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.

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

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.

scholarly journals Comparison of The Risk Factors For Falls Among Older Adults Between Urban and Rural Areas of Shantou City, China

2020 ◽  
Author(s):  
Xiaodong Chen ◽  
Zeting Lin ◽  
Ran Gao ◽  
Yijian Yang ◽  
Liping Li
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Fall Prevention ◽  
Rural Areas ◽  
Urban Areas ◽  
Multivariable Analysis ◽  
Living Environment ◽  
Balance Function ◽  
Urban And Rural Areas ◽  
Risk Factors For Falls

Abstract Background: To investigate the prevalence of falls and risk factors among older adults in urban and rural areas and to facilitate the design of fall prevention interventions.Methods: We used cluster random sampling to investigate the sociodemographic information, living habits, medical history, and falls among 649 older adult participants. Univariable and multivariable logistic regression was used to examine fall risk factors in urban and rural areas.Results: The fall rate and rate of injury from falls among older adults in urban areas were 27.3% and 18.6%, respectively, which were higher than those in rural areas (17.0% and 12.2%; P<0.05). Multivariable analysis showed that the risk factors for falls among urban older adults included a high school or below education level (OR=3.737, 95% CI: 1.503~9.291); diabetes medicine use (OR=4.518, 95% CI: 1.228~16.626); incontinence (OR=8.792, 95% CI: 1.894~40.824); lack of fall prevention education (OR = 11.907, 95% CI: 1.321～107.354); and reduced balance function (OR = 3.901, 95% CI: 1.894~7.815). The risk factors among rural older adults included a previous nonfarming occupation (OR=2.496, 95% CI: 1.416~4.398); incontinence (OR =11.396, 95% CI: 1.901~68.327); poor living environment (OR=3.457, 95% CI: 1.488~8.033); and reduced balance function (OR =4.260, 95% CI: 2.361~7.688).Discussion: The rate of falls among older adults in urban areas is higher than that in rural areas of Shantou City. Fall prevention in urban areas should target older adults with low education and modify the diabetes medication use. Interventions should focus on improving the home environment of older adults in rural areas.

Abstract 13706: Differences in the Distribution of Systolic Blood Pressure by Rural and Urban Residence

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Brittain Heindl ◽  
George Howard ◽  
Elizabeth A Jackson
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Racial Differences ◽  
Rural Areas ◽  
Urban Areas ◽  
Census Bureau ◽  
Urban Group ◽  
Rural And Urban ◽  
Urban Rural ◽  
The Difference

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.

scholarly journals Does living in an urban environment confer advantages for childhood nutritional status? Analysis of disparities in nutritional status by wealth and residence in Angola, Central African Republic and Senegal

2006 ◽  
Vol 9 (2) ◽  
pp. 187-193 ◽  
Author(s):  
Gina Kennedy ◽  
Guy Nantel ◽  
Inge D Brouwer ◽  
Frans J Kok
Keyword(s):  
Nutritional Status ◽  
Urban Environment ◽  
Rural Areas ◽  
Urban Areas ◽  
Central African Republic ◽  
Wealth Index ◽  
Living Conditions ◽  
Urban Rural ◽  
Urban And Rural Areas ◽  
Poor Children

AbstractObjectiveThe purpose of this paper is to examine the relationship between childhood undernutrition and poverty in urban and rural areas.DesignAnthropometric and socio-economic data from Multiple Indicator Cluster Surveys in Angola-Secured Territory (Angola ST), Central African Republic and Senegal were used in this analysis. The population considered in this study is children 0–59 months, whose records include complete anthropometric data on height, weight, age, gender, socio-economic level and urban or rural area of residence. In addition to simple urban/rural comparisons, the population was stratified using a wealth index based on living conditions and asset ownership to compare the prevalence, mean Z-score and odds ratios for stunting and wasting.ResultsIn all cases, when using a simple urban/rural comparison, the prevalence of stunting was significantly higher in rural areas. However, when the urban and rural populations were stratified using a measure of wealth, the differences in prevalence of stunting and underweight in urban and rural areas of Angola ST, Central African Republic and Senegal disappeared. Poor children in these urban areas were just as likely to be stunted or underweight as poor children living in rural areas. The odds ratio of stunting in the poorest compared with the richest quintile was 3.4, 3.2 and 1.5 in Angola ST, Senegal and Central African Republic, respectively.ConclusionsThis paper demonstrates that simple urban/rural comparisons mask wide disparities in subgroups according to wealth. There is a strong relationship between poverty and chronic undernutrition in both urban and rural areas; this relationship does not change simply by living in an urban environment. However, urban and rural living conditions and lifestyles differ, and it is important to consider these differences when designing programmes and policies to address undernutrition.

Faecal sludge management in low income areas: a case study of three districts in the Ashanti region of Ghana

2014 ◽  
Vol 4 (2) ◽  
pp. 189-199 ◽  
Author(s):  
Eugene Appiah-Effah ◽  
Kwabena Biritwum Nyarko ◽  
Samuel Fosu Gyasi ◽  
Esi Awuah
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Urban Areas ◽  
Sludge Management ◽  
The Public ◽  
Ashanti Region ◽  
Toilet Facility ◽  
Urban And Rural Areas ◽  
Public Toilets ◽  
Faecal Sludge

The challenge of faecal sludge management (FSM) in most developing countries is acute, particularly in low income areas. This study examined the management of faecal sludge (FS) from household latrines and public toilets in three districts in the Ashanti region of Ghana based on household surveys, key informant interviews and field observations. Communities did not have designated locations for the disposal and treatment of FS. For household toilets, about 31 and 42% of peri-urban and rural respondents, respectively, with their toilets full reported that they did not consider manual or mechanical desludging as an immediate remedy, although pits were accessible. Households rather preferred to close and abandon their toilets and use public toilets at a fee or practise open defecation. For the public toilets, desludging was manually carried out at a fee of GHC 800–1,800 and the process usually lasted 8–14 days per toilet facility. The study showed that FSM has not been adequately catered for in both peri-urban and rural areas. However, respondents from the peri-urban areas relatively manage their FS better than their rural counterparts. To address the poor FSM in the study communities, a decentralized FS composting is a potential technology that could be used.

scholarly journals Association Between Happiness and Objective/Subjective Economic Status Among Older Adults in Myanmar

2020 ◽  
Author(s):  
Yuri Sasaki ◽  
Yugo Shobugawa ◽  
Ikuma Nozaki ◽  
Daisuke Takagi ◽  
Yuiko Nagamine ◽  
...  
Keyword(s):  
Older Adults ◽  
Rural Areas ◽  
Urban Areas ◽  
Economic Status ◽  
Wealth Index ◽  
Economic Indicator ◽  
Sampling Procedure ◽  
Household Asset ◽  
Face To Face ◽  
Urban And Rural Areas

Abstract BackgroundFew studies have examined whether objective or subjective economic status (ES) has a greater effect on the happiness of older adults in developing countries with ageing populations. This study examined whether objective/subjective economic status (ES) is associated with happiness in older adults in Myanmar.MethodA multistage, random sampling procedure and face-to-face interviews were conducted in urban and rural areas in Myanmar. The happiness of 1,200 participants aged 60+ was evaluated using a single happiness score of 0 (very unhappy) to 10 (very happy). The wealth index, used as an objective economic indicator, was calculated from household asset items. Subjective economic status was assessed by asking “Which of the following best describes your current financial situation in light of general economic conditions?” The possible responses ranged from (1) very difficult to (5) very comfortable. ResultsThe mean happiness score was lower among participants with low objective and subjective ES than among those with medium or high objective ES (6.24 versus 6.80 points, p < 0.001) and average or higher subjective ES (5.62 versus 6.83 points, p < 0.001), respectively. Both low objective and subjective ES were negatively associated with happiness after adjusting for confounding variables (B: -0.41, 95% confidence interval [CI]: -0.69, -0.13 and B: -0.71, 95% CI: -1.00, -0.42, respectively) and stratification by region (low objective ES, urban: B: -0.52, 95% CI: -1.03, -0.02; low subjective ES, urban: B: -0.50, 95% CI: -0.96, -0.03; low objective ES, rural: B: -0.37, 95% CI: -0.73, -0.02; and low subjective ES, rural: B: -0.80, 95% CI: -1.18, -0.41). ConclusionsIn Myanmar, both objective and subjective ES might influence happiness among older adults. Although they had a similar impact on happiness in urban areas, subjective ES had a stronger impact in rural areas. Interventions for promoting happiness in older adults should consider differences in how objective/subjective ES impacts happiness in different regions, and focus should be placed not only on improving objective ES but also subjective ES in society.

Anisometropia in the 5th and 6th school years

2020 ◽  
Vol 30 (Supplement_2) ◽  
Author(s):  
A F Nunes ◽  
A S Nunes ◽  
P Monteiro ◽  
C R Martins ◽  
H Forte
Keyword(s):  
Binocular Vision ◽  
Rural Areas ◽  
Urban Areas ◽  
Basic Education ◽  
Age Groups ◽  
Separate Analysis ◽  
Chi Square ◽  
Screening Programs ◽  
The Difference ◽  
Urban And Rural Areas

Abstract Introduction Anisometropia is characterized by a refractive inter ocular difference greater than 1.00 dioptre (D). It is the main cause of amblyopia and loss of binocular vision. Its prevalence depends on several factors, being different values in different geographical areas of the world and in different age groups. Objectives To estimate the frequency of anisometropia in children of the 2nd cycle of Basic Education. Methodology A total of 519 children attending the 5th and 6th school years, from Covilhã schools, from urban and rural areas, aged between 9 and 14 years (10.8 ± 0.8 years) were enrolled in the study. The refractive error was measured with a paediatric auto refractometer (Plusoptix), without cycloplegic and in binocular conditions. Anisometropia was defined as the inter ocular difference in spherical equivalent or cylindrical, greater than 1.00 D and a separate analysis for values greater than 2.00 D. Results The sample was symmetrically divided into genders (50.9% Male), between school grade (53% 5th year) and higher in urban areas (70.1%). The prevalence of anisometropia with cut-off points of 1.00 D and 2.00 D was 12.3% and 5.0%, respectively. There was a higher prevalence among males, in rural areas and in 6th grade. The Chi-square test (□2) shows that the difference is statistically significant only between years of schooling, with a higher prevalence in the 6th grade (p = 0.001). Conclusion There was a slightly higher prevalence of spherical and cylindrical anisometropia (5% and 12.3%) than is reported in the literature (rates between 4.4% and 9.4%). The 6th school year presented rates significantly higher than the 5th year, which points out that anisometropia increases with age, as was also advocated by other authors. Visual screening programs in adolescence for the detection of anisometropia are fundamental, since their timely correction allows to safeguard the binocular vision.

scholarly journals Urban–rural differences in the prevalence of diabetes mellitus among 25–74 year-old adults of the Yangon Region, Myanmar: two cross-sectional studies

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e020406 ◽  
Author(s):  
Wai Phyo Aung ◽  
Aung Soe Htet ◽  
Espen Bjertness ◽  
Hein Stigum ◽  
Virasakdi Chongsuvivatwong ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Rural Areas ◽  
Urban Areas ◽  
Undiagnosed Diabetes ◽  
Cross Sectional ◽  
Who Steps Methodology ◽  
Urban Rural ◽  
Educational Groups ◽  
Cross Sectional Studies ◽  
Urban And Rural Areas

ObjectivesTo investigate the association between urban–rural location and the occurrence of diabetes mellitus (DM) in the Yangon Region, and to estimate the proportion of urban and rural participants already diagnosed with DM, and of those, the proportion under treatment and under control.DesignTwo cross-sectional studies, using the WHO STEPs methodology.SettingThe Yangon Region of Myanmar, urban and rural areas.ParticipantsMen and women, aged 25–74 years, included during the study period from September–November 2013 (urban) and 2014 (rural areas) (n=1372). Institutionalised people, physically and mentally ill person, monks and nuns were excluded.ResultsThe age-standardised prevalence of DM was 12.1% in urban and 7.1% in rural areas (p=0.039). In urban areas, the prevalence of DM was lowest in the highest educational groups (p<0.001). There were no differences in DM prevalence between gender or income levels. In rural areas, those who were physically inactive had a low intake of fruit and vegetable and were overweight/obese had a higher DM prevalence than others. In a logistic regression, the OR for DM in rural compared with urban areas was 0.38 (0.22, 0.65), adjusted for sociodemographic variables and behavioural risk factors. In urban areas, 43.1% of participants had the experience of receiving blood glucose measurements by a doctor or health worker, and 61.5% of all cases of DM were already diagnosed, 78.7% were under treatment and 45.8% were under control. The corresponding proportions in rural areas were 26.4%, 52.4%, 78.1% and 32.0%, respectively.ConclusionThe prevalence of DM in the Yangon Region was high, and significantly higher in urban than in rural areas. More health services are needed to serve this population with a large proportion of undiagnosed diabetes. Preventive measures to halt and reduce the prevalence of DM are urgently needed.

scholarly journals Difference in PM2.5 Variations between Urban and Rural Areas over Eastern China from 2001 to 2015

Atmosphere ◽  
2018 ◽  
Vol 9 (8) ◽  
pp. 312 ◽  
Author(s):  
Changqing Lin ◽  
Alexis Lau ◽  
Ying Li ◽  
Jimmy Fung ◽  
Chengcai Li ◽  
...  
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Eastern China ◽  
Population Exposure ◽  
Spatial Difference ◽  
The Past ◽  
The Difference ◽  
Urban And Rural Areas ◽  
Pm2.5 Concentration

To more effectively reduce population exposure to PM2.5, control efforts should target densely populated urban areas. In this study, we took advantage of satellite-derived PM2.5 data to assess the difference in PM2.5 variations between urban and rural areas over eastern China during the past three Five-Year Plan (FYP) periods (2001–2015). The results show that urban areas experienced less of a decline in PM2.5 concentration than rural areas did in more than half of the provinces during the 11th FYP period (2006–2010). In contrast, most provinces experienced a greater reduction of PM2.5 concentration in urban areas than in rural areas during the 10th and 12th FYP periods (2001–2005 and 2011–2015, respectively). During the recent 12th FYP period, the rates of decline in PM2.5 concentration in urban areas were more substantial than in rural areas by as much as 1.5 μg·m−3·year−1 in Beijing and 2.0 μg·m−3·year−1 in Tianjin. These results suggest that the spatial difference in PM2.5 change was conducive to a reduction in the population exposure to PM2.5 in most provinces during recent years.

scholarly journals Disability-Free Life Expectancy among People Over 60 Years Old by Sex, Urban and Rural Areas in Jiangxi Province, China

2021 ◽  
Vol 18 (9) ◽  
pp. 4636
Author(s):  
Shengwei Wang ◽  
Songbo Hu ◽  
Pei Wang ◽  
Yuhang Wu ◽  
Zhitao Liu ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Life Expectancy ◽  
Rural Women ◽  
Rural Areas ◽  
Urban Areas ◽  
Rural Elderly ◽  
Jiangxi Province ◽  
Urban Rural ◽  
Disability Free Life Expectancy ◽  
The Difference

Objective: To estimate and compare age trends and the disability-free life expectancy (DFLE) of the population over 60 years old in 2018 in Jiangxi Province, China, by sex and urban–rural areas. Methods: The model life table was employed to estimate the age-specific mortality rate by sex and urban–rural areas, based on the Summary of Health Statistics of Jiangxi Province in 2018 and the Sixth National Health Service survey of Jiangxi Province. DFLE and its ratio to life expectancy (LE) were obtained by the Sullivan method. Results: In 2018, the DFLE among people over 60 is 17.157 years for men and is 19.055 years for women, accounting for 89.7% and 86.5% of their LE respectively. The DFLE/LE of men is higher than that of women at all ages. LE and DFLE are higher for the population in urban areas than in rural areas. For women, DFLE/LE is higher in urban areas than in rural areas (except at ages 75 and 80). Urban men have a higher DFLE/LE than rural men (except at age 85). The difference in DFLE between men and women over 60 years is 1.898 years, of which 2.260 years are attributable to the mortality rate, and 0.362 years are due to the disability-free prevalence. In addition, the difference in DFLE between urban–rural elderly over 60 years old is mostly attributed to the mortality rate by gender (male: 0.902/1.637; female: 0.893/1.454), but the impact of the disability-free rate cannot be ignored either (male: 0.735/1.637; female: 0.561/1.454). Conclusions: The increase in DFLE is accompanied by the increase in LE, but with increased age, DFLE/LE gradually decreases. With advancing age, the effect of disability on elderly people becomes more severe. The government administration must implement some preventive actions to improve health awareness and the life quality of the elderly. Rural elderly; rural women in particular, need to be paid more attention and acquire more health care.

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