SOCIAL ISOLATION AND NETWORKS DO DENSE URBAN CENTERS PROVIDE LARGE SUPPORTIVE SOCIAL NETWORK TO OLDER ADULTS? A CROSS-COUNTRY COMPARATIVE STUDY

Abstract The urban-rural dichotomy underpins the common approach in studying environmental conditions influencing older adults’ lives characterized by post-Second World War urban migration in both Italy and the United States (US). However, the traditional opposition urban-rural dichotomy is inadequate to study how the environmental characteristics of a geographical area can account for the heterogeneous profile of its populations and its age distribution. This study aims to overcome the traditional mobility theories as an explanatory dichotomy for understanding the distribution of the age structure of a given population. The extent of a supportive network, and the connection between the place of residence to the proximity of other residential centres can be seen as potential resources for understanding the attractiveness of certain areas for older adults. A large harmonized set of demographic and socio-economic data were collected from the Italian National Institute of Statistics (ISTAT) and the American Community Survey (ACS). An analysis at the Italian municipality- and US county-level finds the population over 75 years old are overrepresented in rural areas of both countries as would be expected by available employment opportunities, but considerable heterogeneity among both urban and rural areas exist. In particular, rural more than urban settings are based on an informal support network that is argued to rely on human proximity to produce successful aging in the community. The variation in population of older adults in rural areas, therefore, might have implications on how to achieve age-friendly communities, aside from population’s traditional mobility theories and formal support network.

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Decomposing Urban-rural Differences in Multimorbidity Among Older Adults in India: A Study Based on Lasi Data

10.21203/rs.3.rs-701569/v1 ◽

2021 ◽

Author(s):

Shekhar Chauhan ◽

Shobhit Srivast ◽

Pradeep Kumar ◽

Ratna Patel

Keyword(s):

Older Adults ◽

Rural Areas ◽

Urban Areas ◽

Decomposition Analysis ◽

The Public ◽

Analysis Techniques ◽

Ageing Study ◽

Urban Rural ◽

The Difference ◽

Urban And Rural Areas

Abstract Background: Multimorbidity is defined as the co-occurrence of two or more than two diseases in the same person. With rising longevity, multimorbidity has become a prominent concern among the older population. Evidence from both developed and developing countries shows that older people are at much higher risk of multimorbidity, however, urban-rural differential remained scarce. Therefore, this study examines urban-rural differential in multimorbidity among older adults by decomposing the risk factors of multimorbidity and identifying the covariates that contributed to the change in multimorbidity.Methods: The study utilized information from 31,464 older adults (rural-20,725 and urban-10,739) aged 60 years and above from the recent release of the Longitudinal Ageing Study in India (LASI) wave 1 data. Descriptive, bivariate, and multivariate decomposition analysis techniques were used.Results: Overall, significant urban-rural differences were found in the prevalence of multimorbidity among older adults (difference: 16.3; p<0.001). Moreover, obese/overweight and high-risk waist circumference were found to narrow the difference in the prevalence of multimorbidity among older adults between urban and rural areas by 8% and 9.1%, respectively.Conclusion: There is a need to substantially increase the public sector investment in healthcare to address the multimorbidity among older adults, more so in urban areas, without compromising the needs of older adults in rural areas.

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Urban-rural differences in the prevalence of muscle weakness and slow gait speed: A cross-sectional analysis from the NHANES (2001-2002 and 2011-2014)

Journal of Aging Research and Lifestyle ◽

10.14283/jarlife.2021.4 ◽

2021 ◽

pp. 1-7

Author(s):

J.J. Aziz ◽

K.F. Reid ◽

J.A. Batsis ◽

R.A. Fielding

Keyword(s):

United States ◽

Older Adults ◽

Grip Strength ◽

Muscle Weakness ◽

Rural Areas ◽

Gait Speed ◽

The United States ◽

Cross Sectional ◽

Comorbidity Burden ◽

Urban Rural

Background: Older adults living in rural areas suffer from health inequities compared to their urban counterparts. These include comorbidity burden, poor diet, and physical inactivity, which are also risk factors for sarcopenia, for which muscle weakness and slow gait speed are domains. To date, no study has examined urban-rural differences in the prevalence of muscle weakness and slow gait speed in older adults living in the United States. Objective: To compare the prevalence of grip strength weakness and slow gait speed between urban and rural older adults living in the United States. Design: A cross-sectional, secondary data analysis of two cohorts from the National Health and Nutrition Examination Survey (NHANES), using gait speed or grip strength data, and urban-rural residency, dietary, examination, questionnaire and demographic data. Participants: 2,923 adults (≥ 60 yrs.). Measures: Grip weakness was defined as either, an absolute grip strength of <35 kg. and <20 kg. or grip strength divided by body mass index (GripBMI) of <1.05 and <0.79 for men and women, respectively. Slow gait speed was defined as a usual gait speed of ≤0.8m/s. Results: The prevalence of GripBMI weakness was significantly higher in urban compared to rural participants (27.4% vs. 19.2%; p=0.001), whereas their absolute grip strength was lower (31.75(±0.45) vs. 33.73(±0.48)). No urban-rural differences in gait speed were observed. Conclusions: Older adults residing in urban regions of the United States were weaker compared to their rural counterparts. This report is the first to describe urban-rural differences in handgrip strength and slow gait speed in older adults living in the United States.

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Demographic and Disease Characteristics of People With Multiple Sclerosis Living in Urban and Rural Areas

International Journal of MS Care ◽

10.7224/1537-2073-8.3.89 ◽

2006 ◽

Vol 8 (3) ◽

pp. 89-97 ◽

Cited By ~ 11

Author(s):

Robert J. Buchanan ◽

Randolph Schiffer ◽

Alexa Stuifbergen ◽

Li Zhu ◽

Suojin Wang ◽

...

Keyword(s):

United States ◽

Multiple Sclerosis ◽

Rural Areas ◽

Urban Areas ◽

The United States ◽

Primary Progressive ◽

Disease Characteristics ◽

Urban Rural ◽

Disease Modifying ◽

Urban And Rural Areas

This study compares demographic and disease-related characteristics of people with multiple sclerosis (MS) living in urban and rural areas. The data analyzed for this study were collected from a survey of 1518 people with MS living throughout the United States from October 2004 through January 2005. We found significant urban-rural differences in various MS characteristics, including type of MS. A significantly larger proportion of people with MS in remote rural areas than their urban counterparts responded that they had primary progressive MS. People with MS in rural areas were significantly more likely than those in urban areas to report that MS symptoms interfered with their independence. A significantly larger proportion of people with MS in remote rural areas than in urban areas were not receiving disease-modifying medications. Our results suggest that MS disease expression varies across urban-rural gradients. Although the findings are not definitive, we hope that other investigative groups will build on these results and work toward confirming and understanding them.

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Hypertension Prevalence Rates Among Urban and Rural Older Adults of China, 1991–2015: A Standardization and Decomposition Analysis

Frontiers in Public Health ◽

10.3389/fpubh.2021.713730 ◽

2021 ◽

Vol 9 ◽

Author(s):

Qi Yu ◽

Shiqi Lin ◽

Jilei Wu

Keyword(s):

Older Adults ◽

Rural Areas ◽

Decomposition Analysis ◽

Prevalence Rates ◽

Nutrition Survey ◽

Policy Effects ◽

Gender Education ◽

Urban Rural ◽

Urban And Rural Areas ◽

Rural Older Adults

Objectives: The prevalence of hypertension (HTN) among older adults is becoming an important issue in public health in China as it is now stepping into the super-aged society with high pressure of a chronic disease burden. With urban–rural differences in population composition and health facilities, this study aimed to assess the gaps in the prevalence trends of HTN among older adults by considering demographic factors such as age, gender, education level, and regional differences during 1991–2015 in China.Methods: We adopted the consistent sampling design and measure of HTN of the cross-longitudinal surveys of the China Health and Nutrition survey, and we compared the HTN prevalence rates between urban and rural older adults by taking each wave of the survey as a cross-sectional sample of the Chinese population by the following and supplementary samples. The classic standardization and decomposition analysis method was utilized with four factor-specific rates, and contributions were calculated, i.e., age, gender, education, and region, which reflects the aspect of demographic and social development differences between urban and rural areas of China.Results: The prevalence rates of HTN of the whole of older adults were increasing in 1991–2015. However, the gaps of prevalence rates of HTN between urban and rural areas show different trends accompanied by the health policies launched by the government. Namely, the gap was narrowed during 1993–1997 and then enlarged during 1997–2011 and narrowing again. Those trends reflect the policy effects with the health resource allocation and utilization of health services for urban and rural older adults.Conclusions: With the four factors of decomposition analysis, the differences reflect the results of health policy effects, considering the urban–rural discrepancy on older adults with different demographic characteristics. Hence, the differentiated policies should be considered with the urban–rural population, such as HTN prevention and the population health promotion.

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An Analysis of Consumption Pattern in Pakistan

The Pakistan Development Review ◽

10.30541/v21i4pp.275-296 ◽

1982 ◽

Vol 21 (4) ◽

pp. 275-296 ◽

Cited By ~ 4

Author(s):

Rehana Siddiqui

Keyword(s):

Growth Rates ◽

Rural Areas ◽

Household Size ◽

Consumption Pattern ◽

Total Expenditure ◽

Demand Growth ◽

Food Items ◽

Urban Rural ◽

Urban And Rural Areas

The paper aims at testing the validity of Engel's law with data on Pakistan. Consumption functions for urban and rural areas have been estimated separately. These functions are shown to be determined by total expenditure and household size. Engel's law is confirmed for some commodity groups but not for all. Following tests of urban-rural homogeneity and of stability of urban and rural consumption functions, demand growth rates for different food and non-food items have been calculated, assuming different growth rates of total expenditure and household size.

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PM2.5 polluters disproportionately and systemically affect people of color in the United States

Science Advances ◽

10.1126/sciadv.abf4491 ◽

2021 ◽

Vol 7 (18) ◽

pp. eabf4491

Author(s):

Christopher W. Tessum ◽

David A. Paolella ◽

Sarah E. Chambliss ◽

Joshua S. Apte ◽

Jason D. Hill ◽

...

Keyword(s):

United States ◽

Rural Areas ◽

The United States ◽

People Of Color ◽

Emission Sources ◽

Particulate Air Pollution ◽

Fine Particulate ◽

Exposure Levels ◽

Urban And Rural Areas ◽

Racial Ethnic

Racial-ethnic minorities in the United States are exposed to disproportionately high levels of ambient fine particulate air pollution (PM2.5), the largest environmental cause of human mortality. However, it is unknown which emission sources drive this disparity and whether differences exist by emission sector, geography, or demographics. Quantifying the PM2.5 exposure caused by each emitter type, we show that nearly all major emission categories—consistently across states, urban and rural areas, income levels, and exposure levels—contribute to the systemic PM2.5 exposure disparity experienced by people of color. We identify the most inequitable emission source types by state and city, thereby highlighting potential opportunities for addressing this persistent environmental inequity.

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The Rural-Urban Continuum of Polarization: Understanding the Geography of the 2018 Midterms

The Forum ◽

10.1515/for-2020-2102 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Kenneth M. Johnson ◽

Dante J. Scala

Keyword(s):

Rural Areas ◽

Urban Areas ◽

Metropolitan Areas ◽

Political Attitudes ◽

The United States ◽

Rural America ◽

Rural Regions ◽

Urban America ◽

Urban And Rural Areas ◽

The Continuum

Abstract This study of the 2018 congressional midterms demonstrates how voting patterns and political attitudes vary across a spectrum of urban and rural areas in the United States. Rural America is no more a monolith than is urban America. The rural-urban gradient is better represented by a continuum than a dichotomy. This is evident in the voting results in 2018, just as it was in 2016. We found that the political tipping point lies beyond major metropolitan areas, in the suburban counties of smaller metropolitan areas. Democrats enjoyed even greater success in densely populated urban areas in 2018 than in 2016. Residents of these urban areas display distinctive and consistent social and political attitudes across a range of scales. At the other end of the continuum in remote rural areas, Republican candidates continued to command voter support despite the challenging national political environment. Voters in these rural regions expressed social and political attitudes diametrically opposed to their counterparts in large urban cores.

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Delineation of the Urban-Rural Boundary through Data Fusion: Applications to Improve Urban and Rural Environments and Promote Intensive and Healthy Urban Development

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18137180 ◽

2021 ◽

Vol 18 (13) ◽

pp. 7180

Author(s):

Jun Zhang ◽

Xiaodie Yuan ◽

Xueping Tan ◽

Xue Zhang

Keyword(s):

Wavelet Transform ◽

Rural Development ◽

Data Fusion ◽

Urban Development ◽

Urban Sprawl ◽

Rural Areas ◽

Healthy Development ◽

Kappa Value ◽

Urban Rural ◽

Urban And Rural Areas

As one of the most important methods for limiting urban sprawl, the accurate delineation of the urban–rural boundary not only promotes the intensive use of urban resources, but also helps to alleviate the urban issues caused by urban sprawl, realizing the intensive and healthy development of urban cities. Previous studies on delineating urban–rural boundaries were only based on the level of urban and rural development reflected by night-time light (NTL) data, ignoring the differences in the spatial development between urban and rural areas; so, the comprehensive consideration of NTL and point of interest (POI) data can help improve the accuracy of urban–rural boundary delineation. In this study, the NTL and POI data were fused using wavelet transform, and then the urban–rural boundary before and after data fusion was delineated by multiresolution segmentation. Finally, the delineation results were verified. The verification result shows that the accuracy of delineating the urban–rural boundary using only NTL data is 84.20%, and the Kappa value is 0.6549; the accuracy using the fusion of NTL and POI data on the basis of wavelet transform is 93.2%, and the Kappa value is 0.8132. Therefore, we concluded that the proposed method of using wavelet transform to fuse NTL and POI data considers the differences between urban and rural development, which significantly improves the accuracy of the delineation of urban–rural boundaries. Accurate delineation of urban–rural boundaries is helpful for optimizing internal spatial structure in both urban and rural areas, alleviating environmental problems resulting from urban development, assisting the formulation of development policies for urban and rural fringes, and promoting the intensive and healthy development of urban areas.

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RURAL–URBAN MIGRATION AND CHILD SURVIVAL IN URBAN BANGLADESH: ARE THE URBAN MIGRANTS AND POOR DISADVANTAGED?

Journal of Biosocial Science ◽

10.1017/s0021932007002271 ◽

2008 ◽

Vol 40 (1) ◽

pp. 83-96 ◽

Cited By ~ 39

Author(s):

M. MAZHARUL ISLAM ◽

KAZI MD ABUL KALAM AZAD

Keyword(s):

Rural Areas ◽

Urban Areas ◽

Urban Poor ◽

Child Survival ◽

Childhood Mortality ◽

Policy Implications ◽

Urban Migration ◽

Under Five ◽

Urban Migrants ◽

Urban Rural

SummaryThis 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.

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A Program to Increase Health Care for Children: The Pediatric Nurse Practitioner Program, by Henry K. Silver, MD, Loretta C. Ford, EdD, and Susan G. Stearly, MS, Pediatrics, 1967;39:756–760

PEDIATRICS ◽

10.1542/peds.102.s1.245 ◽

1998 ◽

Vol 102 (Supplement_1) ◽

pp. 245-247

Author(s):

Robert A. Hoekelman

Keyword(s):

Health Care ◽

Nurse Practitioner ◽

Rural Areas ◽

The United States ◽

Optimum Level ◽

Socioeconomic Groups ◽

Pediatric Nurse ◽

Lower Socioeconomic ◽

Urban And Rural Areas ◽

Pediatric Nurse Practitioner

The increase in population of the United States is occurring at a much more rapid rate than the increase in medical and nursing personnel available to maintain health services at an optimum level. Unless the pattern of furnishing health care, particularly to lower socioeconomic groups in both urban and rural areas, is drastically improved, these groups will suffer from increasingly inadequate health supervision. This paper describes an educational and training program in pediatrics for professional nurses (the “pediatric nurse practitioner” program), which prepares them to assume an expanded role in providing increased health care for children in areas where there are limited facilities for such care.

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