Home About us Contact
|
Home About us Contact | ||
|
|
||
Urban-rural Differences (urban-rural + difference)
Selected AbstractsUrban-Rural Differences in a Memory Disorders Clinical PopulationJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 5 2001Sarah B. Wackerbarth PhD OBJECTIVES: To compare patient characteristics and family perceptions of patient function at one urban and one rural memory disorders clinic. DESIGN: Secondary, cross-sectional data analyses of an extant clinical database. SETTING/PARTICIPANTS: First time visits (n = 956) at two memory disorders clinics. MEASUREMENTS: Patient and family-member demographics and assessment results for the Mini-Mental State Examination (MMSE), instrumental activities of daily living (IADLs), activities of daily living (ADLs), the Memory Change and Personality Change components of the Blessed Dementia Rating Scale, and the Revised Memory and Behavior Problems Checklist. RESULTS: In both clinics, patients and family members were more likely female. The typical urban clinic patient was significantly more likely to be living in a facility and more educated than the typical rural patient. Urban and rural patients did not show significant differences in age- and education-adjusted MMSE scores or raw ADL/IADL ratings, but the urban family members reported more memory problems, twice as many personality changes, more-frequent behavior problems, and more adverse reactions to problems. CONCLUSION: Physicians who practice in both urban and rural areas can anticipate differences between patients, and their families, who seek a diagnosis of memory disorders. Our most important finding is that despite similarities in reported functional abilities, urban families appear to be more sensitive to and more distressed by patients' cognitive and behavioral symptoms than rural families. These differences may reflect different underlying needs, and should be explored in further research. [source] Urban-Rural Differences in Overweight Status and Physical Inactivity Among US Children Aged 10-17 YearsTHE JOURNAL OF RURAL HEALTH, Issue 4 2008Jihong Liu ScD ABSTRACT:,Context: Few studies have examined the prevalence of overweight status and physical inactivity among children and adolescents living in rural America. Purpose: We examined urban and rural differences in the prevalence of overweight status and physical inactivity among US children. Methods: Data were drawn from the 2003 National Survey of Children's Health, restricted to children aged 10-17 (unweighted N = 47,757). Overweight status was defined as the gender- and age-specific body mass index (BMI) values at or above the 95th percentile. Physical inactivity was defined using parentally reported moderate-to-vigorous intensity leisure-time physical activity lasting for at least 20 minutes/d on less than three days in the past week. The 2003 Urban Influence Codes were used to define rurality. Multiple logistic regression models were used to examine urban/rural differences in overweight status and physical inactivity after adjusting for potential confounders. Findings: Overweight status was more prevalent among rural (16.5%) than urban children (14.3%). After adjusting for covariates including physical activity, rural children had higher odds of being overweight than urban children (OR: 1.13; 95% CI: 1.01-1.25). Minorities, children from families with lower socioeconomic status, and children living in the South experienced higher odds of being overweight. More urban children (29.1%) were physically inactive than rural children (25.2%) and this pattern remained after adjusting for covariates (OR: 0.79; 95% CI: 0.73-0.86). Conclusions: The higher prevalence of overweight among rural children, despite modestly higher physical activity levels, calls for further research into effective intervention programs specifically tailored for rural children. [source] Urban-Rural Differences in Motivation to Control Prejudice Toward People With HIV/AIDS: The Impact of Perceived Identifiability in the CommunityTHE JOURNAL OF RURAL HEALTH, Issue 3 2008Janice Yanushka Bunn PhD ABSTRACT:,Context:HIV/AIDS is occurring with increasing frequency in rural areas of the United States, and people living with HIV/AIDS in rural communities report higher levels of perceived stigma than their more urban counterparts. The extent to which stigmatized individuals perceive stigma could be influenced, in part, by prevailing community attitudes. Differences between rural and more metropolitan community members' attitudes toward people with HIV/AIDS, however, have rarely been examined. Purpose: This study investigated motivation to control prejudice toward people with HIV/AIDS among non-infected residents of metropolitan, micropolitan, and rural areas of rural New England. Methods: A total of 2,444 individuals were identified through a random digit dialing sampling scheme, and completed a telephone interview to determine attitudes and concerns about a variety of health issues. Internal or external motivation to control prejudice was examined using a general linear mixed model approach, with independent variables including age, gender, community size, and perceived indentifiability within one's community. Findings: Results showed that community size, by itself, was not related to motivation to control prejudice. However, there was a significant interaction between community size and community residents' perceptions about the extent to which people in their communities know who they are. Conclusion: Our results indicate that residents of rural areas, in general, may not show a higher level of bias toward people with HIV/AIDS. The interaction between community size and perceived identifiability, however, suggests that motivation to control prejudice, and potentially the subsequent expression of that prejudice, is more complex than originally thought. [source] Medicare-Certified Home Health Care: Urban-Rural Differences in UtilizationTHE JOURNAL OF RURAL HEALTH, Issue 3 2007Lacey Hartman MPP ABSTRACT:,Context:Availability of Medicare-certified home health care (HHC) to rural elders can prevent more expensive institutional care. To date, utilization of HHC by rural elders has not been studied in detail.Purpose:To examine urban-rural differences in Medicare HHC utilization.Methods:The 2002 100% Medicare HHC claims and denominator files were used to estimate use of HHC and to make urban-rural comparisons on the basis of utilization levels within ZIP codes.Findings:Overall, the proportion of Medicare beneficiaries living in areas with little HHC utilization is relatively low. Rural elders, however, are more likely than their urban counterparts to live in such areas. Less than 1% of urban beneficiaries live in ZIP codes with no or low use of HHC, but over 17% of the most rural beneficiaries live in such areas.Conclusions:Continued monitoring of rural HHC utilization and access is important, especially as Medicare seeks to evaluate the effectiveness of payment increases to rural home health agencies. [source] The current status of urban-rural differences in psychiatric disordersACTA PSYCHIATRICA SCANDINAVICA, Issue 2 2010J. Peen Peen J, Schoevers RA, Beekman AT, Dekker J. The current status of urban,rural differences in psychiatric disorders. Objective:, Reviews of urban,rural differences in psychiatric disorders conclude that urban rates may be marginally higher and, specifically, somewhat higher for depression. However, pooled results are not available. Method:, A meta-analysis of urban,rural differences in prevalence was conducted on data taken from 20 population survey studies published since 1985. Pooled urban,rural odds ratios (OR) were calculated for the total prevalence of psychiatric disorders, and specifically for mood, anxiety and substance use disorders. Results:, Significant pooled urban,rural OR were found for the total prevalence of psychiatric disorders, and for mood disorders and anxiety disorders. No significant association with urbanization was found for substance use disorders. Adjustment for various confounders had a limited impact on the urban,rural OR. Conclusion:, Urbanization may be taken into account in the allocation of mental health services. [source] Do Rural Elders Have Limited Access to Medicare Hospice Services?JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 5 2004Beth A. Virnig PhD Objectives:, To examine whether there are urban-rural differences in use of the Medicare hospice benefit before death and whether those differences suggest that there is a problem with access to hospice care for rural Medicare beneficiaries. Design:, Observational study using 100% of Medicare enrollment, hospice, and hospital claims data. Setting:, Inpatient hospitals and hospices. Participants:, Persons aged 65 and older in the Medicare program who died in 1999. Measurements:, Rates of hospice use before death and in-hospital death rates were calculated. Results:, In 1999, there were 1.76 million deaths of Medicare beneficiaries aged 65 and older. Hospice services were used by 365,700 of these beneficiaries. Rates of hospice care before death were negatively associated with degree of rurality. The lowest rate of hospice use, 15.2% of deaths, was seen in rural areas not adjacent to an urban area. The highest rate of use, 22.2% of deaths, was seen in urban areas. Rural areas adjacent to urban areas had an intermediate level of hospice use (17.0% of deaths). Hospices based in rural areas had a smaller number of elderly patients each year than hospices based in urban areas (P<.001) and were more likely to have very low volumes (average daily census of three patients or less). Conclusion:, The consistently lower use of Medicare hospice services before death and smaller sizes of rural hospices suggest that the combination of Medicare hospice payment policies and hospice volumes are problematic for rural hospices. Adjusting Medicare payment policies might be a critical step to assure availability of hospice services forterminally ill beneficiaries regardless of where they live. [source] TRUE WORLD INCOME DISTRIBUTION, 1988 AND 1993: FIRST CALCULATION BASED ON HOUSEHOLD SURVEYS ALONETHE ECONOMIC JOURNAL, Issue 476 2002Branko Milanovic The paper derives world income or expenditure distribution of individuals for 1988 and 1993. It is the first paper to calculate world distribution for individuals based entirely on household surveys from 91 countries, and adjusted for differences in purchasing power parity between countries. Measured by the Gini index, inequality increased from 63 in 1988 to 66 in 1993. The increase was driven more by differences in mean incomes between countries than by inequalities within countries. The most important contributors were rising urban-rural differences in China, and slow growth of rural incomes in South Asia compared to several large developed economies. [source] Urban-Rural Disparities in Injury Mortality in China, 2006THE JOURNAL OF RURAL HEALTH, Issue 1 2010Guoqing Hu PhD Abstract Context: Urban-rural disparity is an important issue for injury control in China. Details of the urban-rural disparities in fatal injuries have not been analyzed. Purpose: To target key injury causes that most contribute to the urban-rural disparity, we decomposed total urban-rural differences in 2006 injury mortality by gender, age, and cause. Methods: Mortality data came from the Chinese Vital Registration data, covering a sample of about 10% of the total population. The chi-square test was used to test the significance of urban-rural disparities. Findings: For all ages combined, the injury death rate for males was 60.1/100,000 in rural areas compared with 40.9 in urban areas; for females, the respective rates were 31.5 and 23.6/100,000. The greatest disparity was at age <1 year for both sexes, where the rate from unintentional suffocation in rural areas was more than twice the urban rate. The higher mortality from drowning among males of all ages and among females ages 1-24 and 35+ contributed substantially to the age-specific urban-rural disparities. For both sexes, transportation incidents and suicide were the most important contributors to higher rates among rural residents ages 15+. Conclusions: Unintentional suffocation, drowning, transportation incidents, and suicide not only are the major causes of injury death, but also play a key role in explaining the urban-rural disparities in fatal injuries. Further research is needed to identify factors leading to higher rural death rates and to explore economical and feasible interventions for reducing injuries and narrowing the urban-rural gap in injury mortality. [source] Medicare-Certified Home Health Care: Urban-Rural Differences in UtilizationTHE JOURNAL OF RURAL HEALTH, Issue 3 2007Lacey Hartman MPP ABSTRACT:,Context:Availability of Medicare-certified home health care (HHC) to rural elders can prevent more expensive institutional care. To date, utilization of HHC by rural elders has not been studied in detail.Purpose:To examine urban-rural differences in Medicare HHC utilization.Methods:The 2002 100% Medicare HHC claims and denominator files were used to estimate use of HHC and to make urban-rural comparisons on the basis of utilization levels within ZIP codes.Findings:Overall, the proportion of Medicare beneficiaries living in areas with little HHC utilization is relatively low. Rural elders, however, are more likely than their urban counterparts to live in such areas. Less than 1% of urban beneficiaries live in ZIP codes with no or low use of HHC, but over 17% of the most rural beneficiaries live in such areas.Conclusions:Continued monitoring of rural HHC utilization and access is important, especially as Medicare seeks to evaluate the effectiveness of payment increases to rural home health agencies. [source] Regional variation in the survival and health of older Australian women: a prospective cohort studyAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2 2009Dimitrios Vagenas Abstract Objective: Older people may act as sensitive indicators of the effectiveness of health systems. Our objective is to distinguish between the effects of socio-economic and behavioural factors and use of health services on urban-rural differences in mortality and health of elderly women. Methods: Baseline and longitudinal analysis of data from a prospective cohort study. Participants were a community-based random sample of women (n=12778) aged 70-75 years when recruited in 1996 to the Australian Longitudinal Study on Women's Health. Measures used were: urban or rural residence in Australian States and Territories, socio-demographic characteristics, health related behaviour, survival up to 1 October 2006, physical and mental health scores and use of medical services. Results: Mortality was higher in rural than in urban women (hazard ratio, HR 1.14; 95% CI, 1.03,-1.26) but there were no differences between States and Territories. There were no consistent baseline or longitudinal differences between women for physical or mental health, with or without adjustment for socio-demographic and behavioural factors. Rural women had fewer visits to general practitioners (odds ratio, OR=0.54; 95% CI, 0.48-0.61) and medical specialists (OR=0.60; 95% CI, 0.55-0.65). Conclusions: Differences in use of health services are a more plausible explanation for higher mortality in rural than urban areas than differences in other factors. Implications: Older people may be the ,grey canaries' of the health system and may thus provide an ,early warning system' to policy makers and governments. [source] | ||||||||||