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PubMed1996

Taste preference for sweetness in urban and rural populations in Iraq.

The consumption of sweetened foods is influenced by a variety of biological, psychological, sociological, and environmental factors. On an individual level, taste preference for sweetness has been shown to have an influence on food consumption, although this may be affected by social and environmental factors. The aim of this study was to assess the taste preference for sweetness in urban and rural populations in Iraq. The hypothesis was that sweet preference and the consumption of sugar increase with urbanization. The sample was composed of 4152 individuals who were divided into urban and rural subgroups based on their place of residence. Sweet preference was assessed by means of a tested Sweet Preference Inventory. Results revealed statistically significant differences between urban and rural populations in preference for sweetness and in actual sugar consumption. Individuals from urban locations showed a much higher preference for sweetness than their rural counterparts and consumed more sugar. Within the urban population, those individuals who had lived in the city longer and who were from families with lower educational qualifications preferred the highest levels of sugar. The findings support the hypothesis that urbanization influences sweet preference and sugar consumption.

Adolescent↗
PubMed2005

Stunted child-overweight mother pairs: prevalence and association with economic development and urbanization.

This paper explores the prevalence of the coexistence of a stunted child and an overweight mother in the same household (SCOWT), a somewhat paradoxical phenomenon when found in the developing world. It tests whether this phenomenon is associated with a country's level of economic development and urbanization and, by implication, the nutrition transition. It then highlights policy directions for public nutrition. Data from 42 Demographic and Health Surveys in Africa, Asia, and Latin America were used. Stunting was defined as height-for-age < -2 SD of the reference population, and maternal overweight as a body-mass index > 25 kg/m2. World Bank and United Nations figures were used for gross domestic product (GDP) per capita (an indicator of economic development) and for level of urbanization. Descriptive statistics were derived, and regression analysis was used to model the association between economic development, urbanization, and the prevalence of pairs of stunted children and overweight mothers. The prevalence of this phenomenon is generally below 10%, except in four countries, three of them in Latin America. The phenomenon is generally more prevalent in Latin America than in Africa, though not necessarily more prevalent in urban than in rural areas. The analysis finds that the phenomenon is associated with economic development, but not urbanization, and that it does differ between urban and rural areas and regions. The association with GDP per capita supports the hypothesis that SCOWT increases with economic development, up to a point. SCOWT appears to be most prevalent, as expected, in those countries in the midst of the nutrition transition. Recognizing this phenomenon is important for delineating strategies that respond to the differential needs of individuals within the household and do not just affect the household as a whole. This may become especially important with future economic development and, potentially, urbanization.

Adult↗
PubMed2006

Urbanization and traffic related exposures as risk factors for schizophrenia.

BACKGROUND: Urban birth or upbringing increase schizophrenia risk. Though unknown, the causes of these urban-rural differences have been hypothesized to include, e.g., infections, diet, toxic exposures, social class, or an artefact due to selective migration. METHODS: We investigated the hypothesis that traffic related exposures affect schizophrenia risk and that this potential effect is responsible for the urban-rural differences. The geographical distance from place of residence to nearest major road was used as a proxy variable for traffic related exposures. We used a large population-based sample of the Danish population (1.89 million people) including information on all permanent addresses linked with geographical information on all roads and house numbers in Denmark. Schizophrenia in cohort members (10,755 people) was identified by linkage with the Danish Psychiatric Central Register. RESULTS: The geographical distance from place of residence to nearest major road had a significant effect. The highest risk was found in children living 500-1000 metres from nearest major road (RR = 1.30 (95% Confidence Interval: 1.17-1.44). However, when we accounted for the degree of urbanization, the geographical distance to nearest major road had no significant effect. CONCLUSION: The cause(s) or exposure(s) responsible for the urban-rural differences in schizophrenia risk were closer related to the degree of urbanization than to the geographical distance to nearest major road. Traffic related exposures might thus be less likely explanations for the urban-rural differences in schizophrenia risk.

Adolescent↗
PubMed2005

Effect of urbanization on bone mineral density: a Thai epidemiological study.

BACKGROUND: The incidence of fractures in rural populations is lower than in urban populations, although the reason for this difference is unclear. This cross-sectional study was designed to examine the difference in bone mineral density (BMD), a primary predictor of fracture risk, between urban and rural Thai populations. METHODS: Femoral neck and lumbar spine BMD was measured by dual-energy X-ray absorptiometry (GE Lunar, Madison, WI) in 411 urban and 436 rural subjects (340 men and 507 women), aged between 20 and 84 years. Body mass index (BMI) was calculated from weight and height. RESULTS: After adjusting for age and body weight in an analysis of covariance model, femoral neck BMD in rural men and women was significantly higher than those in urban men and women (P < 0.001), but the difference was not observed at the lumbar spine. After stratifying by sex, age group, and BMI category, the urban-rural difference in femoral neck BMD became more pronounced in men and women aged <50 years and with BMI > or = 25 kg/m2. CONCLUSIONS: These data suggest that femoral neck BMD in rural men and women was higher than their counterparts in urban areas. This difference could potentially explain part of the urban-rural difference in fracture incidence.

Absorptiometry, Photon↗
PubMed2005

What is urban in the contemporary world?

Central concepts of contemporary life such as politics, civilization, and citizenship derive from the city's form and social organization. The city expresses the socio-spatial division of labor, and Henri Lefebvre proposes to view its transformation within a continuum from the political city to the urban, whereby it completes its domination over the countryside. The city's transformation into the urban takes place when industry brings production (and the proletariat) into that space of power. The city, locus of surplus, power, and the fiesta, a privileged scenario for social reproduction, was subordinated to the industrial logic and underwent a dual process: its centrality imploded, and its outskirts exploded on surrounding areas through the urban fabric, bearing with it the seeds of the polis and civitas. The urban praxis, formerly restricted to the city, re-politicized social space as a whole. In Brazil, the urban has its origins in the military governments' centralizing and integrating policies, following Vargas's expansionism and Kubitschek's developmental interiorization (or occupation of the hinterlands). Today, urban-industrial processes impose themselves over virtually all social space, in contemporary extended urbanization.

Brazil↗
PubMed1990

Urban ties of rural Thais.

This article analyzes interpersonal linkages between villagers and urban dwellers and the effect on circular migration in Thailand. "Using data from Northeast Thailand, it examines the prevalence of urban social contacts, selectivities involved in such linkages, the characteristics of the urban contacts themselves, the salience of the interpersonal relationships, and the potential for the urban contact to act as a sponsor for the villagers. Furthermore, using a prospective research design, the impact of social contacts on subsequent rural-urban mobility of villagers is examined." A distinction is made between Bangkok and Northeastern Thai urban centers in order to illustrate some of the obstacles to the decentralized urbanization program in Thailand.

Asia↗
PubMed1992

Social problems and health in urbanization.

One of the main characteristics of urbanization in Asia is the very rapid increase in population movement from rural to urban centers. This phenomenon has led to changing population structure, its composition and lifestyles in the cities and its fringes. As a consequent of population pressure on urban system and infrastructure, compounded by the nature of the composition of the in-migrant population, the urban concentrates are faced with several social and socio-economic problems. Although there has been a lot of interests among researchers to study the causes and effects or urbanization, there is a vacuum in the area of health implications. Planners and administrators usually give priority to the physical aspects of the urban and urbanities. Social problems and health implications thereof receives very little attention either at the level of administration or research. This paper therefore is a brave attempt to focus and draw some attention to this neglected area by looking at selected social problems and the health consequences.

Crowding↗
PubMed2005

Prevalence of hepatitis B infection in the southeastern region of Turkey: comparison of risk factors for HBV infection in rural and urban areas.

Although hepatitis B has been well studied, there are still aspects of its epidemiology that remain to be clarified. There are many regions with high seroprevalence, particularly in the developing regions of the world, and these regions are known to have different epidemiologic patterns. Nonetheless, there are currently no data on the differences in hepatitis B seroprevalence between urban and rural areas of Turkey. In the present study, therefore, we used 30-cluster sampling to determine and compare the prevalence of hepatitis B in the urban and rural areas of the least developed region of Turkey, the southeastern region. From 2,888 adults living in the region, blood samples were obtained from house visits, and screened for HBsAg, anti-HBs, and anti-HBcIgG. Factors associated with hepatitis B seroprevalence, particularly living in rural areas, were analyzed with multivariate methods. The seroprevalence of HBsAg was 8.2% in the rural and 6.2% in the urban areas. There was a statistically significant difference between urban and rural regions in terms of HBsAg positivity (crude OR: 0.74; 95% CI: 0.55 - 0.98). Exposure to hepatitis B virus (HBV) increased with age both in urban and rural areas. Lower education level was also an important risk factor for hepatitis B seropositivity in urban areas (adjusted OR: 1.66; 95% CI: 1.26 - 2.19) but not in rural ones (adjusted OR: 0.77; 95% CI: 0.36 - 1.69). Familial jaundice history was a statistically significant risk factor for HBsAg positivity in rural areas (adjusted OR: 2.15; 95% CI: 1.30 - 3.56) but not in urban ones (adjusted OR: 1.48; 95% CI: 0.96 - 2.27). This study shows that the prevalence of HBV infection in the southeastern region of Turkey is intermediate among the levels reported for the European region of the World Health Organization.

Adolescent↗
PubMedDate not supplied

Leptin resistance conferred by a combination of single nucleotide polymorphism and the adoption of a Western lifestyle in urban areas of Thailand.

OBJECTIVES: An increasing number of lifestyle disorders have emerged in response to the rapid urbanization that has occurred in Thailand. Recently, leptin resistance has been nominated as a possible marker for the onset of metabolic disorders in Asian countries. The research aimed to assess the relationship between leptin-resistance and environmental and/or genetic factors by comparing urban and rural inhabitants in Thailand. METHODS: A total of 212 age- and sex-matched subjects from an urban area (Bangkok) and from rural areas (Sai Noi) participated in the study. Anthropometric measurements, blood biochemistry, single nucleotide polymorphism analyses, and interviews concerning lifestyles and dietary habits were conducted individually. Backward elimination multiple regression analyses and least trimmed sum of square methods were used to estimate the effects of possible factors. RESULTS: A transition of staple food from rice to bread (decreased rice intake; p < 0.01 and increased bread intake; p < 0.05) was significant in urban areas. Leptin levels were higher in urban groups, with a significant difference in women (p < 0.001 in women and p = 0.06 in men), but not in men. Predictors selected for leptin-resistance in women were genotypes of UCP2, PPARg2, bread intake, living area, and smoking habit (r = 0.510); in men, genotypes of UCP2 and UCP3p, smoking habit, and rice intake (r = 0.315). CONCLUSIONS: Urban women with del/del type of UCP2 exhibited significant leptin resistance. A combination of urbanization and UCP2 genotype were considered to be responsible.

Anthropometry↗
PubMed1988

Urban development patterns in Indonesia.

The author examines recent urban development in Indonesia. "Analysis of urban developments in Indonesia has been hampered in the past by weak data. Recently, the National Urban Development Strategy (NUDS) project has generated a set of improved data. This paper aims at elaborating and supplementing the NUDS study. After a discussion of definitional problems, an analysis is carried out of urban growth rates at the provincial level. Private investment is shown to be a principal determinant of urban growth rates. Other significant determinants are rural immigration and the present level of urbanisation. Private investment is shown to be strongly biased towards provinces with large urban areas. In addition, polarisation is studied at the level of individual cities. It is found that a period of rapidly increasing polarisation has come to an end during the last decade."

Asia↗
PubMed1994

Eating attitudes in urban and suburban adolescents.

We administered the Eating Attitudes Test (EAT), Rosenberg Self-Esteem Scale, and Spielberger Trait Anxiety Inventory to two populations of high school students. The first group, 268 suburban females (mean age 16.2 years), completed their questionnaires in May 1988. The second population, 389 females and 281 males (mean age 16.0 years) in a city school with 92% black of Hispanic students, completed their questionnaires in February 1990 and were also measured for height and weight as part of a health screening. Scores of 21 or higher on the EAT-26 were achieved by 17.5% of the suburban females, 15.0% of the urban females, and 6.0% of the urban males. Significantly more suburban females (63%) considered themselves overweight, compared with both urban females (35%) and males (19%), yet only 14% of suburban females were calculated to be > 10% over ideal body weight, compared with 45% of urban females and 39% of urban males. Contrary to expectations, self-esteem was higher and anxiety lower in the urban students than the suburban students; self-esteem and anxiety were each significantly correlated with higher EAT scores in both populations, but believing oneself overweight was correlated with higher EAT scores in only the suburban students. These data indicate that abnormal eating attitudes are present among both urban and suburban students but with important differences in their manifestations and implications.

Adolescent↗
PubMed1998

Arthritis health service utilization among the elderly: the role of urban-rural residence and other utilization factors.

OBJECTIVE: To compare the impact of urban-rural residence and other factors on the utilization of any type of arthritis-related physician care and on rheumatologist utilization. METHODS: A population-based random sample of adults 65 years of age or older with self-reported arthritis from 10 urban and 12 rural Iowa counties were surveyed by telephone interview. We estimated the arthritis prevalence and health service utilization in this sample and evaluated the effects of predisposing, enabling, and need factors on utilization and satisfaction. Health care utilization was defined as ever having visited specific types of providers for arthritis-related care. RESULTS: A total of 488 individuals participated: 227 from urban counties and 261 rural respondents. Urban respondents more commonly reported having received a diagnosis of osteoarthritis from their physicians but were less likely to report rheumatoid arthritis. A greater proportion of urban versus rural respondents had utilized any physician for arthritis care (50.7% versus 41.0%, P = 0.032) and had more often seen an orthopedist (18.1% versus 9.6%, P = 0.006) or general internist (18.5% versus 8.8%, P = 0.002). A diagnosis of rheumatoid arthritis, younger age, living with another person, higher income, and further distance from an arthritis provider were significantly associated with prior rheumatologist utilization. The strongest adjusted predictor of any physician visit for arthritis care was whether older adults drove themselves to their provider. For rheumatologist utilization, a diagnosis of rheumatoid arthritis and age were independently associated. CONCLUSIONS: The most striking finding was the consistent association of need factors (such as the desire for medical advice), joint swelling, and the presence of a diagnosis of rheumatoid arthritis with physician utilization. We identified significant urban-rural variations in factors both enabling and predisposing to arthritis care, although urban-rural status did not appear to independently influence arthritis physician utilization. In a rural state with a relatively small number of rheumatologists, deleterious enabling factors such as greater distance from the doctor and lack of supplemental insurance did not provide significant obstacles to either rheumatologist or generalist utilization.

Aged↗
PubMed2006

Depressive symptoms among older adults in urban and rural areas.

OBJECTIVES: To determine if there are differences in depressive symptoms between residents of urban areas, small town zones, and predominantly rural regions and to determine factors associated with depressive symptoms among these groups of residents. METHOD: The study was set in the Canadian province of Manitoba amongst a community-dwelling population of older adults who were cognitively intact. The design of the study was a cross-sectional survey and measures included age, gender, education, living arrangements, number of persons providing companionship, perceived adequacy of income, functional impairment, self-rated health and the Center for Epidemiologic Studies-Depression (CES-D) scale. Urban/rural residence was measured by grouping Census sub-divisions according to 1991 Census population: urban (>19,999); small town (2500 to 19,999); or predominantly rural (<2500). RESULTS: In the total sample (n = 1382), 11.5% exhibited depressive symptoms: 11.6% in urban areas (n = 844); 14.0% in small town zones (n = 250); 9.0% in predominantly rural regions (n = 288) (p > 0.05, chi-square test). No rural-urban differences were seen in multivariate models. In predominantly rural regions, living alone, perceiving one's income as inadequate, and having functional impairment were associated with depressive symptoms. The only significant factor in small town zones was poorer self-rated health whereas in urban areas, poorer self-rated health, functional impairment, and fewer persons providing companionship were significantly related to depressive symptoms. CONCLUSIONS: We did not observe rural-urban differences. However, the factors associated with depressive symptoms varied among older adults living in predominantly rural regions, in small towns, and in urban areas.

Aged↗
PubMed2002

Prevalence and correlates of late-life depression compared between urban and rural populations in Korea.

BACKGROUND: The aetiology of late-life depression has received relatively little research in developing countries. Urban and rural populations have rarely been sampled in the same study. OBJECTIVES: To investigate demographic factors associated with depression and depressive symptoms in an urban and rural sample of older Korean people. METHODS: A community survey of residents aged 65 or over was conducted in an urban and a rural area within Kwangju, South Korea. The Korean Form of the Geriatric Depression Scale (KGDS) was administered. Associations with demographic, socio-economic factors and cognitive function (MMSE) were investigated for depression categorised according to a previously validated cut-off. RESULTS: The sample comprised 485 urban-dwelling and 649 rural-dwelling participants. No difference was found between urban and rural samples for prevalence rates of depression. However associations with independent variables varied between the areas. In the urban sample, increased age, low education, manual occupation and current rented accommodation were independently associated with depression. Only low education was associated with depression in the rural sample. The interaction with sample area was strongest for age (p < 0.01) and persisted after further adjustment for cognitive function. CONCLUSIONS: Adverse socio-economic status was strongly associated with depression and appeared to operate across the life-course. While no evidence was found for urban-rural differences in prevalence rates of depression, factors associated with depression differed between these populations.

Aged↗
PubMedDate not supplied

Hepatitis B virus status of southern African Blacks with hepatocellular carcinoma: comparison between rural and urban patients.

Hepatocellular carcinoma (HCC) is less common and occurs at a much older age in urban than in rural southern African Blacks. These differences may reflect differences in the etiology of the tumor in the two populations. The purpose of this study was to compare the hepatitis B virus (HBV) status of 150 HCC patients who were born and had lived all their lives in a rural environment with 158 patients who were born and brought up in a rural setting but then became urbanized. HBsAg and all markers of present or past HBV infection [HBsAg(+) or anti-HBc(+) or anti-HBs] were significantly less common in the urban patients when the two groups were considered as a whole (p less than 0.001 and p less than 0.05, respectively). However, because the rural patients were considerably younger (mean age 34.7 years; 66% less than 40 years of age) than in urban patients [mean age 50.9 years (p less than 0.0005), 19.0% less than 40 years of age (p less than 0.001)], an age-related analysis was performed. No significant difference in any HBV marker was found between rural and urban patients. The association between active HBV infection and HCC was similar in young patients, both rural and urban, and the prevalence of HBs antigenemia decreased in both groups with increasing age. We conclude that the differences in incidence and age of onset of HCC in rural and urban southern African Blacks cannot be attributable to differences in HBV status.

Adult↗
PubMed1996

Hospitalized pneumonia. Outcomes, treatment patterns, and costs in urban and rural areas.

OBJECTIVES: To describe discharge rates, geographic and patient characteristics, treatment patterns, costs, and outcomes of patients hospitalized with community-acquired pneumonia (CAP) in Pennsylvania hospitals and compare these patients from rural and urban counties. DESIGN: A retrospective database study. PATIENTS: Adult patients (age > or = 18) with an ICD-9-CM diagnosis of pneumonia discharged from 193 Pennsylvania hospitals (n = 36,222) in 1991 from the MediQual Systems Pennsylvania database. MEASUREMENTS: Patient characteristics included a pneumonia-specific severity index, microbiologic etiology, and a number of comorbid conditions. Treatment indicators included the specialty of the admitting physician, length of stay, admittance to an intensive care unit, and mechanical ventilation. Cost indicators included charges and estimated costs. Outcomes measured were inpatient mortality and discharge disposition. Counties in Pennsylvania were classified into seven urban or rural groups, and patients were classified by the county of residence. RESULTS: The discharge rate for CAP was 4.0 per 1,000 and did not vary systematically across urban or rural counties. Most patients were treated in local hospitals. The average distance between residence and hospital was 5.4 miles and varied with urban or rural classification (range 2.5-9.3 miles). Among CAP patients, 37.8% were at low risk of mortality, with no systematic differences across rural or urban patients with respect to pneumonia severity. Rural patients were more likely to be treated by a family physician and somewhat less likely to be admitted to an intensive care unit or to be mechanically ventilated. Costs of treating rural patients were lower. In-hospital mortality rates, with controls for admission severity, were comparable or better for rural patients than for urban patients. CONCLUSIONS: Patients with CAP are treated in hospitals located in counties similar to ones in which they reside. The cost of treatment was lower for rural patients than for urban patients, but outcomes were not different.

Adult↗
PubMed2004

A management-orientated comparative analysis of urban and rural anglers living in a metropolis (Berlin, Germany).

Increased efforts to analyze the human dimensions of anglers are necessary to improve freshwater fisheries management. This paper is a comparative analysis of urban and rural anglers living in a metropolis, based on n = 1061 anglers responding to a mail survey in the German capital of Berlin. More than two thirds of the anglers (71%) had spent most (>50%) of their effort outside the city borders of Berlin and thus were categorized as rural anglers. Compared to the rural anglers, urban anglers (>/=50% of total effort spent inside the city) were younger and less educated. Urban anglers were more avid and committed, less mobile, and more frequently fished from boats and during weekdays. Rural anglers were more experienced, fished for longer times per trip, fished more often at weekends and on holidays, were more often members of angling clubs, and more frequently caught higher valued fish species. The achievement and fish quantity aspects of the angling experience were more important for urban than for rural anglers. Concerning management options, urban anglers more frequently suggested constraining other stakeholders and reducing regulations, whereas rural anglers more often proposed improving physical access to angling sites. Future urban fishing programs should offer ease of access, connection to public transportation, moderate prices, and diverse piscivorous fish stocks. In contrast to rural fisheries, the provision of high ecological and aesthetical quality of the angling waters can be regarded as of minor importance in urban fisheries. Rural fisheries managers need to consider the needs of stakeholders living in Berlin to minimize impacts on the less degraded rural water bodies and potential user conflicts with resident anglers. Ecosystem-based management approaches should guide rural fisheries policy.

Berlin↗
PubMed2004

Comparison of dietary habits in the urban and rural Croatian schoolchildren.

BACKGROUND: Post-war socio-economic changes in Croatia probably affected dietary habits, and dietary data about schoolchildren after the war are missing. AIMS OF THE STUDY: The aim of the study was to compare current nutrient intakes and dietary behavior between urban and rural schoolchildren in Croatia. METHODS: A completely quantified Food Frequency Questionnaire was used. Subjects were 315 urban and 163 rural schoolchildren. Mean age was 12.5 and 12.6 years in the urban and rural area, respectively. RESULTS: Consumption of fast food, soft drinks and alcohol was more prevalent and more linked with dietary behavior in the urban than in the rural area. In both living areas protein intake was excessive (in the urban area 38.1% of subjects and in the rural 36.2% of subjects had protein intake higher than 200% RDA). Under 75% RDA/DRI in both living areas was observed for vitamin D, folate, calcium and selenium. Micronutrient intakes negatively correlated with age in both living areas, but were more pronounced in the urban area. CONCLUSION: The urban sample had more adequate energy and nutrient intakes which is consistent with prewar findings.

Child↗