Showing papers on "Rural area published in 2003"
TL;DR: Increased education, higher socioeconomic status, non-Muslim religion, and extended family residence are found to be associated with lower risks of violence in two rural areas of Bangladesh.
Abstract: We explore the determinants of domestic violence in two rural areas of Bangladesh. We found increased education, higher socioeconomic status, non-Muslim religion, and extended family residence to be associated with lower risks of violence. The effects of women's status on violence was found to be highly context-specific. In the more culturally conservative area, higher individual-level women's autonomy and short-term membership in savings and credit groups were both associated with significantly elevated risks of violence, and community-level variables were unrelated to violence. In the less culturally conservative area, in contrast, individual-level women's status indicators were unrelated to the risk of violence, and community-level measures of women's status were associated with significantly lower risks of violence, presumably by reinforcing nascent normative changes in gender relations.
665 citations
TL;DR: Both income level and urban rural status were important predictors of adults’ likelihood to meet physical activity recommendations, and evidence of a positive dose-response relation emerged between number of places to exercise and likelihood to met recommendations for physical activity.
Abstract: Study objectives: Few studies have analysed the rates and correlates of physical activity in economically and geographically diverse populations. Objectives were to examine: (1) urban-rural differences in physical activity by several demographic, geographical, environmental, and psychosocial variables, (2) patterns in environmental and policy factors across urban-rural setting and socioeconomic groups, (3) socioeconomic differences in physical activity across the same set of variables, and (4) possible correlations of these patterns with meeting of physical activity recommendations.
Design: A cross sectional study with an over sampling of lower income adults was conducted in 1999–2000.
Setting: United States.
Participants: 1818 United States adults.
Main results: Lower income residents were less likely than higher income residents to meet physical activity recommendations. Rural residents were least likely to meet recommendations; suburban residents were most likely to meet recommendations. Suburban, higher income residents were more than twice as likely to meet recommendations than rural, lower income residents. Significant differences across income levels and urban/rural areas were found for those reporting neighbourhood streets, parks, and malls as places to exercise; fear of injury, being in poor health, or dislike as barriers to exercise and those reporting encouragement from relatives as social support for exercise. Evidence of a positive dose-response relation emerged between number of places to exercise and likelihood to meet recommendations for physical activity.
Conclusions: Both income level and urban rural status were important predictors of adults’ likelihood to meet physical activity recommendations. In addition, environmental variables vary in importance across socioeconomic status and urban-rural areas.
647 citations
TL;DR: In this article, the authors used simultaneous-equation econometric techniques and household survey data from China to understand the effects of China's migration on source communities and to discuss their policy implications, finding that the loss of labor to migration has a negative effect on household cropping income in source areas.
Abstract: The objective of this paper is to understand the effects of China’s migration on source communities and to discuss their policy implications. We draw from New Economics of Labor Migration (NELM) theory to understand how migration and migrant remittances can relax or tighten market constraints in China’s rural economy. Using simultaneous-equation econometric techniques and household survey data from China, we estimate net, sectorspecific effects of migration on rural household income, focusing on farm production and self-employment. Our econometric findings indicate that the loss of labor to migration has a negative effect on household cropping income in source areas. However, we provide evidence that remittances sent home by migrants positively compensate for this lost-labor effect, contributing to household incomes directly and indirectly by stimulating crop and possibly self-employment production. This finding offers evidence in support of the NELM hypothesis that remittances loosen constraints on production in the imperfect-market environments characterizing rural areas in less developed countries. Taking into account both the multiple effects of migration and the change in household size, participating in migration increases household per-capita income between 14 and 30 percent. Migration and Incomes in Source Communities: A New Economics of Migration Perspective from China China is experiencing the largest peacetime flow of labor out of agriculture ever witnessed in world history (Solinger, 1999; Rozelle et al., 1999). Despite the rapid expansion of labor migration, China’s work force is still disproportionately employed in agriculture compared to other countries at similar levels of per-capita GDP (Taylor and Martin, 2001). Hence, as China’s economy continues to expand, the flow of labor to urban areas will continue and even accelerate (Johnson, 1999). The massive flow of labor away from farms has intensified research interest in China’s migration in recent years. However, as in the broader literature on migration in less developed countries, most recent studies on China’s migration have focused on determining the size and composition of the labor flow, macroeconomic implications of increased migration, and the effects of migration on urban areas (Zhao, 1999; Yang, 1999; 1997). Less emphasis has been placed on researching the effects of migration on the rural communities that migrants leave, even though evidence shows that the rural household in the village of origin is typically the central concern of all those involved in migration– both those who leave and those who stay behind (exceptions include Wang and Zuo, 1999; Bai, 2001). Moreover, the recent increase in migration has left policy makers particularly concerned regarding the way source communities will be affected (MOA, 1999). They are concerned that as labor flows away from farms, food production and crop income will decline, potentially threatening China’s food security. Furthermore, policy makers are concerned about the increasing gap between urban and rural household incomes. If migration exacerbates this gap, some fear that as it grows rural residents eventually will flood cities ill-equipped to absorb them. Others fear that discontent over a rising urban-rural income gap could even spill over into political unrest (Yang, 1999). Because China’s markets and other modern economic institutions are still relatively undeveloped, migration may play a pivotal role in creating or overcoming constraints caused by the lack of well-functioning markets and/or institutions (Knight and Song, 1999; Benjamin and Brandt, 2000). The “new economics of labor migration” (NELM) literature analyzes migration as a household decision rather than as an individual decision (Stark, 1991). The NELM hypothesizes that rural households facing imperfect market environments decide
581 citations
TL;DR: Care-seeking behaviour is worse in poorer than in relatively rich families, even within a rural society that might easily be assumed to be uniformly poor.
511 citations
TL;DR: Evidence from past literature is presented to build a conceptual framework to begin to explain this heterogeneity in malaria transmission and the potential for malaria epidemics owing to decreasing levels of natural immunity being offset by negative impacts of urbanization on the larval ecology of anopheline mosquitoes.
Abstract: The rapid increase in the world's urban population has major implications for the epidemiology of malaria. A review of malaria transmission in sub-Saharan African cities shows the strong likelihood of transmission occurring within these sprawling cities, whatever the size or characteristics of their bioecologic environment. A meta-analysis of results from studies of malaria transmission in sub-Saharan Africa shows a loose linear negative relationship between mean annual entomologic inoculation rates (EIR) and the level of urbanicity. Few studies have failed to find entomologic evidence of some transmission. Our results show mean annual EIRs of 7.1 in the city centers, 45.8 in periurban areas, and 167.7 in rural areas. The impact of urbanization in reducing transmission is more marked in areas where the mean rainfall is low and seasonal. Considerable variation in the level of transmission exists among cities and within different districts in the same city. This article presents evidence from past literature to build a conceptual framework to begin to explain this heterogeneity. The potential for malaria epidemics owing to decreasing levels of natural immunity may be offset by negative impacts of urbanization on the larval ecology of anopheline mosquitoes. Malaria control in urban environments may be simpler as a result of urbanization; however, much of what we know about malaria transmission in rural environments might not hold in the urban context.
446 citations
TL;DR: The study showed that motivation is influenced by both financial and non-financial incentives, and the main motivating factors for health workers were appreciation by managers, colleagues and the community, a stable job and income and training.
Abstract: BACKGROUND: In Viet Nam, most of the public health staff (84%) currently works in rural areas, where 80% of the people live. To provide good quality health care services, it is important to develop strategies influencing staff motivation for better performance. METHOD: An exploratory qualitative research was carried out among health workers in two provinces in North Viet Nam so as to identify entry points for developing strategies that improve staff performance in rural areas. The study aimed to determine the major motivating factors and it is the first in Viet Nam that looks at health workers' job perception and motivation. Apart from health workers, managers at national and at provincial level were interviewed as well as some community representatives. RESULTS: The study showed that motivation is influenced by both financial and non-financial incentives. The main motivating factors for health workers were appreciation by managers, colleagues and the community, a stable job and income and training. The main discouraging factors were related to low salaries and difficult working conditions. CONCLUSION: Activities associated with appreciation such as performance management are currently not optimally implemented, as health workers perceive supervision as control, selection for training as unclear and unequal, and performance appraisal as not useful. The kind of non-financial incentives identified should be taken into consideration when developing HRM strategies. Areas for further studies are identified.
434 citations
TL;DR: The study shows the overriding effect of O3 despite a diversity of altered environmental factors, reveals ‘footprints’ of lower cumulative urban O3 exposures amidst a background of higher regional exposures, and shows a greater adverse effect of urban pollutant emissions beyond the urban core.
Abstract: Plants in urban ecosystems are exposed to many pollutants and higher temperatures, CO2 and nitrogen deposition than plants in rural areas. Although each factor has a detrimental or beneficial influence on plant growth, the net effect of all factors and the key driving variables are unknown. We grew the same cottonwood clone in urban and rural sites and found that urban plant biomass was double that of rural sites. Using soil transplants, nutrient budgets, chamber experiments and multiple regression analyses, we show that soils, temperature, CO2, nutrient deposition, urban air pollutants and microclimatic variables could not account for increased growth in the city. Rather, higher rural ozone (O3) exposures reduced growth at rural sites. Urban precursors fuel the reactions of O3 formation, but NO(x) scavenging reactions resulted in lower cumulative urban O3 exposures compared to agricultural and forested sites throughout the northeastern USA. Our study shows the overriding effect of O3 despite a diversity of altered environmental factors, reveals 'footprints' of lower cumulative urban O3 exposures amidst a background of higher regional exposures, and shows a greater adverse effect of urban pollutant emissions beyond the urban core.
375 citations
TL;DR: In this article, the authors examined the development of cultural rural tourism in a case study of a French Acadian region on an island in eastern Canada and proposed a framework with four evolving development stages.
362 citations
TL;DR: In this paper, the authors examined data for the USA concerning the digital divide and access of residences and businesses, which tend to suggest that all is (or will soon be) well.
344 citations
TL;DR: The "Health for All" vision for rural people is more likely to be achieved through joint concerted efforts of international and national bodies working together with doctors, nurses and other health workers in rural areas around the world.
Abstract: Despite the huge differences between developing and developed countries, access is the major issue in rural health around the world. Even in the countries where the majority of the population lives in rural areas, the resources are concentrated in the cities. All countries have difficulties with transport and communication, and they all face the challenge of shortages of doctors and other health professionals in rural and remote areas. Many rural people are caught in the poverty- ill health-low productivity downward spiral, particularly in developing countries. Since 1992, WONCA, the World Organization of Family Doctors, has developed a specific focus on rural health through the WONCA Working Party on Rural Practice. This Working Party has drawn national and international attention to major rural health issues through World Rural Health Conferences and WONCA Rural Policies. The World Health Organization (WHO) has broadened its focus beyond public health to partnership with family practice, initially through a landmark WHO-WONCA Invitational Conference in Canada. From this has developed the Memorandum of Agreement between WONCA and WHO which emphasizes the important role of family practitioners in primary health care and also includes the Rural Health Initiative. In April 2002, WHO and WONCA held a major WHO-WONCA Invitational Conference on Rural Health. This conference addressed the immense challenges for improving the health of people of rural and remote areas of the world and initiated a specific action plan: The Global Initiative on Rural Health. The "Health for All" vision for rural people is more likely to be achieved through joint concerted efforts of international and national bodies working together with doctors, nurses and other health workers in rural areas around the world.
295 citations
TL;DR: In this paper, the relative importance of rural versus urban areas in terms of monetary poverty and seven other related living standards indicators is examined, and the relative and absolute rates of change for urban and rural areas are examined.
Abstract: In this paper we examine the relative importance of rural versus urban areas in terms of monetary poverty and seven other related living standards indicators. We present the levels of urban--rural differences for several African countries for which we have data and find that living standards in rural areas lag far behind those in urban areas. Then we examine the relative and absolute rates of change for urban and rural areas, and find no overall evidence of declining differences in the gaps between urban and rural living standards. Finally, we conduct urban--rural decompositions of inequality, examining the within versus between (urban and rural) group inequality for asset inequality, education inequality, and health (height) inequality. Copyright 2003, Oxford University Press.
TL;DR: There is consistent evidence that the likelihood of working in rural practice is approximately twice greater among doctors with a rural background, and there is a smaller body of evidence in support of the other rural factors studied.
Abstract: Objective: We sought to summarise the evidence for an association between rural background and rural practice by systematically reviewing the national and international published reports.
Design: A systematic review.
Setting: A search of the national and international published reports from 1973 to October 2001.
Subject: The search criteria included observational studies of a case-control or cohort design making a clear and quantitative comparison between current rural and urban doctors, this resulted in the identification of 141 studies for potential inclusion.
Results: We systematically reviewed 12 studies. Rural background was associated with rural practice in 10 of the 12 studies, in which it was reported, with most odds ratios (OR) approximately 2–2.5. Rural schooling was associated with rural practice in all 5 studies that reported on it, with most OR approximately 2.0. Having a rural partner was associated with rural practice in 3 of the 4 studies reporting on it, with OR approximately 3.0. Rural undergraduate training was associated with rural practice in 4 of 5 studies, with most OR approximately 2.0. Rural postgraduate training was associated with rural practice in 1 of 2 studies, with rural doctors reporting rural training about 2.5 times more often.
Conclusions: There is consistent evidence that the likelihood of working in rural practice is approximately twice greater among doctors with a rural background. There is a smaller body of evidence in support of the other rural factors studied, and the strength of association is similar to that for rural background.
What is already known on this subject?: It is widely perceived that doctors with a rural background are more likely to return to work in rural areas and major policy initiatives in Australia rely on this assumption. It is recognised that other factors such as location of primary and secondary education, rural medical training and spouse or partner background may also be influential. In order to determine the strength of the evidence for an association between rural background and rural practice we did a systematic review of the published reports.
What does this study add?: This systematic review provides good evidence that doctors with a rural background are about twice as likely to work as rural doctors, compared with those with an urban background. Rural background seems to be an important factor that can be employed in policy and practice, however, the problem of increasing the number of rural doctors is multifactorial and so is the solution.
TL;DR: In this paper, the authors investigated the impact of growth on poverty in Ethiopia by analyzing panel data covering 1994-97, a period of economic recovery driven by peace, good weather, and much improved macroeconomic management.
TL;DR: Results of the study showed that the coverage of maternity-care services was very low in Ethiopia and revealed that demographic and sociocultural factors were the most important aspects that influenced the use of maternal healthcare services in Ethiopia.
Abstract: This study examined the factors that influence the use of maternal healthcare services in Ethiopia and particularly assessed the use of antenatal and delivery-care services. Data for the study were drawn from the 2000 Ethiopia Demographic and Health Survey. Multivariate logistic regression analysis was employed to explore the relative importance of a number of demographic and sociocultural variables in the likelihood of using these services. Results of the study showed that the coverage of maternity-care services was very low in Ethiopia, i.e. about 27% and 6% of women, respectively, received professionally-assisted antenatal and delivery-care services in the five years preceding the survey. The study also revealed that demographic and sociocultural factors were the most important aspects that influenced the use of maternal healthcare services in Ethiopia. The independent factors influencing the use of maternal healthcare services included education of mothers, marital status, place of residence, parity, and religion. However, this cannot detract from the relevance of servicerelated factors, especially in the rural areas of the country.
TL;DR: The analysis on mortality determination shows that at the national level access to electricity, incomes, vaccination in the first year of birth, and public health expenditure significantly reduce child mortality, which suggests that health interventions implemented in the past decade may not have been as effective in reaching the poor.
TL;DR: This paper aims to summarize strategies to solve inequitable distribution of human resources for health between urban and rural areas, by using four decades of experience in Thailand as a case study for analysis.
Abstract: Inequitable distribution of doctors with high concentration in urban cities negatively affects the public health objective of Health for All. Thus it is one of the main concerns for most health policy makers, particularly in developing countries. This paper aims to summarize strategies to solve inequitable distribution of human resources for health (HRH) between urban and rural areas, by using four decades of experience in Thailand as a case study for analysis.
TL;DR: The survey finds that distance is the most important factor that influences the utilization of health services in the Ahafo-Ano South district, and recommendations to reduce distance coverage, improve formal education and reduce poverty are made.
Abstract: Although the distance factor has been identified as key in the utilization of health services in rural areas of developing countries, it has been analysed without recourse to related factors of travel time and transport cost. Also, the influence of distance on vulnerable groups in utilization has not been an object of survey by researchers. This paper addresses the impact of distance on utilization, and how distance compares with travel time and transport cost that are related to it in the utilization of health services in the Ahafo-Ano South (rural) district in Ghana. The study, a cross-sectional survey, also identifies the position of distance among other important factors of utilization. A sample of 400, drawn through systematic random technique, was used for the survey. Data were analysed using the regression model and some graphic techniques. The main instruments used in data collection were formal (face-by-face) interview and a questionnaire. The survey finds that distance is the most important factor that influences the utilization of health services in the Ahafo-Ano South district. Other key factors are income, service cost and education. The effect of travel time on utilization reflects that of distance and utilization. Recommendations to reduce distance coverage, improve formal education and reduce poverty have been made.
TL;DR: In this article, the urban-rural mortality continuum is examined for nineteenth-century England and Wales using log-normal distributions, and it is found that urban areas had relatively favorable mortality environments compared to rural areas.
Abstract: Historians and demographers have long debated the existence, causes, and consequences of historical differences between urban and rural mortality levels In Europe it has been usual to observe excess mortality in cities compared to the countryside, but in East Asia, by contrast, it has been found that urban areas had relatively favorable mortality environments The debate continues because a number of pertinent questions remain to be resolved For example, the way in which mortality is measured may influence the apparent extent of the differential, as may the way in which“urban” and“rural” are defined Cultural factors need to be taken into account, including the practices of childrearing and the conventions surrounding baptism Examples drawn from Japan, China, England, and France illustrate the issues involved in comparative analysis, while the urban-rural mortality continuum is examined for nineteenth-century England and Wales using log-normal distributions
TL;DR: The results support the validity of the SF-36 Arabic version, which showed wide variability and acceptable internal consistency, and patterns of factor correlation comparable to that found in the U.S.A and France.
Abstract: Measuring health status in a population is important for the evaluation of interventions and the prediction of health and social care needs. Quality of life (QoL) studies are an essential complement to medical evaluation but most of the tools available in this area are in English. In order to evaluated QoL in rural and urban areas in Lebanon, the short form 36 health survey (SF-36) was adapted into Arabic. SF-36 was administered in a cross-sectional study, to collect sociodemographic and environmental variables as well as self reported morbidity. We analysed a representative sample containing 1632 subjects, from whom we randomly picked 524 subjects aged 14 years and over. The translation, cultural adaptation and validation of the SF-36 followed the International Quality of Life Assessment methodology. Multivariate analysis (generalized linear model) was performed to test the effect of habitat (rural on urban areas) on all domains of the SF-36. The rate of missing data is very low (0.23% of items). Item level validation supported the assumptions underlying Likert scoring. SF-36 scale scores showed wide variability and acceptable internal consistency (Cronbach's alpha >0.70), factor analysis yielded patterns of factor correlation comparable to that found in the U.S.A and France. Patients resident in rural areas had higher vitality scores than those in urban areas. Older people reported more satisfaction with some domains of life than younger people, except for physical functioning. The QoL of women is poorer than men; certain symptoms and morbidity independently influence the domains of SF-36 in this population. The results support the validity of the SF-36 Arabic version. Habitat has a minor influence on QoL, women had a poor QoL, and health problems had differential impact on QoL.
TL;DR: Older patients need intentional messages from physicians that recommend vaccination, and more patient education is needed to counter myths about adverse reactions.
TL;DR: In this article, the authors propose that shifts in rural population and economic growth patterns may help explain rising levels of support for environmental values in many rural areas in particular, and assesses a model of "green migration" that assumes that domestic in-migration, with its impacts on the character and composition of rural communities, is one of the reasons environmental values may be gaining support in rural America.
Abstract: This article proposes that shifts in rural population and economic growth patterns may help explain rising levels of support for environmental values in many rural areas In particular, it assesses a model of "green migration" that assumes that domestic in-migration, with its impacts on the character and composition of rural communities, is one of the reasons environmental values may be gaining support in rural America Results based on survey data obtained from two groups of rural residents of southern Appalachia lend support to the model A majority of the in-migrants to the region came because of its environment, and protecting environmental values remained a high priority In-migrants are a bit more knowledgeable about environmental issues, more concerned about the environment, place higher priority on environmental protection, and are more engaged in activities that promote environmental values than nonmigrants Knowledge of the sociodemographic characteristics of both groups of rural residents is ke
TL;DR: According to as mentioned in this paper, road traffic crashes were a leading cause of death and injuries in Ghana, while occupational injuries are occupational injuries which involve non-mechanized farming and tribal conflicts.
Abstract: Road traffic injuries and fatalities are increasing in Ghana. Police-collected crash and injury data for the period 1994-1998 were aggregated and analyzed using the MAAP5 accident analysis package developed by the Transport Research Laboratory, U.K. Published results of recent transport-related epidemiological and other surveys provided an additional data source. According to the 1994-1998 police data, road traffic crashes were a leading cause of death and injuries in Ghana. The other leading causes of death and injuries are occupational injuries which involve non-mechanized farming and tribal conflicts. The majority of road traffic fatalities (61.2%) and injuries (52.3%) occurred on roads in rural areas. About 58% more people died on roads in the rural areas than in urban areas, and generally more severe crashes occurred on rural roads compared with urban areas. Pedestrians accounted for 46.2% of all road traffic fatalities. The majority of these (66.8%) occurred in urban areas. The second leading population of road users affected was riders in passenger-ferrying buses, minibuses and trucks. The majority of these (42.8%) were killed on roads that pass through rural areas. Pedestrian casualties were overrepresented (nearly 90%) in five regions located in the southern half of the country. Efforts to tackle pedestrian safety should focus on the five regions of the country where most pedestrian fatalities occur in urban areas. Policies are also needed to protect passengers in commercially operated passenger-ferrying buses, minibuses and trucks because these vehicles carry a higher risk of being involved in fatal crashes.
TL;DR: Medical expenditure has become an important source of transient poverty in rural China and raised the number of rural households living below the poverty line by 44.3%.
Abstract: Thanks to continued economic growth and increasing income, the overall poverty rate has been on the decline in China. However, due to escalating medical costs and lack of insurance coverage, medical spending often causes financial hardship for many rural families. Using data from the 1998 China National Health Services Survey, the impact of medical expenditure on the poverty headcount for different rural regions was estimated. Based on the reported statistics on income alone, 7.22% of the whole rural sample was below the poverty line. Out-of-pocket medical spending raised this by more than 3 percentage points. In other words, medical spending raised the number of rural households living below the poverty line by 44.3%. Medical expenditure has become an important source of transient poverty in rural China.
TL;DR: This study examines the association between population indicators of access to obstetric care and levels of maternal mortality in urban and rural West Africa.
Abstract: OBJECTIVES: Process evaluation has become the mainstay of safe motherhood evaluation in developing countries, yet the extent to which indicators measuring access to obstetric services at the population level reflect levels of maternal mortality is uncertain. In this study we examine the association between population indicators of access to obstetric care and levels of maternal mortality in urban and rural West Africa. METHODS: In this ecological study we used data on maternal mortality and access to obstetric services from two population-based studies conducted in 16 sites in eight West African countries: the Maternal Mortality and Obstetric Care in West Africa (MAMOCWA) study in rural Senegal, Guinea-Bissau and The Gambia and the Morbidite Maternelle en Afrique de l'Ouest (MOMA) study in urban Burkina Faso, Cote d'Ivoire, Mali, Mauritanie, Niger and Senegal. RESULTS: In rural areas, maternal mortality, excluding early pregnancy deaths, was 601 per 100,000 live births, compared with 241 per 100,000 for urban areas [RR = 2.49 (CI 1.77-3.59)]. In urban areas, the vast majority of births took place in a health facility (83%) or with a skilled provider (69%), while 80% of the rural women gave birth at home without any skilled care. There was a relatively close link between levels of maternal mortality and the percentage of births with a skilled attendant (r = -0.65), in hospital (r = -0.54) or with a Caesarean section (r = -0.59), with marked clustering in urban and rural areas. Within urban or rural areas, none of the process indicators were associated with maternal mortality. CONCLUSION: Despite the limitations of this ecological study, there can be little doubt that the huge rural-urban differences in maternal mortality are due, at least in part, to differential access to high quality maternity care. Whether any of the indicators examined here will by themselves be good enough as a proxy for maternal mortality is doubtful however, as more than half of the variation in mortality remained unexplained by any one of them.
TL;DR: There are considerable British urban-rural differences in mental health, which may largely be attributable to more adverse urban social environments, and differences on CIS-R morbidity were considerably reduced.
Abstract: Studies of urban-rural differences in prevalence of non-psychotic mental disorder have not given consistent findings. Such differences have received relatively little study in Great Britain. Data from 9777 subjects in the Household Survey of the National Morbidity Survey of Great Britain were analysed for differences between urban, semi-rural, and rural areas. Psychiatric morbidity was assessed by scores on the Revised Clinical Interview Schedule (CIS-R), together with alcohol dependence, drug dependence, and receipt of treatment from general practitioners. Associations with other characteristics were examined by logistic regression. Urban subjects had higher rates than rural of CIS-R morbidity, alcohol dependence, and drug dependence, with semi-rural subjects intermediate. Urban subjects also tended to be members of more deprived social groups, with more adverse living circumstances and greater life stress--factors themselves associated with disorder. Urban-rural differences in alcohol and drug dependence were no longer significant after adjustment for these factors by logistic regression, and differences on CIS-R morbidity were considerably reduced. There were no differences in treatment. There are considerable British urban-rural differences in mental health, which may largely be attributable to more adverse urban social environments.
TL;DR: In this article, the relationship between rural migration processes and landscape developments was investigated in their regional, local, and domestic contexts, showing that the great diversity of the rural areas indicates an increasing dissociation between the agricultural and socio-demographic trajectories.
TL;DR: In this article, the authors look at young people's accounts of life in communities in rural northern Scotland, and consider in what ways affective and social aspects of community are bound up with well-being, over and above rural youth concerns for the future, rural youth transitions, and out-migration.
Abstract: This study looks at young people's accounts of life in communities in rural northern Scotland, and considers in what ways affective and social aspects of community are bound up with well-being, over and above young people's concerns for the future, rural youth transitions, and out-migration. Interviews were held with 15–18 year-olds in four study areas (16 groups, N=60+) and a parallel survey of 11–16 year-olds was conducted in eight study areas (N=2400+). Themes to emerge from the interviews included: opportunities locally, the future and staying on, as well as local amenities and services; but older teenagers also spoke at length about their social lives, family and social networks, and their community, both as close-knit and caring and as intrusive and controlling. Rural communities were seen as good places in childhood, but not necessarily for young people. In parallel with that, the survey data paints a picture where feelings of support, control, autonomy, and attachment were all associated with emotional well-being. Importantly, links between emotional well-being and practical, material concerns were outweighed by positive identifications of community as close-knit and caring; and equally, by negative identifications as intrusive and constraining, where the latter was felt more strongly by young women. Certainly, beliefs about future employment and educational opportunities were also linked to well-being, but that was over and above, and independently of, affective and social aspects of community life. Additionally, migration intentions were also bound up with sense of self and well-being, and with feelings about community life; and links between thoughts about leaving and community life as controlling and constraining were, yet again, felt more strongly by young women. Thus, gender was a key dimension affecting young people's feelings about their communities with significant implications for well-being, and out-migration. The study illustrates the importance of understanding the experiences young people have of growing up in rural areas, and how they evaluate those experiences: particularly, how life in rural communities matters for young people's well-being; and especially, for young women.
TL;DR: In this article, the authors conducted a comparative cross-sectional study using a standardized questionnaire and biological tests was conducted among samples in two rural communities of Senegal (Niakhar and Bandafassi, 866 and 952 adults, respectively) and a rural community of Guinea-Bissau (Caio, 1416 adults).
Abstract: Background In eastern and southern Africa, the human immunodeficiency virus (HIV) epidemic appeared first in urban centres and then spread to rural areas. Its overall prevalence is lower in West Africa, with the highest levels still found in cities. Rural areas are also threatened, however, because of the population’s high mobility. We conducted a study in three different communities with contrasting infection levels to understand the epidemiology of HIV infection in rural West Africa. Method A comparative cross-sectional study using a standardized questionnaire and biological tests was conducted among samples in two rural communities of Senegal (Niakhar and Bandafassi, 866 and 952 adults, respectively) and a rural community of Guinea-Bissau (Caio, 1416 adults). We compared the distribution of population characteristics and analysed risk factors for HIV infection in Caio at the individual level. Results The level of HIV infection was very low in Niakhar (0.3%) and Bandafassi (0.0%), but 10.5% of the adults in Caio were infected, mostly with HIV type 2 (HIV-2). Mobility was very prevalent in all sites. Short-term mobility was found to be a risk factor for HIV infection among men in Caio (adjusted odds ratio (aOR) = 2.06; 95% CI: 1.06‐3.99). Women from Caio who reported casual sex in a city during the past 12 months were much more likely to be infected with HIV (aOR = 5.61 95% CI: 1.56‐20.15). Short-term mobility was associated with risk behaviours at all sites. Conclusions Mobility appears to be a key factor for HIV spread in rural areas of West Africa, because population movement enables the virus to disseminate and also because of the particularly risky behaviours of those who are mobile. More prevention efforts should be directed at migrants from rural areas who travel to cities with substantial levels of HIV infection.
TL;DR: Under the Rainbow: Rural Gay Life and its Relevance for Family Providers as mentioned in this paper surveyed 527 nonmetropolitan gay, lesbian, bisexual, or transgender people and inductively analyzed their responses to open-ended questions regarding the "best" and "worst" aspects of being GLBT in that area, and how to improve their lives as rural GLBT people.
Abstract: Under the Rainbow: Rural Gay Life and Its Relevance for Family Providers* We surveyed 527 nonmetropolitan gay, lesbian, bisexual, or transgender people (GLBT) and inductively analyzed their responses to open-ended questions regarding the "best" and "worst" aspects of being GLBT in that area, and how to improve their lives as rural GLBT people. Field observations supplemented the qualitative data. "Best things" included close relationships, high quality of life, involvement with GLBT social networks or organizations, and self-acceptance. "Worst things" included weak and fragmented GLBT resources, living within a homophobic social climate, and lacking equal rights. Suggested improvements included pursuing civil rights, fostering a supportive climate, and strengthening personal relationships. Ways that family professionals can develop commitment to GLBT people, enhance existing services, and advocate for political change are discussed. Key Words: community, gay, lesbian, rural, sexual orientation. Ramona: Driving south from Chicago on Highway 57 there is an abrupt shift where the city ends and prairie begins. The sky suddenly opens over vast cornfields and a loud quiet settles on your ears. The first time I encountered this shift my heart sank with the realization that I was about to become a prairie resident. Having spent half my life in south Minneapolis, a place where lesbians take for granted a tremendous array of visible and accessible resources, I was stunned to find myself within a geography that appeared to offer absolutely nothing. Like the urban gays and lesbians interviewed by Weston (1995), I believed in the "gay imaginary," the notion that rural life is profoundly hostile to gay men and lesbians, and that urban gay ghettos are the homeland "over the rainbow" where one can find true family, community, and happiness. Linda: Growing up in a town with less than 1,000 people, marrying a farmer (my childhood sweetheart), and raising our children in that same community taught me both the joys and pitfalls of rural life. I was always aware that gay people existed in my community, but we were implicitly taught to never acknowledge such a difference. In 1996 my oldest son committed suicide at age 21. Although the truth died with him, I suspect that he was struggling with his sexuality and felt that he would never belong. I will never know the truth about my son's situation, but his death opened my eyes to the impact that silence has on people's lives. By failing openly to accept differences, my home community made real the gay imaginary. The prevailing wisdom appears to be that "rural" and "gay" are incompatible. This notion has been upheld by omission within academia: Rurality and sexuality rarely are integrated in social science research (Bell & Valentine, 1995). However, our training as feminist scholars has sensitized us to reflexively examine the gaps between mythology and lived experience (Lather, 1991). Despite the allure and opportunity that cities may hold, some gay, lesbian, bisexual, and transgender (GLBT) people choose to live in more rural surroundings. Therefore, here we look more carefully at the lives of nonmetropolitan GLBT people and reconsider the accuracy of the gay imaginary. Our purpose is to present descriptive findings regarding the positive and negative aspects of rural gay life and show how family professionals can be part of strengthening the available supports. We use the terms rural and nonmetropolitan interchangeably. (Although nonmetropolitan is more accurate given the geographical range covered by this study, it is cumbersome and less readily understood.) Review of Literature Rural culture is traditionally organized by kinship systems that link blood lineage, legal marriage, and land ownership (Boswell, 1980). Cultural coherence is bolstered when there is consistency and fluidity between family, community, and religious systems (Salamon, 1992). …