Specialized cardiological care may be overutilized in urban areas of Québec

2011 ◽  
Vol 19 (4) ◽  
pp. 731-737
Author(s):  
Alan A Cohen ◽  
Alain Vanasse ◽  
Josiane Courteau ◽  
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Population Level ◽  
Population Based ◽  
Care Utilization ◽  
Service Usage ◽  
Health Service Usage ◽  
Specialized Care ◽  
Urban Rural ◽  
Revascularization Procedures

Background: Urban/rural differences in secondary cardiovascular disease (CVD) events have previously been observed for Québec. These differences could be attributable to differential utilization of specialized cardiological care, such as revascularization procedures and visits to cardiologists; if this were the case, policies to increase utilization in rural areas would be indicated. Design: This is a population-based cohort study. Methods: We analysed mortality and hospital re-admission in Québec within 1 year after an initial cardiovascular event in relation to urban/rural location and specialized care utilization, controlling for demography, comorbidities, and cumulative hospitalization. Results: Analysis showed higher hospital re-admissions and slightly lower CVD mortality in rural areas, as well as less use of specialized care in rural areas. However, urban/rural differentials were not attributable to differences in utilization of care. Paradoxically, comorbidities were lower among patients who saw specialists. Conclusions: Ultimately, urban/rural differences in secondary CVD outcomes were not attributable to differences in care utilization or our measures of underlying health status, and were likely due to cultural or lifestyle factors that are both hard to model and hard to change through policy. There appears to be overutilization of specialized care in urban areas, an issue which requires further study. Our results suggest that substantial caution is required when interpreting health service usage data and that critical factors in the relationship between specialized cardiological care and outcomes are still poorly understood at a population level.

scholarly journals The Burden of Seizures in Manitoba Children: A Population-Based Study

2004 ◽  
Vol 31 (1) ◽  
pp. 48-52 ◽  
Author(s):  
Anita L. Kozyrskyj ◽  
Asuri N. Prasad
Keyword(s):  
Health Care ◽  
Urban Areas ◽  
Census Data ◽  
Population Based ◽  
Care Utilization ◽  
Published Data ◽  
Prevalence Rates ◽  
Seizure Disorders ◽  
Urban Rural ◽  
The Impact

Background:Population-based studies are necessary to better understand the risk factors for developing seizure disorders and the impact of these conditions on children. We undertook an assessment of the prevalence of seizure disorders in a population of children on the basis of health care utilization records.Methods:Using Manitoba’s population-based prescription and health care data for 1998/99, the prevalence of children with seizure disorders, on the basis of at least one physician visit or hospitalization for epilepsy or a prescription for an antiepileptic drug, was determined by age, urban/rural region and socioeconomic status. The latter was measured as neighbourhoods stratified by income quintiles according to Census data.Results:Age-specific prevalence rates for seizure disorders in Manitoba children, determined from health care administrative records, were similar to published data on the prevalence of epilepsy, with one exception. Prevalence rates in adolescents were higher than those reported in the literature. No statistically significant differences in prevalence rates were observed between urban and rural populations. However, a higher prevalence was found among children of all ages living in lower socioeconomic neighbourhoods in urban areas, which presented as a gradient of increased prevalence with decreased levels of income.Conclusion:Population-based health care administrative data can be used to describe the geographical distribution of seizure disorders. Our data suggest that the burden of seizure disorders is not evenly distributed among children.

scholarly journals Life in the fast lane: roadkill risk along an urban–rural gradient

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Eleri Kent ◽  
Amy L W Schwartz ◽  
Sarah E Perkins
Keyword(s):  
Species Distribution ◽  
Rural Areas ◽  
Urban Areas ◽  
Population Level ◽  
Urban Environments ◽  
Distribution Models ◽  
Road Density ◽  
A Value ◽  
Animal Populations ◽  
Urban Rural

Abstract Wildlife-vehicle collisions are a major cause of mortality in animal populations and can cause significant population-level effects. Urban areas are typically associated with higher road densities and unique wildlife communities in comparison to rural areas, and therefore have the potential to be associated with high numbers of collisions, and roadkill risk. Here, we use a citizen science database of wildlife roadkill and species distribution models to assess how roadkill risk (probability of roadkill observation per km2) varied along an urban–rural gradient for British wildlife. Roadkill risk was positively associated with road density, until around 5000 m/km2, a value representing villages or the outskirts of towns and cities. Beyond 5000 m/km2, risk remained high for some species (hedgehog, fox, pigeons and gulls) but reduced for other species (badger, rabbit, pheasant). Roadkill risk was a function of live species distribution for badger, hedgehog and rabbit, with significant overlap between spatial patterns of roadkill risk and the species’ live distribution. This was not the case for fox, pheasant, pigeons and gulls. Fox roadkill risk was underrepresented in rural areas, possibly due to low road density, while pheasant risk was overrepresented. For pigeons and gulls—well-known urban exploiters—roadkill risk was overrepresented in urban areas given their live distributions, possibly due to risks associated with foraging, particularly roadkill scavenging by gulls. Our results highlight the dangers of the UK’s dense road networks to wildlife, even to species considered adapted to urban environments and human disturbance.

Urban–Rural Dichotomy in Planning: Review of Legal Framework in Four States of India

2021 ◽  
pp. 001955612110016
Author(s):  
Anurima Mukherjee Basu ◽  
Rutool Sharma
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Planning Process ◽  
Legal Framework ◽  
Quantum Jump ◽  
Class 1 ◽  
Urban Settlements ◽  
Urban Rural ◽  
Territorial Approach ◽  
Sizeable Number

Current urbanisation trends in India show a quantum jump in number of ‘census towns’, which are not statutorily declared as urban areas, but have acquired all characteristics of urban settlements. Sizeable number of such census towns are not located near any Class 1 city. Lack of proper and timely planning has led to unplanned growth of these settlements. This article is based on a review of planning legislations, institutional framework and planning process of four states in India. The present article analyses the scope and limitations of the planning process adopted in the rapidly urbanising rural areas of these states. The findings reveal that states are still following a conventional approach to planning that treats ‘urban’ and ‘rural’ as separate categories and highlights the need for adopting an integrated territorial approach to planning of settlements.

scholarly journals Salt intake and blood pressure in Iranian children and adolescents: a population-based study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mohammad Hassan Emamian ◽  
Hossein Ebrahimi ◽  
Hassan Hashemi ◽  
Akbar Fotouhi
Keyword(s):  
Blood Pressure ◽  
Rural Areas ◽  
Urban Areas ◽  
Salt Intake ◽  
Daily Intake ◽  
Population Based ◽  
World Health ◽  
Second Phase ◽  
Salt Consumption ◽  
The Mean

Abstract Background Previous studies have reported a high prevalence of hypertension in Iranian students, especially in rural areas. The aim of this study was to investigate the daily intake of salt in students and its association with high blood pressure. Methods A random sub-sample was selected from the participants of the second phase of Shahroud schoolchildren eye cohort study and then a random urine sample was tested for sodium, potassium and creatinine. Urine electrolyte esexcretion and daily salt intake were calculated by Tanaka et al.’s formula. Results Among 1455 participants (including 230 participants from rural area and 472 girls), the mean age was 12.9 ± 1.7 year and the mean daily salt intake was 9.7 ± 2.6 g (95% CI 9.5–9.8). The mean salt consumption in rural areas [10.8 (95% CI 10.4–11.2)] was higher than urban areas [9.4 (95% CI 9.3–9.6)], in people with hypertension [10.8 (95% CI 10.3–11.3)] was more than people with normal blood pressure [9.4 (95% CI 9.3–9.6)], and in boys [9.8 (95% CI 9.7–10.0)] was more than girls [9.3 (95% CI 9.1–9.6)]. Higher age, BMI z-score, male sex and rural life, were associated with increased daily salt intake. Increased salt intake was associated with increased systolic and diastolic blood pressure. Conclusion Daily salt intake in Iranian adolescents was about 2 times the recommended amount of the World Health Organization, was higher in rural areas and was associated with blood pressure. Reducing salt intake should be considered as an important intervention, especially in rural areas.

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.

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

2008 ◽  
Vol 40 (1) ◽  
pp. 83-96 ◽  
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.

scholarly journals Seasonal variation and spatial distribution of carbonaceous aerosols in Taiwan

2010 ◽  
Vol 10 (19) ◽  
pp. 9563-9578 ◽  
Author(s):  
C. C.-K. Chou ◽  
C. T. Lee ◽  
M. T. Cheng ◽  
C. S. Yuan ◽  
S. J. Chen ◽  
...  
Keyword(s):  
Spatial Distribution ◽  
Rural Areas ◽  
Urban Areas ◽  
Air Pollutants ◽  
Chemical Properties ◽  
Anthropogenic Sources ◽  
Carbonaceous Aerosols ◽  
Urban Rural ◽  
Southern Taiwan ◽  
Northern Taiwan

Abstract. To investigate the physico-chemical properties of aerosols in Taiwan, an observation network was initiated in 2003. In this work, the measurements of the mass concentration and carbonaceous composition of PM10 and PM2.5 are presented. Analysis on the data collected in the first 5-years, from 2003 to 2007, showed that there was a very strong contrast in the aerosol concentration and composition between the rural and the urban/suburban stations. The five-year means of EC at the respective stations ranged from 0.9±0.04 to 4.2±0.1 μgC m−3. In rural areas, EC accounted for 2–3% of PM10 and 3–5% of PM2.5 mass loadings, comparing to 4–6% of PM10 and 4–8% of PM2.5 in the urban areas. It was found that the spatial distribution of EC was consistent with CO and NOx across the network stations, suggesting that the levels of EC over Taiwan were dominated by local sources. The measured OC was split into POC and SOC counterparts following the EC tracer method. Five-year means of POC ranged from 1.8±0.1 to 9.7±0.2 μgC m−3 among the stations. It was estimated that the POM contributed 5–17% of PM10 and 7–18% of PM2.5 in Taiwan. On the other hand, the five-year means of SOC ranged from 1.5±0.1 to 3.8±.3 μgC m−3. The mass fractions of SOM were estimated to be 9–19% in PM10 and 14–22% in PM2.5. The results showed that the SOC did not exhibit significant urban-rural contrast as did the POC and EC. A significant cross-station correlation between SOC and total oxidant was observed, which means the spatial distribution of SOC in Taiwan was dominated by the oxidant mixing ratio. Besides, correlation was also found between SOC and particulate nitrate, implying that the precursors of SOA were mainly from local anthropogenic sources. In addition to the spatial distribution, the carbonaceous aerosols also exhibited distinct seasonality. In northern Taiwan, the concentrations of all the three carbonaceous components (EC, POC, and SOC) reached their respective minima in the fall season. POC and EC increased drastically in winter and peaked in spring, whereas the SOC was characterized by a bimodal pattern with the maximal concentration in winter and a second mode in summertime. In southern Taiwan, minimal levels of POC and EC occurred consistently in summer and the maxima were observed in winter, whereas the SOC peaked in summer and declined in wintertime. The discrepancies in the seasonality of carbonaceous aerosols between northern and southern Taiwan were most likely caused by the seasonal meteorological settings that dominated the dispersion of air pollutants. Moreover, it was inferred that the Asian pollution outbreaks could have shifted the seasonal maxima of air pollutants from winter to spring in the northern Taiwan, and that the increases in biogenic SOA precursors and the enhancement in SOA yield were responsible for the elevated SOC concentrations in summer.

Agriculture Biomaterial Industry in Romania

2021 ◽  
Vol 10 (1) ◽  
pp. 32-44
Author(s):  
Irina Bancescu
Keyword(s):  
Rural Development ◽  
Rural Areas ◽  
Urban Areas ◽  
Rural Poverty ◽  
Value Added ◽  
Poverty Rate ◽  
Economic Implications ◽  
Income Gap ◽  
Rural Income ◽  
Urban Rural

Rural areas in Romania are underdeveloped, with the main economic activity being agriculture. Urban-rural income gap and poverty levels are indicative of an underdeveloped rural area. Urban-rural absolute income gap for average monthly income increased from 352 RON in 2007 to 663 RON in 2017. Moreover, the work poverty rate is higher in rural areas than in urban areas. Economic rural development can be achieved by improvements of the labour market and introduction of new value-added products. Agricultural and non-agricultural activities are dependent on each other for a successful rural development leading to poverty alleviation. An industry that combines the two types of economic activities is agriculture biomaterial industry. In this paper, the authos investigates the factors influencing rural poverty and analyses the current stage of the bioplastics market in Romania and its economic implications. Bioplastics industry can reduce urban-rural income gaps and poverty in rural areas.

scholarly journals Seasonal patterns of dengue incidence in Thailand across the urban-rural gradient

2020 ◽  
Author(s):  
Qifang Bi ◽  
Derek AT Cummings ◽  
Nicholas G. Reich ◽  
Lindsay T. Keegan ◽  
Joshua Kaminsky ◽  
...  
Keyword(s):  
Wavelet Analysis ◽  
Temporal Variation ◽  
Rural Areas ◽  
Urban Areas ◽  
Dynamic Models ◽  
Seasonal Patterns ◽  
Disease Dynamics ◽  
Urban Rural ◽  
Spatio Temporal ◽  
Dengue Epidemics

AbstractIn Southeast Asia, endemic dengue follows strong spatio-temporal patterns with major epidemics occurring every 2-5 years. However, important spatio-temporal variation in seasonal dengue epidemics remains poorly understood. Using 13 years (2003-2015) of dengue surveillance data from 926 districts in Thailand and wavelet analysis, we show that rural epidemics lead urban epidemics within a dengue season, both nationally and within health regions. However, local dengue fade-outs are more likely in rural areas than in urban areas during the off season, suggesting rural areas are not the source of viral dispersion. Simple dynamic models show that stronger seasonal forcing in rural areas could explain the inconsistency between earlier rural epidemics and dengue “over wintering” in urban areas. These results add important nuance to earlier work showing the importance of urban areas in driving multi-annual patterns of dengue incidence in Thailand. Feedback between geographically linked locations with markedly different ecology is key to explaining full disease dynamics across urban-rural gradient.

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

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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