Political Polarization along the Rural-Urban Continuum? The Geography of the Presidential Vote, 2000–2016

Author(s):  
Dante J. Scala ◽  
Kenneth M. Johnson

This article documents the diversity of political attitudes and voting patterns along the urban-rural continuum of the United States. We find that America’s rural and urban interface, in terms of political attitudes and voting patterns, is just beyond the outer edges of large urban areas and through the suburban counties of smaller metropolitan areas. Both Barack Obama and Hillary Clinton performed well in densely populated areas on the urban side of the interface, but they faced increasingly difficult political climates and sharply diminished voter support on the rural side of the interface. The reduction in support for Clinton in 2016 in rural areas was particularly pronounced. Even after controlling for demographic, social, and economic factors (including geographic region, education, income, age, race, and religious affiliation) in a spatial regression, we find that a county’s position in the urban-rural continuum remained statistically significant in the estimation of voting patterns in presidential elections.

The Forum ◽  
2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Kenneth M. Johnson ◽  
Dante J. Scala

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.


BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e042762
Author(s):  
Shuai Yuan ◽  
Shao-Hua Xie

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.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Brittain Heindl ◽  
George Howard ◽  
Elizabeth A Jackson

Introduction: The incidence of stroke is higher in rural areas. Hypertension is the leading risk factor for stroke, but the difference in systolic blood pressure (SBP) for those living in rural and urban areas is unknown. Hypothesis: We hypothesized that rural residence is associated with higher SBP levels, and this difference is modified by race, sex, and United States (US) division. Methods: We analyzed 26,113 participants enrolled in the REasons for Geographic And Racial Differences in Stroke (REGARDS) Study, recruited between 2003 and 2007. Participants were grouped based on the Rural-Urban Commuting Area (RUCA) scheme into urban, large-rural, and small-isolated rural groups. Resting SBP was measured during the initial home visit. Differences in percentiles of SBP distribution were compared using multivariate models with adjustment for age, race, sex, and US Census Bureau division. Results: Of the participants, 20,976 (80.3%) were classified as urban, 3,020 (11.6%) as large-rural, and 2,137 (8.2%) as small-isolated rural, reflecting the distribution of the population. The large-rural group had a 0.09 mmHg higher mean SBP compared to the urban group (95% CI, 0.33 to 1.52 mmHg, p = 0.0023), but the difference in SBP at the 95th percentile between these groups was 3.23 mmHg (95% CI, 1.43 to 4.73 mmHg, p = 0.0006). A similar difference was present between the small-isolated rural and urban groups at the highest percentiles. No urban-rural interaction was observed by race, sex, or US division. However, large SBP differences were present between US divisions, especially at the highest percentiles. To illustrate, SBP at the 95th percentile was 9.51 mmHg higher in the East North Central division than in the Pacific (95% CI, 6.41 to 12.61 mmHg, p < 0.0001). Conclusions: Residence in a rural area is associated with higher SBP, with larger differences at the highest percentiles of distribution. SBP differences are present between US divisions, independent of urban-rural status.


2020 ◽  
pp. 107755872094591
Author(s):  
Hannah T. Neprash ◽  
Laura Barrie Smith ◽  
Bethany Sheridan ◽  
Ira Moscovice ◽  
Shailendra Prasad ◽  
...  

The growing ranks of nurse practitioners (NPs) in rural areas of the United States have the potential to help alleviate existing primary care shortages. This study uses a nationwide source of claims- and EHR-data from 2017 to construct measures of NP clinical autonomy and complexity of care. Comparisons between rural and urban primary care practices reveal greater clinical autonomy for rural NPs, who were more likely to have an independent patient panel, to practice with less physician supervision, and to prescribe Schedule II controlled substances. In contrast, rural and urban NPs provided care of similar complexity. These findings provide the first claims- and EHR-based evidence for the commonly held perception that NPs practice more autonomously in rural areas than in urban areas.


2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Katherine Vallejo ◽  
Jose Tapias ◽  
Ivan Arroyave

Objective. To analyze the relationship between rural and urban homicide rates in Colombia between 1992 and 2015 and the fluctuations in these rates. Methods. Individual records of homicides and population aggregates in men and women aged 15-64 years were used. The adjusted rates of annual homicides were calculated for urban/rural areas and standardized by age. Rate Ratios (RRs) adjusted by region were calculated. A joinpoint analysis was performed to identify inflection points and the Annual Percentage Change (APC). Results. Four joinpoints were identified in rural and urban rates: after peaking in 1992, homicide rates fell until 1997, and then increased until 2002. From this point on there was a continuous reduction until 2015, although this reduction slowed down from 2005 onward. During almost the whole period, the rates of rural homicides were higher than those of urban homicides, although they equalized at the end of the period. Conclusions. Unlike in other countries, during the study period Colombian homicide rates, which coincided with the dynamics of the armed conflict, were higher in rural than in urban areas. In recent years, a predominance of urban homicides committed by younger men has been identified, which could pose a challenge to postconflict in Colombia.


2020 ◽  
Vol 15 (1) ◽  
pp. 71
Author(s):  
Syamsul Syamsul ◽  
Bala Bakri ◽  
Hizry Stevany Limonu

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.


2006 ◽  
Vol 8 (3) ◽  
pp. 89-97 ◽  
Author(s):  
Robert J. Buchanan ◽  
Randolph Schiffer ◽  
Alexa Stuifbergen ◽  
Li Zhu ◽  
Suojin Wang ◽  
...  

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.


2021 ◽  
pp. 140349482110378
Author(s):  
Reidun Heggem ◽  
Alexander Zahl-Thanem

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.


2021 ◽  
Author(s):  
Jack Thompson ◽  
Stuart James Turnbull-Dugarte

The literature on LGBT participation is growing, but there is still little empirical analysis on the importance of urbanicity in shaping Queer activism. In this paper, we address this critical gap by examining how patterns of participation among LGBT Americans vary by geographic context. Using data from the 2020 Cooperative Election Study (CES) to explore how patterns of LGBT participation differ across the urban-rural interface, we find that individuals identifying as LGBT living in urban areas exhibit higher rates of participation than those living in rural areas, and that these results hold across multiple urban-rural classification schemes. Estimating a multilevel model that leverages local-level data on the density of the LGBT population, we also provide strong empirical validation of the theoretical effects of intragroup contact and mobilization on LGBT participation in large metro areas. When we limit our sample to respondents living in the 55 largest metro areas in the US but vary the metro-level percentage of LGBT individuals, we find that LGBT individuals living in metro areas with a higher percentage of LGBT individuals exhibit higher rates of participation relative to metro areas with a lower percentage of LGBT individuals. The results indicate that urban contexts foster Queer participation by engendering intragroup contact and mobilization among LGBT populations.


Author(s):  
Romana Głowicka-Wołoszyn ◽  
Joanna Stanisławska ◽  
Andrzej Wołoszyn

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.


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