Abstract P94: Rural-Urban Utilization of Echocardiography: Analysis of Veterans Administration Data

2011 ◽  
Vol 4 (suppl_1) ◽  
Author(s):  
Kingston Okrah ◽  
Mary Vaughan-Sarrazin ◽  
Peter Kaboli ◽  
Peter Cram
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Regression Models ◽  
Rural Regions ◽  
Integrated Networks ◽  
Logistic Regression Models ◽  
Rural And Urban Areas ◽  
Patient Demographics ◽  
Rural And Urban ◽  
Urban Rural

BACKGROUND: Patients residing in rural areas may have reduced access to many medical services. This is a particular concern for highly regionalized delivery systems such as VA Healthcare System. We examine echocardiography (echo) utilization among veterans residing in urban and rural regions of the US. METHODS: We used VA administrative data to identify patients receiving care at the VA from 1999-2007. Patients were included during any year that they were engaged in care at the VA, defined by having at least 2 primary care visits during the year (“VA users”). For each year, we identified echos performed on VA users using CPT or ICD-9 codes. We classified each veteran as living in an urban, rural or highly rural region using the RUCA classification system. We compared demographics, comorbidity, and echo utilization rates per 1000 VA users among veterans living in each of the 3 regions using bivariate methods. We used logistic regression models to compare echo utilization for veterans residing in rural and highly rural areas with urban veterans serving as the reference while adjusting for patient demographics, comorbidity, and clustering of patients within 23 veteran integrated networks. RESULTS: Echo recipients residing in highly rural areas were older than residents in rural and urban areas (67.3 yrs vs. 66.7 yrs vs. 66.6 yrs), and more likely to be white, (76.5% vs. 73.6% vs. 59.4%). Unadjusted echo utilization was significantly higher for residents of urban areas compared to rural areas, but similar to highly rural areas (64.0 echos per 1000 per year for urban vs. 59.2 for rural vs. 63.7 for highly rural). In regression models however, we found that veterans living in rural and highly rural areas were slightly more likely to receive echos compared to veterans living in urban areas after adjusting for patient demographics and comorbidity (OR 1.03 95% CI 1.03-1.04 for rural and OR 1.13 95% CI 1.12-1.14 for isolated rural). CONCLUSION: We found no evidence that veterans residing in rural and highly rural regions of the U.S. had reduced utilization of echocardiography after adjusting for patient demographics and comorbidity. These findings suggest that the regionalization of the VA delivery system does not limit the performance of echocardiography for rural veterans.

scholarly journals Urban–rural disparity in cancer incidence in China, 2008–2012: a cross-sectional analysis of data from 36 cancer registers

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e042762
Author(s):  
Shuai Yuan ◽  
Shao-Hua Xie
Keyword(s):  
Cancer Incidence ◽  
Rural Areas ◽  
Urban Areas ◽  
Incidence Rates ◽  
Cancer Type ◽  
Anatomic Site ◽  
Cross Sectional ◽  
Rural And Urban Areas ◽  
Rural And Urban ◽  
Urban Rural

ObjectiveThe substantial differences in socioeconomic and lifestyle exposures between urban and rural areas in China may lead to urban–rural disparity in cancer risk. This study aimed to assess the urban–rural disparity in cancer incidence in China.MethodsUsing data from 36 regional cancer registries in China in 2008–2012, we compared the age-standardised incidence rates of cancer by sex and anatomic site between rural and urban areas. We calculated the rate difference and rate ratio comparing rates in rural versus urban areas by sex and cancer type.ResultsThe incidence rate of all cancers in women was slightly lower in rural areas than in urban areas, but the total cancer rate in men was higher in rural areas than in urban areas. The incidence rates in women were higher in rural areas than in urban areas for cancers of the oesophagus, stomach, and liver and biliary passages, but lower for cancers of thyroid and breast. Men residing in rural areas had higher incidence rates for cancers of the oesophagus, stomach, and liver and biliary passages, but lower rates for prostate cancer, lip, oral cavity and pharynx cancer, and colorectal cancer.ConclusionsOur findings suggest substantial urban–rural disparity in cancer incidence in China, which varies across cancer types and the sexes. Cancer prevention strategies should be tailored for common cancers in rural and urban areas.

scholarly journals PENGGUNAAN ALAT KB PADA WANITA KAWIN DI PERDESAAN DAN PERKOTAAN (Studi Hasil SDKI 2017 Provinsi Gorontalo)

2020 ◽  
Vol 15 (1) ◽  
pp. 71
Author(s):  
Syamsul Syamsul ◽  
Bala Bakri ◽  
Hizry Stevany Limonu
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Contraceptive Use ◽  
Information Provision ◽  
Married Women ◽  
Modern Contraceptive ◽  
Rural And Urban Areas ◽  
Rural And Urban ◽  
Knowledge Age ◽  
Urban Rural

The Indonesia and Demographic Health Survey (IDHS) in 2017 reported a gap between urban and rural contraceptive use in Gorontalo Province, Indonesia. This urban-rural inequality calls for an exploration of its drivers. Hence, this study aims at reviewing the literature to analyze the level of use of contraception for married women in rural and urban areas by examining several factors, such as education, knowledge, age, occupation, information provision, and source of service. The main data source used for this study is 2017 IDHS Report, Gorontalo Province section. The results shows that despite a higher knowledge of contraception in urban married women than their rural counterpart, modern contraceptive use is higher in rural areas than in urban areas. Moreover, provision of information plays a larger role in contraceptive use compared to other aspects. Furthermore, the low contraceptive use among urban women is due to the limited services, where there is a mismatch between the needs and the availability of contraception.

scholarly journals Overweight and obesity among children in rural areas: The importance of culture

2021 ◽  
pp. 140349482110378
Author(s):  
Reidun Heggem ◽  
Alexander Zahl-Thanem
Keyword(s):  
Social Inequality ◽  
Rural Areas ◽  
Urban Areas ◽  
Overweight And Obesity ◽  
National Guidelines ◽  
Important Distinction ◽  
Rural And Urban Areas ◽  
Rural And Urban ◽  
Urban Rural ◽  
Depth Interviews

Aims: This paper focuses on how social inequality is associated with overweight and obesity in children. There is a lack of research with a focus on an important distinction in social inequality, namely geography. The aim of this study was to reduce this knowledge gap by looking closely at the links between rurality and overweight. Methods: The findings in this paper are based on in-depth interviews with school nurses and teachers in rural Norway. The focus was on their experiences with and knowledge about overweight and obesity numbers in rural versus urban areas. Results: We used Bourdieu’s terminology to address the challenges related to urban–rural differences, and found that cultural factors connected to tradition, identity and courtesy play an important role in the rural overweight and obesity discourse. Conclusions: Actors and ‘experts’ working with overweight and obesity and national guidelines need to understand rural contexts and customs and address problems of the countryside on rural, not exclusively urban, premises. Different contexts imply different needs when it comes to reducing the inequalities between rural and urban areas regarding overweight and obesity.

scholarly journals MULTI-DIMENSIONAL ASSESSMENT OF HOUSING CONDITIONS OF THE POPULATION IN RURAL AND URBAN AREAS OF THE WIELKOPOLSKIE VOIVODESHIP

2019 ◽  
Vol XXI (2) ◽  
pp. 79-87 ◽  
Author(s):  
Romana Głowicka-Wołoszyn ◽  
Joanna Stanisławska ◽  
Andrzej Wołoszyn
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Data Bank ◽  
Housing Conditions ◽  
Local Data ◽  
Rural And Urban Areas ◽  
Rural And Urban ◽  
Central Statistical ◽  
Urban Rural ◽  
Central Statistical Office

The aim of the study was to compare the housing conditions of the population living in rural and urban areas of Wielkopolska province communes. The multidimensional assessment of housing conditions was carried out using the TOPSIS method. The research drew on 2016 data published by the Central Statistical Office in the Local Data Bank. The housing conditions in rural areas of the Wielkopolska province were found to be significantly worse than in urban areas. Over 38% of all examined urban areas and only 5% of rural areas (mainly located in the Poznań Metropolitan Area) were classified as Class I with the highest level of housing conditions. Class IV – with the lowest level of housing conditions – included as many as 25% of rural areas and only one urban area located in a mixed, urban-rural commune. In many of the studies, dynamic, beneficial changes in housing conditions in rural areas are emphasized despite the continuous worse situation of rural areas compared to cities. However, due to the observed suburbanisation processes in rural areas in the vicinity of large urban agglomerations, it would be necessary to distinguish living transformations in these rural areas, from changes in housing conditions in rural areas that perform typical agricultural functions.

scholarly journals Rural development of regions of the Republic of Serbia in terms of employment and sources of income

2021 ◽  
pp. 131-148
Author(s):  
Miloš Dimitrijević ◽  
Lela Ristić ◽  
Danijela Despotović
Keyword(s):  
Rural Development ◽  
Rural Areas ◽  
Urban Areas ◽  
Economic Activities ◽  
Rural Regions ◽  
Balanced Development ◽  
Rural And Urban Areas ◽  
Integrated Rural Development ◽  
Rural And Urban ◽  
The Republic

Integrated rural development enables linking agriculture with other economic activities whereby an adequate approach to regional development contributing to a more balanced development among regions. The aim of this research is to indicate that with the concept of integral rural development the differences between regions or rural and urban areas of Serbia could be reduced. Through the Kruskal-Wallis test for comparison of groups, the important differences were compared, where the results of research showed that they are very significant, especially between the Belgrade Region and the predominantly rural regions of Serbia. These differences can be overcome in rural areas if agriculture is more intensively linked with tertiary and secondary sectors.

scholarly journals National report 2009-2019 - Rural NEET in Bosnia-Herzegovina

2020 ◽  
Keyword(s):  
Bosnia And Herzegovina ◽  
Rural Areas ◽  
Urban Areas ◽  
Youth Unemployment ◽  
Youth Employment ◽  
Male Population ◽  
Rural Regions ◽  
Rural And Urban Areas ◽  
Rural And Urban ◽  
Youth Population

This report outlines in detail the situation of rural Youths Neither in Employment, nor in Education or Training (NEET) aged between 15 and 34 years old, over the last decade (2009-2019) in Bosnia and Herzegovina. To do this, the report utilised indicators of: you-th population; youth employment and unemployment; education; and, NEETs distribution. The characterisation of all indicators adopted the degree of urbanisation as a central cri-terion, enabling proportional comparisons between rural areas, towns and suburbs, cities and the whole country. These analyses are further divided into age subgroups and, where possible, into sex groups for greater detail. The statistical procedures adopted across the different selected dimensions involve: des-criptive longitudinal analysis; using graphical displays (e.g., overlay line charts); and, the calculation of proportional absolute and relative changes between 2009 and 2013, 2013 and 2019, and finally 2009 and 2019. These time ranges were chosen to capture the in-dicators evolution before and after the economic crisis which hit European countries. All data was extracted from ILOSTAT explorer public datasets.The analyses show that between 2009 and 2019 youth population in both rural and urban areas decreased. In general, a strong decline in youth population was observed within all categories, with the most significant decrease within the age group 25-29 (21.57%) and 15-19 (20.35%). Youth employment has tended to decrease overall, and the decrease is stron-ger within rural regions. Interestingly, youth unemployment has also tended to decrease, and a significantly higher share of unemployed youth is from rural regions. A somewhat similar trend is observed in the field of education where the number of those enrolled significantly decreased during the observed period for all education levels in Bosnia and Herzegovina. The ESLET rate tended to decrease, while the proportion of the female po-pulation tends to have higher ESLET levels compared to the male population. However, the ESLET rate is still below the 10% target defined by the Europe 2020 strategy. Finally, the proportion of NEETs in Bosnia and Herzegovina is higher in rural areas, while in general the tendency has been for it to decrease during the observed period.

scholarly journals National reports 2009-2019 - Rural NEET across Europe (14 countries reports)

2020 ◽  
Keyword(s):  
Bosnia And Herzegovina ◽  
Rural Areas ◽  
Urban Areas ◽  
Youth Unemployment ◽  
Youth Employment ◽  
Male Population ◽  
Rural Regions ◽  
Rural And Urban Areas ◽  
Rural And Urban ◽  
Youth Population

This report outlines in detail the situation of rural Youths Neither in Employment, nor in Education or Training (NEET) aged between 15 and 34 years old, over the last decade (2009-2019) in Bosnia and Herzegovina. To do this, the report utilised indicators of: you-th population; youth employment and unemployment; education; and, NEETs distribution. The characterisation of all indicators adopted the degree of urbanisation as a central cri-terion, enabling proportional comparisons between rural areas, towns and suburbs, cities and the whole country. These analyses are further divided into age subgroups and, where possible, into sex groups for greater detail. The statistical procedures adopted across the different selected dimensions involve: des-criptive longitudinal analysis; using graphical displays (e.g., overlay line charts); and, the calculation of proportional absolute and relative changes between 2009 and 2013, 2013 and 2019, and finally 2009 and 2019. These time ranges were chosen to capture the in-dicators evolution before and after the economic crisis which hit European countries. All data was extracted from ILOSTAT explorer public datasets.The analyses show that between 2009 and 2019 youth population in both rural and urban areas decreased. In general, a strong decline in youth population was observed within all categories, with the most significant decrease within the age group 25-29 (21.57%) and 15-19 (20.35%). Youth employment has tended to decrease overall, and the decrease is stron-ger within rural regions. Interestingly, youth unemployment has also tended to decrease, and a significantly higher share of unemployed youth is from rural regions. A somewhat similar trend is observed in the field of education where the number of those enrolled significantly decreased during the observed period for all education levels in Bosnia and Herzegovina. The ESLET rate tended to decrease, while the proportion of the female po-pulation tends to have higher ESLET levels compared to the male population. However, the ESLET rate is still below the 10% target defined by the Europe 2020 strategy. Finally, the proportion of NEETs in Bosnia and Herzegovina is higher in rural areas, while in general the tendency has been for it to decrease during the observed period.

TURNING FARMERS INTO SOCIAL FARMER ENTREPRENEURS FOR DISADVANTAGED PEOPLE

2020 ◽  
Author(s):  
Remus Runcan
Keyword(s):  
Rural Communities ◽  
Low Income ◽  
Rural Areas ◽  
Urban Areas ◽  
Health And Safety ◽  
Physical Work ◽  
Healthy Environment ◽  
Rural And Urban Areas ◽  
Rural Development Programme ◽  
Rural And Urban

According to Romania’s National Rural Development Programme, the socio-economic situation of the rural environment has a large number of weaknesses – among which low access to financial resources for small entrepreneurs and new business initiatives in rural areas and poorly developed entrepreneurial culture, characterized by a lack of basic managerial knowledge – but also a large number of opportunities – among which access of the rural population to lifelong learning and entrepreneurial skills development programmes and entrepreneurs’ access to financial instruments. The population in rural areas depends mainly on agricultural activities which give them subsistence living conditions. The gap between rural and urban areas is due to low income levels and employment rates, hence the need to obtain additional income for the population employed in subsistence and semi-subsistence farming, especially in the context of the depopulation trend. At the same time, the need to stimulate entrepreneurship in rural areas is high and is at a resonance with the need to increase the potential of rural communities from the perspective of landscape, culture, traditional activities and local resources. A solution could be to turn vegetal and / or animal farms into social farms – farms on which people with disabilities (but also adolescents and young people with anxiety, depression, self-harm, suicide, and alexithymia issues) might find a “foster” family, bed and meals in a natural, healthy environment, and share the farm’s activities with the farmer and the farmer’s family: “committing to a regular day / days and times for a mutually agreed period involves complying with any required health and safety practices (including use of protective clothing and equipment), engaging socially with the farm family members and other people working on and around the farm, and taking on tasks which would include working on the land, taking care of animals, or helping out with maintenance and other physical work”

Relating Household Consumption Expenditures to Road Traffic Fatalities: A Rural–Urban Study

2021 ◽  
pp. 036119812110332
Author(s):  
Ruchika Agarwala ◽  
Vinod Vasudevan
Keyword(s):  
Developing Countries ◽  
Traffic Safety ◽  
Rural Areas ◽  
Urban Areas ◽  
Household Consumption ◽  
Household Expenditure ◽  
Traffic Fatality ◽  
Rural And Urban Areas ◽  
Rural And Urban ◽  
The Relationship

Research shows that traffic fatality risk is generally higher in rural areas than in urban areas. In developing countries, vehicle ownership and investments in public transportation typically increase with economic growth. These two factors together increase the vehicle population, which in turn affects traffic safety. This paper presents a study focused on the relationship of various factors—including household consumption expenditure data—with traffic fatality in rural and urban areas and thereby aims to fill some of the gaps in the literature. One such gap is the impacts of personal and non-personal modes of travel on traffic safety in rural versus urban areas in developing countries which remains unexplored. An exhaustive panel data modeling approach is adopted. One important finding of this study is that evidence exists of a contrasting relationship between household expenditure and traffic fatality in rural and urban areas. The relationship between household expenditure and traffic fatality is observed to be positive in rural areas and a negative in urban areas. Increases in most expenditure variables, such as fuel, non-personal modes of travel, and two-wheeler expenditures, are found to be associated with an increase in traffic fatality in rural areas.

scholarly journals Urban–Rural Disparities in the Magnitude and Determinants of Stunting among Children under Five in Tanzania: Based on Tanzania Demographic and Health Surveys 1991–2016

2021 ◽  
Vol 18 (10) ◽  
pp. 5184
Author(s):  
Wenjun Zhu ◽  
Si Zhu ◽  
Bruno F. Sunguya ◽  
Jiayan Huang
Keyword(s):  
Urban Areas ◽  
Health Surveys ◽  
Demographic And Health Surveys ◽  
Household Level ◽  
Individual Level ◽  
Child Stunting ◽  
Rural And Urban Areas ◽  
Rural And Urban ◽  
Urban Rural ◽  
The Individual

Our study aims to examine the disparity of under-5 child stunting prevalence between urban and rural areas of Tanzania in the past three decades, and to explore factors affecting the rural–urban disparity. Secondary analyses of Tanzania Demographic and Health Surveys (TDHS) data drawn from 1991–1992, 1996, 1999, 2004–2005, 2009–2010, and 2015–2016 surveys were conducted. Under-5 child stunting prevalence was calculated separately for rural and urban children and its decline trends were examined by chi-square tests. Descriptive analyses were used to present the individual-level, household-level, and societal-level characteristics of children, while multivariable logistic regression analyses were performed to examine determinants of stunting in rural and urban areas, respectively. Additive interaction effects were estimated between residence and other covariates. The results showed that total stunting prevalence was declining in Tanzania, but urban–rural disparity has widened since the decline was slower in the rural area. No interaction effect existed between residence and other determinants, and the urban–rural disparity was mainly caused by the discrepancy of the individual-level and household-level factors between rural and urban households. As various types of determinants exist, multisector nutritional intervention strategies are required to address the child stunting problem. Meanwhile, the intervention should focus on targeting vulnerable children, rather than implementing different policies in rural and urban areas.

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