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PubMed1997

A comparative study on family, social supports and mental health of rural and urban Malay women.

The present study aims to compare the family's social environment, social supports and mental health of Malay women from rural and urban areas. Equal number (n-184) of Malay women from similar socio-economic back grounds were chosen from the rural areas of Kedah and urban areas of Pulau Pinang using the stratified random sampling method. The results indicated significantly higher level of mental health problems among the rural respondents when compared with the urban subjects. Among the family related variables included in the present study, cohesiveness, moral religious emphasis and organization and intellectual and cultural orientation were found to be significantly associated with the mental health problems of rural respondents. Whereas, only one variable, namely, active recreational orientation was found to be having an impact on the mental health of urban respondents. Similarly, deficiencies in the social support perceived from family and other members of the community were found to be significantly associated with the mental health problems of rural samples when compared to the social support perceived from the others for the urban subjects. The implications of these observations are discussed.

Adult↗
PubMedDate not supplied

Gun deaths in rural and urban settings: recommendations for prevention.

BACKGROUND: Family physicians can play a vital role in preventing gun violence, and better data on which to base their interventions might result in more effective prevention efforts. Using Washington State data, two assumptions on which interventions can be based were tested: compared with urban areas, rural areas have (1) a higher percentage of gun deaths from shotguns and rifles, and (2) a higher percentage of gun deaths from suicides and accidents METHODS: From 1990 to 1996, 4,271 gun deaths on Washington death certificates were classified as rural or urban. The data were retrospectively sorted and analyzed by gun type (handguns, rifles, shotguns, or other) and by intent (suicide, homicide, or accidental death). RESULTS: Compared with urban settings, rural areas had a higher percentage of gun deaths from shotguns and rifles and a higher percentage from suicides and accidents (P < .01). Two similarities, however, stand out as more important than the confirmed hypothesized differences: handguns accounted for more than 50% of gun deaths, and suicides accounted for nearly 70% of gun deaths in both urban and rural areas. CONCLUSIONS: Family physicians might want to focus their firearm safety efforts on preventing handgun deaths and suicides, which accounted for most gun deaths in rural and urban areas. Also, data from this study suggest that deaths from shotguns and rifles as well as accidental and suicide gun deaths deserve special attention in rural areas.

Data Collection↗
PubMedDate not supplied

[Migration from a rural zone to an urban one is associated with android distribution of body fat in obese women].

INTRODUCTION: Studies about migration to industrialized countries have shown an increased prevalence of diabetes, obesity and dyslipidaemias, all of them related to android body fat distribution. Migration status might be influence body fat distribution but it has not been sufficiently investigated. The aim of this study is to determine the relationship between body fat distribution and migration from rural to urban areas in Mexico. MATERIAL AND METHODS: This sequential sample of 433 women were seen in the outpatient obesity clinic of four federal states: Tabasco (n = 81), Mexico City (n = 166), Coahuila (n = 80), and Yucatan (n = 106). Migration history from rural to urban area, familial history of diabetes, ages of onset of obesity, height and weight circumferences were obtained. A regression logistic model was used and maintained as dependent variable body fat distribution. Age and federal state were considered as confounders and they adjusted the model. RESULTS: Migrating women from rural to urban area were 121 (27.9%). The waist circumference was higher in Tabasco (102.2 +/- 12 cm), and lesser in Yucatan (93.6 +/- 15 cm, p < 0.001); no differences were found for hip circumference. The logistic regression model showed that body fat distribution is associated to migration from rural to urban area, and also to diabetes of mother and age of onset of obesity. CONCLUSIONS: Migrating from rural to urban area is a risk factor for android body fat distribution and this risk increases with age, history of diabetes in mother and adulthood onset o obesity.

Abdomen↗
PubMed2001

Role of urbanization and air pollution in adolescent asthma: a mass screening in Taiwan.

BACKGROUND AND PURPOSE: The prevalence of asthma in school children in Taiwan is increasing. This study used mass screening among middle school children in Taiwan to determine the prevalence of asthma and related factors. METHODS: Data were collected from parents using a self-reported questionnaire and from children using the International Study of Asthma and Allergies in Childhood (ISAAC) video questionnaire. Six study teams conducted the survey nationwide in 1995-1996, with the assistance of middle school nurses and teachers. RESULTS: Among the 1,018,031 students at 795 middle schools who returned questionnaires, 8.5% had a history of asthma (ranging in prevalence from 4.2% to 13% in 25 areas). The prevalence of asthma was higher in boys than in girls (10.0% vs 7%) and was highest in more urbanized areas (11.2%), followed by moderately urbanized areas (7.4%) and less urbanized and rural areas (6.5%). Controlling for age, family smoking, family incense burning, and parental education level, multivariate logistic regression models indicated that children living in an area with heavy air pollution were more likely to have asthma than those in an area with no or light pollution (odds ratio, OR = 2.01 and 95% confidence interval, CI = 1.94-2.09 based on parental ranking of pollution level, or OR = 1.30 and 95% CI = 1.18-1.42 based on pollution level reported by the Environmental Protection Administration). CONCLUSIONS: Adolescent asthma in Taiwan is most prevalent in the most urbanized areas and decreases in prevalence in less urbanized areas. This study also found that higher parental education level and higher area air pollution were associated with higher adolescent asthma prevalence.

Adolescent↗
PubMed2002

Time allocation to subsistence activities among the Huli in rural and urban Papua New Guinea.

Time spent on subsistence activities was compared between rural sedentes and urban migrants of the Huli population in Papua New Guinea. Person-day observation data were collected for rural sedentes (441) in the Tari basin and for urban migrants in Port Moresby (175). The time spent on subsistence activities by males was longer in the urban area than in rural areas, while that by females was similar in both areas. Conspicuous gender inequality with respect to labour hours in rural areas seems to diminish when people move to urban areas, reflecting the different subsistence regime between rural and urban environments.

Activities of Daily Living↗
PubMed1985

[Analysis--of family-planning in urban low-income brackets based on Daejon and Daegu Cities].

Since the inception of the national family planning program in 1962, the main emphasis has been placed on the provision of contraceptive services and information, education, and communication (IEC) activities through home visits by family planning field workers and through government designated private physicians. This approach has been a powerful management system for the national program, particularly in the rural area. However, new issues in the national family planning program emerged with the subsequent socioeconomic changes since 1962. An increasing number of the rural population began to migrate to the urban area, and, therefore, beginning in the 1970s, more weight had to be given to the family planning service for the urban area; in particular, for those in the low-income brackets. In an effort to increase contraceptive acceptors among the urban low-income people, the government has implemented various special projects for them since 1974, through maximum utilization of community leaders including Tong and Ban Chiefs and mothers' clubs, and family planning workers in their areas. Thus, this paper analyzes the current status of family planning and fertility behavior of urban low-income wives as a part of program evaluation. Also, this paper is based on an analysis of the 1984 Family Planning Survey data, which was conducted in July 1984 and responded to by 600 married women aged 15-44 in the low-income areas of the Daejon and Daegu cities. The survey data revealed that the contraceptive practice rate was 77.0%, which was much higher than 70.3% of the national practice rate in the same year, and the approval rate for the 1 or 2 children of the low-income areas was much higher than that of other urban areas. Based on the results of the analysis, the following recommendations are suggested for the better program implementation: 1) improvement of program management system for recruiting new acceptors in their 20s for birth spacing; 2) development and inducement of innovative incentive schemes and IEC activities for increasing the proportion of the 1 child families; and 3) strengthening the utilization of community resources including mothers' clubs.

Asia↗
PubMed1986

Sex ratio in the Iranian urban and rural areas.

Factors affecting the sex ratio are examined using data for 1,169,489 births occurring in rural and urban districts of Tehran, Iran, between 1971 and 1979. Attention is given to geographic, socioeconomic, psychological, and nutritional factors. It is found that "male births occurred more in Winter and Spring in the urban and rural areas, respectively. Female births occurred more in Fall in both urban and rural areas. Mean sex ratio was 108.20 in rural and 105.44 in urban areas." Reasons for the differentials between urban and rural areas are suggested.

Asia↗
PubMed2003

Roles of urban vegetation on balance of carbon and oxygen in Guangzhou, China.

The plant biomass and net primary production (NPP) of urban vegetation in Guangzhou were estimated by dimension analysis, tree truck volume, and harvest methods as well as relationship between biomass and NPP and so on. The biomass and NPP were respectively 2875150t and 1058122 t/a. They were respectively 392495t and 64948 t/a in the built-up area and 2482655t and 993147 t/a in the unbuilt-up area. It would make plant biomass, especially NPP decline obviously, if the unbuilt-up area were changed to the built-up area. The carbon content of plant was 1328649 for the total and 13.78 t/hm2 for the mean, and amounts of carbon fixed and oxygen made by urban vegetation were respectively 4.80 t/(hm2 x a) and 12.79 t/(hm2 x a) for the mean and 462624 t/a and 1232430 t/a for the total, which were equal to 1.45 times and 1.04 times of those by human breathing. However, they were only equal to 7.61% and 4.97% of amount of carbon released and oxygen consumption in urban Guangzhou. The biomass and NPP of urban vegetation in Guangzhou only corresponded to 7.8% and 47.3% of those of southern subtropical evergreen broad-leaf forest in Dinghu Mountain. Therefore, the roles of Guangzhou urban vegetation in balance of carbon and oxygen would be increased greatly if it could be conserved and improved in some way.

Biomass↗
PubMed1999

Characteristics and career intentions of Scottish rural and urban GP registrars: cause for concern?

OBJECTIVES: To investigate the differences between the characteristics and career intentions of GP registrars in urban and rural areas, and to make recommendations to reduce a potential work force crisis in rural practice. DESIGN: Postal survey. SETTING: All general practices in Scotland. SUBJECTS: In February 1996, 40/196 (20%) of urban and 45/150 (30%) of rural GP registrar places available in Scotland, were vacant (chi 2 = 4.22, df = 1, p = 0.02). Postal questionnaires were sent to all 261 GP registrars in post. RESULTS: Of 235 respondents (90%), the majority wished to remain in general practice (63% of urban and 53% of rural registrars), but only 22% of urban and 18% of rural registrars intended to apply for principal posts immediately after training. Fewer urban (8%) than rural registrars (21%) stated an intention to go abroad to work after training. Rural registrars tended to want to work in rural areas, and vice versa. Part-time and job-sharing were attractive employment options for both groups, and more flexible career structures were favoured by over 80%. CONCLUSIONS: Though much more attention has been paid to recruitment in inner cities, the findings from this study suggest that in Scotland difficulties in finding principals may occur first in rural areas. As general practitioners have an extended role in rural areas, including that of emergency care, shortages could have a serious impact on patient care.

Adult↗
PubMedDate not supplied

Socioeconomic status and dyslipidaemia in a South Indian population: the Chennai Urban Population Study (CUPS 11).

BACKGROUND: Socioeconomic differences have been shown to be linked with the prevalence of coronary artery disease (CAD) and its risk factors such as dyslipidaemia based on urban-rural comparisons. However, very little data are available on the prevalence of dyslipidaemia within an urban environment. The aim of this study was to assess the pattern of dyslipidaemia in two different socioeconomic groups within an urban South Indian population. METHODS: The Chennai Urban Population Study is an epidemiological study involving two residential areas in Chennai, South India representing different socioeconomic strata. Of the 1399 eligible subjects (age > or = 20 years), 1262 (90.2%) participated in the study (Tirumangalam: middle income group, 479 subjects, response rate 91.4%; and T. Nagar: low income group, 783 subjects, response rate 89.4%). A detailed questionnaire on the socioeconomic and clinical background of the subjects was collected. Biochemical investigations included lipid profile and oral glucose tolerance tests. The classification of lipid abnormalities was done according to the National Cholesterol Education Programme-Adult Treatment Panel III [NCEP (ATP III)] guidelines. RESULTS: The Tirumangalam group (mean monthly income of Rs 8075) represents the middle income group, while the T. Nagar group (mean monthly income of Rs 1399) represents the low income group. The prevalence rates of lipid abnormalities were higher among the middle income group compared to the low income group. The prevalence of high risk cholesterol levels in men was 10.6% (middle income group) v. 2.7% (low income group; p<0.001) and among women 19.1 v. 4.7% (p<0.001). Similarly, the prevalence of high risk triglyceride levels in men was 15.7% v. 9.3% (p=0.02) and among women 10.3% v. 7.5% (p<0.05); high risk low density lipoprotein (LDL) levels among men was 7.8% v. 3.0% (p=0.01), and among women 11.2% v. 4.5% (p<0.001). High density lipoprotein (HDL) cholesterol levels were lower in the low income group but the total cholesterol/HDL cholesterol ratio was higher among men in the middle income group (p<0.001) but not among women. Logistic regression analysis revealed that socioeconomic status had a strong association with hypercholesterolaemia and high LDL levels, even after adjusting for age and body mass index. CONCLUSION: Socioeconomic factors influence the pattern of dyslipidaemia in this urban South Indian population, with dyslipidaemia being more common and severe in the middle income group.

Adult↗
PubMed1992

A rural advantage? Urban-rural health differences in northern England.

Rural health inequalities have been relatively neglected in recent years. The data assembled for a large study of health and deprivation in the Northern Region of England have been reanalysed to examine three questions. How wide are rural health inequalities compared with those in urban areas? Is health intrinsically better in rural areas, given comparable deprivation or affluence? Is the association between health and wealth weaker in rural than in urban areas? It is shown that, although health inequalities are wider in urban areas, this corresponds to wider socio-economic divisions: at equivalent levels of wealth, health measures are similar. This relationship breaks down, however, when the most remote rural areas are compared with matching localities in conurbations, for in this case rural areas have a clear advantage. We go on to show that the apparent weakness of the association between health and wealth in rural areas is largely an artefact; the association becomes stronger when the units of population (electoral wards) are enlarged to resemble more closely those in urban contexts. The comparability of rural and urban forms of deprivation is discussed in the light of these results.

Catchment Area, Health↗
PubMed2003

[Influence of urban migration on physical activity, nutritional status and growth of Senegalese adolescents of rural origin].

In Africa, rural populations especially adolescent girls resort to urban migrations for labour in order to diversify and improve their livelihood. Their work and their living conditions may influence their health and development patterns. The aim of this study was to evaluate the influence of these migrations on physical activity, nutritional and growth status of rural Senegalese adolescent girls. In 1998, within the framework of a longitudinal study of growth during puberty (n = 406), a sub-sample (n = 80, 14.4 +/- 0.5 years) was drawn in order to estimate physical activity, during three days, quantitatively by accelerometry and qualitatively by questionnaire. One part of this sample temporarily migrated to Dakar in order to work as maids (migrants, n = 40). The other part remained in the rural community of Niakhar in order to help their families in daily domestic and agricultural tasks and/or to attend school (non-migrants, n = 40). In 1999, sexual maturation of 331 adolescent girls (15.5 +/- 0.5 years) belonging to this group was based on stages of breast development and occurrence of menarche. Their growth and nutritional status were assessed with anthropometry (height, weight, mid arm circumference, six skinfolds). Adolescents were asked about their urban migratory histories and were divided into four categories according to the duration of urban migration: no migration (NM), short (S), medium (M) and long duration (L). These adolescent girls had a very high physical activity which is far higher than that of American girls. Migrants were more active than non-migrants (p < 0.0001). In 1999, as a whole, these 331 adolescent girls were smaller, thinner and less mature than adolescent girls from industrialized countries. Midarm circumference, body mass index (BMI) and fat mass index (FMI) were significantly higher with the duration of migration (p < 0.01), after adjusting for differences in sexual maturation. Growth retardation seemed more important for the adolescent girls who never migrated and for those who have the longest duration of migration (p = 0.05). At the beginning of puberty, there were no differences in height for age indice and BMI. Urban migrations resulted in an advanced puberty and an improvement of nutritional status (higher BMI, FMI and midarm circumference) but without catch-up in growth. These findings could be explained by precarious living conditions in rural area and by higher workload in urban area.

Adolescent↗
PubMed2003

Factors associated with carriage of penicillin-resistant Streptococcus pneumoniae among Vietnamese children: a rural-urban divide.

This study examined the relationship between antimicrobial resistance in Streptococcus pneumoniae and patterns of antimicrobial usage and over-the-counter dispensing by pharmacies in urban and rural districts of Vietnam. The antimicrobial susceptibility of S. pneumoniae carried by healthy urban and rural school children was determined. Questionnaires were distributed to parents to describe their healthcare-seeking behaviour. Mock parents presented standardized cases of mild respiratory infection and acute watery diarrhoea to pharmacies in the district surrounding each school. Penicillin resistance was significantly more common in S. pneumoniae carried by urban children compared to rural children as was recent antibiotic usage. Both urban and rural pharmacies showed high rates of dispensing inadequate antimicrobial regimens. The high level of antimicrobial resistance in S. pneumoniae may be related to greater antimicrobial usage. This may result from the much easier access to healthcare providers in urban areas and may suggest that relying solely on education without limiting access to outlets may have only limited impact. The results suggest a greater understanding of the subtleties of healthcare-seeking behaviour, and access to healthcare is needed to help refine and guide rationale suggestions to reduce the continued spread of drug resistance.

Child↗
PubMed2004

Early childhood development in deprived urban settlements.

Poverty, the root cause of the existence of slums or settlement colonies in urban areas has a great impact on almost all aspects of life of the urban poor, especially the all-round development of children. Examples from countries, across the globe provide evidence of improved early child development, made possible through integrated slum improvement programs, are few in numbers. The observed 2.5% prevalence of developmental delay in the less than 2 year olds of deprived urban settlements, the presence of risk factors for developmental delay like low birth weight, birth asphyxia, coupled with poor environment of home and alternate child care services, highlights the need for simple cost effective community model for promoting early child development. This review on early child development focuses on the developmental status of children in the deprived urban settlements, who are yet to be on the priority list of Governments and international agencies working for the welfare of children, the contributory nature-nurture factors and replicable working models like infant stimulation, early detection of developmental delay in infancy itself, developmental screening of toddlers, skill assessment for preschool children, school readiness programs, identification of mental sub-normality and primary education enhancement program for primary school children. Further, the review probes feasible intervention strategies through community owned early child care and development facilities, utilizing existing programs like ICDS, Urban Basic Services and by initiating services like Development Friendly Well Baby Clinics, Community Extension services, Child Development Referral Units at district hospitals and involving trained manpower like anganwadi/creche workers, public health nurses and developmental therapists. With the decentralization process the local self-government at municipalities and city corporations are financially equipped to be the prime movers to initiate, monitor and promote early child development programs, to emerge as a part and parcel of community owned sustainable development process.

Child↗
PubMed2004

Applying sustainable water management concepts in rural and urban areas: some thoughts about reasons, means and needs.

Serving the world population with adequate drinking water and sanitation is an important prerequisite, not only to hygienic safety, but to prosperity and political stability as well, and will foster the adaptive capacity of the societies in the developing countries and beyond. To avoid hygienic and political disasters impacting the world economy, investment in water supply and sanitation must urgently be made. Whether the classical system of urban water supply and sanitation is appropriate to satisfy the needs of the developing world, however, and whether this system meets the general criteria of sustainability is questionable. The costs and the time needed for installation of sewers and wastewater treatment plants are tremendous. In water shortage areas, the amount of tap water required to transport pollutants to the treatment plant is hardly affordable. Recovery and re-introduction of valuable substances, including water, into the urban cycle of materials is impossible because of mixing and dilution effects inherent in the system. Decentralized water and wastewater management should be seriously taken into account as an alternative. Source separation of specific fractions of domestic and industrial wastewater, separate treatment of these fractions and recovery of water and raw materials including fertilizer and energy are the main characteristics of modern high-tech on-site treatment/reuse systems. Mass production of the key components of the system could reduce the costs of the treatment units to a reasonable level. On-site units could be installed independently of the development stage of the urban sewer system. In conjunction with building new housing complexes a stepwise improvement of the hygienic situation in urban and peri-urban areas could be achieved, therefore. Remote control of the satellite systems using modern telecommunication methods would allow reliable operation, and comfort for the users. Intensive research is required, however, to develop this system and bring it to a standard allowing efficient application worldwide.

Conservation of Natural Resources↗
PubMed2003

HIV prevalence in 72,000 urban and rural male army recruits, Ethiopia, 1999-2000.

BACKGROUND: The recent estimate of around 2 million HIV-infected people in Ethiopia derives from data that are sparse, especially in the rural areas where the majority (> 85%) of the population lives. We assessed HIV prevalence in almost 72,000 army recruits who resided in urban and rural areas prior to recruitment. METHODS: Rapid HIV tests, HIVSPOT and Determine, were conducted on blood samples drawn at enrolment from almost 10,000 urban recruits, in 1999, and 62,000 rural recruits, in 2000. Socio-demographic data from recruits were available. RESULTS: In urban recruits, overall HIV prevalence was 7.2%, ranging from 4.3 to 10.5% depending on region. In rural recruits, overall HIV prevalence was 3.8%, but the majority were farmers (57%) and students (18%) with an HIV prevalence of 2.7% and 2.6%, respectively. (Higher) level of education in rural recruits was associated with HIV infection. Rural recruits of the Muslim religion were less likely to be HIV infected than recruits of the Orthodox Christian religion (odds ratio: 0.7; 95% confidence interval, 0.65-0.84). Urban and rural residents of Amhara region were at higher risk of HIV infection. CONCLUSION: Prevalence in both rural and urban army recruits is below previous estimates. Geographic distribution of HIV is uneven. The impact of religion, education, and region on HIV prevalence suggests avenues for targeting HIV prevention efforts in Ethiopia.

Adolescent↗
PubMedDate not supplied

Differences in cardiovascular function of rural and urban African males: the THUSA study.

INTRODUCTION: South Africa's black population has been in a process of transition from rural monocultural environments to industrialised urban environments since the early 1990s. This transition has led to an increased susceptibility to cardiovascular diseases such as hypertension, which in this group commonly leads to stroke. Besides the already observed increases in blood pressure, there is still uncertainty as to how the factors associated with urbanisation influence the cardiovascular system as a whole. AIM: To obtain a more complete cardiovascular profile and its association with the lipid profile and subcutaneous fat distribution of the African in transition. METHODS: A cross-sectional epidemiological study was performed which included 433 men from the North-West Province. The Finapres apparatus and Modelflow software program were used to obtain a more elaborate cardiovascular profile. The lipid profile and subcutaneous fat were also determined. RESULTS: An increase in systolic blood pressure (SBP) and diastolic blood pressure (DBP) was observed in the urban group. The heart rate (HR) did not differ while the stroke volume (SV) and cardiac output (CO) was lower in the urban group. Arterial compliance (Cw) also showed a decrease in the urban group along with an increased total peripheral resistance (TPR), compared with the rural group. The lipid profile and BMI did not differ between the two groups. CONCLUSIONS: The factors associated with urbanization elevate blood pressure via a peripheral mechanism. This peripheral mechanism may be due to endothelial damage associated with low-density lipoprotein cholesterol (LDL-C) and a truncal subcutaneous fat distribution.

Adipose Tissue↗
PubMedDate not supplied

Rural versus urban analysis of dental procedures provided to Virginia Medicaid recipients.

PURPOSE: The purpose of this study was to report the distribution of procedures provided to Virginia Medicaid children by 3 types of dental providers in rural and urban areas. METHODS: Medicaid claims filed for dental patients less than 21 years old were obtained and analyzed for fiscal years 1994-1995. Dental providers were categorized according to their practice type: (1) general practice (GP); (2) pediatric (PD); and (3) public health (PH) dentists. Each type of practice was categorized as practicing in a metropolitan, urban, rural, or completely rural location and evaluated for percentages of preventive, diagnostic, and corrective services provided. RESULTS: Rural areas had a higher percentage of significant providers than did metropolitan or urban areas. General dentists performed more diagnostic and preventive but fewer corrective procedures than pediatric dentists. Pediatric dentists and general dentists in completely rural areas performed more corrective procedures than their counterparts in metropolitan or urban areas. CONCLUSIONS: General, pediatric, and public health dentists in metropolitan and urban areas perform slightly more diagnostic services and fewer corrective services than practitioners in more rural areas.

Adolescent↗