosa community in the Transkei of Southern Africa.

PubMed

Beighton, P; Daynes, G; Soskolne, C L

1976-02-01

Serum uric acid (SUA) concentrations were measured in specimens obtained from 479 respondents aged 15 and over during an epidemiological survey of bone and joint conditions in a tribal Xhosa community living in the Transkei, Southern Africa. Population SUA levels in the Xhosa were significantly lower than those previously observed in South Africa Negro groups in rural and urban environments. This finding agrees with the observations that population SUA concentrations tend to rise with increasing complexity of life style.

Serum uric acid concentrations in a Xhosa community in the Transkei of Southern Africa.

PubMed Central

Beighton, P; Daynes, G; Soskolne, C L

1976-01-01

Serum uric acid (SUA) concentrations were measured in specimens obtained from 479 respondents aged 15 and over during an epidemiological survey of bone and joint conditions in a tribal Xhosa community living in the Transkei, Southern Africa. Population SUA levels in the Xhosa were significantly lower than those previously observed in South Africa Negro groups in rural and urban environments. This finding agrees with the observations that population SUA concentrations tend to rise with increasing complexity of life style. PMID:1275585

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.

[Zoo-anthroponoses involving rodents: epidemiologic considerations].

PubMed

Rodhain, F

1996-01-01

A large number of zoo-anthroponoses is known, in the natural cycle of which are involved rodents or lagomorphs. This is mainly related to the numerical importance of rodents, their ecological plasticity, their relationships with man. Thus, it is important, for the epidemiologist, to differentiate synanthropic rodents living in close contact with man and often spread by him, which are at the origine of frequently urban diseases, from wild rodents usually having only few contacts with man in rural areas only. The events allowing the passage of an infectious agent from rodent to man appear varied, as are epidemiological schemes in which these animals can play different roles: they can act, alone or together with other animals, as natural reservoirs, or, on the contrary, they are only occasionally infected, and the transmission can occur by direct contact, by bite, through the environment, or with the help of an arthropod vector. It is particularly interesting to follow the evolution of some of these epidemiological systems, in order to evaluate the impact of human activities, such as deforestations, new technics for agriculture and cattle breeding, urbanization, increasing transportation, development of leisure activities. In order to reduce this infectious risk, we should look for the means of a correct balance between rodent and human populations, by joining the control of epidemiologically dangerous species, modification of some of our behaviours, a relevant health information, together with the care of the protection of natural ecosystems.

Space-temporal analysis of Chagas disease and its environmental and demographic risk factors in the municipality of Barcarena, Pará, Brazil.

PubMed

Sousa, Alcinês da Silva; Palácios, Vera Regina da Cunha Menezes; Miranda, Claúdia do Socorro; Costa, Rodrigo Junior Farias da; Catete, Clistenes Pamplona; Chagasteles, Eugenia Janis; Pereira, Alba Lucia Ribeiro Raithy; Gonçalves, Nelson Veiga

2017-01-01

Chagas disease is a parasitosis considered a serious problem of public health. In the municipality of Barcarena, Pará, from 2007 to 2014, occurred the highest prevalence of this disease in Brazil. To analyze the disease distribution related to epidemiological, environmental and demographic variables, in the area and period of the study. Epidemiological and demographic data of Barcarena Health Department and satellite images from the National Institute For Space Research (INPE) were used. The deforestation data were obtained through satellite image classification, using artificial neural network. The statistical significance was done with the χ2 test, and the spatial dependence tests among the variables were done using Kernel and Moran techniques. The epidemiological curve indicated a disease seasonal pattern. The major percentage of the cases were in male, brown skin color, adult, illiterate, urban areas and with probable oral contamination. It was confirmed the spatial dependence of the disease cases with the different types of deforestation identified in the municipality, as well as agglomerations of cases in urban and rural areas. Discussion: The disease distribution did not occur homogeneously, possibly due to the municipality demographic dynamics, with intense migratory flows that generates the deforestation. Different relationships among the variables studied and the occurrence of the disease in the municipality were observed. The technologies used were satisfactory to construct the disease epidemiological scenarios.

Epidemiology of lyme borreliosis.

PubMed

Hubálek, Zdenek

2009-01-01

Lyme borreliosis (LB) is the most frequent ixodid tick-borne human disease in the world, with an estimated 85,500 patients annually (underlying data presented in this review: Europe 65,500, North America 16,500, Asia 3,500, North Africa 10; approximate figures). This chapter summarizes the up-to-date knowledge about facts and factors important in the epidemiology of LB all over the world. Individual sections briefly describe geographic (latitudinal and altitudinal) distribution and incidence rates of LB in individual countries; seasonal distribution of the disease; effects of patients' age, sex, and profession; comparison of urban versus rural settings; weather-related effects on LB incidence; risk factors for LB acquisition by humans; and risk assessment. This chapter finishes by recommending a more thorough epidemiological surveillance for LB, including morbidity notification in some additional countries where it has not yet been fully implemented. Copyright 2009 S. Karger AG, Basel.

Developmental vitamin D deficiency and risk of schizophrenia: a 10-year update.

PubMed

McGrath, John J; Burne, Thomas H; Féron, François; Mackay-Sim, Allan; Eyles, Darryl W

2010-11-01

There is an urgent need to generate and test candidate risk factors that may explain gradients in the incidence of schizophrenia. Based on clues from epidemiology, we proposed that developmental vitamin D deficiency may contribute to the risk of developing schizophrenia. This hypothesis may explain diverse epidemiological findings including season of birth, the latitude gradients in incidence and prevalence, the increased risk in dark-skinned migrants to certain countries, and the urban-rural gradient. Animal experiments demonstrate that transient prenatal hypovitaminosis D is associated with persisting changes in brain structure and function, including convergent evidence of altered dopaminergic function. A recent case-control study based on neonatal blood samples identified a significant association between neonatal vitamin D status and risk of schizophrenia. This article provides a concise summary of the epidemiological and animal experimental research that has explored this hypothesis.

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.

Diabetes and urbanization in the Omani population: an analysis of national survey data

PubMed Central

Al-Moosa, Siba; Allin, Sara; Jemiai, Nadia; Al-Lawati, Jawad; Mossialos, Elias

2006-01-01

Background The prevalence of type 2 diabetes in Oman is high and appears to be rising. Rising rates of diabetes and associated risk factors have been observed in populations undergoing epidemiological transition and urbanization. A previous study in Oman indicated that urban-dwellers were not significantly more likely to have diabetes. This study was undertaken to determine if a more accurate urban and rural categorization would reveal different findings. Methods This study included 7179 individuals aged 20 years or above who participated in a cross-sectional interviewer-administered survey in Oman including blood and anthropomorphic tests. Multiple logistic regression analyses were conducted to analyze the factors associated with diabetes, first in the whole population and then stratified according to region. Results The prevalence of diabetes (fasting blood glucose ≥ 7 mmol/l) in the capital region of Muscat was 17.7% compared to 10.5% in rural areas. The prevalence of self-reported diabetes was 4.3%. Urban residence was significantly associated with diabetes (adjusted odds ratio (OR) = 1.7, 95% confidence interval (CI): 1.4–2.1), as was age (OR = 1.2, 95% CI: 1.1- 1.2), obesity (abnormal waist circumference) (OR = 1.8, 95% CI: 1.5–2.1), and systolic blood pressure (SBP) 120–139 (OR = 1.4, 95% CI:1.04–1.8), SBP 140–159 (OR = 1.9, 95% CI: 1.4–2.6), SBP ≥ 160 (OR = 1.7, 95% CI: 1.2–2.5). Stratified analyses revealed higher education was associated with reduced likelihood of diabetes in rural areas (OR = 0.6, 95% CI: 0.4–0.9). Conclusion A high prevalence of diabetes, obesity, hypertension and high cholesterol exist in the Omani population, particularly among urban-dwellers and older individuals. It is vital to continue monitoring chronic disease in Oman and to direct public health policy towards preventing an epidemic. PMID:16635266

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

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 Family Life Project: an epidemiological and developmental study of young children living in poor rural communities.

PubMed

Vernon-Feagans, Lynne; Cox, Martha

2013-10-01

About 20% of children in the United States have been reported to live in rural communities, with child poverty rates higher and geographic isolation from resources greater than in urban communities. There have been surprisingly few studies of children living in rural communities, especially poor rural communities. The Family Life Project helped fill this gap by using an epidemiological design to recruit and study a representative sample of every baby born to a mother who resided in one of six poor rural counties over a 1-year period, oversampling for poverty and African American. 1,292 children were followed from birth to 36 months of age. This monograph described these children and used a cumulative risk model to examine the relation between social risk and children's executive functioning, language development, and behavioral competence at 36 months. Using both the Family Process Model of development and the Family Investment Model of development, observed parenting was examined over time in relation to child functioning at 36 months. Different aspects of observed parenting were examined as mediators/moderators of risk in predicting child outcomes. Results suggested that cumulative risk was important in predicting all three major domains of child outcomes and that positive and negative parenting and maternal language complexity were mediators of these relations. Maternal positive parenting was found to be a buffer for the most risky families in predicting behavioral competence. In a final model using both family process and investment measures, there was evidence of mediation but with little evidence of the specificity of parenting for particular outcomes. Discussion focused on the importance of cumulative risk and parenting in understanding child competence in rural poverty and the implications for possible intervention strategies that might be effective in maximizing the early development of these children.

Determinants of rural and urban fertility differentials in Nigeria.

PubMed

Chimere-Dan, O

1990-07-01

Whatever proximate variables are examined, their differential effects on rural and urban fertility are small. This indicates that no major disturbance has taken place in urban or rural reproductive norms. However, two possible reasons for the converging pattern of rural and urban fertility in Nigeria are identified. One is that urban mothers in the first half of the childbearing age range have higher fertility than their rural counterparts. The other is that breast-feeding and post-partum abstinence, which are the major determinants of marital fertility, exert a more depressing influence on rural than urban fertility.

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.

The prevalence, awareness, treatment and control of dyslipidemia among adults in China.

PubMed

Pan, Ling; Yang, Zhenhua; Wu, Yue; Yin, Rui-Xing; Liao, Yunhua; Wang, Jinwei; Gao, Bixia; Zhang, Luxia

2016-05-01

To analyze the prevalence, awareness, treatment, control and epidemiological characteristics of dyslipidemia in Chinese adults. In this cross-sectional study, we adopted a multi-stage, stratified sampling method to obtain representative samples of the general population aged >18 years from different urban and rural regions in China. All subjects completed a lifestyle and medical history questionnaire and were examined for risk factors. Dyslipidemia was defined according to criteria of the 2007 Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults. Continuous variables were compared using variance analysis. Multivariate logistic regression analysis was performed to explore the risk factors of dyslipidemia. The prevalence of dyslipidemia was 34.0% overall, and 35.1%, and 26.3% in urban and rural areas, respectively. The prevalence of dyslipidemia was significantly higher in men than women (41.9% vs 32.5%; P < 0.001). Rates of awareness, treatment, and control were 31.0%, 19.5%, and 8.9%, respectively. Increasing age (OR = 1.012; 95% CI:1.010, 1.014), male sex (OR = 1.411; 95% CI:1.318, 1.510), obesity (OR = 1.424; 95% CI:1.345, 1.507), cardiovascular disease (OR = 1.343; 95% CI:1.125, 1.603), diabetes (OR = 1.955; 95% CI:1.751, 2.182), hypertension (OR = 1.481; 95% CI:1.391, 1.577) and hyperuricemia (OR = 2.223; 95% CI:2.060, 2.399) were independent risk factors of dyslipidemia. The prevalence of dyslipidemia among Chinese adults was high but awareness, treatment, and control of dyslipidemia were low. Urban high income earners and rural medium income earners show higher prevalence. Low income earners in urban and rural population have the worst awareness treatment, and control rate. There is an increased need for closely monitoring and controlling high risk factors in the populations including postmenopausal women, unhealthy lifestyle peoples and patients with chronic non-communicable diseases. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

A community-based epidemiological study of peripheral neuropathies in Assiut, Egypt.

PubMed

Kandil, Mahmoud R; Darwish, Esam S; Khedr, Eman M; Sabry, Mahmoud M; Abdulah, Mohamed A

2012-12-01

There is very little published information about the prevalence, patterns, and predictors of peripheral neuropathies. The current study is a community-based survey was conducted in the Assiut Governorate to estimate their prevalence and clinical profile. A door-to-door study was carried out on 42,223 persons from rural and urban communities in the Assiut Governorate, Egypt. There were 13,288 (31.5%) subjects from the urban and 28,935 (68·5%) from the rural area. All subjects filled in a questionnaire designed specifically for diagnosis of peripheral neuropathy. Positive cases were then given a complete medical and neurological examination, routine laboratory tests, neurophysiology, and neuroimaging (magnetic resonance). The crude prevalence rate (CPR) of peripheral neuropathy was 3181/100,000 inhabitants. There was a significantly higher prevalence in the rural compared with the urban population (3795 versus 1844/100,000) and in females than males (4473 versus 1943/100,000; P<0.001 for both). The most common type reported was entrapment neuropathy (736 cases with CPR of 1743/100,000), particularly carpal tunnel syndrome (1686/100,000). Diabetic neuropathy was the most common non-compressive neuropathy with a CPR of 649/100,000. Type II diabetes was recorded in 241 patients with a CPR of 571/100,000. Compressive radiculopathy had a crude prevalence of 358/100,000; traumatic and iatrogenic radiculopathy had a prevalence rate of 149/100,000. Less common conditions were: uremic neuropathy (21/100,000) hepatic neuropathy (14/100,000), Bell's palsy (28/100,000), Guillian-Barre' syndrome (12/100,000), chronic inflammatory demyelinating polyneuropathy (12/100,000), hereditary sensory motor neuropathy (12/100,000), and idiopathic neuropathy (92/100,000). The overall prevalence of peripheral neuropathies was high in comparison to other studies. Entrapment neuropathy, diabetic neuropathy, and spondylotic radiculopathy were the most common. Overall, the prevalence of peripheral neuropathy was higher in the rural than in the urban population.

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.

Spatial analysis for the epidemiological study of cardiovascular diseases: A systematic literature search.

PubMed

Mena, Carlos; Sepúlveda, Cesar; Fuentes, Eduardo; Ormazábal, Yony; Palomo, Iván

2018-05-07

Cardiovascular diseases (CVDs) are the primary cause of death and disability in de world, and the detection of populations at risk as well as localization of vulnerable areas is essential for adequate epidemiological management. Techniques developed for spatial analysis, among them geographical information systems and spatial statistics, such as cluster detection and spatial correlation, are useful for the study of the distribution of the CVDs. These techniques, enabling recognition of events at different geographical levels of study (e.g., rural, deprived neighbourhoods, etc.), make it possible to relate CVDs to factors present in the immediate environment. The systemic literature presented here shows that this group of diseases is clustered with regard to incidence, mortality and hospitalization as well as obesity, smoking, increased glycated haemoglobin levels, hypertension physical activity and age. In addition, acquired variables such as income, residency (rural or urban) and education, contribute to CVD clustering. Both local cluster detection and spatial regression techniques give statistical weight to the findings providing valuable information that can influence response mechanisms in the health services by indicating locations in need of intervention and assignment of available resources.

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…

Urban-rural status affects associations between domains of ...

EPA Pesticide Factsheets

Childhood cancer is associated with individual ambient environmental exposures such as hazardous air pollutants and pesticides. However, the role of cumulative ambient environmental exposures is not well-understood. An Environmental Quality Index (EQI) for 2000-2005 was constructed to estimate cumulative environmental exposures. The EQI represents five environmental domains (air, water, land, built and sociodemographic) for each U.S. county. Annual county-level, age-adjusted, childhood (≤ 19 years) cancer incidence rates for 2006-2010 from Surveillance, Epidemiology, and End Results Program (SEER) 18 Registries were linked to the EQI. Random intercept fixed slope linear models were used to estimate the relationship between EQI quintiles and childhood cancer incidence for counties for which data were available (n=611). Incidence rate differences (95% confidence intervals (95%CI)) comparing highest quintile/worst environmental quality to lowest quintile/best quality are reported. All cause childhood cancer was positively, though not significantly, associated with EQI (1.20(-2.60, 5.00)). Models were also stratified by four rural-urban continuum codes (RUCC) ranging from metropolitan urbanized (RUCC1) to thinly-populated (RUCC4). We observed positive associations between all cause childhood cancer and EQI by RUCC; however, significant positive associations were seen in only in the most urbanized areas (RUCC1: 1.79 (0.24, 3.34); RUCC2: 3.45 (-1.05, 5.84), RUCC3: 0

Healthy lifestyle behaviors among individuals with chronic obstructive pulmonary disease in urban and rural communities in China: a large community-based epidemiological study

PubMed Central

Yan, Ruohua; Wang, Yang; Bo, Jian; Li, Wei

2017-01-01

Background Lifestyle modification is one of the most cost-effective strategies in self-management and secondary prevention of chronic obstructive pulmonary disease (COPD). However, the prevalence of healthy lifestyle behaviors in COPD patients in China remains unclear. The objective of this study was to examine the rates of healthy lifestyle behaviors including smoking cessation, regular exercise, and healthy diet in community population with COPD in China. Methods We recruited 46,285 individuals aged 35–70 years from 115 urban and rural communities in 12 provinces of China from 2005 to 2009. We recorded the smoking status, physical activity intensity, and quality of diet for all spirometry-diagnosed COPD patients by standardized questionnaires. Results Among 3,690 individuals with COPD, 18.2% (95% confidence interval [CI], 13.0–24.9) quitted smoking, 27.1% (95% CI, 24.7–29.7) exercised often, and 34.8% (95% CI, 31.8–38.0) ate high-quality diet. More than half of the individuals followed one or less key healthy lifestyle, and only 8.4% (95% CI, 7.0–10.0) followed all of the three healthy behaviors. Urban residents had significant higher rates of smoking cessation (23.5% [95% CI, 17.3–31.1] vs 14.4% [95% CI, 9.9–20.5], p=0.0008), regular exercise (45.6% [95% CI, 42.4–48.8] vs 14.0% [95% CI, 12.1–16.2], p<0.0001), and healthy diet (38.5% [95% CI, 35.5–41.6] vs 32.2% [95% CI, 29.2–35.4], p=0.0013) than rural residents. Age, sex, education level, body mass index, respiratory symptoms, and family income were associated with healthy living, and the strength of associations varied between urban and rural areas. Conclusion There is a large gap between the anticipated rate and the real participation in healthy lifestyle behaviors in Chinese adults with COPD, especially in rural communities. Simple and effective strategies are warranted to improve patients’ lifestyle in China. PMID:29180861

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

Prevalence, risk factors and molecular epidemiology of Brachyspira pilosicoli in humans on the island of Bali, Indonesia.

PubMed

Margawani, K Rini; Robertson, Ian D; Brooke, C Josephine; Hampson, David J

2004-04-01

The purpose of this study was to investigate the prevalence and epidemiology of the anaerobic intestinal spirochaete Brachyspira pilosicoli amongst Indonesians living in rural and urban settings on the island of Bali. Faecal samples (n = 992) were collected on two occasions, 4 months apart, from people living in four traditional farming villages, one peri-urban location and one urban area. Samples were cultured anaerobically on selective agar and intestinal spirochaete isolates were confirmed to be B. pilosicoli by using a species-specific PCR. Forty-eight of the 121 isolates obtained were typed by using PFGE. A questionnaire was administered to participants and analysed in order to identify potential risk factors for colonization. Overall prevalence of carriage on the two visits was 11.8 and 12.6 %, respectively. Prevalence at different locations varied from 3.3 to 23.4 %, with the highest prevalence occurring in the peri-urban location. Considerable strain diversity was found, with the 48 isolates being divided into 44 PFGE types. There was no significant association between colonization and ownership of animals, contact with animals, farming, age or gender. On the first visit, colonization was significantly more common in people who used well water compared to those who used tap water. On the second visit, colonization was significantly more common in people with wet faeces than in those with normal faeces.

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…

Epidemiology of coronary heart disease: the Puerto Rico heart health program revisted.

PubMed

García-Palmieri, Mario R

2013-01-01

Coronary heart disease (CHD) remains as the main cause of death in most countries of the world including Puerto Rico. Due to the importance of gathering knowledge regarding the harmful effects and risk factors associated with the development of CHD some basic information is reviewed to stimulate the institution of measures for reduction of the prevalence of clinical CHD and its ultimate consequences. Special attention is given in the manuscript of the Puerto Rico Heart Health Program conducted in men aged 45-64 residing in four rural and three urban areas. The Puerto Rico and the Honolulu Study confirmed the initial publication on the epidemiology of coronary heart disease by the Framingham study. The presentation of some data collected among the three studies strengthen the message of avoiding the development of CHD by installing preventive measures for control and reduction of the risk factors. Concurrent data obtained in the three studies is presented. Although the degree of the involvement of the populations is higher in Framingham than in Puerto Rico and Honolulu, the deleterious effects of specific risk factors are harmful in all the three populations. Difference in the prevalence of risk factors among the urban and rural males in Puerto Rico is also illustrated. It is our hope that more intense measures be instituted in Puerto Rico at all levels in order to control risk factors and reduce the incidence of coronary disease in Puerto Rico.

Reference ranges of handgrip strength from 125,462 healthy adults in 21 countries: a prospective urban rural epidemiologic (PURE) study.

PubMed

Leong, Darryl P; Teo, Koon K; Rangarajan, Sumathy; Kutty, V Raman; Lanas, Fernando; Hui, Chen; Quanyong, Xiang; Zhenzhen, Qian; Jinhua, Tang; Noorhassim, Ismail; AlHabib, Khalid F; Moss, Sarah J; Rosengren, Annika; Akalin, Ayse Arzu; Rahman, Omar; Chifamba, Jephat; Orlandini, Andrés; Kumar, Rajesh; Yeates, Karen; Gupta, Rajeev; Yusufali, Afzalhussein; Dans, Antonio; Avezum, Álvaro; Lopez-Jaramillo, Patricio; Poirier, Paul; Heidari, Hosein; Zatonska, Katarzyna; Iqbal, Romaina; Khatib, Rasha; Yusuf, Salim

2016-12-01

The measurement of handgrip strength (HGS) has prognostic value with respect to all-cause mortality, cardiovascular mortality and cardiovascular disease, and is an important part of the evaluation of frailty. Published reference ranges for HGS are mostly derived from Caucasian populations in high-income countries. There is a paucity of information on normative HGS values in non-Caucasian populations from low- or middle-income countries. The objective of this study was to develop reference HGS ranges for healthy adults from a broad range of ethnicities and socioeconomically diverse geographic regions. HGS was measured using a Jamar dynamometer in 125,462 healthy adults aged 35-70 years from 21 countries in the Prospective Urban Rural Epidemiology (PURE) study. HGS values differed among individuals from different geographic regions. HGS values were highest among those from Europe/North America, lowest among those from South Asia, South East Asia and Africa, and intermediate among those from China, South America, and the Middle East. Reference ranges stratified by geographic region, age, and sex are presented. These ranges varied from a median (25 th -75 th percentile) 50 kg (43-56 kg) in men <40 years from Europe/North America to 18 kg (14-20 kg) in women >60 years from South East Asia. Reference ranges by ethnicity and body-mass index are also reported. Individual HGS measurements should be interpreted using region/ethnic-specific reference ranges.

Prevalence and care index of early childhood caries in mainland China: evidence from epidemiological surveys during 1987–2013

PubMed Central

Zhang, Xiaonan; Yang, Sheng; Liao, Zhaoying; Xu, Ling; Li, Conghua; Zeng, Huan; Song, Jinlin; Zhang, Lei

2016-01-01

Early childhood caries (ECC) is the most common chronic disease in young children. Its reported prevalence varies greatly across China. This systematic review aimed to explore the epidemiological characteristics of ECC in mainland China from 1987 to 2013. In total, 102 articles were included. The pooled national prevalence and care index (ft/dmft%) for ECC were 65.5% and 3.6%, respectively. The overall ECC prevalence declined from 77.9% during 1987–1994 to 56.4% during 2010–2013. The pooled ECC prevalence for children aged 1–6 years was 0.3%, 17.3%, 40.2%, 54.4%, 66.1%, and 70.7%, respectively. There was no significant difference in prevalence between boys (59.1%) and girls (58.9%); and the care index was also similar (8.1% versus 7.7%). Slightly higher ECC prevalence was observed in rural areas (63.5%) compared with urban areas (59.5%) (RR = 1.08, 95% CI: 1.02–1.14); but a much higher care index was reported in urban children (6.0%) than their rural counterparts (1.6%) (RR = 3.68, 95% CI: 2.54–5.35). The 2006–2013 map of ECC prevalence among 5-year-olds showed wide geographic variations across China. Four adjacent provinces, including Sichuan, Chongqing, Hubei, and Shaanxi, constituted the areas with the lowest ECC prevalence in mainland China. PMID:26758962

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.

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

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.

Hypertension in Sub-Saharan Africa: A Contextual View of Patterns of Disease, Best Management, and Systems Issues.

PubMed

Nulu, Shanti; Aronow, Wilbert S; Frishman, William H

2016-01-01

Sub-Saharan Africa (SSA) bears the highest burden of both communicable and noncommunicable disease and has the weakest health systems. Much attention is directed toward a rising burden of chronic disease in the setting of epidemiologic transition and urbanization. Indeed, the highest prevalence of hypertension globally is in the World Health Organization's African region at 46% of adults aged 25 and above. And while hypertension in SSA is common, its prevalence varies significantly between urban and rural settings. Although there is evidence for epidemiologic transition in urban areas, there is also evidence of static levels of hypertension within rural areas, which comprise more than 70% of the population of SSA. Furthermore, overall cardiovascular (CV) risk in rural areas remains low. The mean age of hypertensives in SSA is approximately 30s to 40s, burdening those at peak productivity. Complications of hypertension are frequent, given the poor levels of awareness and treatment (<10%) of hypertension on the continent. Such complications include primarily stroke and hypertensive heart disease, as ischemic heart disease is uncommon. Mortality associated with these complications is high, with in-hospital mortality from 2 different sites reported as around 20%. The overall burden of hypertension is likely to be more related to poor access and availability of health systems and is representative of a looming crisis in health care delivery. The best approaches to population-wide treatment are those that utilize CV risk prediction for those with stage 1 hypertension, whereas treatment is generally indicated for all those with stage 2 or greater hypertension, especially in light of the high burden of stroke in SSA. Current guidelines recommend first-line drug therapy with a diuretic or calcium channel blocker. Despite these recommendations, the major obstacles to hypertension treatment are systemic and include the availability and cost of medications, the adequacy of health facilities and systems, and the lack of health insurance to address affordability. New and innovative systems-oriented approaches are needed to address the burden of hypertension on a platform of global equity.

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

New epidemiological aspects of visceral and cutaneous leishmaniasis in Taza, Morocco.

PubMed

Hakkour, Maryam; Hmamouch, Asmae; El Alem, Mohamed Mahmoud; Rhalem, Abdelkbir; Amarir, Fatima; Touzani, Mohamed; Sadak, Abderrahim; Fellah, Hajiba; Sebti, Faiza

2016-11-29

Leishmaniasis is considered among the main endemic diseases in Morocco. However, further knowledge about epidemiological aspects of this disease is needed in several provinces to plan control and preventive strategies to tackle the disease. The present study aims to determine the epidemiological aspect of cutaneous and visceral leishmaniasis in Taza Province from 2007-2014 and to identify the circulating species in this province. The temporal study from 2007 to 2014 showed that the number of cutaneous leishmaniasis cases increased since 2010. During the period of study, most leishmaniasis cases were detected in both urban and rural areas with 34% of cases detected in two urban localities, Bab Zitouna and Bab tété with 297 and 106 cases, respectively. The molecular study of cutaneous leishmaniasis showed the presence of non-sporadic Leishmania infantum and Leishmania tropica in this province. Regarding visceral leishmaniasis, Leishmania infantum is the species that has been identified. The epidemio-molecular study of leishmaniasis in Taza Province showed the coexistence of two species of Leishmania in the same foci. They also indicated that CL due to Leishmania infantum is more prevalent than reported in the literature. These results will be helpful for the implementation of control strategies by targeting dogs that constitute a reservoir of Leishmania infantum.

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.

The epidemiology of first episode psychosis in early intervention in psychosis services: findings from the Social Epidemiology of Psychoses in East Anglia [SEPEA] study

PubMed Central

Kirkbride, James B.; Hameed, Yasir; Ankireddypalli, Gayatri; Ioannidis, Konstantinos; Crane, Carolyn M.; Nasir, Mukhtar; Kabacs, Nikolett; Metastasio, Antonio; Jenkins, Oliver; Espandian, Ashkan; Spyridi, Styliani; Ralevic, Danica; Siddabattuni, Suneetha; Walden, Ben; Adeoye, Adewale; Perez, Jesus; Jones, Peter B.

2018-01-01

Objective Few studies have characterized the epidemiology of first episode psychoses in rural or urban settings since the introduction of Early Intervention Psychosis services. To address this, we conducted a naturalistic cohort study in England, where such services are well-established. Method We identified all new first episode psychosis cases, 16-35 years old, presenting to Early Intervention Psychosis services in the East of England, during 2 million person-years follow-up. Presence of International Classification of Diseases, Tenth Revision, F10-33 psychotic disorder was confirmed using OPCRIT. We estimated incidence rate ratios [IRR] following multivariable Poisson regression, adjusting for age, sex, ethnicity, socioeconomic status, neighborhood-level deprivation and population density. Results Of 1,005 referrals, 687 participants (68.4%) fulfilled epidemiological and diagnostic criteria for first episode psychosis (34.0 new cases per 100,000 person-years; 95%CI: 31.5-36.6). Median age-at-referral was similar (p=0.27) for men (22.5 years; interquartile range: 19.5-26.7) and women (23.4 years; 19.5-29.1); incidence rates were highest for men and women before 20 years old. Rates increased for ethnic minority groups (IRR: 1.4; 95%CI: 1.1-1.6), with lower socioeconomic status (IRR: 1.3: 95%CI: 1.2-1.4) and in more urban (IRR: 1.4; 95%CI: 1.0-1.8) and deprived neighborhoods (IRR: 2.1; 95%CI: 1.3-3.3) after adjustment for confounders. Conclusions Pronounced variation in psychosis incidence, peaking before 20 years old, exists in populations served by Early Intervention Psychosis services. Excess rates were restricted to urban and deprived communities, suggesting a threshold of socioenvironmental adversity may be necessary to increase incidence. This robust epidemiology can inform service development in various settings about likely population-level need. PMID:27771972

Rural-Urban Connections.

ERIC Educational Resources Information Center

Perkins, Daniel F.; LaGreca, Anthony J.; Mullis, Ronald L.

This publication combines three papers on rural and urban youth issues. "Key Issues Facing Rural Youth" (Daniel F. Perkins) notes that rural adolescents share the same concerns and exhibit the same problem behaviors as their urban counterparts. But in addition, geographic isolation presents problems unique to rural areas. A framework is proposed…

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.

Working Memory Differences Between Children Living in Rural and Urban Poverty

PubMed Central

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 high-income urban developmental contexts. Both low-income rural and low-income urban children showed working memory deficits compared with their high-income counterparts, but their deficits were distinct. Low-income urban children exhibited symmetrical verbal and visuospatial working memory deficits compared with their high-income urban counterparts. Meanwhile, low-income rural children exhibited asymmetrical deficits when compared with their high-income rural counterparts, with more extreme visuospatial working memory deficits than verbal working memory deficits. These results suggest that different types of poverty are associated with different working memory abilities. PMID:25554726

Working Memory Differences Between Children Living in Rural and Urban Poverty.

PubMed

Tine, Michele

2014-10-02

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 high-income urban developmental contexts. Both low-income rural and low-income urban children showed working memory deficits compared with their high-income counterparts, but their deficits were distinct. Low-income urban children exhibited symmetrical verbal and visuospatial working memory deficits compared with their high-income urban counterparts. Meanwhile, low-income rural children exhibited asymmetrical deficits when compared with their high-income rural counterparts, with more extreme visuospatial working memory deficits than verbal working memory deficits. These results suggest that different types of poverty are associated with different working memory abilities.

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.

[Vectors of malaria: biology, diversity, prevention, and individual protection].

PubMed

Pages, F; Orlandi-Pradines, E; Corbel, V

2007-03-01

Only the Anopheles mosquitoes are implicated in the transmission of malaria. Among the numerous species of anopheles, around fifty are currently involved in the transmission. 20 are responsible for most of the transmission in the world. The diversity of behavior between species and in a single species of anopheles as well as climatic and geographical conditions along with the action of man on the environment condition the man vector contact level and the various epidemiological aspects of malaria. The anopheles are primarily rural mosquitoes and are less likely to be found in city surroundings in theory. But actually, the adaptation of some species to urban surroundings and the common habit of market gardening in big cities or in the suburbs is responsible for the de persistence of Anopheles populations in town. Except for South-East Asia, urban malaria has become a reality. The transmission risk of malaria is heterogeneous and varies with time. There is a great variation of risk within a same country, a same zone, and even within a few kilometers. The transmission varies in time according to seasons but also according to years and to the level of climatic events. For the traveler, prevention at any time relies on the strict application of individual protection, as well in rural than in urban surroundings.

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

[Epidemiological profile of rabies in the northwestern region of São Paulo State, from 1993 to 2007].

PubMed

Queiroz, Luzia Helena; de Carvalho, Cristiano; Buso, Daniel Sartori; Ferrari, Clara Isabel de Lucca; Pedro, Wagner André

2009-01-01

The epidemiology of animal rabies in the region of Araçatuba, in the northwest of São Paulo State, from 1993 to 2007, is described according to the results from diagnoses made at laboratories in the region, using the fluorescent antibody and mouse inoculation tests. Out of 10,579 samples analyzed, 4.9% were positive (518/10,579). Dogs accounted for 67% of the cases (346/518) and these occurred between 1993 and 1997. Among the other positive samples, 16% (84/518) were in cattle and 9.7% (50/518) were in bats. Among the 42 municipalities in the region, 23 (55%) presented at least one rabies-positive case, while 13 of them had cases in bats. Three distinct cycles of rabies were identified in the northwestern region of the State of São Paulo: the urban cycle characterized predominantly by canine rabies (1993 to 1997); and the aerial and rural cycles starting in 1998, with predominance of cases in bats in urban areas and in herbivores.

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.

Prevalence of type 2 diabetes mellitus among inland residents in China (2000-2014): A meta-analysis.

PubMed

Yang, Lili; Shao, Jing; Bian, Yaoyao; Wu, Huiqun; Shi, Lili; Zeng, Li; Li, Wenlin; Dong, Jiancheng

2016-11-01

Besides the aging population in China, the following have become serious public health problems: increasing urban population, lifestyle changes and diabetes. We assessed the epidemiology of type 2 diabetes mellitus in China between 2000 and 2014, and analyzed time trends to better determine the prevalence status of diabetes in China and to provide a basis for prevention and decision-making. In our systematic review, we searched China National Knowledge Infrastructure, Chinese VIP Information, Wanfang and PubMed databases for studies on type 2 diabetes mellitus between 2000 and 2014 in China. Two investigators extracted the data and assessed the quality of the included literature independently. We excluded studies that did not use 1999 World Health Organization criteria for diabetes. We also excluded reviews and viewpoints, studies with insufficient data, studies that were not carried out in mainland China and studies on troops, community, schools or physical examination people. We used stata 12.0 to combine the prevalence of all studies, calculated the pooled prevalence and its 95% confidence interval, and analyzed the differences among men/women, urban/rural areas and year of study. We calculated the prevalence of seven geographic areas of China, respectively, and mapped the distribution in the whole country to estimate the pooled prevalence of each area. Our search returned 4,572 studies, 77 of which satisfied the inclusion criteria. The included studies had a total of 1,287,251 participants, in which 680,574 cases of type 2 diabetes mellitus were recorded. The overall prevalence (9.1%) has been increasing since the 1970s, and it increased rapidly with age. The prevalence of the 65-74 years group was as high as 14.1%. Meanwhile, the prevalence among men/women and urban/rural areas was significantly different. The prevalence was 9.9% for men and 11.6% for women, which were significantly higher than the average at the end of the last century and the beginning of this century. The prevalence rate in urban areas (11.4%) was significantly higher than that in rural areas and in urban-rural fringe areas, and the prevalence in rural areas (8.2%) was slightly higher than that in urban-rural fringe areas (7.5%). In addition, the prevalence in each geographic area were estimated and mapped, which showed a large imbalance in the map. Our analysis suggested that type 2 diabetes mellitus is highly prevalent in China. These results underscore the urgent need for the government to vigorously strengthen the management of diabetes prevention and control. © 2016 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

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.

Influence of Urbanicity and County Characteristics on the Association between Ozone and Asthma Emergency Department Visits in North Carolina

PubMed Central

Rappold, Ana G.; Davis, J. Allen; Richardson, David B.; Waller, Anna E.; Luben, Thomas J.

2014-01-01

Background: Air pollution epidemiologic studies, often conducted in large metropolitan areas because of proximity to regulatory monitors, are limited in their ability to examine potential associations between air pollution exposures and health effects in rural locations. Methods: Using a time-stratified case-crossover framework, we examined associations between asthma emergency department (ED) visits in North Carolina (2006–2008), collected by a surveillance system, and short-term ozone (O3) exposures using predicted concentrations from the Community Multiscale Air Quality (CMAQ) model. We estimated associations by county groupings based on four urbanicity classifications (representative of county size and urban proximity) and county health. Results: O3 was associated with asthma ED visits in all-year and warm season (April–October) analyses [odds ratio (OR) = 1.019; 95% CI: 0.998, 1.040; OR = 1.020; 95% CI: 0.997, 1.044, respectively, for a 20-ppb increase in lag 0–2 days O3]. The association was strongest in Less Urbanized counties, with no evidence of a positive association in Rural counties. Associations were similar when adjusted for fine particulate matter in copollutant models. Associations were stronger for children (5–17 years of age) compared with other age groups, and for individuals living in counties identified with poorer health status compared with counties that had the highest health rankings, although estimated associations for these subgroups had larger uncertainty. Conclusions: Associations between short-term O3 exposures and asthma ED visits differed by overall county health and urbanicity, with stronger associations in Less Urbanized counties, and no positive association in Rural counties. Results also suggest that children are at increased risk of O3-related respiratory effects. Citation: Sacks JD, Rappold AG, Davis JA Jr, Richardson DB, Waller AE, Luben TJ. 2014. Influence of urbanicity and county characteristics on the association between ozone and asthma emergency department visits in North Carolina. Environ Health Perspect 122:506–512; http://dx.doi.org/10.1289/ehp.1306940 PMID:24569869

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.

Urbanization prolongs hantavirus epidemics in cities.

PubMed

Tian, Huaiyu; Hu, Shixiong; Cazelles, Bernard; Chowell, Gerardo; Gao, Lidong; Laine, Marko; Li, Yapin; Yang, Huisuo; Li, Yidan; Yang, Qiqi; Tong, Xin; Huang, Ru; Bjornstad, Ottar N; Xiao, Hong; Stenseth, Nils Chr

2018-05-01

Urbanization and rural-urban migration are two factors driving global patterns of disease and mortality. There is significant concern about their potential impact on disease burden and the effectiveness of current control approaches. Few attempts have been made to increase our understanding of the relationship between urbanization and disease dynamics, although it is generally believed that urban living has contributed to reductions in communicable disease burden in industrialized countries. To investigate this relationship, we carried out spatiotemporal analyses using a 48-year-long dataset of hemorrhagic fever with renal syndrome incidence (HFRS; mainly caused by two serotypes of hantavirus in China: Hantaan virus and Seoul virus) and population movements in an important endemic area of south China during the period 1963-2010. Our findings indicate that epidemics coincide with urbanization, geographic expansion, and migrant movement over time. We found a biphasic inverted U-shaped relationship between HFRS incidence and urbanization, with various endemic turning points associated with economic growth rates in cities. Our results revealed the interrelatedness of urbanization, migration, and hantavirus epidemiology, potentially explaining why urbanizing cities with high economic growth exhibit extended epidemics. Our results also highlight contrasting effects of urbanization on zoonotic disease outbreaks during periods of economic development in China. Copyright © 2018 the Author(s). Published by PNAS.

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.

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.

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.

Epidemiology of multiple sclerosis in London and Middlesex County, Ontario, Canada.

PubMed

Hader, W J; Elliot, M; Ebers, G C

1988-04-01

A case-controlled epidemiologic study of multiple sclerosis (MS) was carried out in London, Ontario, and its surrounding Middlesex County for the period 1974-1983. The prevalence rates for clinically definite/probable MS on January 1, 1984 were 94/100,000 for the city and 91/100,000 for the county. The estimated annual incidence rate for the decade 1974-83 was 3.4/100,000. The female-to-male sex ratio was 2.5:1. A familial history of MS was recorded in 14.4% of close relatives and a total of 17% when distant relatives are included. The MS group is predominantly of British (70%) and European (23%) origin. The urban-rural residence pattern analysis indicates no significant regional influence on the risk of developing MS.

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…

Health Care in China.

PubMed

Younger, David S

2016-11-01

China has recently emerged as an important global partner. However, like other developing nations, China has experienced dramatic demographic and epidemiologic changes in the past few decades. Population discontent with the health care system has led to major reforms. China's distinctive health care system, including its unique history, vast infrastructure, the speed of health reform, and economic capacity to make important advances in health care, nonetheless, has incomplete insurance coverage for urban and rural dwellers, uneven access, mixed quality of health care, increasing costs, and risk of catastrophic health expenditures. Copyright © 2016 Elsevier Inc. All rights reserved.

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.

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.

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.

Type 2 diabetes mellitus in Pakistan: Current prevalence and future forecast.

PubMed

Meo, Sultan Ayoub; Zia, Inam; Bukhari, Ishfaq A; Arain, Shoukat Ali

2016-12-01

Diabetes mellitus is a chronic health problem of all age groups, both gender, involves rural and urban areas and developing and developed countries globally. The aim of this study was to assess the prevalence of type 2 diabetes mellitus in Pakistan. Systematic bibliographic search of scientific databases including PubMed, ISI-web of science and Google Scholar was conducted with key words of "type 2 diabetes mellitus" "prevalence", "incidence", "occurrence". A total of 22 peer reviewed papers published in ISI and PubMed indexed journals were selected and examined. All the epidemiologic and experimental studies reporting the diabetes prevalence in Pakistan were included. Lastly, we analyzed 18 publications and remaining 04 papers were excluded. The current prevalence of type 2 diabetes mellitus in Pakistan is 11.77%. In males the prevalence is 11.20% and in females 9.19%. The mean prevalence in Sindh province is 16.2% in males and 11.70 % in females; in Punjab province it is 12.14% in males and 9.83% in females. In Baluchistan province 13.3% among males, 8.9% in females; while in Khyber Pakhtunkhwa (KPK) it is 9.2% in males and 11.60% in females. The prevalence of type 2 diabetes mellitus in urban areas is 14.81% and 10.34% in rural areas of Pakistan. The prevalence of type 2 diabetes mellitus in Pakistan is11.77%. The prevalence is higher in males than females and more common in urban areas compared to the rural areas. Pakistan must include diabetes preventive measures in their national health policy to minimize the burden of the disease.

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.

[Height deficit in school aged children: a multivariate analysis of possible risk factors, Pernambuco-1997].

PubMed

Laurentino, G E C; Arruda, I K G; Raposo, M C F; Batista Filho, M

2005-06-01

The nutritional status and some risk factors in 894 school children (ages 6 to 12) in the State of Pernambuco, Brazil, were analyzed based on the data collected by the Second State Research on Nourishment, Health and Nutrition carried out in 1997. The cutoff point used in the nutritional evaluation was the limit referring to -2 score-Z, being the NCHS the reference standard. The prevalence of stunting in the state was of 16.9%. Rural areas were more affected, reaching 27.1%. Bivariate analysis showed that the low socioeconomic level of the children and their families is associated with the occurrence of stunting. The logistic regression model pointed the variables: residence location, gender, access to treated potable water, low education, and per-capita income as the main determinants in stunting. The conjunct analysis of all the factors that explain the malnutrition found among the school children studied showed that the probability of a school-aged child to present height deficit varied from 1.5 to 60.3% depending on the risk factors taken into account, therefore showing different epidemiological "scenarios." The study also concluded that in the State of Pernambuco the height deficit constitutes a public health problem especially for school children in rural areas, showing two very different epidemiologic realities between urban and rural areas.

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

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.

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

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...

Effects of overweight and leisure-time activities on aerobic fitness in urban and rural adolescents.

PubMed

Albarwani, Sulayma; Al-Hashmi, Khamis; Al-Abri, Mohammed; Jaju, Deepali; Hassan, Mohammed O

2009-08-01

The aim of this research was to study the effects of overweight and leisure-time activities on maximal aerobic capacity (VO(2)max) in urban and rural Omani adolescents. A total of 529 (245 males, 284 females) adolescents, aged 15-16 years were randomly selected from segregated urban and rural schools. Maximal aerobic capacity was estimated using the multistage 20-meter shuttle-run test. The body mass index (BMI) of urban boys and girls was significantly higher than that of rural boys and girls. Urban boys and girls spent significantly less weekly hours on sports activities and significantly more weekly hours on TV/computer games than their rural counterpart. Urban boys and girls achieved significantly less VO(2)max than rural boys and girls (44.2 and 33.0 vs. 48.3 and 38.6 mL/kg/min, respectively). Maximal aerobic capacity was negatively correlated with BMI in urban boys. Overweight and inactivity had significant negative effects on cardiorespiratory fitness in urban boys and girls as compared to their rural counterparts. Weight gain in adolescence requires early intervention.

Introductory Epidemiology. An Instructor Resource Guide. Appendix to a Final Report on the Paraprofessional Rurally Oriented Family Home Health Training Program.

ERIC Educational Resources Information Center

Best, Stephen H.; Myer, Donna Foster

This instructor's resource guide, one in a series of products from a project to develop an associate degree program for paraprofessional rural family health promoters, deals with teaching a course in introductory epidemiology. Covered in the first section of the guide are the role of epidemiology in rural health promotional training, general…

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.

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.

Use of rapid rural appraisal and cross-sectional studies in the assessment of constraints in smallholder cattle production systems in the western Kenya highlands.

PubMed

Okuthe, O S; McLeod, A; Otte, J M; Buyu, G E

2003-09-01

Assessment of livestock production constraints in the smallholder dairy systems in the western Kenya highlands was carried out using both qualitative and quantitative epidemiological methods. Rapid rural appraisals (qualitative) were conducted in rural and peri-urban areas. A cross-sectional survey (quantitative) was then conducted on a random sample of farms in the study area. Diseases, poor communication, lack of marketing of livestock produce, lack of artificial insemination services, and feed and water shortages during the dry season were identified as the major constraints to cattle production in both areas. Tick borne diseases (especially East Coast fever) were identified as the major constraint to cattle production. Qualitative methods were found to be more flexible and cheaper than the quantitative methods by a ratio of between 2.19-2.0. The two methods were found to complement each other. Qualitative studies could be applied in preliminary studies before initiating more specific follow up quantitative studies.

Colorectal cancer outcome inequalities: association between population density, race, and socioeconomic status.

PubMed

Fitzgerald, Timothy L; Lea, C S; Brinkley, Jason; Zervos, Emmanuel E

2014-01-01

Conflicting data exists regarding the influence of population density on colorectal cancer (CRC) outcomes; to better understand this, the present study evaluated outcomes along an urban-rural continuum. Colorectal patients aged ≥40 years from 1992 to 2002 were identified in the SEER (Surveillance, Epidemiology, and End Results) Registries of the National Cancer Institute in the USA. A total of 176 011 patients were identified, with median age 71; most lived in populous counties and were white (90%). Patients from large metropolitan counties were more often African-American, and those in rural counties were more likely to be white and have low socioeconomic status (SES). Patients from large metropolitan (>1 million) and rural counties were more likely to have metastatic disease and decreased survival compared to smaller metropolitan counties (<1 million). Late stage of presentation and diminished survival were also associated with African-American race, male sex and lower SES. Metropolitan counties with populations <1 million had superior CRC outcomes, in part secondary to race and SES.

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.

[Human African trypanosomiasis in an urban area: an emerging problem?].

PubMed

Louis, F J; Bilenge, C M; Simarro, P P; Meso, V Kande; Lucas, P; Jannin, J

2003-08-01

The human African trypanosomiasis is essentially a rural disease. The notification of cases in urban area has always been incidental; either a diagnosis made in town revealed a disease contracted in rural environment or it meant the preservation of a complete epidemiological cycle in a remaining urban micro-focus. In Kinshasa, in Democratic Republic of Congo, about forty cases have been notified each year. All of them came from the nearby foci of Bandundu, Lower Congo and Kasaï. In 1996 the number of cases reached suddenly 254 and today the average annual number comes up to 500 in spite of all the efforts undertaken to fight the disease. A study of cases in 1998 and 1999 shows that patients are essentially distributed in suburbs and that the most affected by the disease are the 15-49 year old ones whose job is related with agricultural or fishing activities. Two phenomena seem to explain this sudden increase: the massive inflow of refugees in outskirts of town coming from provinces where trypanosomiasis is endemic and a major economic crisis throwing out urban population in suburbs living on a subsistence micro-agriculture. These concomitant factors have contributed to the setting up of a trypanosomiasis belt around the capital. Today a strategy has to be reconsidered in order to fight against the disease in the capital itself and to make the medical staff aware of the diagnosis of a disease still unknown in their sanitary district.

Phylogeography of recently emerged DENV-2 in southern Viet Nam.

PubMed

Rabaa, Maia A; Ty Hang, Vu Thi; Wills, Bridget; Farrar, Jeremy; Simmons, Cameron P; Holmes, Edward C

2010-07-27

Revealing the dispersal of dengue viruses (DENV) in time and space is central to understanding their epidemiology. However, the processes that shape DENV transmission patterns at the scale of local populations are not well understood, particularly the impact of such factors as human population movement and urbanization. Herein, we investigated trends in the spatial dynamics of DENV-2 transmission in the highly endemic setting of southern Viet Nam. Through a phylogeographic analysis of 168 full-length DENV-2 genome sequences obtained from hospitalized dengue cases from 10 provinces in southern Viet Nam, we reveal substantial genetic diversity in both urban and rural areas, with multiple lineages identified in individual provinces within a single season, and indicative of frequent viral migration among communities. Focusing on the recently introduced Asian I genotype, we observed particularly high rates of viral exchange between adjacent geographic areas, and between Ho Chi Minh City, the primary urban center of this region, and populations across southern Viet Nam. Within Ho Chi Minh City, patterns of DENV movement appear consistent with a gravity model of virus dispersal, with viruses traveling across a gradient of population density. Overall, our analysis suggests that Ho Chi Minh City may act as a source population for the dispersal of DENV across southern Viet Nam, and provides further evidence that urban areas of Southeast Asia play a primary role in DENV transmission. However, these data also indicate that more rural areas are also capable of maintaining virus populations and hence fueling DENV evolution over multiple seasons.

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.

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;…

Rabies in southeast Brazil: a change in the epidemiological pattern.

PubMed

Queiroz, Luzia Helena; Favoretto, Silvana Regina; Cunha, Elenice Maria S; Campos, Angélica Cristine A; Lopes, Marissol Cardoso; de Carvalho, Cristiano; Iamamoto, Keila; Araújo, Danielle Bastos; Venditti, Leandro Lima R; Ribeiro, Erica S; Pedro, Wagner André; Durigon, Edison Luiz

2012-01-01

This epidemiological study was conducted using antigenic and genetic characterisation of rabies virus isolates obtained from different animal species in the southeast of Brazil from 1993 to 2007. An alteration in the epidemiological profile was observed. One hundred two samples were tested using a panel of eight monoclonal antibodies, and 94 were genetically characterised by sequencing the nucleoprotein gene. From 1993 to 1997, antigenic variant 2 (AgV-2), related to a rabies virus maintained in dog populations, was responsible for rabies cases in dogs, cats, cattle and horses. Antigenic variant 3 (AgV-3), associated with Desmodus rotundus, was detected in a few cattle samples from rural areas. From 1998 to 2007, rabies virus was detected in bats and urban pets, and four distinct variants were identified. A nucleotide similarity analysis resulted in two primary groups comprising the dog and bat antigenic variants and showing the distinct endemic cycles maintained in the different animal species in this region.

Health Risk Assessment of Inhalable Particulate Matter in Beijing Based on the Thermal Environment

PubMed Central

Xu, Lin-Yu; Yin, Hao; Xie, Xiao-Dong

2014-01-01

Inhalable particulate matter (PM10) is a primary air pollutant closely related to public health, and an especially serious problem in urban areas. The urban heat island (UHI) effect has made the urban PM10 pollution situation more complex and severe. In this study, we established a health risk assessment system utilizing an epidemiological method taking the thermal environment effects into consideration. We utilized a remote sensing method to retrieve the PM10 concentration, UHI, Normalized Difference Vegetation Index (NDVI), and Normalized Difference Water Index (NDWI). With the correlation between difference vegetation index (DVI) and PM10 concentration, we utilized the established model between PM10 and thermal environmental indicators to evaluate the PM10 health risks based on the epidemiological study. Additionally, with the regulation of UHI, NDVI and NDWI, we aimed at regulating the PM10 health risks and thermal environment simultaneously. This study attempted to accomplish concurrent thermal environment regulation and elimination of PM10 health risks through control of UHI intensity. The results indicate that urban Beijing has a higher PM10 health risk than rural areas; PM10 health risk based on the thermal environment is 1.145, which is similar to the health risk calculated (1.144) from the PM10 concentration inversion; according to the regulation results, regulation of UHI and NDVI is effective and helpful for mitigation of PM10 health risk in functional zones. PMID:25464132

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.

All-cause and cause-specific mortality among US youth: socioeconomic and rural-urban disparities and international patterns.

PubMed

Singh, Gopal K; Azuine, Romuladus E; Siahpush, Mohammad; Kogan, Michael D

2013-06-01

We analyzed international patterns and socioeconomic and rural-urban disparities in all-cause mortality and mortality from homicide, suicide, unintentional injuries, and HIV/AIDS among US youth aged 15-24 years. A county-level socioeconomic deprivation index and rural-urban continuum measure were linked to the 1999-2007 US mortality data. Mortality rates were calculated for each socioeconomic and rural-urban group. Poisson regression was used to derive adjusted relative risks of youth mortality by deprivation level and rural-urban residence. The USA has the highest youth homicide rate and 6th highest overall youth mortality rate in the industrialized world. Substantial socioeconomic and rural-urban gradients in youth mortality were observed within the USA. Compared to their most affluent counterparts, youth in the most deprived group had 1.9 times higher all-cause mortality, 8.0 times higher homicide mortality, 1.5 times higher unintentional-injury mortality, and 8.8 times higher HIV/AIDS mortality. Youth in rural areas had significantly higher mortality rates than their urban counterparts regardless of deprivation levels, with suicide and unintentional-injury mortality risks being 1.8 and 2.3 times larger in rural than in urban areas. However, youth in the most urbanized areas had at least 5.6 times higher risks of homicide and HIV/AIDS mortality than their rural counterparts. Disparities in mortality differed by race and sex. Socioeconomic deprivation and rural-urban continuum were independently related to disparities in youth mortality among all sex and racial/ethnic groups, although the impact of deprivation was considerably greater. The USA ranks poorly in all-cause mortality, youth homicide, and unintentional-injury mortality rates when compared with other industrialized countries.

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…

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.

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.

Comparative analysis of characteristics and risk factors of traffic injury in aged people from urban and rural areas in Chongqing.

PubMed

Zhang, Liang; Zhou, Ji-Hong; Qiu, Jun; Zhang, Xiu-Zhu; Yuan, Dan-Feng; Gao, Zhi-Ming; Dai, Wei

2012-01-01

To study the epidemiologic characteristics of traffic injuries among people over 60 years old in the Nan'an district (urban) and Jiangjin district (rural) of Chongqing, and to discuss the corresponding strategies for its prevention and cure. Records of traffic injuries in people over 60 years old registered by the traffic police between 2000 and 2006 in Nan'an district and Jiangjin district were collected in the Database of Road Traffic Accidents and Traffic Injuries. Epidemiologic characteristics of traffic injuries among the aged people were analyzed and compared. Between the year 2000 and 2006, the average annual incidence of traffic injuries and mortality rate in the aged people in Nan'an district were 124.62/100 000 and 13.85/ 100 000 respectively, higher than that in Jiangjin district (27.49/ 100 000, 7.13/100 000, P less than 0.01). However, the mortality rate for the aged people who were involved in traffic injuries in Jiangjin district was 20.60%, higher than that in Nan'an district (10.00%, P less than 0.01). Head injury was the primary cause of death. Totally 76.58% of casualties were pede-strians. Over 90% of the traffic accidents occurred in the areas with no traffic signal or traffic control system. The traffic environment is unfavorable to the aged people. It is important to enhance traffic safety consciousness of drivers and the elderly and to strengthen traffic safety system and traffic law, so as to provide a safe road traffic environment for the aged people.

Prevalence and socio-demographic characteristics of disability in older adults in China: Findings from China Comprehensive Geriatric Assessment Study.

PubMed

Ma, Lina; Li, Zhenzhen; Tang, Zhe; Sun, Fei; Diao, Lijun; Li, Jian; He, Yao; Dong, Birong; Li, Yun

2017-11-01

Disability affects older adults' quality of life. This study aimed to examine the socio-demographic characteristics of disability in older adults in China. Data was obtained from the China Comprehensive Geriatric Assessment Study (CCGAS). The sample comprised 6864 people aged 60 years and above from seven provinces in China. A door-to-door survey was conducted by formally trained interviewers using a unified questionnaire. Disability was assessed with physical health assessment comprising activities of daily living (ADL), and independent activities of daily living (IADL). For the purpose of this study, we analyzed only disability and some socio-demographic dimensions. The rates were standardized based on China's Sixth National Census population distribution. The disability rate in older adults was 7.0%. The disability rate was significantly higher in women than men, significantly higher in rural areas than urban areas, and higher in northern China than southern China. Urban disability rates ranged from 5.7% to 1.2%. The differences were statistically significant, with Beijing having the highest and Shanghai the lowest disability rates. Disability increased with age. In China, the disability rate in older adults is 7.0%, and increases with age. The disability rate is significantly higher in women, rural area, and northern China. This is the first study to report the epidemiology of disability in older adults in China in recent years and indicates the need for further epidemiological data on disability in China to facilitate long-term care and care policy formulation. Copyright © 2017 Elsevier B.V. All rights reserved.

Modeling Disease Vector Occurrence when Detection Is Imperfect: Infestation of Amazonian Palm Trees by Triatomine Bugs at Three Spatial Scales

PubMed Central

Abad-Franch, Fernando; Ferraz, Gonçalo; Campos, Ciro; Palomeque, Francisco S.; Grijalva, Mario J.; Aguilar, H. Marcelo; Miles, Michael A.

2010-01-01

Background Failure to detect a disease agent or vector where it actually occurs constitutes a serious drawback in epidemiology. In the pervasive situation where no sampling technique is perfect, the explicit analytical treatment of detection failure becomes a key step in the estimation of epidemiological parameters. We illustrate this approach with a study of Attalea palm tree infestation by Rhodnius spp. (Triatominae), the most important vectors of Chagas disease (CD) in northern South America. Methodology/Principal Findings The probability of detecting triatomines in infested palms is estimated by repeatedly sampling each palm. This knowledge is used to derive an unbiased estimate of the biologically relevant probability of palm infestation. We combine maximum-likelihood analysis and information-theoretic model selection to test the relationships between environmental covariates and infestation of 298 Amazonian palm trees over three spatial scales: region within Amazonia, landscape, and individual palm. Palm infestation estimates are high (40–60%) across regions, and well above the observed infestation rate (24%). Detection probability is higher (∼0.55 on average) in the richest-soil region than elsewhere (∼0.08). Infestation estimates are similar in forest and rural areas, but lower in urban landscapes. Finally, individual palm covariates (accumulated organic matter and stem height) explain most of infestation rate variation. Conclusions/Significance Individual palm attributes appear as key drivers of infestation, suggesting that CD surveillance must incorporate local-scale knowledge and that peridomestic palm tree management might help lower transmission risk. Vector populations are probably denser in rich-soil sub-regions, where CD prevalence tends to be higher; this suggests a target for research on broad-scale risk mapping. Landscape-scale effects indicate that palm triatomine populations can endure deforestation in rural areas, but become rarer in heavily disturbed urban settings. Our methodological approach has wide application in infectious disease research; by improving eco-epidemiological parameter estimation, it can also significantly strengthen vector surveillance-control strategies. PMID:20209149

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.

Associations between macrolevel economic factors and weight distributions in low- and middle-income countries: a multilevel analysis of 200,000 adults in 40 countries.

PubMed

Nandi, Arijit; Sweet, Elizabeth; Kawachi, Ichiro; Heymann, Jody; Galea, Sandro

2014-02-01

We examined associations between macrolevel economic factors hypothesized to drive changes in distributions of weight and body mass index (BMI) in a representative sample of 200,796 men and women from 40 low- and middle-income countries. We used meta-regressions to describe ecological associations between macrolevel factors and mean BMIs across countries. Multilevel regression was used to assess the relation between macrolevel economic characteristics and individual odds of underweight and overweight relative to normal weight. In multilevel analyses adjusting for individual-level characteristics, a 1-standard-deviation increase in trade liberalization was associated with 13% (95% confidence interval [CI] = 0.76, 0.99), 17% (95% CI = 0.71, 0.96), 13% (95% CI = 0.76, 1.00), and 14% (95% CI = 0.75, 0.99) lower odds of underweight relative to normal weight among rural men, rural women, urban men, and urban women, respectively. Economic development was consistently associated with higher odds of overweight relative to normal weight. Among rural men, a 1-standard-deviation increase in foreign direct investment was associated with 17% (95% CI = 1.02, 1.35) higher odds of overweight relative to normal weight. Macrolevel economic factors may be implicated in global shifts in epidemiological patterns of weight.

Associations Between Macrolevel Economic Factors and Weight Distributions in Low- and Middle-Income Countries: A Multilevel Analysis of 200 000 Adults in 40 Countries

PubMed Central

Sweet, Elizabeth; Kawachi, Ichiro; Heymann, Jody; Galea, Sandro

2014-01-01

Objectives. We examined associations between macrolevel economic factors hypothesized to drive changes in distributions of weight and body mass index (BMI) in a representative sample of 200 796 men and women from 40 low- and middle-income countries. Methods. We used meta-regressions to describe ecological associations between macrolevel factors and mean BMIs across countries. Multilevel regression was used to assess the relation between macrolevel economic characteristics and individual odds of underweight and overweight relative to normal weight. Results. In multilevel analyses adjusting for individual-level characteristics, a 1–standard-deviation increase in trade liberalization was associated with 13% (95% confidence interval [CI] = 0.76, 0.99), 17% (95% CI = 0.71, 0.96), 13% (95% CI = 0.76, 1.00), and 14% (95% CI = 0.75, 0.99) lower odds of underweight relative to normal weight among rural men, rural women, urban men, and urban women, respectively. Economic development was consistently associated with higher odds of overweight relative to normal weight. Among rural men, a 1–standard-deviation increase in foreign direct investment was associated with 17% (95% CI = 1.02, 1.35) higher odds of overweight relative to normal weight. Conclusions. Macrolevel economic factors may be implicated in global shifts in epidemiological patterns of weight. PMID:24228649

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.

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.

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 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.

Association between prenatal exposure to traffic-related air pollution and preterm birth in the PELAGIE mother-child cohort, Brittany, France. Does the urban-rural context matter?

PubMed

Bertin, Mélanie; Chevrier, Cécile; Serrano, Tania; Monfort, Christine; Rouget, Florence; Cordier, Sylvaine; Viel, Jean-François

2015-10-01

Evidence has accumulated that exposure to ambient air pollution during pregnancy may influence preterm birth (PTB) in urban settings. Conversely, this relation has barely been investigated in rural areas where individual characteristics (demographic, socioeconomic, and psychosocial factors) and environmental co-exposures may differ. We examined the association between prenatal exposure to traffic-related air pollution and PTB among pregnant women from the PELAGIE mother-child cohort (Brittany, France, 2002-2006) living in urban (n=1550) and rural (n=959) settings. Women's residences were classified as either urban or rural according to the French census bureau rural-urban definitions. Nitrogen dioxide (NO2) concentrations at home addresses were estimated from adjusted land-use regression models as a marker of traffic-related pollution. Associations between NO2 concentrations and PTB were assessed with logistic regression models. Prevalence of PTB was similar among women living in urban (3.2%) and in rural (3.5%) settings. More positive socioeconomic characteristics and health behaviors but more single-parent families were observed among urban women. NO2 exposure averaged 20.8±6.6 µg m(-3) for women residing in urban areas and 18.8±5.6 µg m(-3) for their rural counterparts. A statistically significant increased risk of PTB was observed among women exposed to NO2 concentrations ≥16.4 µg m(-3) and residing in urban areas but not among their rural counterparts. The results of this study, conducted in a region with interspersed urban-rural areas, are in line with previous findings suggesting an increased risk of PTB associated with higher NO2 concentrations for women living in urban areas. The absence of association among their rural counterparts for whom exposure levels were similar suggests that environmental mixtures and psychosocial inequalities might play a role in this heterogeneity. Copyright © 2015 Elsevier Inc. 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.

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.

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.

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.

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.

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

Factors Associated with Excessive Body Fat in Men and Women: Cross-Sectional Data from Black South Africans Living in a Rural Community and an Urban Township

PubMed Central

Okop, Kufre Joseph; Levitt, Naomi; Puoane, Thandi

2015-01-01

Objective To determine the factors associated with excessive body fat among black African men and women living in rural and urban communities of South Africa. Methods This is a cross-sectional analysis of data from the Prospective Urban and Rural Epidemiology (PURE) study, Cape Town, South Africa conducted in 2009/2010. The study sample included 1220 participants (77.2% women) aged 35–70 years, for whom anthropometric measurements were obtained and risk factors documented through face-to-face interviews using validated international PURE study protocols. Sex-specific logistic regression models were used to evaluate socio-demographic, lifestyle and psychological factors associated with three excessive body fat indicators, namely body mass index (BMI), waist circumference (WC) and body fat percent (BF%). Results The prevalence of excessive body fat based on BF%, WC and BMI cut-offs were 96.0%, 86.1%, and 81.6% for women respectively, and 62.2%, 25.9%, and 36.0% for men respectively. The significant odds of excessive body fat among the currently married compared to unmarried were 4.1 (95% CI: 1.3–12.5) for BF% and 1.9 (95% CI: 1.3–2.9) for BMI among women; and 4.9 (95% CI: 2.6–9.6), 3.2 (95% CI: 1.6–6.4) and 3.6 (95% CI: 1.9–6.8) for BF%, WC and BMI respectively among men. Age ≤50 years (compared to age >50 years) was inversely associated with excessive BF% in men and women, and less-than-a-college education was inversely associated with excessive BMI and WC in men. Tobacco smoking was inversely associated with all three excessive adiposity indicators in women but not in men. Unemployment, depression, and stress did not predict excessive body fat in men or women. Conclusion The sex-differences in the socio-demographic and lifestyle factors associated with the high levels of excessive body fat in urban and rural women and men should be considered in packaging interventions to reduce obesity in these communities. PMID:26447880

Amyotrophic lateral sclerosis, rural environment and agricultural work in the Local Health District of Ferrara, Italy, in the years 1964-1998.

PubMed

Govoni, Vittorio; Granieri, Enrico; Fallica, Elisa; Casetta, Ilaria

2005-11-01

Previous epidemiological surveys, both analytic and descriptive, in the Local Health District (LHD) of Ferrara, northern Italy, have indicated that rural residence and agricultural work might constitute risk factors for Amyotrophic Lateral Sclerosis (ALS). The present investigation is a demographic survey in the LHD of Ferrara in the years 1964-1998 which aimed to verify whether the level of urbanization and agricultural activities might influence the risk of ALS. Based on the data obtained in a recent incidence study in the LHD of Ferrara which reported a mean annual crude incidence rate of ALS in the years 1964-1998 of 1.63 per 100,000 population (95 % CI 1.31-2.00), it was possible to compare the number of observed ALS cases and the number of expected ALS cases according to the level of urbanization and usual occupation on the basis of the residential and occupational pattern identified in the population of the LHD of Ferrara in the study period under the assumption of a homogeneous distribution of ALS. The present survey identified four different levels of urbanization in the LHD of Ferrara in the study period and for none of them was a difference between the number of observed and expected ALS cases found. Also in the most rural of the four identified levels of urbanization (small villages with an average population in the study period lower than 1,000 inhabitants and scattered houses in the countryside) no difference was found between observed and expected number of ALS cases (observed ALS cases 16, 95% Poisson CI 9.1-25.9, expected ALS cases 18.3). Based on the occupational pattern identified in the population of the LHD of Ferrara in the study period the number of incident cases of ALS whose usual occupation was in agricultural work exceeded the expected number (observed ALS cases 22, 95% Poisson CI 13.8-32.3, expected ALS cases 6.0). The present findings indicate that rural residence itself does not influence the risk of ALS while agricultural activities could influence the risk of ALS, with occupational exposure to agricultural chemicals playing a possible role.

Prevalence of primary open-angle glaucoma in an urban south Indian population and comparison with a rural population. The Chennai Glaucoma Study.

PubMed

Vijaya, Lingam; George, Ronnie; Baskaran, M; Arvind, Hemamalini; Raju, Prema; Ramesh, S Ve; Kumaramanickavel, Govindasamy; McCarty, Catherine

2008-04-01

To estimate the prevalence and risk factors of primary open-angle glaucoma (POAG) in an urban population and compare the same with that of our published rural population data in southern India. Population-based cross-sectional study. Four thousand eight hundred subjects 40 years or older were selected using a multistage random cluster sampling procedure in Chennai city. Three thousand eight hundred fifty (80.2%) subjects underwent a complete ophthalmic examination, including applanation tonometry, gonioscopy, pachymetry, optic disc photography, and automated perimetry. Glaucoma was diagnosed using the International Society of Geographical and Epidemiological Ophthalmology Classification. The distribution of intraocular pressure (IOP) and vertical cup-to-disc ratio (VCDR) was obtained from the right eye of the 2532 subjects with normal suprathreshold visual fields. Mean IOP was 16.17+/-3.74 mmHg (97.5th and 99.5th percentiles, 24 mmHg and 30 mmHg). The mean VCDR was 0.43+/-0.17 (97.5th and 99.5th percentiles, 0.7 and 0.8). One hundred thirty-five (64 men, 71 women) subjects had POAG (3.51%; 95% confidence interval [CI], 3.04-4.0). Primary open-angle glaucoma subjects (58.4+/-11.3 years) were older (P<0.0001) than the study population (54.8+/-10.6 years). One hundred twenty-seven (94%) subjects were diagnosed to have POAG for the first time. Two subjects (1.5%) were bilaterally blind, and 3 (3.3%) were unilaterally blind due to POAG. The urban population prevalence was more than that of the rural population (1.62%; 95% CI, 1.4%-1.8%; P<0.0001). In both populations, increasing IOP (per millimeter of mercury) and older age were associated with the disease. There was no association with gender, myopia, systemic hypertension, diabetes, or central corneal thickness. The prevalence of POAG in a > or =40-year-old south Indian urban population was 3.51%, higher than that of the rural population. The prevalence increased with age, and >90% were not aware of the disease.

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.

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.

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

The CCRUSH study: Characterization of coarse and fine particulate matter in northeastern Colorado

NASA Astrophysics Data System (ADS)

Clements, Nicholas Steven

Particulate matter in the troposphere adversely impacts human health when inhaled and alters climate through cloud formation processes and by absorbing/scattering light. Particles smaller than 2.5 mum in diameter (fine particulate matter; PM2.5), are typically emitted from combustion-related sources and can form and grow through secondary processing in the atmosphere. Coarse particles (PM10-2.5), ranging 2.5 to 10 mum, are typically generated through abrasive processes, such as erosion of road surfaces, entrained via resuspension, and settle quickly out of the atmosphere due to their large size. After deciding against regulating PM10-2.5 in 2006 citing, among other reasons, mixed results from epidemiological studies of the pollutant and lack of knowledge on health impacts in rural areas, the United States Environmental Protection Agency (US EPA) funded a series of studies that investigated the ambient composition, toxicology, and epidemiology of PM10-2.5. One such study, The Colorado Coarse Rural-Urban Sources and Health (CCRUSH) study, aimed to characterize the composition, sources, and health effects of PM10-2.5 in semi-arid northeastern Colorado and consisted of two field campaigns and an epidemiological study. Summarized here are the results from the two field campaigns, the first of which included over three years of continuous PM10-2.5 and PM2.5 mass concentration monitoring at multiple sites in urban-Denver and rural-Greeley, Colorado. This data set was used to characterize the spatiotemporal variability of PM10-2.5 and PM2.5. During the second year of continuous monitoring, PM 10-2.5 and PM2.5 filter samples were collected for compositional analyses that included: elemental composition, bulk elemental and organic carbon concentrations, water-soluble organic carbon concentrations, UV-vis absorbance, fluorescence spectroscopy, and endotoxin content. Elemental composition was used to understand enrichment of trace elements in atmospheric particles and to identify sources via positive matrix factorization (PMF). The organic fraction of both particulate size ranges was explored with a variety of bulk characterization techniques commonly utilized in analysis of soil and aquatic natural organic matter. To date, the CCRUSH study is one of the largest research efforts devoted to understanding PM10-2.5 and provides the US EPA with vital information that will be used in future policy making decisions regarding the regulation of this pollutant.

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.

[Research on prevalence and related factors in allergic rhinitis].

PubMed

Wang, Ze-hai; Lin, Wen-sen; Li, Shu-yan; Zhao, Shao-cheng; Wang, Li; Yang, Zhong-gang; Chen, Jie; Zhang, Zhen-fu; Yu, Jin-zhen

2011-03-01

To obtain the prevalence and related factors in allergic rhinitis (AR) and other allergic diseases in rural area in China through epidemiological investigation with large sample and multi-faceted survey data. Face to face survey was conducted in different regions (rural areas of Cangzhou, Hebei, coastal fishing village of Bohai Bay, area of Wuling Mountain, Chengde, urban areas of Tianjin) from April 2007 to May 2009. In the same time, serum specific IgE (sIgE) was detected in the digits of every 0, 1or 5 in them. SPSS 13.0 software was used to analyze the data. Five thousand and ten cases were investigated. There were 823 cases with the symptoms or signs of AR (16.4%). Four hundred and two cases were found to have positive serum sIgE antibody in 1576 detected cases (25.5%). One hundred and fourty-six cases with nasal allergic symptoms or signs were diagnosed as AR. The incidence of AR was 9.3% (146/1576). The occurrence of allergic symptoms or signs had a significant statistical difference with factors such as age, occupation, atopic constitution (χ(2) value were 7.96, 9.73, 16.53, 8.95 respectively, all P < 0.05), and it was closely related to lower respiratory tract allergies (β = 2.544, P < 0.01). The most common allergens were dog and cat epithelium in rural areas and dust mites in city. The incidence of AR is higher whether in urban or rural areas, it should be taken seriously as the impact on human health. The occurrence is closely related to physical characteristics and environmental factors.

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…

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.

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.

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.

Seroepidemiology of leptospirosis in dogs from rural and slum communities of Los Rios Region, Chile.

PubMed

Lelu, Maud; Muñoz-Zanzi, Claudia; Higgins, Brooke; Galloway, Renee

2015-02-12

Leptospirosis is a zoonotic disease of global importance and often neglected as a public health problem due to lack of awareness, under-diagnosis and under-reporting. Animals serve as a source of transmission through the shedding of Leptospira in their urine. Because of their proximity to humans, dogs may play a role in human infections. In order to assess and mitigate leptospirosis in dogs and the risk of transmission to humans it is important to understand the epidemiology of leptospirosis under natural conditions. This study aimed to characterize leptospirosis in owned dogs from three distinct community types. Blood, dog and household data were collected from 265 dogs in 190 households from 12 communities representing farms, rural villages, and urban slums in the Los Rios region, Chile. Serologic profiles with a 20-serovar microagglutination test panel were obtained. Binomial and multinomial logistic regression models were used to evaluate the associations between spatial, ecological, socio-economic variables and overall seropositivity as well as seropositivity to serogroup Canicola. Results from 247 dogs with no history of vaccination were used. Overall seroprevalence was 25.1% (62/247) with significant differences by community type: 10.9% (9/82) in dogs from farms, 22.3% (21/94) from rural villages, and 45.1% (32/71) from urban slums (p <0.001). This trend by community type was also observed for dogs with evidence of seropositivity to the Canicola serogroup. Factors associated with seropositive dogs included dog density and precipitation two-weeks prior to sampling. Presence of Leptospira positive puddles collected from the peri-domestic household environment was also associated with increased seropositivity. Results suggest that leptospirosis is actively maintained in the dog population in this study region with notably distinct patterns by community type. Dog populations from rural villages, and urban slums in particular, showed evidence of high levels of transmission probably as a result of the combined effects of dog living conditions as well as community-level ecological and environmental factors.

Access to Health Services Among Slum Dwellers in an Industrial Township and Surrounding Rural Areas: A Rapid Epidemiological Assessment

PubMed Central

Banerjee, Amitav; Bhawalkar, J.S.; Jadhav, S.L.; Rathod, Hetal; Khedkar, D.T.

2012-01-01

Context: The biggest challenge in implementing the primary health care principles is of equitable distribution of health care to all. The rural masses and urban slum dwellers are most vulnerable to lack of access to health care. Aim: To study access to health services among slum dwellers and rural population. Setting and Design: A cross-sectional survey in an urban slum and surrounding rural areas in field practice area of a medical college. Materials and Methods: Structured instrument along with qualitative techniques such as focus group discussions, were used to collect information on access and utilization of health services from 865 individuals of both sexes and all ages selected from urban slums, villages, and indoor and outdoor patients. Access to basic determinants of good health such as housing, water, and sanitation was also elicited. Besides, health needs based on self-reported disease conditions were compiled. Results: More than 50% of respondents were living in poor housing and insanitary conditions. Besides the burden of communicable diseases and malnutrition (especially in children), risk of lifestyle diseases as evidenced by high Body mass index in 25% of adults surveyed was found. Private medical practitioners were more accessible than government facilities. More than 60% sought treatment from private medical facilities for their own ailments (for sickness in children this proportion was 74%). People who visited government facilities were more dissatisfied with the services (30.88%) than those who visited private facilities (18.31%). This difference was significant (OR=1.99, 95% confidence interval 1.40 to 2.88; χ2 =15.95, df=1, P=0.007). The main barriers to health care identified were waiting time long, affordability, poor quality of care, distance, and attitude of health workers. Conclusion: The underprivileged in India continue to have poor access to basic determinants of good health as well as to curative services from government sources during illness. PMID:24478995

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.

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.

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.

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.

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...

The panorama of animal leptospirosis in Rio de Janeiro, Brazil, regarding the seroepidemiology of the infection in tropical regions.

PubMed

Martins, Gabriel; Lilenbaum, Walter

2013-12-01

Leptospirosis is an important disease caused by various serovars of Leptospira sp. It can affect humans as well as domestic and wild animals; therefore, it has importance for public health, animal production, and wild species. The aim of this paper is to discuss the epidemiology of animal leptospirosis in Rio de Janeiro, Brazil, as a possible model for other tropical regions. In several studies conducted in the last 20 years, a total of 47 rats, 120 dogs, 875 cows, 695 horses, 1,343 goats, 308 sheep and 351 pigs from all regions of the state, in addition to 107 wild mammals and 73 golden-lion tamarins were tested (MAT) for anti-Leptospira antibodies. Seroreactivity was frequent in all studied species, confirming that the infection is endemic in Rio de Janeiro. Serogroups Icterohaemorrhagiae and Sejroe were the most prevalent in urban and rural scenarios, respectively. This paper reviews the current knowledge on animal leptospirosis in Rio de Janeiro and describes important differences between urban versus rural cycles of the infection in various species. Identification of the prevailing serogroups and their reservoirs is essential for understanding agent-host-environment interactions under tropical conditions.

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.

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.

Trends of T. cruzi infection based on data from blood bank screening.

PubMed

Zicker, F; Martelli, C M; de Andrade, A L; Almeida e Silva, S

1990-01-01

Between October 1988 and April 1989 a cross-sectional survey was carried out in six out of eight blood banks of Goiánia, Central Brazil. Subjects attending for first-time blood donation in the mornings of the study period (n = 1358) were interviewed and screened for T. cruzi infection as a part of a major study among blood donors. Tests to anti-T. cruzi antibodies were performed, simultaneously, by indirect hemagglutination test (IHA) and complement fixation test (CFT). A subject was considered seropositive when any one of the two tests showed a positive result. Information on age, sex, place of birth, migration and socio-economic level was recorded. Results from this survey were compared with seroprevalence rates obtained in previous studies in an attempt to analyse trend of T. cruzi infection in an endemic urban area. The overall seroprevalence of T. cruzi infection among first-time donors was found to be 3.5% (95% confidence interval 2.5%-4.5%). The seroprevalence rate increased with age up to 45 years and then decreased. Migrants from rural areas had higher seroprevalence rates than subjects from urban counties (1.8%-16.2% vs. 0%-3.6%). A four fold decrease in prevalence rates was observed when these rates were compared with those of fifteen years ago. Two possible hypotheses to explain this difference were suggested: 1. a cohort effect related with the decrease of transmission in rural areas and/or 2. a differential proportion of people of rural origin among blood donors between the two periods. The potential usefulness of blood banks as a source of epidemiological information to monitor trends of T. cruzi infection in an urban adult population was stressed.

Comparison of UTCI with Other Thermal Indices in the Assessment of Heat and Cold Effects on Cardiovascular Mortality in the Czech Republic

PubMed Central

Urban, Aleš; Kyselý, Jan

2014-01-01

We compare the recently developed Universal Thermal Climate Index (UTCI) with other thermal indices in analysing heat- and cold-related effects on cardiovascular (CVD) mortality in two different (urban and rural) regions in the Czech Republic during the 16-year period from 1994–2009. Excess mortality is represented by the number of deaths above expected daily values, the latter being adjusted for long-term changes, annual and weekly cycles, and epidemics of influenza/acute respiratory infections. Air temperature, UTCI, Apparent Temperature (AT) and Physiologically Equivalent Temperature (PET) are applied to identify days with heat and cold stress. We found similar heat effects on CVD mortality for air temperature and the examined thermal indices. Responses of CVD mortality to cold effects as characterised by different indices were much more varied. Particularly important is the finding that air temperature provides a weak cold effect in comparison with the thermal indices in both regions, so its application—still widespread in epidemiological studies—may underestimate the magnitude of cold-related mortality. These findings are important when possible climate change effects on heat- and cold-related mortality are estimated. AT and PET appear to be more universal predictors of heat- and cold- related mortality than UTCI when both urban and rural environments are of concern. UTCI tends to select windy rather than freezing days in winter, though these show little effect on mortality in the urban population. By contrast, significant cold-related mortality in the rural region if UTCI is used shows potential for UTCI to become a useful tool in cold exposure assessments. PMID:24413706

Rheumatoid arthritis in an urban South African Negro population.

PubMed Central

Solomon, L; Robin, G; Valkenburg, H A

1975-01-01

(1) An epidemiological study of an urban South African Negro community has been carried out in Johannesburg. Altogether 964 respondents were examined and in each case radiographs of the hands and feet were obtained. Rheumatoid factor tests were carried out on 404 serum samples. (2) Rheumatoid arthritis (RA) was graded 'definite' or 'probable' on the basis of a modification of the Rome criteria (Kellgren, Jeffrey, and Ball, 1963a). (3) In marked contrast to the findings in rural Africans the prevalence of RA in this community was similar to that in Caucasian populations. Five respondents (all elderly women) had 'definite' RA, giving a prevalence of 1.4% of the females and 0.9% of the total population sample over 15 years old. The prevalence of 'definite' and 'probable' RA combined was 2.6% for males, 3.7% for females, and 3.3% for all individuals over 15 years old. Prevalence increased with age, reaching a maximum in the 65- to 74-year cohort. (4) The form and severity of the clinical and radiological features were unlike the mild manifestations seen in rural African peoples and closely resembled the usual clinical picture of rheumatoid disease. (5) The latex fixation test was positive in 12.1% of the sera tested, which is similar to the high titres found in other African populations. No obvious cause for this phenomenon was found. (6) Several reasons for the marked difference in prevalence of RA between this urban African population and a rural African population are considered. Marked intraracial differences such as this point to the importance of sociological and environmental factors in the pathogenesis of rheumatoid arthritis. PMID:1137439

Assessment of Dietary Sodium and Potassium in Canadians Using 24-Hour Urinary Collection.

PubMed

Mente, Andrew; Dagenais, Gilles; Wielgosz, Andreas; Lear, Scott A; McQueen, Matthew J; Zeidler, Johannes; Fu, Lily; DeJesus, Jane; Rangarajan, Sumathy; Bourlaud, Anne-Sophie; De Bluts, Anne Leblanc; Corber, Erica; de Jong, Veronica; Boomgaardt, Jacob; Shane, Alexandra; Jiang, Ying; de Groh, Margaret; O'Donnell, Martin J; Yusuf, Salim; Teo, Koon

2016-03-01

Although salt intake derived from data on urinary sodium excretion in free-living populations has been used in public policy, a population study on urinary sodium excretion has not been done in Canada. We assessed dietary sodium and potassium intake using a 24-hour urine collection in a large survey of urban and rural communities from 4 Canadian cities and determined the association of these electrolytes with blood pressure (BP). One thousand seven hundred consecutive individuals, aged 37-72 years, attending their annual follow-up visits of the ongoing Prospective and Urban Rural Epidemiology (PURE) study in Vancouver, Hamilton, Ottawa, and Quebec City, Canada, collected a 24-hour urine sample using standardized procedures. Mean sodium excretion was 3325 mg/d and mean potassium excretion was 2935 mg/d. Sodium excretion ranged from 3093 mg/d in Vancouver to 3642 mg/d in Quebec City, after adjusting for covariates. Potassium excretion ranged from 2844 mg/d in Ottawa to 3082 mg/d in Quebec City. Both electrolytes were higher in men than in women and in rural populations than in urban settings (P < 0.001 for all). Sodium excretion was between 3000 and 6000 mg/d in 48.3% of the participants, < 3000 mg/d in 46.7%, and > 6000 mg/d in only 5%. No significant association between sodium or potassium excretion and BP was found. Sodium consumption in these Canadians is within a range comparable to other Western countries, and intake in most individuals is < 6000 mg/d, with only 5% at higher levels. Within this range, sodium or potassium levels were not associated with BP. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

[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.

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

Accuracy of two geocoding methods for geographic information system-based exposure assessment in epidemiological studies.

PubMed

Faure, Elodie; Danjou, Aurélie M N; Clavel-Chapelon, Françoise; Boutron-Ruault, Marie-Christine; Dossus, Laure; Fervers, Béatrice

2017-02-24

Environmental exposure assessment based on Geographic Information Systems (GIS) and study participants' residential proximity to environmental exposure sources relies on the positional accuracy of subjects' residences to avoid misclassification bias. Our study compared the positional accuracy of two automatic geocoding methods to a manual reference method. We geocoded 4,247 address records representing the residential history (1990-2008) of 1,685 women from the French national E3N cohort living in the Rhône-Alpes region. We compared two automatic geocoding methods, a free-online geocoding service (method A) and an in-house geocoder (method B), to a reference layer created by manually relocating addresses from method A (method R). For each automatic geocoding method, positional accuracy levels were compared according to the urban/rural status of addresses and time-periods (1990-2000, 2001-2008), using Chi Square tests. Kappa statistics were performed to assess agreement of positional accuracy of both methods A and B with the reference method, overall, by time-periods and by urban/rural status of addresses. Respectively 81.4% and 84.4% of addresses were geocoded to the exact address (65.1% and 61.4%) or to the street segment (16.3% and 23.0%) with methods A and B. In the reference layer, geocoding accuracy was higher in urban areas compared to rural areas (74.4% vs. 10.5% addresses geocoded to the address or interpolated address level, p < 0.0001); no difference was observed according to the period of residence. Compared to the reference method, median positional errors were 0.0 m (IQR = 0.0-37.2 m) and 26.5 m (8.0-134.8 m), with positional errors <100 m for 82.5% and 71.3% of addresses, for method A and method B respectively. Positional agreement of method A and method B with method R was 'substantial' for both methods, with kappa coefficients of 0.60 and 0.61 for methods A and B, respectively. Our study demonstrates the feasibility of geocoding residential addresses in epidemiological studies not initially recorded for environmental exposure assessment, for both recent addresses and residence locations more than 20 years ago. Accuracy of the two automatic geocoding methods was comparable. The in-house method (B) allowed a better control of the geocoding process and was less time consuming.

Prevalence of head lice and hygiene practices among women over twelve years of age in Sindh, Balochistan, and North West Frontier Province: National Health Survey of Pakistan, 1990-1994.

PubMed

Mahmud, Sadia; Pappas, Gregory; Hadden, Wilbur C

2011-02-02

Head lice infestation is an infection of the scalp and skin which causes blood loss, discomfort, and social and psychological distress with the possibility of secondary bacterial infections occurring at scratch sites. In Pakistan, although some small scale studies have been conducted to investigate prevalence of head lice in school children and the general population, no population based estimates have been reported. The National Health Survey of Pakistan (NHSP 1990 - 94) was a nationally representative health examination survey of the Pakistani population. The NHSP is the first population based household survey to collect data on the prevalence of head lice in adult women in Pakistan. In this paper we use data from the NHSP to present an epidemiological profile of personal hygiene practices and head lice infestation among women aged 12 years or older in three provinces of Pakistan; Balochistan, Sindh and North West Frontier Province (NWFP). Overall about 7% women aged 12 years and older suffered from head lice infestation. Multivariable logistic regression analysis identified factors independently associated with presence of head lice. Age less than 16 years and crowding at home were associated with higher infestation-rates. The impact of household socio-economic status on infestation rates among women was different in urban and rural settings; urban women with low socio-economic status were more vulnerable than similar women in rural settings. Bathing infrequently in summer was associated with higher prevalence rates only in Sindh, possibly due to the fact that among the three provinces Sindh has a hotter and more humid summer. The results of our analysis of NHSP indicate high levels of head lice infestation among girls and women in the three Provinces. The epidemiological profile of hygienic practices of women indicated that NWFP and Balochistan as compared to Sindh, and rural as compared to urban areas were less developed with respect to access to water supply and soap for maintaining personal hygiene. Simple and cost-effective measures such as provision of water and soap, and improving awareness regarding maintaining personal hygiene can contribute significantly towards improving public health status of the women in Pakistan.

Prevalence of head lice and hygiene practices among women over twelve years of age in Sindh, Balochistan, and North West Frontier Province: National Health Survey of Pakistan, 1990-1994

PubMed Central

2011-01-01

Background Head lice infestation is an infection of the scalp and skin which causes blood loss, discomfort, and social and psychological distress with the possibility of secondary bacterial infections occurring at scratch sites. In Pakistan, although some small scale studies have been conducted to investigate prevalence of head lice in school children and the general population, no population based estimates have been reported. The National Health Survey of Pakistan (NHSP 1990 - 94) was a nationally representative health examination survey of the Pakistani population. The NHSP is the first population based household survey to collect data on the prevalence of head lice in adult women in Pakistan. In this paper we use data from the NHSP to present an epidemiological profile of personal hygiene practices and head lice infestation among women aged 12 years or older in three provinces of Pakistan; Balochistan, Sindh and North West Frontier Province (NWFP). Results Overall about 7% women aged 12 years and older suffered from head lice infestation. Multivariable logistic regression analysis identified factors independently associated with presence of head lice. Age less than 16 years and crowding at home were associated with higher infestation-rates. The impact of household socio-economic status on infestation rates among women was different in urban and rural settings; urban women with low socio-economic status were more vulnerable than similar women in rural settings. Bathing infrequently in summer was associated with higher prevalence rates only in Sindh, possibly due to the fact that among the three provinces Sindh has a hotter and more humid summer. Conclusions The results of our analysis of NHSP indicate high levels of head lice infestation among girls and women in the three Provinces. The epidemiological profile of hygienic practices of women indicated that NWFP and Balochistan as compared to Sindh, and rural as compared to urban areas were less developed with respect to access to water supply and soap for maintaining personal hygiene. Simple and cost-effective measures such as provision of water and soap, and improving awareness regarding maintaining personal hygiene can contribute significantly towards improving public health status of the women in Pakistan. PMID:21288357

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…

Down and Out in Rural America: The Status of Blacks and Hispanics in the 1980s.

ERIC Educational Resources Information Center

Lyson, Thomas A.

Blacks and Hispanics in rural America face opportunities and life circumstances distinctively different from their urban counterparts. Not only are rural conditions generally worse than urban areas in job opportunity, social services, and human capital, but the problem of inequity is also more severe within rural areas than within urban areas.…

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.

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.

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

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.

Homeless Children: Addressing the Challenge in Rural Schools. ERIC Digest.

ERIC Educational Resources Information Center

Vissing, Yvonne M.

Despite stereotypes to the contrary, homelessness is as prevalent in rural as urban areas. This digest examines the implications of homelessness for rural children and youth and discusses possible actions by rural educators. An estimated half of the rural homeless are families with children. Compared to urban counterparts, rural homeless families…

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...

Epidemiological and clinical perspectives on irritable bowel syndrome in India, Bangladesh and Malaysia: A review.

PubMed

Rahman, M Masudur; Mahadeva, Sanjiv; Ghoshal, Uday C

2017-10-07

Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder, common in clinic and in the community. It has a significant impact on both society and patients' quality of life. The epidemiology, clinical presentation, and management of IBS may vary in different geographical regions due to differences in diet, gastrointestinal infection, socio-cultural and psycho-social factors, religious and illness beliefs, symptom perception and reporting. Although previous reviews and consensus reports on IBS in Asia have been published, Asia is quite diverse socio-demographically. In this context, India, Bangladesh and Malaysia share some similarities, including: (1) large proportion of the population living in rural areas; (2) rapid development and associated lifestyle changes in urban areas; and (3) dietary, cultural and religious practices. The present review explores the clinical and epidemiological data on IBS from these three major nations in South and South-East Asia. In-depth review of the literature revealed important differences between IBS in the East, as revealed by studies from these three countries, and the West; these include a predominantly rural profile, differences in bowel habit and symptom profile, raising concern with regards to diagnostic criteria and subtyping of IBS, higher dietary fiber consumption, frequent lactose malabsorption, parasitosis, and possible overlap between post-infectious IBS and tropical sprue. Moreover, the current perception on difference in prevalence of the disorder in these countries, as compared to the West, might be related to variation in survey methods.

Epidemiological and clinical perspectives on irritable bowel syndrome in India, Bangladesh and Malaysia: A review

PubMed Central

Rahman, M Masudur; Mahadeva, Sanjiv; Ghoshal, Uday C

2017-01-01

Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder, common in clinic and in the community. It has a significant impact on both society and patients’ quality of life. The epidemiology, clinical presentation, and management of IBS may vary in different geographical regions due to differences in diet, gastrointestinal infection, socio-cultural and psycho-social factors, religious and illness beliefs, symptom perception and reporting. Although previous reviews and consensus reports on IBS in Asia have been published, Asia is quite diverse socio-demographically. In this context, India, Bangladesh and Malaysia share some similarities, including: (1) large proportion of the population living in rural areas; (2) rapid development and associated lifestyle changes in urban areas; and (3) dietary, cultural and religious practices. The present review explores the clinical and epidemiological data on IBS from these three major nations in South and South-East Asia. In-depth review of the literature revealed important differences between IBS in the East, as revealed by studies from these three countries, and the West; these include a predominantly rural profile, differences in bowel habit and symptom profile, raising concern with regards to diagnostic criteria and subtyping of IBS, higher dietary fiber consumption, frequent lactose malabsorption, parasitosis, and possible overlap between post-infectious IBS and tropical sprue. Moreover, the current perception on difference in prevalence of the disorder in these countries, as compared to the West, might be related to variation in survey methods. PMID:29085223

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.

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.

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

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.

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.

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

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

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.

Perceptions of participation in an observational epidemiologic study of cancer among African Americans.

PubMed

Gooden, Kyna M; Carter-Edwards, Lori; Hoyo, Cathrine; Akbar, Jabar; Cleveland, Rebecca J; Oates, Veronica; Jackson, Ethel; Furberg, Helena; Gammon, Marilie D

2005-01-01

Recruitment and retention of African Americans in cancer research studies has become increasingly important. However, little is known about factors bearing on recruitment and retention in etiologic observational studies of cancer. We assessed perceptions and attitudes of African Americans towards participation in an observational epidemiologic study of cancer, and attitudes toward the data collection process. Five focus groups, each lasting approximately 2 hours, were conducted. Participants were comprised of men and women between 41-65 years of age. A total of 35 adults from three rural and two urban counties in North Carolina participated. Data were analyzed using NVivo software. Four key themes emerged on the perception of participation and retention in an epidemiologic study of cancer: (1) fear of cancer prognosis; (2) conflicts between mistrust and trust in researchers; (3) comprehension of prospective study purpose, structure, and participation strategies; and (4) the necessity for and obligation to provide feedback. Results indicate that African Americans would be willing to participate in epidemiologic studies to identify etiologic risk factors for cancer. However, culturally appropriate efforts to thoroughly inform them of study process and progress are deemed essential for successful recruitment and retention.

Phylogeography of Recently Emerged DENV-2 in Southern Viet Nam

PubMed Central

Rabaa, Maia A.; Ty Hang, Vu Thi; Wills, Bridget; Farrar, Jeremy; Simmons, Cameron P.; Holmes, Edward C.

2010-01-01

Revealing the dispersal of dengue viruses (DENV) in time and space is central to understanding their epidemiology. However, the processes that shape DENV transmission patterns at the scale of local populations are not well understood, particularly the impact of such factors as human population movement and urbanization. Herein, we investigated trends in the spatial dynamics of DENV-2 transmission in the highly endemic setting of southern Viet Nam. Through a phylogeographic analysis of 168 full-length DENV-2 genome sequences obtained from hospitalized dengue cases from 10 provinces in southern Viet Nam, we reveal substantial genetic diversity in both urban and rural areas, with multiple lineages identified in individual provinces within a single season, and indicative of frequent viral migration among communities. Focusing on the recently introduced Asian I genotype, we observed particularly high rates of viral exchange between adjacent geographic areas, and between Ho Chi Minh City, the primary urban center of this region, and populations across southern Viet Nam. Within Ho Chi Minh City, patterns of DENV movement appear consistent with a gravity model of virus dispersal, with viruses traveling across a gradient of population density. Overall, our analysis suggests that Ho Chi Minh City may act as a source population for the dispersal of DENV across southern Viet Nam, and provides further evidence that urban areas of Southeast Asia play a primary role in DENV transmission. However, these data also indicate that more rural areas are also capable of maintaining virus populations and hence fueling DENV evolution over multiple seasons. PMID:20668540

[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)

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).

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

The spatial epidemiology of cocaine, methamphetamine and 3,4-methylenedioxymethamphetamine (MDMA) use: a demonstration using a population measure of community drug load derived from municipal wastewater.

PubMed

Banta-Green, Caleb J; Field, Jennifer A; Chiaia, Aurea C; Sudakin, Daniel L; Power, Laura; de Montigny, Luc

2009-11-01

To determine the utility of community-wide drug testing with wastewater samples as a population measure of community drug use and to test the hypothesis that the association with urbanicity would vary for three different stimulant drugs of abuse. Single-day samples were obtained from a convenience sample of 96 municipalities representing 65% of the population of the State of Oregon. Chemical analysis of 24-hour composite influent samples for benzoylecgonine (BZE, a cocaine metabolite), methamphetamine and 3,4-methylenedioxymethamphetamine (MDMA). The distribution of community index drug loads accounting for total wastewater flow (i.e. dilution) and population are reported. The distribution of wastewater-derived drug index loads was found to correspond with expected epidemiological drug patterns. Index loads of BZE were significantly higher in urban areas and below detection in many rural areas. Conversely, methamphetamine was present in all municipalities, with no significant differences in index loads by urbanicity. MDMA was at quantifiable levels in fewer than half the communities, with a significant trend towards higher index loads in more urban areas. CONCLUSION; This demonstration provides the first evidence of the utility of wastewater-derived community drug loads for spatial analyses. Such data have the potential to improve dramatically the measurement of the true level and distribution of a range of drugs. Drug index load data provide information for all people in a community and are potentially applicable to a much larger proportion of the total population than existing measures.

[Mental health in physicians doing the rural and suburban health service in Peru: a baseline study].

PubMed

Galán-Rodas, Edén; Gálvez-Buccollini, Juan Antonio; Vega-Galdós, Favio; Osada, Jorge; Guerrero-Padilla, Daisy; Vega-Dienstmaier, Johann; Talledo, Lety; Catacora, Manuel; Fiestas, Fabián

2011-06-01

The disadvantageous conditions in which young physicians have to do their rural and sub-urban health service (SERUMS) may put them in a high risk for mental disorders. This study aims to establish the baseline levels of depression and alcohol use problems among those physicians scheduled to complete their SERUMS during the period 2011-2012. The Center for Epidemiologic Studies Depression Scale (CES-D) and the Alcohol Use Disorders Identification Test (AUDIT) were administered as screening tests to 493 physicians. Depression scores were met by 26% females and 14.5% males, and alcohol use problem scores were met by 22% females and 26% males. Overall, 39% persons scored for either of both mental health entities. Mental health problems seem to be common among young physicians scheduled to migrate to their SERUMS. These problems must be addressed to avoid greater risks.

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.

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.

[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.

Cystic echinococcosis in children - the seventeen-year experience of two large medical centers in Serbia.

PubMed

Djuricic, Slavisa M; Grebeldinger, Slobodan; Kafka, Dejan I; Djan, Igor; Vukadin, Miroslav; Vasiljevic, Zorica V

2010-06-01

Cystic echinococcosis (CE) is a public health problem in countries having such endemic areas. Epidemiological studies of CE, especially pediatric, are rare. The aim of this study was to evaluate epidemiological and clinical characteristics of CE in children in Serbia. Data were obtained retrospectively from the case records of patients under the age of 18 years admitted for surgical treatment of CE at two large pediatric medical institutions in the period 1990-2006. Patients' age, number of cysts and their anatomic location were evaluated in relation to differences by patients' gender and socio-geographic status (urban or rural origin). The study included 149 children with 272 hydatid cysts. The mean age of patients was 10.1+/-3.8 years. There were no significant differences in the number of patients in relation to gender and urban:rural origin. There were no significant differences in patients' age at the time of surgery or the number of cysts per patient when patients' gender or socio-geographic status was evaluated. The anatomic location of cysts was as follows: liver (N=165; 60.7%), lungs (N=82; 30.1%), and other locations (N=25; 9.2%). Multiple cysts, and combined liver/lung involvement were identified in 34.2% (N=51), and 6.0% (N=9) of patients, respectively. Hepatic cysts were significantly more common in girls than in boys. There were no significant differences in anatomic location of cysts between socio-geographic groups. The large number of infected children during a long period of investigation indicates an active transmission of disease and a lack of program for control and prevention of CE in Serbia.

Scarlet fever in Poland in 2014

PubMed

Staszewska-Jakubik, Ewa; Czarkowski, Mirosław P; Kondej, Barbara

Assessment of the epidemiological situation of scarlet fever in Poland in 2014. The evaluation was performed by reviewing surveillance data published in the bulletin “Infectious diseases and poisonings in Poland in 2014” as well as in previous bulletins, and unpublished data collected under Statistical survey program of official statistics. These data relate to cases of scarlet fever registered by health sanitary inspection on the basis of statutory notification of scarlet fever reported by physicians. In 2014, annual, incidence rate of scarlet fever in Poland was about 9% lower in comparison to previous year. There were 22 855 cases all over the country and the incidence was 59.5 per 100,000 population; depending on the voivodeship ranged from 19.5 in podkarpackie to 93.2 in pomorskie. The highest incidence was noted among 4-year-old children (981.4) and 5-year-old children (971.0). However the incidence among children and young people up to 15 years accounted for 95.7% of all cases. The incidence among men (67.2) was higher by 28.5% than incidence among women (52.3). Incidence rate in urban areas, in any size town, was higher than in rural areas. Overall incidence in urban areas was 66.4; in rural areas - 49.0. 1,11% of patients were hospitalized. There were no reported deaths related to scarlet fever. In the surveillance of scarlet fever it is necessary to ensure that the collected data will be valid and reliable. Very low specificity of this surveillance may not only impinge on the assessment of epidemiological situation of this disease in Poland but also overshadow the situation of other diseases, including diseases under elimination program (rubella, measles). This is one of the greatest challenges facing sanitary inspection in the coming years.

Legume consumption and its association with fasting glucose, insulin resistance and type 2 diabetes in the Indian Migration Study.

PubMed

Dhillon, Preet K; Bowen, Liza; Kinra, Sanjay; Bharathi, Ankalmadugu Venkatsubbareddy; Agrawal, Sutapa; Prabhakaran, Dorairaj; Reddy, Kolli Srinath; Ebrahim, Shah

2016-11-01

Legume consumption is associated with lower fasting glucose (FG) and insulin levels in nutrition trials and lower CVD mortality in large-scale epidemiological studies. In India, legumes are widely consumed in various preparations, yet no epidemiological study has evaluated the association of legumes with FG levels, insulin resistance and diabetes risk. The present study aimed to fill this gap. Fasting blood samples, in-person interviews to obtain information on demographic/socio-economic factors, physical activity, alcohol and tobacco use, and anthropometric measurements were collected. Dietary intakes were assessed by an interviewer-administered, validated, semi-quantitative FFQ. Lucknow, Nagpur, Hyderabad and Bangalore, India. Men and women (n 6367) aged 15-76 years - urban residents, urban migrants and their rural siblings. In multivariate random-effects models adjusted for age, BMI, total energy intake, macronutrients, physical activity and rural/migration status, daily legume consumption was not associated with FG (P-for-trend=0·78), insulin resistance (homeostasis model assessment score; P-for-trend=0·73) or the prevalence of type 2 diabetes mellitus (P-for-trend=0·41). Stratified analyses by vegetarian diet and migration status did not change the findings. Inverse associations between legumes and FG emerged for participants with lower BMI and higher carbohydrate, protein, fat and sugar intakes. Although legumes are essential in traditional Indian diets, as well as in prudent and Mediterranean diets in the West, we did not find an association between legumes and markers of glycaemic control, insulin resistance or diabetes, except for subgroups based on BMI and macronutrient intake. The ubiquitous presence and complexity of legume preparations in Indian diets may contribute to these findings.

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.

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.

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.

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.

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.

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.

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.

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.

Prevalence of Nonalcoholic Fatty Liver Disease and Economy.

PubMed

Zhu, Jin-Zhou; Dai, Yi-Ning; Wang, Yu-Ming; Zhou, Qin-Yi; Yu, Chao-Hui; Li, You-Ming

2015-11-01

Nonalcoholic fatty liver disease (NAFLD) is a growing health issue around the world. This study is to investigate whether adult prevalence of NAFLD correlates with national economic status. Literature search on PubMed database was conducted to identify eligible records fully published before September 2014. Gross national income (GNI) per capita was chosen to evaluate national economic status. Pearson coefficient, linear regression, and unpaired t test were performed in the statistical analyses. Twenty-one population-based surveys (seven in East Asia, five in South Asia, three in Middle East, and six in Europe) were included. The pooled prevalence of NAFLD was 24.24%, and the global prevalence was positively correlated with GNI per capita (r = 0.4782, P = 0.0283). Europe witnessed a higher prevalence (28.04%) than Middle East (12.95%, P = 0.0092) and East Asia (19.24%, P = 0.0083). Male presented a higher prevalence than female (P = 0.019), especially in Europe (P = 0.0132) and in Caucasians (P = 0.0383). Furthermore, male prevalence and rural prevalence individually were correlated with economic status (r = 0.5725, P = 0.0257 and r = 0.7389, P = 0.0060). Lastly, the urban (23.93%) witnessed a higher prevalence than the rural or the urban + rural (12.65%, P = 0.0141) in the countries of GNI per capita <$10,000. This study suggested that countries with higher economic status tend to present a higher prevalence of NAFLD. It is believed to provide a distinctive epidemiologic perspective to global situation of NAFLD.

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…

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

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.

Perception of Rural and Urban Mothers about Consumption of Targeted Fortified Products in Jaipur, Rajasthan - India: A Cross-Sectional Study.

PubMed

Nagaraj, Anup; Yousuf, Asif; Ganta, Shravani

2013-01-01

Food fortification is the addition of one or more essential nutrients to a food whether or not it is normally contained in the food, for the purpose of preventing or correcting a demonstrated deficiency of one or more nutrients in the population or specific population groups. The present cross-sectional study was conducted to obtain comprehensive information towards consumption of Targeted Fortified Products (TFP) among rural and urban mothers of children <3 years in Jaipur, India. In this cross-sectional study conducted in 2012, three hundred rural and urban mothers were selected from Primary Health Centre, Achrol Village and Uniara Hospital in Jaipur, Rajasthan. The data were collected using a selfadministered questionnaire. The current nutritional status of children was determined by anthropometric measurements. A total of 53.33% rural and 65.33% urban mothers had knowledge (P=0.046), amongst which 52.67% rural and 66.00% urban mothers (P= 0.026) consumed TFP directed towards mothers. In addition, 56% rural and 94.67% urban mothers had knowledge (P=0.000) about TFP directed towards children, amongst which 19.33% rural and 50.67% urban mothers (P=0.000) fed their children with TFP. There was significantly less awareness regarding consumption of TFP directed towards both pregnant women and children among rural when compared to urban population. Attitudes seemed to be governed by the traditional beliefs and family influences of region rather than the knowledge obtained. There is a need of intensive coordinated efforts to create awareness among mothers to enhance the maternal and child diets through TFP.

Differences in health care seeking behaviour between rural and urban communities in South Africa

PubMed Central

2012-01-01

Objective The aim of this study was to explore possible differences in health care seeking behaviour among a rural and urban African population. Design A cross sectional design was followed using the infrastructure of the PURE-SA study. Four rural and urban Setswana communities which represented different strata of urbanisation in the North West Province, South Africa, were selected. Structured interviews were held with 206 participants. Data on general demographic and socio-economic characteristics, health status, beliefs about health and (access to) health care was collected. Results The results clearly illustrated differences in socio-economic characteristics, health status, beliefs about health, and health care utilisation. In general, inhabitants of urban communities rated their health significantly better than rural participants. Although most urban and rural participants consider their access to health care as sufficient, they still experienced difficulties in receiving the requested care. The difference in employment rate between urban and rural communities in this study indicated that participants of urban communities were more likely to be employed. Consequently, participants from rural communities had a significantly lower available weekly budget, not only for health care itself, but also for transport to the health care facility. Urban participants were more than 5 times more likely to prefer a medical doctor in private practice (OR:5.29, 95% CI 2.83-988). Conclusion Recommendations are formulated for infrastructure investments in rural communities, quality of health care and its perception, improvement of household socio-economical status and further research on the consequences of delay in health care seeking behaviour. PMID:22691443

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 Central

Lerner, Alana G.; Bernabe-Ortiz, Antonio; Gilman, Robert H.; Smeeth, Liam; Miranda, J. Jaime

2015-01-01

Objective To determine the awareness, treatment, and control of hypertension and diabetes by migration status. Design Cross-sectional study, secondary analyses of the PERU MIGRANT study. Patients Rural, rural-to-urban migrants, and urban participants. Main outcome measures Awareness, treatment and control of hypertension and diabetes mellitus were calculated using weights to account for participant’s group size. Results Of the 205/987 (weighted prevalence 24.1%, 95%CI: 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 33/987 (weighted prevalence 4.6%, 95%CI: 3.1%–6%) and diabetes awareness, treatment and control were 71.1%, 40.6%, and 7.7%, respectively. Sub-optimal 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 to rural participants. However, treatment rates were much lower among migrants compared to the urban group. Conclusions 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. PMID:23680809

Climate Change as Migration Driver from Rural and Urban Mexico

PubMed Central

Hunter, Lori M.; Runfola, Daniel M.; Riosmena, Fernando

2015-01-01

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. PMID:26692890

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

Population growth and rural-urban migration, with special reference to Ghana.

PubMed

De Graft-johnson, K T

1974-01-01

While the population of Ghana is expected to double in 25 years at the current rate of increase (approximately 2.5% per annum), the population of urban centers is increasing even faster. The 1970 census shows the urban population growing by 4.8% per annum. This is mainly the result of rural to urban migration and, to a smaller extent, the increase in the number of urban centers from 39 in 1948 to 98 in 1960 to 135 in 1970. In the 1970 census only 57.1% of the population were enumerated in their locality of birth and only 20.9% in a locality other than their place of birth but in the same region. 4.1% were born outside Ghana, mostly in another West African country. 1 striking difference between urban and rural areas is the differing sex ratio of the working population. In rural areas there are 91.0 males aged 15-64 years for every 100 females while in urban areas there are 107.1. Most migration in Africa is for employment and those most likely to migrate are working-age males. Because secondary schools are scarce in rural areas, urban dwellers generally have a higher education level. There are no significant differences between overall labor force participation rates for females. The nationwide participation rate was 38.9% for both males and females (males 43.8%, females 34.1%); in urban areas the total was 40.0% (males 46.3%, females 33.7%) and in rural areas 38.5% (males 42.7%, females 34.3%). Ghanaian women have traditionally occupied a prominent place in the labor force. The theory that urban migration is due to urban-rural income disparities is not confirmed by figures. Considering the high amount of unemployment in urban areas, a rural dweller can average as much as a city dweller. In fact, poorly educated migrants are the ones most affected by urban unemployment. A recent study by Kodwo Ewusi considered the impact of many variables on migration; he found depressed social conditions at the place of origin are more compelling motivations than economic factors but that once people decide to migrate, they base their choice of destination primarily on economic opportunities available at that end. Distance bears little relationship to choice of destination. To stem this tide efforts need to be made to increase rural income, provide employment opportunities for those displaced as agriculture becomes more efficient, and to provide for greater amenities in rural areas. Urban unemployment is an ever-increasing problem, accentuated by population growth and migration. Intensive rural development is needed to reverse this trend.

Urbanization affects neophilia and risk-taking at bird-feeders

NASA Astrophysics Data System (ADS)

Tryjanowski, Piotr; Møller, Anders Pape; Morelli, Federico; Biaduń, Waldemar; Brauze, Tomasz; Ciach, Michał; Czechowski, Paweł; Czyż, Stanisław; Dulisz, Beata; Goławski, Artur; Hetmański, Tomasz; Indykiewicz, Piotr; Mitrus, Cezary; Myczko, Łukasz; Nowakowski, Jacek J.; Polakowski, Michał; Takacs, Viktoria; Wysocki, Dariusz; Zduniak, Piotr

2016-06-01

Urban environments cover vast areas with a high density of humans and their dogs and cats causing problems for exploitation of new resources by wild animals. Such resources facilitate colonization by individuals with a high level of neophilia predicting that urban animals should show more neophilia than rural conspecifics. We provided bird-feeders across urban environments in 14 Polish cities and matched nearby rural habitats, testing whether the presence of a novel item (a brightly coloured green object made out of gum with a tuft of hair) differentially delayed arrival at feeders in rural compared to urban habitats. The presence of a novel object reduced the number of great tits Parus major, but also the total number of all species of birds although differentially so in urban compared to rural areas. That was the case independent of the potentially confounding effects of temperature, population density of birds, and the abundance of cats, dogs and pedestrians. The number of great tits and the total number of birds attending feeders increased in urban compared to rural areas independent of local population density of birds. This implies that urban birds have high levels of neophilia allowing them to readily exploit unpredictable resources in urban environments.

Suicide in Castellon, 2009-2015: Do sociodemographic and psychiatric factors help understand urban-rural differences?

PubMed

Suso-Ribera, Carlos; Mora-Marín, Rafael; Hernández-Gaspar, Carmen; Pardo-Guerra, Lidón; Pardo-Guerra, María; Belda-Martínez, Adela; Palmer-Viciedo, Ramón

Studies have pointed to rurality as an important factor influencing suicide. Research so far suggests that several sociodemograpic and psychiatric factors might influence urban-rural differences in suicide. Also, their contribution appears to depend on sex and age. Unfortunately, studies including a comprehensive set of explanatory variables altogether are still scare and most studies have failed to present their analyses split by sex and age groups. Also, urban-rural differences in suicide in Spain have been rarely investigated. The present study aimed at explaining rural-urban differences in suicidality in the province of Castellon (Spain). A comprehensive set of sociodemographic and psychiatric factors was investigated and analyses were split by sex and age. The sample comprised all suicides recorded in the province of Castellon from January 2009 to December 2015 (n=343). Sociodemographic data included sex, age, and suicide method. Psychiatric data included the history of mental health service utilization, psychiatric diagnosis, suicide attempts, and psychiatric hospitalization. Consistent with past research, suicide rates were highest in rural areas, especially in men and older people. We also found that urban-rural differences in sociodemographic and psychiatric variables were sensitive to sex and age. Our results indicated that specialized mental health service use and accessibility to suicide means might help understand urban-rural differences in suicide, especially in men. When exploring urban-rural differences as a function of age, general practitioner visits for psychiatric reasons were more frequent in the older age group in rural areas. Study implications for suicide prevention strategies in Spain are discussed. Copyright © 2017 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

Rural-Urban Differences in Cancer Incidence and Trends in the United States.

PubMed

Zahnd, Whitney E; James, Aimee S; Jenkins, Wiley D; Izadi, Sonya R; Fogleman, Amanda J; Steward, David E; Colditz, Graham A; Brard, Laurent

2017-07-27

Cancer incidence and mortality rates in the US are declining, but this decrease may not be observed in rural areas where residents are more likely to live in poverty, smoke, and forego cancer screening. However, there is limited research exploring national rural-urban differences in cancer incidence and trends. We analyzed data from the North American Association of Central Cancer Registries' public use dataset, which includes population-based cancer incidence data from 46 states. We calculated age-adjusted incidence rates, rate ratios, and annual percentage change (APC) for: all cancers combined; selected individual cancers; and cancers associated with tobacco use and human papillomavirus (HPV). Rural-urban comparisons were made by demographic, geographic, and socioeconomic characteristics for 2009 to 2013. Trends were analyzed for 1995 to 2013. Combined cancers incidence rates were generally higher in urban populations, except for the South, though the urban decline in incidence rate was greater than in rural populations (10.2% vs. 4.8%, respectively). Rural cancer disparities included higher rates of tobacco associated, HPV associated, lung and bronchus, cervical , and colorectal cancers across most population groups. Further, HPV-associated cancer incidence rates increased in rural areas (APC=0.724, p<0.05) while temporal trends remained stable in urban areas. Cancer rates associated with modifiable risks - tobacco, HPV, and some preventive screening modalities (e.g. colorectal and cervical cancers) - were higher in rural compared to urban populations. Population-based, clinical, and/or policy strategies and interventions that address these modifiable risk factors could help reduce cancer disparities experienced in rural populations. Copyright ©2017, American Association for Cancer Research.

Does Migration Limit the Effect of Health Insurance on Hypertension Management in China?

PubMed

Fang, Hai; Jin, Yinzi; Zhao, Miaomiao; Zhang, Huyang; A Rizzo, John; Zhang, Donglan; Hou, Zhiyuan

2017-10-20

Background: In China, rapid urbanization has caused migration from rural to urban areas, and raised the prevalence of hypertension. However, public health insurance is not portable from one place to another, and migration may limit the effectiveness of this non-portable health insurance on healthcare. Our study aims to investigate whether migration limits the effectiveness of health insurance on hypertension management in China. Methods: Data were obtained from the national baseline survey of the China Health and Retirement Longitudinal Study in 2011, including 4926 hypertensive respondents with public health insurance. Outcome measures included use of primary care, hypertension awareness, medication use, blood pressure monitoring, physician advice, and blood pressure control. Multivariate logistic regressions were estimated to examine whether the effects of rural health insurance on hypertension management differed between those who migrated to urban areas and those who did not migrate and lived in rural areas. Results: Among hypertensive respondents, 60.7% were aware of their hypertensive status. Compared to rural residents, the non-portable feature of rural health insurance significantly reduced rural-to-urban migrants' probabilities of using primary care by 7.8 percentage points, hypertension awareness by 8.8 percentage points, and receiving physician advice by 18.3 percentage points. Conclusions: In China, migration to urban areas limited the effectiveness of rural health insurance on hypertension management due to its non-portable nature. It is critical to improve the portability of rural health insurance, and to extend urban health insurance and primary care coverage to rural-to-urban migrants to achieve better chronic disease management.

Does rural or urban residence make a difference to neonatal outcome in premature birth? A regional study in Australia.

PubMed

Abdel-Latif, M E; Bajuk, B; Oei, J; Vincent, T; Sutton, L; Lui, K

2006-07-01

Patients living in rural areas may be at a disadvantage in accessing tertiary health care. To test the hypothesis that very premature infants born to mothers residing in rural areas have poorer outcomes than those residing in urban areas in the state of New South Wales (NSW) and the Australian Capital Territory (ACT) despite a coordinated referral and transport system. "Rural" or "urban" status was based on the location of maternal residence. Perinatal characteristics, major morbidity and case mix adjusted mortality were compared between 1879 rural and 6775 urban infants <32 weeks gestational age, born in 1992-2002 and admitted to all 10 neonatal intensive care units in NSW and ACT. Rural mothers were more likely to be teenaged, indigenous, and to have had a previous premature birth, prolonged ruptured membrane, and antenatal corticosteroid. Urban mothers were more likely to have had assisted conception and a caesarean section. More urban (93% v 83%) infants were born in a tertiary obstetric hospital. Infants of rural residence had a higher mortality (adjusted odds ratio (OR) 1.26, 95% confidence interval (CI) 1.07 to 1.48, p = 0.005). This trend was consistently seen in all subgroups and significantly for the tertiary hospital born population and the 30-31 weeks gestation subgroup. Regional birth data in this gestational age range also showed a higher stillbirth rate among rural infants (OR 1.20, 95% CI 1.09 to 1.32, p<0.001). Premature births from rural mothers have a higher risk of stillbirth and mortality in neonatal intensive care than urban infants.

Does Migration Limit the Effect of Health Insurance on Hypertension Management in China?

PubMed Central

Fang, Hai; Jin, Yinzi; Zhang, Huyang; A. Rizzo, John; Zhang, Donglan; Hou, Zhiyuan

2017-01-01

Background: In China, rapid urbanization has caused migration from rural to urban areas, and raised the prevalence of hypertension. However, public health insurance is not portable from one place to another, and migration may limit the effectiveness of this non-portable health insurance on healthcare. Our study aims to investigate whether migration limits the effectiveness of health insurance on hypertension management in China. Methods: Data were obtained from the national baseline survey of the China Health and Retirement Longitudinal Study in 2011, including 4926 hypertensive respondents with public health insurance. Outcome measures included use of primary care, hypertension awareness, medication use, blood pressure monitoring, physician advice, and blood pressure control. Multivariate logistic regressions were estimated to examine whether the effects of rural health insurance on hypertension management differed between those who migrated to urban areas and those who did not migrate and lived in rural areas. Results: Among hypertensive respondents, 60.7% were aware of their hypertensive status. Compared to rural residents, the non-portable feature of rural health insurance significantly reduced rural-to-urban migrants’ probabilities of using primary care by 7.8 percentage points, hypertension awareness by 8.8 percentage points, and receiving physician advice by 18.3 percentage points. Conclusions: In China, migration to urban areas limited the effectiveness of rural health insurance on hypertension management due to its non-portable nature. It is critical to improve the portability of rural health insurance, and to extend urban health insurance and primary care coverage to rural-to-urban migrants to achieve better chronic disease management. PMID:29053607

Leading causes of unintentional injury and suicide mortality in Canadian adults across the urban-rural continuum.

PubMed

Burrows, Stephanie; Auger, Nathalie; Gamache, Philippe; Hamel, Denis

2013-01-01

We examined the leading causes of unintentional injury and suicide mortality in adults across the urban-rural continuum. Injury mortality data were drawn from a representative cohort of 2,735,152 Canadians aged ≥ 25 years at baseline, who were followed for mortality from 1991 to 2001. We estimated hazard ratios and 95% confidence intervals for urban-rural continuum and cause-specific unintentional injury (i.e., motor vehicle, falls, poisoning, drowning, suffocation, and fire/burn) and suicide (i.e., hanging, poisoning, firearm, and jumping) mortality, adjusting for socioeconomic and demographic characteristics. Rates of unintentional injury mortality were elevated in less urbanized areas for both males and females. We found an urban-rural gradient for motor vehicle, drowning, and fire/burn deaths, but not for fall, poisoning, or suffocation deaths. Urban-rural differences in suicide risk were observed for males but not females. Declining urbanization was associated with higher risks of firearm suicides and lower risks of jumping suicides, but there was no apparent trend in hanging and poisoning suicides. Urban-rural gradients in adults were more pronounced for unintentional motor vehicle, drowning, and fire/burn deaths, as well as for firearm and jumping suicide deaths than for other causes of injury mortality. These results suggest that the degree of urbanization may be an important consideration in guiding prevention efforts for many causes of injury fatality.

Implementing an MSN nursing program at a distance through an urban-rural partnership.

PubMed

Zukowsky, Ksenia; Swan, Beth Ann; Powell, Mary; Frisby, Tony; Lauver, Lori; West, Margaret Mary; Marsella, Alexis

2011-04-01

Recruiting, retaining, and educating advanced practice nurses is essential to meet the growing need for advanced practice nurses in rural and urban communities. Through the support of Health Resources and Services Administration funding, the urban school of nursing expanded its MSN program and implemented the graduate curriculum on its rural campus by utilizing emerging online and distance education technologies. The purpose of this manuscript is to provide an overview of expanding an existing MSN program offered in an urban, traditional classroom setting to rural graduate nursing students via an online synchronous format. In addition, the article will describe the rural growth of the existing neonatal nurse practitioner program as an exemplar and the different methodologies that are being used in each program to engage the rural nurse practitioner students in clinical courses. In addition, strategies to address barriers related to rural nurse practitioner student recruitment and retention will be discussed.

Rural-Urban Disparities in Child Abuse Management Resources in the Emergency Department

ERIC Educational Resources Information Center

Choo, Esther K.; Spiro, David M.; Lowe, Robert A.; Newgard, Craig D.; Hall, Michael Kennedy; McConnell, Kenneth John

2010-01-01

Purpose: To characterize differences in child abuse management resources between urban and rural emergency departments (EDs). Methods: We surveyed ED directors and nurse managers at hospitals in Oregon to gain information about available abuse-related resources. Chi-square analysis was used to test differences between urban and rural EDs.…

Self-Assessed Intelligence: Inter-Ethnic, Rural-Urban, and Sex Differences in Malaysia

ERIC Educational Resources Information Center

Swami, Viren; Furnham, Adrian

2010-01-01

The present study examined inter-ethnic, rural-urban, and sex differences in self-assessed intelligence (SAI) in a Malaysian general population sample. In total, 633 individuals varying in rural or urban location, ethnicity (Malay, Kadazan, and Bajau), and sex (women versus men) provided their self-assessed overall intelligence and ten multiple…

Two Aspects of the Rural-Urban Divide and Educational Stratification in China: A Trajectory Analysis

ERIC Educational Resources Information Center

Hao, Lingxin; Hu, Alfred; Lo, Jamie

2014-01-01

Contextualized in China's social change of the past half-century, this article conceptualizes the two aspects of China's rural-urban divide in educational inequality--the household registration system ("hukou") assigns people to a hierarchy, and the rural-urban schooling system institutionalizes unequal resource distribution and diverse…

Characteristics of Rural and Urban Cadaveric Organ Transplant Donors and Recipients

ERIC Educational Resources Information Center

Weeks, William B.; Lushkov, Gili; Nelson, William A.; Wallace, Amy E.

2006-01-01

Context: Health disparities have been found when comparing rural and urban populations. Purpose: To compare characteristics of rural and urban cadaveric transplant donors and recipients. Methods: We used deidentified individual-level data on 55,929 cadaveric transplant donor-recipient exchanges between 2000 and 2003 and examined the relative rates…

Similar Secondary Stroke Prevention and Medication Persistence Rates among Rural and Urban Patients

ERIC Educational Resources Information Center

Rodriguez, Daniel; Cox, Margueritte; Zimmer, Louise O.; Olson, DaiWai M.; Goldstein, Larry B.; Drew, Laura; Peterson, Eric D.; Bushnell, Cheryl D.

2011-01-01

Purpose: Rural residents are less likely to obtain optimal care for many serious conditions and have poorer health outcomes than those residing in more urban areas. We determined whether rural vs urban residence affected postdischarge medication persistence and 1 year outcomes after stroke. Methods: The Adherence eValuation After Ischemic…

Rurality/Urbanism and Extended Familism Among Working- and Lower-Class Blacks.

ERIC Educational Resources Information Center

Dietrich, Katheryn Thomas

A comprehensive look is taken at the rural-urban variation in extended familism among a segment of the population for which extended familism purportedly is especially salient: lower and working class black Americans. The study is guided by the general hypothesis that rurality/urbanism affects extended familism when nonecological variables are…

Divergent Urban-Rural Trends in College Attendance: State Policy Bias and Structural Exclusion in China

ERIC Educational Resources Information Center

Tam, Tony; Jiang, Jin

2015-01-01

Despite the massive expansion of higher education in China since 1998, the cohort trends of urban and rural "hukou" holders in college attendance have widened sharply. Prevailing explanations emphasize the advantages of urban students over rural students in school quality and household financial resources. We propose the structural…

Rural-Urban Gaps in Academic Achievement, Schooling Conditions, Student, and Teachers' Characteristics in Pakistan

ERIC Educational Resources Information Center

Tayyaba, Saadia

2012-01-01

Purpose: Recent educational research has demonstrated rural-urban gaps in achievement and schooling conditions. Evidence from developing countries is still sparse. This study seeks to report rural-urban disparities in achievement, student, teacher, and school characteristics based on a nationally representative sample of grade four students from…

Psychological health among Chinese college students: a rural/urban comparison.

PubMed

Zhang, Jie; Qi, Qing; Delprino, Robert P

2017-09-01

The literature on suicide among the Chinese indicates that younger individuals from rural areas are at higher risk of suicide than their urban counterparts. While earlier studies have investigated the relationship between psychological health and major demographic variables, the relationship of psychological health as it relates to suicide by those from urban and rural areas have been rare. Studying the psychological health of college students from rural China in comparison with students who originate from urban areas may shed light on the mental health disparities of the two populations. This study examined the relationship of psychological health and rural/urban origins of college students in China. Data was obtained from 2 400 college students who completed a survey questionnaire while in attendance at a key university in Beijing China in 2013. Four standardised psychological health scales were administered to obtain measures of participants' self-esteem, depression, social support, and suicide ideation. Findings indicated that urban students had significantly higher scores than their rural counterparts on self-esteem and social support. However, there was no statistically significant difference between the groups on measures of depression and suicide ideation.

Discrimination against Rural-to-Urban Migrants: The Role of the Hukou System in China

PubMed Central

Kuang, Lei; Liu, Li

2012-01-01

China's rural-urban dual society system is instituted by its unique hukou system. This system causes inequalities in social status between permanent urban and rural residents, and discrimination against rural-to-urban migrants is thus prevalent. A series of studies, based on system justification theory, sought to address the impact of the hukou system on the discrimination against rural-to-urban migrants. Study 1 showed that the justification of the hukou system could predict discrimination operationalized using a social distance measure. Study 2 found that priming of the proposed abolishment of the current hukou system led to reduced social distance. Study 3, using a recruiting scenario, further demonstrated that priming of the proposed abolishment of the system led to reduced discrimination in salary decision. Consistent with our predictions, discrimination against rural-to-urban migrants could be triggered by justifying the current hukou system, while priming of the abolishment of the system serves to decrease discrimination. The present research thereby sheds light on China's reform of its hukou system to achieve social justice and equality from a psychological perspective. PMID:23144794

Diet, physical activity, and sedentary behaviors as risk factors for childhood obesity: an urban and rural comparison.

PubMed

Liu, Ji-Hong; Jones, Sonya J; Sun, Han; Probst, Janice C; Merchant, Anwar T; Cavicchia, Philip

2012-10-01

The aim of this study was to examine the differences in diet, physical activity, and weight status among children living in rural and urban America and to study the roles of obesity-related behaviors in residence-based differences in childhood obesity. We performed cross-sectional analysis of the 1999-2006 National Health and Nutrition Examination Survey data, restricted to 14,332 children aged 2-19 years old (2771 rural, 13,766 urban). Residence was measured at the census tract level using Rural-Urban Commuting Areas. Age-specific questions were used to assess physical activity, and the 24-hour diet recall was used to measure dietary intake. Among 2- to 11-year-olds, rural children consumed 90 more kcal/day on average than urban children (p < 0.05) and were more likely to consume the recommended two to three cups of dairy per day (p < 0.05). More 2- to 11-year-old rural children also reported participating in exercise five or more times per week than urban children of the same age (79.7% vs. 73.8%). Among 12- to 19-year-olds, rural children were less likely to consume any fruit or meet the recommendation of two cups of fruit. Using measured height and weight data, proportionately more rural than urban children were overweight/obese (35.4% v. 29.3%) and obese (18.6% v. 15.1%). Rural children had 30% higher odds of being overweight and/or obese even after adjustment for sociodemographics, health, diet, and exercise behaviors. The persistently higher odds of overweight and obesity among rural children even after adjustment suggest that rural environments may be "obesogenic" in ways that a person-level analysis cannot discern. Future research should examine disparities in the accessibility and affordability of healthy food and beverage choices and safe physical activity locales in rural areas.

Rural to urban migration is an unforeseen impact of development intervention in Ethiopia.

PubMed

Gibson, Mhairi A; Gurmu, Eshetu

2012-01-01

Rural development initiatives across the developing world are designed to improve community well-being and livelihoods. However they may also have unforeseen consequences, in some cases placing further demands on stretched public services. In this paper we use data from a longitudinal study of five Ethiopian villages to investigate the impact of a recent rural development initiative, installing village-level water taps, on rural to urban migration of young adults. Our previous research has identified that tap stands dramatically reduced child mortality, but were also associated with increased fertility. We demonstrate that the installation of taps is associated with increased rural-urban migration of young adults (15-30 years) over a 15 year period (15.5% migrate out, n = 1912 from 1280 rural households). Young adults with access to this rural development intervention had three times the relative risk of migrating to urban centres compared to those without the development. We also identify that family dynamics, specifically sibling competition for limited household resources (e.g. food, heritable land and marriage opportunities), are key to understanding the timing of out-migration. Birth of a younger sibling doubled the odds of out-migration and starting married life reduced it. Rural out-migration appears to be a response to increasing rural resource scarcity, principally competition for agricultural land. Strategies for livelihood diversification include education and off-farm casual wage-labour. However, jobs and services are limited in urban centres, few migrants send large cash remittances back to their families, and most return to their villages within one year without advanced qualifications. One benefit for returning migrants may be through enhanced social prestige and mate-acquisition on return to rural areas. These findings have wide implications for current understanding of the processes which initiate rural-to-urban migration and transitions to low fertility, as well as for the design and implementation of development intervention across the rural and urban developing world.

Rural to Urban Migration Is an Unforeseen Impact of Development Intervention in Ethiopia

PubMed Central

Gibson, Mhairi A.; Gurmu, Eshetu

2012-01-01

Rural development initiatives across the developing world are designed to improve community well-being and livelihoods. However they may also have unforeseen consequences, in some cases placing further demands on stretched public services. In this paper we use data from a longitudinal study of five Ethiopian villages to investigate the impact of a recent rural development initiative, installing village-level water taps, on rural to urban migration of young adults. Our previous research has identified that tap stands dramatically reduced child mortality, but were also associated with increased fertility. We demonstrate that the installation of taps is associated with increased rural-urban migration of young adults (15–30 years) over a 15 year period (15.5% migrate out, n = 1912 from 1280 rural households). Young adults with access to this rural development intervention had three times the relative risk of migrating to urban centres compared to those without the development. We also identify that family dynamics, specifically sibling competition for limited household resources (e.g. food, heritable land and marriage opportunities), are key to understanding the timing of out-migration. Birth of a younger sibling doubled the odds of out-migration and starting married life reduced it. Rural out-migration appears to be a response to increasing rural resource scarcity, principally competition for agricultural land. Strategies for livelihood diversification include education and off-farm casual wage-labour. However, jobs and services are limited in urban centres, few migrants send large cash remittances back to their families, and most return to their villages within one year without advanced qualifications. One benefit for returning migrants may be through enhanced social prestige and mate-acquisition on return to rural areas. These findings have wide implications for current understanding of the processes which initiate rural-to-urban migration and transitions to low fertility, as well as for the design and implementation of development intervention across the rural and urban developing world. PMID:23155400

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.

Comparing earnings profiles in urban areas of an LDC: rural-to-urban migrants vs. native workers.

PubMed

Vijverberg, W P; Zeager, L A

1994-12-01

"We use Tanzanian data to test a recently proposed hypothesis that rural-to-urban migrants have an incentive to supply greater work effort than native urban workers, because of the migrants' positive probability of returning to the low-wage rural areas. We treat the choice between public- and private-sector employment as endogenous and, for theoretical and empirical reasons, distinguish migrants with access to rural land from those without access. Our results show that migrants in both sectors face lower initial wage offers than native urban workers. But, the wage gap is eliminated within a decade or less, and thereafter, migrants surpass the wage offers of native workers." excerpt

Element content of Xanthoparmelia scabrosa growing on asphalt in urban and rural New Zealand

USGS Publications Warehouse

Bennett, J.P.; Wright, D.M.

2004-01-01

Xanthoparmelia scabrosa is a foliose lichen that grows abundantly on pedestrian and automobile asphalt in New Zealand, which are considered inhospitable habitats for lichens. Samples were collected at eight localities ranging from urban streets to very rural roads and analyzed for 28 chemical elements in order to determine elemental chemistry and to test hypotheses about tolerance mechanisms. Anthropogenic elements (Cu, Pb, and Zn) decreased significantly from urban to rural areas, while nutritional elements (K, P, and S) increased. Samples from urban areas contained 10% calcium. Sulfur was elevated at both urban and rural sites, possibly due to pollution in the former site and higher levels of sulfur-containing scabrosin esters at the rural sites. The ability of this lichen to accumulate high levels of Cu, Pb and Zn may make it useful as a remediation tool.

Socioeconomic Disparities in Adverse Birth Outcomes in Urban and Rural Contexts: a French Mother-Child Cohort.

PubMed

Bertin, Mélanie; Viel, Jean-François; Monfort, Christine; Cordier, Sylvaine; Chevrier, Cécile

2015-09-01

Although adverse birth outcomes have been associated with neighbourhood deprivation in urban areas, few studies have addressed this issue in rural zones. This study examines whether associations between neighbourhood deprivation and adverse birth outcomes differ in urban and rural contexts, while taking individual characteristics and spatial accessibility of prenatal care (SAPC) into account. Pregnant women from a French mother-child cohort were recruited from 2002 to 2006 in Brittany. Their residential addresses were geocoded into their census blocks (the finest geographical resolution available). Deprivation was assessed at the same neighbourhood level. Models to assess the associations of deprivation, stratified by urban/rural status, with preterm delivery (PTD), with small for gestational age birth weight (SGA) and with small for gestational age head circumference at birth (SHC), estimated odds ratios (ORs), adjusted for maternal socioeconomic characteristics and SAPC. This study considered 2929 liveborn singleton pregnancies from 780 census blocks. Neighbourhood deprivation was associated with increased risks of SGA and SHC (P trend < 0.01 and 0.03 respectively), only among mothers residing in rural areas. Neighbourhood deprivation had statistically significantly heterogeneous effects on SGA and SHC according to the urban/rural status of maternal residence. These findings suggest that neighbourhood deprivation affects fetal growth differentially in urban and rural areas and that SAPC does not seem to be responsible for this difference. Comparison of these findings with the literature requires caution in the conceptualisation of urban and rural settings. © 2015 John Wiley & Sons Ltd.

Rural-urban differences in end-of-life nursing home care: facility and environmental factors.

PubMed

Temkin-Greener, Helena; Zheng, Nan Tracy; Mukamel, Dana B

2012-06-01

This study examines urban-rural differences in end-of-life (EOL) quality of care provided to nursing home (NH) residents. We constructed 3 risk-adjusted EOL quality measures (QMs) for long-term decedent residents: in-hospital death, hospice referral before death, and presence of severe pain. We used CY2005-2007 100% Minimum Data Set, Medicare beneficiary file, and inpatient and hospice claims. Logistic regression models were estimated to predict the probability of each outcome conditional on decedents' risk factors. For each facility, QMs were calculated as the difference between the actual and the expected risk-adjusted outcome rates. We fit multivariate linear regression models, with fixed state effects, for each QM to assess the association with urban-rural location. We found urban-rural differences for in-hospital death and hospice QMs, but not for pain. Compared with NHs located in urban areas, facilities in smaller towns and in isolated rural areas have significantly (p < .001) worse EOL quality for in-hospital death and hospice use. Whereas the differences in these QMs are statistically significant between facilities located in large versus small towns, they are not statistically significant between facilities located in small towns and isolated rural areas. This study provides empirical evidence for urban-rural differences in EOL quality of care using a national sample of NHs. Identifying differences is a necessary first step toward improving care for dying NH residents and for bridging the urban-rural gap.

Paediatric case mix in a rural clinical school is relevant to future practice.

PubMed

Wright, Helen M; Maley, Moira A L; Playford, Denese E; Nicol, Pam; Evans, Sharon F

2017-11-29

Exposure to a representative case mix is essential for clinical learning, with logbooks established as a way of demonstrating patient contacts. Few studies have reported the paediatric case mix available to geographically distributed students within the same medical school. Given international interest in expanding medical teaching locations to rural contexts, equitable case exposure in rural relative to urban settings is topical. The Rural Clinical School of Western Australia locates students up to 3500 km from the urban university for an academic year. There is particular need to examine paediatric case mix as a study reported Australian graduates felt unprepared for paediatric rotations. We asked: Does a rural clinical school provide a paediatric case mix relevant to future practice? How does the paediatric case mix as logged by rural students compare with that by urban students? The 3745 logs of 76 urban and 76 rural consenting medical students were categorised by presenting symptoms and compared to the Australian Institute of Health and Welfare (AIHW) database Major Diagnostic Categories (MDCs). Rural and urban students logged core paediatric cases, in similar order, despite the striking difference in geographic locations. The pattern of overall presenting problems closely corresponded to Australian paediatric hospital admissions. Rural students logged 91% of cases in secondary healthcare settings; urban students logged 90% of cases in tertiary settings. The top four presenting problems were ENT/respiratory, gastrointestinal/urogenital, neurodevelopmental and musculoskeletal; these made up 60% of all cases. Rural and urban students logged similar proportions of infants, children and adolescents, with a variety of case morbidity. Rural clinical school students logged a mix of core paediatric cases relevant to illnesses of Australian children admitted to public hospitals, with similar order and pattern by age group to urban students, despite major differences in clinical settings. Logged cases met the curriculum learning outcomes of graduates. Minor variations were readily addressed via recommendations about logging. This paper provides evidence of the legitimacy of student logs as useful tools in affirming appropriate paediatric case mix. It validates the rural clinical school context as appropriate for medical students to prepare for future clinical paediatric practice.

The associations between interpersonal violence and psychological distress among rural and urban young women in South Africa.

PubMed

Manyema, M; Norris, S A; Said-Mohamed, R; Tollman, S T; Twine, R; Kahn, K; Richter, L M

2018-05-01

Approximately 25% of the world's population consists of young people. The experience of violence peaks during adolescence and the early adult years. A link between personal experience of violence and mental health among young people has been demonstrated but rural-urban differences in these associations are less well known in low to middle income countries. The aim of this study was to investigate the associations between interpersonal violence and psychological distress among rural and urban young women. Data on experiences of violence and psychological distress were collected from a total of 926 non-pregnant young women aged between 18 and 22 years of age in rural and urban sites in South Africa. The General Health Questionnaire-28 was used to assess psychological distress as an indicator of mental health. Generalised structural equation models were employed to assess potential pathways of association between interpersonal violence and psychological distress. Thirty-four percent of the urban young women (n = 161) reported psychological distress compared to 18% of rural young women (n = 81). In unadjusted analysis, exposure to interpersonal violence doubled the odds of psychological distress in the urban adolescents and increased the odds 1.6 times in the rural adolescents. In adjusted models, the relationship remained significant in the urban area only (OR 1.84, 95% CI 1.13-3.00). Rural residence seemed protective against psychological distress (OR 0.41, 95% CI 0.24-0.69). Structural equation modelling did not reveal any direct association between exposure to interpersonal violence and psychological distress among rural young women. Stressful household events were indirectly associated with psychological distress, mediated by violence among young women in the urban area. The relationship between violence and psychological distress differs between urban and rural-residing young women in South Africa, and is influenced by individual, household and community (contextual) factors. Copyright © 2018 Elsevier Ltd. All rights reserved.

Urban-rural differences in factors associated with willingness to receive eldercare among the elderly: a cross-sectional survey in China

PubMed Central

Wang, Juan; Zhou, Hao; Wang, Zhaoqing; Yan, Wenxin; Sun, Xinran; Sun, Tao; Li, Li

2018-01-01

Objective Willingness to receive eldercare is an important factor affecting the reasonable allocation of resources and appropriate development of eldercare services. This study aimed to investigate the differences in willingness to receive eldercare and the influencing factors in urban and rural areas. Design Cross-sectional survey. Setting Research was conducted in the urban and rural areas of three cities (Harbin, Qiqihar and Jiamusi) in Heilongjiang province, China. Participants A total of 1003 elderly were selected through multistage sampling in Heilongjiang province, including 581 in urban areas and 422 in rural areas. Main outcome measures Descriptive statistics were reported for socioeconomic and demographic status, physical health, life satisfaction and social support in urban and rural areas. Mean differences were examined using t-tests, and categorical variable differences were examined using χ2 tests. The factors influencing willingness to receive eldercare in urban and rural areas were analysed using logistic regression. Results The results showed that 51.6% of urban elderly and 59.0% of rural elderly preferred family eldercare. Factors that influenced willingness to receive eldercare for urban elderly were age (OR 2.791, 95% CI 1.644 to 4.737), house property (OR 0.494, 95% CI 0.329 to 0.740) and objective support (OR 0.764, 95% CI 0.681 to 0.858). For rural elderly, the factors were having children (OR 0.368, 95% CI 0.146 to 0.930), house property (OR 0.371, 95% CI 0.231 to 0.596) and living arrangement (OR 3.361, 95% CI 1.436 to 7.866). Conclusion More attention should be paid to improving the functioning of family eldercare and promoting the development of varied eldercare services. Investments and targeted policies should be undertaken for different subgroups of urban and rural elderly. PMID:29858413