Showing papers on "Rural area published in 2002"

Mental Health Care for Latinos: Inequalities in Use of Specialty Mental Health Services Among Latinos, African Americans, and Non-Latino Whites

Abstract: OBJECTIVE: The authors investigated whether there are disparities in the rates of specialty mental health care for Latinos and African Americans compared with non-Latino whites in the United States. METHODS: Data were analyzed from the 1990-1992 National Comorbidity Survey, which surveyed a probability sample of 8,098 English-speaking respondents aged 15 to 54 years. Respondents self-identified their race or ethnicity, yielding a sample of 695 Latinos, 987 African Americans, and 6,026 non-Latino whites. Data on demographic characteristics, insurance status, psychiatric morbidity, whether the respondent lived in an urban or a rural area, geographic location, income, and use of mental health services were determined for each ethnic or racial group. Logistic regression analyses were used to examine the associations between ethnic or racial group and use of specialty services, with relevant covariates adjusted for. RESULTS: Significant differences between ethnic groups were found in demographic characteristic...

Poverty and Inequality in India: A Re-Examination

Abstract: This paper presents a new set of integrated poverty and inequality estimates for India and Indian states for 1987-88, 1993-94 and 1999-2000. The poverty estimates are broadly consistent with independent evidence on per-capita expenditure, state domestic product and real agricultural wages. They show that poverty decline in the 1990s proceeded more or less in line with earlier trends. Regional disparities increased in the 1990s, with the southern and western regions doing much better than the northern and eastern regions. Economic inequality also increased within states, especially within urban areas, and between urban and rural areas. We briefly examine other development indicators, relating for instance to health and education. Most indicators have continued to improve in the nineties, but social progress has followed very diverse patterns, ranging from accelerated progress in some fields to slowdown and even regression in others. We find no support for sweeping claims that the nineties have been a period of "unprecedented improvement" or "widespread impoverishment".

Nelson Mandela / HSRC study of HIV/AIDS. South African national HIV prevalence behavioural risks and mass media. Household survey 2002.

Abstract: In the last decade in South Africa the number of deaths from AIDS each year has risen to hundreds of thousands. The burden of care and loss falls hardest upon the poor making the development challenges of our nation difficult and costly. In this context the pioneering study presented in this report – the first systematically sampled nationwide community-based survey of the prevalence of HIV in South Africa – assumes great importance. Its findings open three windows of opportunity for concerted interventions in South Africa. Firstly we now have information for different race gender and age groups in urban and rural areas thus allowing programme planners to develop targeted interventions. Secondly we have a clearer understanding of the positive relationship between communication and risk reduction as well as of information needs. Thirdly because the findings are representative they will enable reliable modelling for the first time giving a solid basis for optimising and extending programmes of prevention care treatment and support. (excerpt)

The roles of nature and nurture in the recruitment and retention of primary care physicians in rural areas: a review of the literature.

Abstract: PurposeA systematic review of factors associated with recruitment and retention of primary care physicians in rural areas.MethodUsing PubMed and Medline databases, 21 quantitative articles analyzing recruitment and retention of primary care physicians in rural areas from 1990 to 2000 were fo

Physical activity and its relationship with obesity, hypertension and diabetes in urban and rural Cameroon

Abstract: Objectives: To evaluate and compare physical activity patterns of urban and rural dwellers in Cameroon, and study their relationship with obesity, diabetes and hypertension Methods: We studied 2465 subjects aged ≥15 y, recruited on the basis of a random sampling of households, of whom 1183 were urban dwellers from Yaounde, the capital city of Cameroon and 1282 rural subjects from Bafut, a village of western Cameroon They all had an interviewer-administered questionnaire for the assessment of their physical activity and anthropometric measurements, blood pressure and fasting blood glucose determination The procedure was satisfactorily completed in 2325 (943%) subjects Prevalences were age-adjusted and subjects compared according to their region, sex and age group Results: Obesity was diagnosed in 171 and 30% urban and rural women, respectively (P<0001), and in 54 vs 12% urban and rural men, respectively (P<0001) The prevalence of hypertension was significantly higher in urban vs rural dwellers (114 vs 66% and 176 vs 91% in women and men, respectively; P<0001) Diabetes was more prevalent in urban compared to rural women (P<005), but not men Urban subjects were characterized by lower physical activity (P<0001), light occupation, high prevalence of multiple occupations, and reduced walking and cycling time compared to rural subjects Univariate analysis showed significant associations between both physical inactivity and obesity and high blood pressure The relationship of physical inactivity with hypertension and obesity were independent in both urban and rural men, but not in women Body mass index, blood pressure and glycaemia were higher in the first compared with the fourth quartiles of energy expenditure Conclusion: Obesity, diabetes and hypertension prevalence is higher in urban compared to rural dwellers in the populations studied Physical activity is significantly lower and differs in pattern in urban subjects compared to rural Physical inactivity is associated with these diseases, although not always significant in women

Export Horticulture and Poverty in Kenya

Abstract: The reduction of absolute poverty has become a central goal of the international community including the governments of many developing countries. However, the appropriate strategy for achieving pro-poor growth in any given country remains an open question. In sub-Saharan Africa, the promotion of export horticulture has often been proposed as a pro-poor development strategy due to its intensive use of land and unskilled labour. However, few studies have examined the linkage between export horticulture and poverty reduction. This paper reports the results of a household survey in Kenya undertaken explicitly to compare the incomes of households involved in export horticulture with those which are not. We find evidence that households involved in export horticulture are better off than those which are not, particularly in rural areas. A simulation exercise shows that enabling more households to participate in the sector could reduce poverty substantially in both urban and rural areas. However, analysis of the determinants of participation in export horticulture suggests that some households may face important constraints to participation in the sector. JEL Codes: O13, I32, O18, O19 We gratefully acknowledge funding for this research from the Department for International Development’s Globalisation and Poverty Research Programme. We are also grateful to Mr. David Nalo, Director of the Central Bureau of Statistics and his staff for permitting our household survey to proceed and to Dr. Aus Schek, Social Policy Advisory Service, Ministry of Finance and Economic Planning, Nairobi, for providing detailed information on poverty monitoring in Kenya. We are indebted to Rod Evans and Dicky Evans from Homegrown, John Karuga of Everest, James Cartwright of VegPro, Nipul Dodhia of East Asian Growers, Tiku Shah of Sunripe, and numerous members of the staff of these companies, for generously giving their time to assist our research. Jane Likimani and Cosmas N’Kyengo of FPEAK and the staff of the Horticultural Crop Development Authority provided us with invaluable insights into the horticultural sector in Kenya. Mary Omosa of IDS Nairobi also helped to co-ordinate a qualitative survey with our survey. Our principle debt is to Leonard Obidha and his team of enumerators who conducted the survey diligently despite sometimes difficult circumstances. All errors remain our responsibility. 1 Correspondence should be sent to Neil McCulloch at neilm@ids.ac.uk.

Small Firm Dynamics: Evidence from Africa and Latin America

Abstract: This paper investigates the determinants of survival and growth among small and very small enterprises in Africa and Latin America. Location is found to be an important factor. Firms located in urban and commercial areas are more likely to survive during a given year than those located in rural areas or those being operated out of home. Urban and commercial location is also associated with faster growth, as measured by the number of employees hired in a given year. Studies are also cited to show that human capital matters, especially when it is in the form of vocational training or prior business experience.

The nutrition and health transition in Thailand

Abstract: Objective: To explore and describe the nutrition and health transition in Thailand in relation to social and economic changes, shifts in food consumption patterns and nutritional problems, as well as morbidity and mortality trends. Design: This report reviews the nutrition and health situation and other related issues by compiling information from various reports and publications from several sources. Yearly statistics and reports from the National Statistical Office were used as well as data from the Food and Agriculture Organization (FAO) and national surveys on the nutrition and health situation of the Thai population. Results: Thailand has undergone social and economic transitions during the past three decades and is approaching the post-demographic transitional period. These are evidenced by an increase in life expectancy at birth of the population, and declines in the total fertility and infant mortality rates. The economic structure has also moved from agricultural to industrial. Industrial growth has surpassed that of the agricultural sector as indicated by a steady rise in the share of the industrial sector in the gross domestic product, which is greater than that of other sectors. At the same time, results from several nation-wide surveys indicate that the food consumption pattern of the population has changed considerably; Thai staples and side dishes are being replaced by diets containing a higher proportion of fats and animal meat. A shift in the proportion of expenditure on food prepared at home and that expended on purchased, ready-to-eat food, in both rural and urban settings, gives another reflection of the change in food consumption of the Thai population. The prevalence of overweight and obesity among children and adolescents has increased dramatically during the past 20 years and is more pronounced in children from private schools and urban communities than in those from public schools or rural areas. Among adults, results from two national surveys in 1991 and 1996 indicated that the problem of overweight and other risk factors for cardiovascular disease have increased significantly. In considering the overall causes of death among the Thai population, the leading causes are diet-related chronic degenerative diseases. Diseases of the circulatory system have become the number one cause of death in Thailand and cancer has ranked as the number three cause of death since the late 1980s. Conclusions: The rapid changes in food intake and lifestyle patterns in Thailand clearly demonstrate a significant impact on the shifting pattern of disease burden of the population. These changes should be monitored carefully and must be reversed through appropriate behaviour modification and the promotion of appropriate eating practices and physical activities.

Increasing use of mammography among older, rural African American women: Results from a community trial

Abstract: Objectives. A community trial was undertaken to evaluate the effectiveness of the North Carolina Breast Cancer Screening Program, a lay health advisor network intervention intended to increase screening among rural African American women 50 years and older. Methods. A stratified random sample of 801 African American women completed baseline (1993‐1994) and follow-up (1996‐1997) surveys. The primary outcome was self-reported mammography use in the previous 2 years. Results. The intervention was associated with an overall 6 percentage point increase (95% confidence interval [CI] = −1, 14) in communitywide mammography use. Low-income women in intervention counties showed an 11 percentage point increase (95% CI = 2, 21) in use above that exhibited by lowincome women in comparison counties. Adjustment for potentially confounding characteristics did not change the results. Conclusions. A lay health advisor intervention appears to be an effective public health approach to increasing use of screening mammography among low-income, rural populations. (Am J Public Health. 2002;92:646‐654)

Sexual risk-taking in the slums of Nairobi, Kenya, 1993-98

Abstract: Relatively less attention has been paid to reproductive health problems facing deprived urban residents than to those facing rural residents in sub-Saharan Africa. This is probably because the majority of Africans live in rural areas, where they are presumed to have poorer medical, educational, and other social services. Yet, the unprecedented rate of urbanization and the accompanying disproportionate growth in the proportion of poor city residents pose new challenges for health care in the region. This study examines differences in sexual behaviour between slum residents and non-slum residents in Nairobi city. The results show that slum residents start sexual intercourse at earlier ages, have more sexual partners, and are less likely than other city residents to know of or adopt preventive measures against contracting HIV/AIDS. The findings highlight the need to treat slum residents as a subpopulation uniquely vulnerable to reproductive health problems, and to expend more resources in slum settings.

Multiplex livelihoods in rural Africa: recasting the terms and conditions of gainful employment

Abstract: Citing recent case study evidence from various parts of Africa, this article argues that the income diversification efforts of most rural dwellers over the past decade have been directed at meeting daily needs amidst declining returns to commercial agriculture. Individuals and households have experimented with new forms of livelihood, expanding their non-agricultural income sources, while retaining their base in subsistence farming. Various livelihood patterns are emerging, depending on historical, geographical and agro-ecological factors at local and national levels. Livelihood experimentation has catalysed overlapping arenas of dynamic change, notably disequilibria between households and individual members, tensions between generations, the recalibration of gender power balances, and a search for new social networks. So far this surge of livelihood ‘multiplexity’ has not generated adequate overall levels of gainful employment, technical innovation, purchasing power or welfare improvement. Thus, probing the complex interplay of economic, social, cultural and political dynamics in rural Africa becomes all the more essential for effective policy formulation.

Rural migrants in Shanghai: Living under the shadow of socialism

Abstract: This article examines the fate of rural migrants in Shanghai, China's largest metropolis. Relying on data from a representative survey, it provides a profile of recent rural migrants and analyzes the pattern of occupational and income determination among them. The economic status between migrants and local residents is also compared. The authors show that despite a marked income improvement, rural migrants in Shanghai are still segregated from urban residents and argue that the social divide between urban and rural areas created under socialism has continued to function and may contribute to the formation of a dual society in urban China.

Determinants of car ownership in rural and urban areas: a pseudo-panel analysis

Abstract: This paper examines the factors determining car ownership for households living in rural and urban areas. A dynamic car ownership model is estimated using a pseudo-panel approach, based on data from Family Expenditure Surveys in the UK for 1982–1995. The results show that rural households' car ownership is far less sensitive to motoring costs than that of their urban counterparts. The implication of these results is that general increases in the costs of car transport would pose a considerable economic burden for rural households, and that other area-specific transport measures may be more suitable, particularly from an equity point of view.

Breast and cervical carcinoma screening practices among women in rural and nonrural areas of the United States, 1998–1999

Abstract: BACKGROUND Prior studies have suggested that women living in rural areas may be less likely than women living in urban areas to have had a recent mammogram and Papanicolau (Pap) test and that rural women may face substantial barriers to receiving preventive health care services. METHODS The authors examined both breast and cervical carcinoma screening practices of women living in rural and nonrural areas of the United States from 1998 through 1999 using data from the Behavioral Risk Factor Surveillance System. The authors limited their analyses of screening mammography and clinical breast examination to women aged 40 years or older (n = 108,326). In addition, they limited their analyses of Pap testing to women aged 18 years or older who did not have a history of hysterectomy (n = 131,813). They divided the geographic areas of residence into rural areas and small towns, suburban areas and smaller metropolitan areas, and larger metropolitan areas. RESULTS Approximately 66.7% (95% confidence interval [CI] = 65.8% to 67.6%) of women aged 40 years or older who resided in rural areas had received a mammogram in the past 2 years, compared with 75.4% of women living in larger metropolitan areas (95% CI = 74.9% to 75.9%). About 73.0% (95% CI = 72.2% to 73.9%) of women aged 40 years or older who resided in rural areas had received a clinical breast examination in the past 2 years, compared with 78.2% of women living in larger metropolitan areas (95% CI = 77.8% to 78.7%). About 81.3% (95% CI = 80.6% to 82.0%) of 131,813 rural women aged 18 years or older who had not undergone a hysterectomy had received a Pap test in the past 3 years, compared with 84.5% of women living in larger metropolitan areas (95% CI = 84.1% to 84.9%). The differences in screening across rural and nonrural areas persisted in multivariate analysis (P < 0.001). CONCLUSIONS These results underscore the need for continued efforts to provide breast and cervical carcinoma screening to women living in rural areas of the United States. Cancer 2002; 94:2801–12. © 2002 American Cancer Society. DOI 10.1002/cncr.10577

The Social Management of Rural Nature: Understanding Agrarian-Based Rural Development:

Abstract: There is a growing realisation that agriculture is a central mechanism for delivering sustainable rural development in Europe. However, agro-industrial and postproductivist logics and dynamics have largely tended to marginalise its significance. In this paper we explore some of the conceptual parameters needed to develop the rural development dynamic. This is one which recentralises agriculture and farm-based activities and provides a basis for countering the growing crisis in rural and agricultural policymaking. In order to further embed the rural development dynamic, however, new alliances need to be attached to the struggles that are currently underway in rural areas. This will involve the state and social scientists playing a greater constructive role in developing the social infrastructure around which current exemplars of agrarian-based rural development can become more mainstream.

The Transformation of Rural China

Abstract: During the past quarter century Jonathan Unger has interviewed farmers and rural officials from various parts of China in order to track the extraordinary changes that have swept the countryside from the Maoist era through the Deng era to the present day. A leading specialist on rural China, Professor Unger presents a vivid picture of life in rural areas during the Maoist revolution, and then after the post-Mao disbandment of the collectives. This is a story of unexpected continuities amidst enormous change. Unger describes how rural administrations retain Mao-era characteristics - despite the major shifts that have occurred in the economic and social hierarchies of villages as collectivization and "class struggle" gave way to the slogan "to get rich is glorious." A chapter explores the private entrepreneurship that has blossomed in the prosperous parts of the countryside. Another focuses on the tensions and exploitation that have arisen as vast numbers of migrant laborers from poor districts have poured into richer ones. Another, based on five months of travel by jeep into impoverished villages in the interior, describes the dilemmas of under-development still faced by many tens of millions of farmers, and the ways in which government policies have inadvertently hurt their livelihoods.

What does a school mean to a community? assessing the social and economic benefits of schools to rural villages in new york

Abstract: A study identified community-level characteristics associated with the presence or absence of a school. Data from the 1990 Census and the New York Department of Education identified 64 villages in New York with populations of 500 or less, 36 of which had schools, and 233 villages with populations of 501-2,500, 192 of which had schools. Results indicate that for the smallest rural communities, the presence of a school was associated with many social and economic benefits. Housing values were considerably higher in small villages with schools, and municipal infrastructure was more developed. Occupational structure differed qualitatively, in that places with schools had more people employed in more favorable occupational categories and more employment in civic occupations. While average household income was not markedly different across places with and without schools, income inequality and welfare dependence was lower in villages with schools. Although differences between places with and without schools were not as dramatic in larger rural communities, larger rural communities with schools ranked higher than communities without schools on virtually every indicator of social and economic well-being. This study shows that schools serve as important markers of social and economic viability and vitality, and that the money that might be saved through school consolidation could be forfeited in lost taxes, declining property values, and lost business. (Contains 21 references.) (TD) Reproductions supplied by EDRS are the best that can be made from the original document. WHAT DOES A SCHOOL MEAN TO A COMMUNITY? ASSESSING THE SOCIAL AND ECONOMIC BENEFITS OF SCHOOLS TO RURAL VILLAGES IN NEW YORK Thomas A. Lyson Department of Rural Sociology Cornell University Ithaca, New York 14853 tal2@cornell.edu U.S. DEPARTMENT OF EDUCATION Office of Educafional Research and Improvement EDUCATIONAL RESOURCES INFORMATION CENTER (ERIC) IVI:t*:s document has been reproduced as received from the person or organization originating d. 0 Minor changes have been made to Improve reproductron Qua lay o Points of view or opinions stated in this docu. went do not necessanly represent otficral OERI positron or policy PERMISSION TO REPRODUCE AND DISSEMINATE THIS MATERIAL HAS BEEN GRANTED BY TA 0 ivICk4 f. san TO THE EDUCATIONAL RESOURCES INFORMATION CENTER (ERIC) 1 Support for this research was provided in part by the Cornell University Agricultural Experiment Station and the National Science Foundation in conjunction with USDA/CSREES regional research project NE-185 and NSF project No. 9905904, Civic Community and Civic Welfare.

Current health scenario in rural india

Abstract: India is the second most populous country of the world and has changing socio-political- demographic and morbidity patterns that have been drawing global attention in recent years. Despite several growth- orientated policies adopted by the government, the widening economic, regional and gender disparities are posing challenges for the health sector. About 75% of health infrastructure, medical man power and other health resources are concentrated in urban areas where 27% of the population live. Contagious, infectious and waterborne diseases such as diarrhoea, amoebiasis, typhoid, infectious hepatitis, worm infestations, measles, malaria, tuberculosis, whooping cough, respiratory infections, pneumonia and reproductive tract infections dominate the morbidity pattern, especially in rural areas. However, non-communicable diseases such as cancer, blindness, mental illness, hyper- tension, diabetes, HIV/ AIDS, accidents and injuries are also on the rise. The health status of Indians, is still a cause for grave concern, especially that of the rural population. This is reflected in the life expectancy (63 years), infant mortality rate (80/1000 live births), maternal mortality rate (438/100 000 live births); however, over a period of time some progress has been made. To improve the prevailing situation, the problem of rural health is to be addressed both at macro (national and state) and micro (district and regional) levels. This is to be done in an holistic way, with a genuine effort to bring the poorest of the population to the centre of the fiscal policies. A paradigm shift from the current 'biomedical model' to a 'sociocultural model', which should bridge the gaps and improve quality of rural life, is the current need. A revised National Health Policy addressing the prevailing inequalities, and working towards promoting a long-term perspective plan, mainly for rural health, is imperative.

Use, quality, and outcomes of care for mental health: The rural perspective.

Abstract: This review synthesizes empirical research in rural mental health services to identify current research priorities to improve the mental health of rural Americans. Using a conceptual framework of the multiple determinants of use, quality, and outcomes, the authors address (1) how key constructs are operationalized, (2) their theoretical influence on the care process, (3) reported differences for nonmetropolitan and metropolitan individuals or within nonmetropolitan individuals, (4) salient issues rural advocates have raised, and (5) key research questions. While the authors recognize that rurality is a useful political umbrella to organize advocacy efforts, they propose that investigators no longer employ any of the multiple definitions of the term in the literature as even intrarural comparisons have not provided compelling evidence about the underlying causes of observed outcomes differences. Until these underlying causes have been identified, it is difficult to determine which components of the nonmetropolitan service system need to be improved.

From Pillar to Post? In search of the post-productivist countryside in Australia

Abstract: According to a growing number of commentators, the agricultural sectors and rural areas of advanced Western nations are experiencing a transition from productivism to post-productivism. In Britain and Western Europe, where this putative transition is most evident, the salient features of the shift include: the gradual removal of farm-level subsidies and related stimulatory policies; the introduction of a range of agri-environmental programs aimed at reducing agricultural commodity surpluses and halting farm-related environmental degradation; and the development of a more socially and culturally heterogeneous rural population as counter-urbanisation has brought a new stratum of residents into rural areas. This paper explores this notion in the Australian context. In analysing a wide range of data and policy documents, the paper argues that while there is some evidence of a productivist regime operating in Australia from 1945 to the early 1980s, and some more recent incipient trends consistent with a transi...