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Many Rural Areas (many + rural_area)
Selected AbstractsGender, Traditional Authority, and the Politics of Rural Reform in South AfricaDEVELOPMENT AND CHANGE, Issue 4 2002Haripriya Rangan The new South African Constitution, together with later policies and legislation, affirm a commitment to gender rights that is incompatible with the formal recognition afforded to unelected traditional authorities. This contradiction is particularly evident in the case of land reform in many rural areas, where women's right of access to land is denied through the practice of customary law. This article illustrates the ways in which these constitutional contradictions play out with particular intensity in the ,former homelands' through the example of a conflict over land use in Buffelspruit, Mpumalanga province. There, a number of women who had been granted informal access to communal land for the purposes of subsistence cultivation had their rights revoked by the traditional authority. Despite desperate protests, they continue to be marginalized in terms of access to land, while their male counterparts appropriate communal land for commercial farming and cattle grazing. Drawing on this protest, we argue that current South African practice in relation to the pressing issue of gender equity in land reform represents a politics of accommodation and evasion that tends to reinforce gender biases in rural development, and in so doing, undermines the prospects for genuinely radical transformation of the instituted geographies and institutionalized practices bequeathed by the apartheid regime. [source] The spatial epidemiology of cocaine, methamphetamine and 3,4-methylenedioxymethamphetamine (MDMA) use: a demonstration using a population measure of community drug load derived from municipal wastewaterADDICTION, Issue 11 2009Caleb J. Banta-Green ABSTRACT Aims To determine the utility of community-wide drug testing with wastewater samples as a population measure of community drug use and to test the hypothesis that the association with urbanicity would vary for three different stimulant drugs of abuse. Design and participants Single-day samples were obtained from a convenience sample of 96 municipalities representing 65% of the population of the State of Oregon. Measurements Chemical analysis of 24-hour composite influent samples for benzoylecgonine (BZE, a cocaine metabolite), methamphetamine and 3,4-methylenedioxymethamphetamine (MDMA). The distribution of community index drug loads accounting for total wastewater flow (i.e. dilution) and population are reported. Findings The distribution of wastewater-derived drug index loads was found to correspond with expected epidemiological drug patterns. Index loads of BZE were significantly higher in urban areas and below detection in many rural areas. Conversely, methamphetamine was present in all municipalities, with no significant differences in index loads by urbanicity. MDMA was at quantifiable levels in fewer than half the communities, with a significant trend towards higher index loads in more urban areas. Conclusion This demonstration provides the first evidence of the utility of wastewater-derived community drug loads for spatial analyses. Such data have the potential to improve dramatically the measurement of the true level and distribution of a range of drugs. Drug index load data provide information for all people in a community and are potentially applicable to a much larger proportion of the total population than existing measures. [source] Do International Medical Graduates (IMGs) "Fill the Gap" in Rural Primary Care in the United States?THE JOURNAL OF RURAL HEALTH, Issue 2 2009A National Study ABSTRACT:,Context: The contribution that international medical graduates (IMGs) make to reducing the rural-urban maldistribution of physicians in the United States is unclear. Quantifying the extent of such "gap filling" has significant implications for planning IMG workforce needs as well as other state and federal initiatives to increase the numbers of rural providers. Purpose: To compare the practice location of IMGs and US medical graduates (USMGs) practicing in primary care specialties. Methods: We used the 2002 AMA physician file to determine the practice location of all 205,063 primary care physicians in the United States. Practice locations were linked to the Rural-Urban Commuting Areas, and aggregated into urban, large rural, small rural, and isolated small rural areas. We determined the difference between the percentage of IMGs and percentage of USMGs in each type of geographic area. This was repeated for each Census Division and state. Findings: One quarter (24.8% or 50,804) of primary care physicians in the United States are IMGs. IMGs are significantly more likely to be female (31.9% vs 29.9%, P < .0001), older (mean ages 49.7 and 47.1 year, P < .0001), and less likely to practice family medicine (19.0% vs 38%, P < .0001) than USMGs. We found only two Census Divisions in which IMGs were relatively more likely than USMGs to practice in rural areas (East South Central and West North Central). However, we found 18 states in which IMGs were more likely, and 16 in which they were less likely to practice in rural areas than USMGs. Conclusions: IMGs fill gaps in the primary care workforce in many rural areas, but this varies widely between states. Policies aimed to redress the rural-urban physician maldistribution in the United States should take into account the vital role of IMGs. [source] Perspectives on Health Among Adult Users of Illicit Stimulant Drugs in Rural OhioTHE JOURNAL OF RURAL HEALTH, Issue 2 2006Harvey A. Siegal PhD ABSTRACT:,Context: Although the nonmedical use of stimulant drugs such as cocaine and methamphetamine is increasingly common in many rural areas of the United States, little is known about the health beliefs of people who use these drugs. Purpose: This research describes illicit stimulant drug users' views on health and health-related concepts that may affect their utilization of health care services. Methods: A respondent-driven sampling plan was used to recruit 249 not-in-treatment, nonmedical stimulant drug users who were residing in 3 rural counties in west central Ohio. A structured questionnaire administered by trained interviewers was used to collect information on a range of topics, including current drug use, self-reported health status, perceived need for substance abuse treatment, and beliefs about health and health services. Findings: Participants reported using a wide variety of drugs nonmedically, some by injection. Alcohol and marijuana were the most commonly used drugs in the 30 days prior to the interview. Powder cocaine was used by 72.3% of the sample, crack by 68.3%, and methamphetamine by 29.7%. Fair or poor health status was reported by 41.3% of the participants. Only 20.9% of the sample felt they needed drug abuse treatment. Less than one third of the sample reported that they would feel comfortable talking to a physician about their drug use, and 65.1% said they preferred taking care of their problems without getting professional help. Conclusions: Stimulant drug users in rural Ohio are involved with a range of substances and hold health beliefs that may impede health services utilization. [source] | ||||||||||