scholarly journals Examine the association between key determinants identified by the chronic disease indicator framework and multimorbidity by rural and urban settings

2021 ◽  
Vol 11 ◽  
pp. 263355652110281
Author(s):  
John S. Moin ◽  
Richard H. Glazier ◽  
Kerry Kuluski ◽  
Alex Kiss ◽  
Ross E.G. Upshur
Keyword(s):  
Chronic Disease ◽  
Low Income ◽  
Rural Areas ◽  
Chronic Conditions ◽  
Significant Risk ◽  
Administrative Databases ◽  
Multivariable Logistic Regression Model ◽  
Urban Settings ◽  
Rural And Urban ◽  
Indicator Framework

Background: Multimorbidity, often defined as having two or more chronic conditions is a global phenomenon. This study examined the association between key determinants identified by the chronic disease indicator framework and multimorbidity by rural and urban settings. The prevalence of individual diseases was also investigated by age and sex. Methods: The Canada Community Health Survey and linked health administrative databases were used to examine the association between multimorbidity, sociodemographic, behavioral, and other risk factors in the province of Ontario. A multivariable logistic regression model was used to conduct the main analysis. Results: Analyses were stratified by age (20–64 and 65–95) and area of residence (rural and urban). A total sample of n = 174,938 residents between the ages of 20–95 were examined in the Ontario province, of which 18.2% (n = 31,896) were multimorbid with 2 chronic conditions, and 23.4% (n = 40,883) with 3+ chronic conditions. Females had a higher prevalence of 2 conditions (17.9% versus 14.6%) and 3+ conditions (19.7% vs. 15.6%) relative to males. Out of all examined variables, poor self-perception of health, age, Body Mass Index, and income were most significantly associated with multimorbidity. Smoking was a significant risk factor in urban settings but not rural, while drinking was significant in rural and not urban settings. Income inequality was associated with multimorbidity with greater magnitude in rural areas. Prevalence of multimorbidity and having three or more chronic conditions were highest among low-income populations. Conclusion: Interventions targeting population weight, age/sex specific disease burdens, and additional focus on stable income are encouraged.

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”

Gender and sexual minorities

2019 ◽  
pp. 258-268
Author(s):  
Richard Bradlow ◽  
Neha Singh ◽  
Suraj Beloskar ◽  
Gurvinder Kalra
Keyword(s):  
Mental Health ◽  
Urban Area ◽  
Rural Areas ◽  
Urban Areas ◽  
Living Environment ◽  
Substantial Impact ◽  
Urban Settings ◽  
Rural And Urban Areas ◽  
Rural And Urban ◽  
Push And Pull

A person’s living environment can have substantial impact on his/her mental health due to a range of factors related to the environment. It has often been argued that urban settings are a hotpot of sociocultural evolutions that attract individuals from the gender and sexual minority (GSM) groups. This has led to migration from rural to urban areas and also from one urban area to another urban area. Various push and pull factors in both the rural and urban areas help GSM individuals decide in which direction to move. While rural areas present with challenges such as social isolation within a homophobic/transphobic environment, urban areas also have their own unique set of challenges for the GSM population. In this chapter, we focus on various factors in both rural and urban settings that impact on the mental health of GSM population.

scholarly journals Needs and rights awareness of stroke survivors and caregivers in urban and rural China: a cross-sectional, multiple-centre questionnaire survey

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e021820
Author(s):  
Xiaoshuang Xia ◽  
Xiaolin Tian ◽  
Tianli Zhang ◽  
Peilu Wang ◽  
Yanfen Du ◽  
...  
Keyword(s):  
Social Support ◽  
Rural Areas ◽  
Urban Areas ◽  
Rural China ◽  
Potential Effect ◽  
Psychological Support ◽  
Stroke Survivors ◽  
Cross Sectional ◽  
Urban Settings ◽  
Rural And Urban

ObjectivesStroke survivors require assistance and support in their daily lives. This survey aims to investigate the needs and rights awareness in Chinese stroke survivors and caregivers in rural and urban settings.SettingThis survey was adapted from the one created by the World Stroke Organization. The questionnaire included demands for psychological support, treatment and care, social support and information. From January 2015 to January 2016, the survey was pilot tested with urban and rural-dwelling stroke survivors and caregivers from 12 hospitals. Stroke survivors were invited to participate if they were over 18 years old and had experienced a stroke. Exclusion criteria were patients who had disorders of consciousness, significant cognitive impairment, aphasia, communication difficulties or psychiatric disorders. Only caregivers who were family members of the patients were chosen. Paid caregivers were excluded.ParticipantsOne thousand, one hundred and sixty-seven stroke survivors and 1119 caregivers were enrolled.Primary outcome measuresThe needs of stroke survivors and caregivers in rural and urban areas were compared. The correlations between needs of rural and urban stroke survivors and caregivers and potential effect factors were analysed, respectively.ResultsAmong the cohort, 93.5% reported the need for psychological support, 88.6% for treatment and care, 84.8% for information and 62.7% for social support. The total needs and each aspect of needs of stroke survivors in urban settings were greater than of those in rural settings (p<0.01). In rural areas, total needs and each aspect of needs were positively correlated with education level (p<0.01).ConclusionsNeeds and rights awareness of stroke survivors should also be recognised in both urban and rural China. According to the different needs of patients and their caregivers, regional and individualised services were needed by stroke survivors and their caregivers.

scholarly journals Rural Accessibility, Rural Development, and Natural Disasters in Bangladesh

2019 ◽  
Vol 35 (3) ◽  
pp. 391-411 ◽  
Author(s):  
Saleh Ahmed ◽  
Elizabeth Eklund
Keyword(s):  
Developing Countries ◽  
Economic Development ◽  
Rural Development ◽  
Natural Disasters ◽  
Low Income ◽  
Rural Areas ◽  
National Development ◽  
Cost Effective ◽  
Rural And Urban ◽  
Social And Economic Development

Rural accessibility means more than just reliable roads and cost-effective transportation networks. Rural accessibility is critical for achieving social and economic development in low-income developing countries such as Bangladesh where both rural and urban development are constrained by significant infrastructural deficiencies. It is also an important factor that determines the effects of natural disasters on these resource-constrained societies, since both disaster responses and sustainable development are compromised by poor rural accessibility. Using two contrasting case studies from Bangladesh, this article reveals the significance of improved rural accessibility on rural development and the effects of natural disasters on rural areas. The findings of this article suggest that the improvement of rural accessibility should be a top national development priority, since it increases the opportunities for sustainable social and economic development and reduces the adverse effects of natural disasters on the rural areas in developing countries such as Bangladesh.

scholarly journals The rural–urban gap: differences in injury characteristics

2019 ◽  
Vol 39 (12) ◽  
pp. 317-322
Author(s):  
Felix Bang ◽  
Steven McFaull ◽  
James Cheesman ◽  
Minh T. Do
Keyword(s):  
Rural Areas ◽  
Motor Vehicle ◽  
Soft Tissue Injuries ◽  
Eye Injuries ◽  
Injury Rates ◽  
Urban Settings ◽  
Rural And Urban ◽  
Rural Settings ◽  
Severity Of Injury ◽  
The Difference

Background Injuries are among the top 10 leading causes of death in Canada. However, the types and rates of injuries vary between rural versus urban settings. Injury rates increase with rurality, particularly those related to motor vehicle collisions. Factors such as type of work, hazardous environments and longer driving distances contribute to the difference in rural and urban injury rates. Further examination of injuries comparing rural and urban settings with increased granularity in the nature of injuries and severity is needed. Methods The study population consisted of records from the electronic Canadian Hospitals Injury Reporting and Prevention Program (eCHIRPP) from between 2011 and July 2017. Rural and urban status was determined based on postal codes as defined by Canada Post. Proportionate injury ratios (PIRs) were calculated to compare rural and urban injury rates by nature and severity of injury and sex, among other factors. Results Rural injuries were more likely to involve multiple injuries (PIR = 1.66 for 3 injuries) and crush injuries (PIR = 1.72). More modestly elevated PIRs for rural settings were found for animal bites (1.14), burns (1.22), eye injuries (1.32), fractures (1.20) and muscle or soft tissue injuries (1.11). Injuries in rural areas were more severe, with a higher likelihood of cases being admitted to hospital (1.97), and they were more likely to be due to a motor vehicle collision (2.12). Conclusion The nature of injuries in rural settings differ from those in urban settings. This suggests a need to evaluate current injury prevention efforts in rural settings with the aim to close the gap between rural and urban injury rates.

scholarly journals The Development of Chosen Social and Economic Indicators in Rural Areas of the Slovak Republic

2018 ◽  
Vol 15 (2) ◽  
pp. 38-42
Author(s):  
Marián Kováčik ◽  
Eva Žuffová
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Urban Areas ◽  
Slovak Republic ◽  
Economic Indicators ◽  
Rural And Urban Areas ◽  
Rural And Urban ◽  
Study Development

Abstract The focus of the following article was to study development of certain social and economic indicators in Slovakia. We focused this paper on two types of regions in Slovakia, urban and rural. For this purpose we decided to measure the development of inhabitants in rural and urban areas as well as median age of the population. We also partially focused on the sector of agriculture since it used to play an important role in rural areas as a key employer. We found that there is a trend of moving people from urban to rural areas and that agriculture is losing its key role because of decreasing employment trend. This can be caused by low attractiveness of this sector and low income which, nowadays, plays an important role in finding a job.

scholarly journals ANALISIS KONSUMSI PANGAN TINGKAT RUMAH TANGGA DI PROPINSI LAMPUNG

Agro Ekonomi ◽  
2006 ◽  
Vol 13 (2) ◽  
Author(s):  
Meliyanah Meliyanah ◽  
Suhatmini Hardyastuti ◽  
Djuwari Djuwari
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Urban Areas ◽  
Household Consumption ◽  
Income Level ◽  
High Income ◽  
Middle Income ◽  
Household Level ◽  
Rural And Urban Areas ◽  
Rural And Urban

This research diamed to: 1) knowing the selft-price elasticity, cross-price elasticity and income elasticity of consumption per food item on household level according to location and income level; and 2) knowing the reation between level of income and food consumption on household level according to location and income level.This research used data from SUSENAS of Lmapung Province in 2002 with number of sample of 2091 household, which being differed between rural and urban areas based on low, middle, and high level of income. The data analysis used tobit model and sensored regression.The result showed that: 1) the demand of rice and beeh for household consumption in every level of income in rural and urban areas were inelastic; 2) Coen only been consumed by low income level household in rural areas and the demand was inelastic; 3) the demand of cassava for household consumption on low income level in urban area was elastic, While in middle income level, high income level and every level of income in rural area, cassava demand was inelastic. Cassava was considered as inferior goods; 4) The demand of fish for household consumption an every level of income in rural and urban areas was elastic. Household in rural area on every level of income and in urban areas on middle and high income level consider fish as a main necessity. While on low income level  household in urban areas, it was considered as classy/exclusive good; 5) the demand of chicken; for household in rural areas on middle and high income level was inelastic. When in rural low income level and urban middle and high income level, was inelastic chicken meat was considend as classy/exclusive good the rural low income level household; 6) egg demand for household consumption in rural areas on every level of income was inelastic, while in urban area it was elastic for every level income; 7) the rural and urban household on every level of income considered rice as the stpale food; 8) Household in rural and urban areas on middle and high level of income considered beef as main necessity; 9) On household with middle income level in rural areas, egg was considere as inferior good; while an low income level in urban areas, egg was considere as expensive good.

scholarly journals Rural vs urban residence and experience of discrimination among people with severe mental illnesses in Ethiopia

2019 ◽  
Author(s):  
Sarah Forthal ◽  
Abebaw Fekadu ◽  
Girmay Medhin ◽  
Medhin Selamu ◽  
Graham Thornicroft ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Low Income ◽  
Rural Areas ◽  
Negative Binomial ◽  
Mental Illnesses ◽  
Urban Setting ◽  
Low Income Countries ◽  
Urban Settings ◽  
Adjusted Risk

Abstract Background Few studies have addressed mental illness-related discrimination in low-income countries, where the mental health treatment gap is highest. We aimed to evaluate the experience of discrimination among persons with severe mental illnesses (SMI) in Ethiopia, a low-income, rapidly urbanizing African country, and hypothesised that experienced discrimination would be higher among those living in a rural compared to an urban setting. Methods The study was a cross-sectional survey of a community-ascertained sample of people with SMI who underwent confirmatory diagnostic interview. Experienced discrimination was measured using the Discrimination and Stigma Scale (DISC-12). Zero-inflated negative binomial regression was used to estimate the effect of place of residence (rural vs. urban) on discrimination, adjusted for potential confounders. Results Of the 300 study participants, 63.3% had experienced discrimination in the previous year, most commonly being avoided or shunned because of mental illness (38.5%). Urban residents were significantly more likely to have experienced unfair treatment from friends (χ2(1)=4.80; p=0.028), the police (χ2(1) =11.97; p=0.001), in keeping a job (χ2(1)=5.43; p=0.020), and in safety (χ2(1)=5.00; p=0.025), and had a significantly higher DISC-12 score than those living in rural areas (adjusted risk ratio: 1.66; 95% CI: 1.18, 2.33). Conclusions Persons with SMI living in urban settings report more experience of discrimination than their rural counterparts, which may reflect a downside of wider social opportunities in urban settings. Initiatives to expand access to mental health care should consider how social exclusion can be overcome in different settings.

scholarly journals COVID-19 Emergence and Social and Health Determinants in Colorado: A Rapid Spatial Analysis

2020 ◽  
Vol 17 (11) ◽  
pp. 3856 ◽  
Author(s):  
Ivan J. Ramírez ◽  
Jieun Lee
Keyword(s):  
Social Determinants ◽  
Low Income ◽  
Rural Areas ◽  
Urban Areas ◽  
Chronic Conditions ◽  
Health Determinants ◽  
Front Range ◽  
Mountain Communities ◽  
Communities Of Color ◽  
Northern Colorado

The aim of this rapid analysis was to investigate the spatial patterns of COVID-19 emergence across counties in Colorado. In the U.S. West, Colorado has the second highest number of cases and deaths, second only to California. Colorado is also reporting, like other states, that communities of color and low-income persons are disproportionately affected by COVID-19. Using GIS and correlation analysis, this study explored COVID-19 incidence and deaths from March 14 to April 8, 2020, with social determinants and chronic conditions. Preliminary results demonstrate that COVID-19 incidence intensified in mountain communities west of Denver and along the Urban Front Range, and evolved into new centers of risk in eastern Colorado. Overall, the greatest increase in COVID-19 incidence was in northern Colorado, i.e., Weld County, which reported the highest rates in the Urban Front Range. Social and health determinants associated with higher COVID-19-related deaths were population density and asthma, indicative of urban areas, and poverty and unemployment, suggestive of rural areas. Furthermore, a spatial overlap of high rates of chronic diseases with high rates of COVID-19 may suggest a broader syndemic health burden, where comorbidities intersect with inequality of social determinants of health.

scholarly journals The Impacts of Medicaid Expansion on Rural Low-Income Adults: Lessons From the Oregon Health Insurance Experiment

2017 ◽  
Vol 75 (3) ◽  
pp. 354-383 ◽  
Author(s):  
Heidi Allen ◽  
Bill Wright ◽  
Lauren Broffman
Keyword(s):  
Health Insurance ◽  
Low Income ◽  
Health Care Access ◽  
Rural Areas ◽  
Qualitative Interviews ◽  
Rural Populations ◽  
Controlled Study ◽  
Rural And Urban ◽  
Patient Resources ◽  
Oregon Health

Medicaid expansions through the Affordable Care Act began in January 2014, but we have little information about what is happening in rural areas where provider access and patient resources might be more limited. In 2008, Oregon held a lottery for restricted access to its Medicaid program for uninsured low-income adults not otherwise eligible for public coverage. The Oregon Health Insurance Experiment used this opportunity to conduct the first randomized controlled study of a public insurance expansion. This analysis builds off of previous work by comparing rural and urban survey outcomes and adds qualitative interviews with 86 rural study participants for context. We examine health care access and use, personal finances, and self-reported health. While urban and rural populations have unique demographic profiles, rural populations appear to have benefited from Medicaid as much as urban. Qualitative interviews revealed the distinctive challenges still facing low-income uninsured and newly insured rural populations.

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