Showing papers on "Rural area published in 2006"

Animal behavior in urban ecosystems: Modifications due to human-induced stress

Abstract: Wildlife-human interactions are increasing in prevalence as urban sprawl continues to encroach into rural areas Once considered to be unsuitable habitat for most wildlife species, urban/suburban areas now host an array of wildlife populations, many of which were previously restricted to rural or pristine habitats The presence of some wildlife species in close proximity to dense human populations can create conflict, forcing resource managers to address issues relating to urban wildlife However, evidence suggests that wildlife residing in urban areas may not exhibit the same life history traits as their rural counterparts because of adaptation to human-induced stresses This creates difficulty for biologists or managers that must address problems associated with urban wildlife Population control or mitigation efforts aimed at urban wildlife require detailed knowledge of the habits of wildlife populations in urban areas This paper describes the history of wildlife in urban areas, provides examples of wildlife populations that have modified their behavior as an adaptation to urban stresses, and discusses the challenges that resource managers face when dealing with urban wildlife

Geographic Access to Health Care for Rural Medicare Beneficiaries

Abstract: : Context: Patients in rural areas may use less medical care than those living in urban areas. This could be due to differences in travel distance and time and a utilization of a different mix of generalists and specialists for their care. Purpose: To compare the travel times, distances, and physician specialty mix of all Medicare patients living in Alaska, Idaho, North Carolina, South Carolina, and Washington. Methods: Retrospective design, using 1998 Medicare billing data. Travel time was determined by computing the road distance between 2 population centroids: the patient's and the provider's zone improvement plan codes. Findings: There were 2,220,841 patients and 39,780 providers in the cohort, including 6,405 (16.1%) generalists, 24,772 (62.3%) specialists, and 8,603 (21.6%) nonphysician providers. There were 20,693,828 patient visits during the study. The median overall 1-way travel distance and time was 7.7 miles (interquartile range 1.9–18.7 miles) and 11.7 minutes (interquartile range 3.0–25.7 minutes). The patients in rural areas needed to travel 2 to 3 times farther to see medical and surgical specialists than those living in urban areas. Rural residents with heart disease, cancer, depression, or needing complex cardiac procedures or cancer treatment traveled the farthest. Increasing rurality was also related to decreased visits to specialists and an increasing reliance on generalists. Conclusions: Residents of rural areas have increased travel distance and time compared to their urban counterparts. This is particularly true for rural residents with specific diagnoses or those undergoing specific procedures. Our results suggest that most rural residents do not rely on urban areas for much of their care.

Defining Urban and Rural Areas in U.S. Epidemiologic Studies

Abstract: Among epidemiologists, there has been increasing interest in the characteristics of communities that influence health. In the United States, the rural health disparity has been a recent focus of attention and made a priority for improvement. While many standardized definitions of urban and rural exist and are used by social scientists and demographers, they are found in sources unfamiliar to health researchers and have largely not been used in public health studies. This paper briefly reviews some available definitions of urban and rural for American geographic subunits and their respective strengths and weaknesses. For example, some definitions are better suited than others for capturing access to health care services. The authors applied different definitions to breast cancer incidence rates to show how urban/rural rate ratio comparisons would vary by choice of definition and found that dichotomous definitions may fail to capture variability in very rural areas. Further study of the utility of these measures in health studies is warranted.

Use of antenatal services and delivery care among women in rural western Kenya: a community based survey

Abstract: Background Improving maternal health is one of the UN Millennium Development Goals. We assessed provision and use of antenatal services and delivery care among women in rural Kenya to determine whether women were receiving appropriate care.

Education and the Inequalities of Place

Abstract: Students living in inner city and rural areas of the United States exhibit lower educational achievement and a higher likelihood of dropping out of high school than do their suburban counterparts. Educational research and policy has tended to neglect these inequalities or, at best, focus on one type but not the other. In this article, we integrate literatures on spatial stratification and educational outcomes, and offer a framework in which resources influential for achievement/attainment are viewed as embedded within, and varying across, inner city, rural and suburban places. We draw from the National Educational Longitudinal Survey and the Common Core of Data, and employ hierarchical linear and hierarchical logistic modeling techniques to test our arguments. Results reveal inner city and rural disadvantages in both family and school resources. These resource inequalities translate into important educational investments at both family and school levels, and help explain deficits in attainment and standardized achievement. We conclude by discussing the implications of our approach and findings for analyses of educational stratification specifically and spatial patterning of inequality more generally.

Ecological consequences of rapid urban expansion: Shanghai, China

Abstract: Since China's economic reform in the late 1970s, Shanghai, the country's largest and most modern city, has experienced rapid expansion and urbanization. Here, we explore its land‐use and land‐cover changes, focusing on the impacts of the urbanization process on air and water quality, local climate, and biodiversity. Over the past 30 years, Shanghai's urban area and green land (eg urban parks, street trees, lawns) have increased dramatically, at the expense of cropland. Concentrations of major air pollutants (eg SO₂, NOₓ, and total suspended particles) were higher in urban areas than in suburban and rural areas. Overall, however, concentrations have decreased (with the exception of NOₓ), due primarily to a decline in coal consumption by industry and in private households. Increased NOₓ pollution was mainly attributed to the huge increase in the number of vehicles on the roads. Water quality changes showed a pattern similar to that of air quality, with the most severe pollution occurring in urban areas. Differences in mean air temperatures between urban and rural areas also increased, in line with the rapid pace of urban expansion, indicating an accelerating “urban heat island” effect. Urban expansion also led to a decrease in native plant species. Despite its severe environmental problems, Shanghai has also seen major economic development. Managing the tradeoffs between urbanization and environmental protection will be a major challenge for Chinese policy makers. [Formula: see text]

Shortages of medical personnel at community health centers: implications for planned expansion.

Abstract: ContextThe US government is expanding the capacity of community health centers (CHCs) to provide care to underserved populations.ObjectiveTo examine the status of workforce shortages that may limit CHC expansion.Design and SettingSurvey questionnaire of all 846 federally funded US CHCs that directly provide clinical services and are within the 50 states and the District of Columbia, conducted between May and September 2004. Questionnaires were completed by the chief executive officer of each grantee. Information was supplemented by data from the 2003 Bureau of Primary Health Care Uniform Data System and weighted to be nationally representative.Main Outcome MeasuresStaffing patterns and vacancies for major clinical disciplines by rural and urban location, use of federal and state recruitment programs, and perceived barriers to recruitment.ResultsOverall response rate was 79.3%. Primary care physicians made up 89.4% of physicians working in the CHCs, the majority of whom are family physicians. In rural CHCs, 46% of the direct clinical providers of care were nonphysician clinicians compared with 38.9% in urban CHCs. There were 428 vacant funded full-time equivalents (FTEs) for family physicians and 376 vacant FTEs for registered nurses. There were vacancies for 13.3% of family physician positions, 20.8% of obstetrician/gynecologist positions, and 22.6% of psychiatrist positions. Rural CHCs had a higher proportion of vacancies and longer-term vacancies and reported greater difficulty filling positions compared with urban CHCs. Physician recruitment in CHCs was heavily dependent on National Health Service Corps scholarships, loan repayment programs, and international medical graduates with J-1 visa waivers. Major perceived barriers to recruitment included low salaries and, in rural CHCs, cultural isolation, poor-quality schools and housing, and lack of spousal job opportunities.ConclusionsCHCs face substantial challenges in recruitment of clinical staff, particularly in rural areas. The largest numbers of unfilled positions were for family physicians at a time of declining interest in family medicine among graduating US medical students. The success of the current US national policy to expand CHCs may be challenged by these workforce issues.

A review of the literature on rural suicide: risk and protective factors, incidence, and prevention.

Abstract: . Background. Suicide is a major cause of mortality worldwide. Differences in rates of suicide exist between urban and rural areas; however, little rigorous research has examined the phenom...

Neighbourhoods and health: a GIS approach to measuring community resource accessibility

Abstract: Objective: Recent studies suggest an association between the contextual attributes of neighbourhoods and the health status of residents. However, there has been a scarcity of studies that have directly measured the material characteristics of neighbourhoods theorised to have an impact on health and health inequalities. This paper describes the development of an innovative methodology to measure geographical access to a range of community resources that have been empirically linked to health. Geographical information systems (GIS) were applied to develop precise measures of community resource accessibility for small areas at a national scale. Design: Locational access to shopping, education, recreation, and health facilities was established for all 38 350 census meshblocks across New Zealand. Using GIS, distance measures were calculated from the population weighted centroid of each meshblock to 16 specific types of facilities theorised as potentially health related. From these data, indices of community resource accessibility for all New Zealand neighbourhoods were constructed. Results: Clear regional variations in geographical accessibility to community resources exist across the country, particularly between urban and rural areas of New Zealand. For example, the average travel time to the nearest food shop ranged from less than one minute to more than 244 minutes. Noticeable differences were also apparent between neighbourhoods within urban areas. Conclusions: Recent advances in GIS and computing capacity have made it feasible to directly measure access to health related community resources at the neighbourhood level. The construction of access indices for specific community resources will enable health researchers to examine with greater precision, variations in the material characteristics of neighbourhoods and the pathways through which neighbourhoods impact on specific health outcomes.

Child health inequities in developing countries: differences across urban and rural areas

Abstract: To document and compare the magnitude of inequities in child malnutrition across urban and rural areas, and to investigate the extent to which within-urban disparities in child malnutrition are accounted for by the characteristics of communities, households and individuals. The most recent data sets available from the Demographic and Health Surveys (DHS) of 15 countries in sub-Saharan Africa (SSA) are used. The selection criteria were set to ensure that the number of countries, their geographical spread across Western/Central and Eastern/Southern Africa, and their socioeconomic diversities, constitute a good yardstick for the region and allow us to draw some generalizations. A household wealth index is constructed in each country and area (urban, rural), and the odds ratio between its uppermost and lowermost category, derived from multilevel logistic models, is used as a measure of socioeconomic inequalities. Control variables include mother's and father's education, community socioeconomic status (SES) designed to represent the broad socio-economic ecology of the neighborhoods in which families live, and relevant mother- and child-level covariates. Across countries in SSA, though socioeconomic inequalities in stunting do exist in both urban and rural areas, they are significantly larger in urban areas. Intra-urban differences in child malnutrition are larger than overall urban-rural differentials in child malnutrition, and there seem to be no visible relationships between within-urban inequities in child health on the one hand, and urban population growth, urban malnutrition, or overall rural-urban differentials in malnutrition, on the other. Finally, maternal and father's education, community SES and other measurable covariates at the mother and child levels only explain a slight part of the within-urban differences in child malnutrition. The urban advantage in health masks enormous disparities between the poor and the non-poor in urban areas of SSA. Specific policies geared at preferentially improving the health and nutrition of the urban poor should be implemented, so that while targeting the best attainable average level of health, reducing gaps between population groups is also on target. To successfully monitor the gaps between urban poor and non-poor, existing data collection programs such as the DHS and other nationally representative surveys should be re-designed to capture the changing patterns of the spatial distribution of population.

Rural-urban differences in depression prevalence: implications for family medicine.

Abstract: Background and objectives Rural populations experience more adverse living circumstances than urban populations, but the evidence regarding the prevalence of mental health disorders in rural areas is contradictory. We examined the prevalence of depression in rural versus urban areas. Methods We performed a cross-sectional study using the 1999 National Health Interview Survey (NHIS). In face-to-face interviews, the NHIS administered the Composite International Diagnostic Interview Short Form (CIDI-SF) depression scale to a nationally representative sample of 30,801 adults, ages 18 and over. Results An estimated 2.6 million rural adults suffer from depression. The unadjusted prevalence of depression was significantly higher among rural than urban populations (6.1% versus 5.2% ). After adjusting for rural/urban population characteristics, however, the odds of depression did not differ by residence. Depression risk was higher among persons likely to be encountered in a primary care setting: those with fair or poor self-reported health, hypertension, with limitations in daily activities, or whose health status changed during the previous year. Conclusions The prevalence of depression is slightly but significantly higher in residents of rural areas compared to urban areas, possibly due to differing population characteristics.

The urban transition in Sub-Saharan Africa: implications for economic growth and poverty reduction

Abstract: This paper challenges several common myths that cloud discourse about urban development in Africa. It finds that urbanization in the region is not excessive or imbalanced relative to the experience of other regions. Internal migration, which is not the main source of urban growth, does not account for urban poverty. Migration appears favorable on balance for sending and receiving areas, and population mobility benefits rural and urban households as many retain a foothold in both areas to spread risks. Although Africa has been frequently described as featuring a disconnect between urbanization and economic growth, in reality most of the economic growth that has taken place in the past decade derives from mainly urban-based sectors (industry and services), and this is especially true of the better-performing economies. But cities have clearly not lived up to their productive potential because of widespread neglect and bad management. Urban poverty is not mainly a function of urban expansion, nor is it a sign of failure of the urban economies in Africa. There is evidence that much of the deprivation in cities, and the emerging urban public health problems, relate to institutional failures that perpetuate social exclusion and inequalities between the urban poor and the urban non-poor.

Handbook of rural studies

Abstract: PART ONE: APPROACHES TO RURAL STUDIES Pathways in the Sociology of Rural Knowledge - Terry Marsden Conceptualizing Rurality - Paul Cloke Reconfiguring Rural Resource Governance - Stewart Lockie, Geoffrey Lawrence and Lynda Cheshire The Legacy of Neo-Liberalism in Australia Rural Space - Keith Halfacree Constructing a Three-Fold Architecture Rural Society - Ruth Panelli Rural Economies - Matteo B Marini and Patrick H Mooney Rural Policy and Planning - Mark B Lapping PART TWO: RURAL RESEARCH: KEY THEORETICAL COORDINATES A Cultural Representation Landscapes of Desires? - E Melanie DuPuis Idyllic Ruralities - Brian Short Variations on the Rural Idyll - David Bell Constructing Rural Natures - 03S NatureNoel Castree and Bruce Braun Networking Rurality - Jonathan Murdoch Emergent Complexity in the Countryside Non-Human Rural Studies - Owain Jones Sustainability The Road Towards Sustainable Rural Development - Terry Marsden Issues of Theory, Policy and Practice in a European Context Sustaining the Unsustainable - Frederick H Buttel Agro-Food Systems and Environment in the Modern World Social Forestry - Paul Milbourne, Lawrence Kitchen and Kieron Stanley Exploring the Social Contexts of Forests and Forestry in Rural Areas New Economies Commodification - Harvey C Perkins Re-Resourcing Rural Areas Agricultural Production in Crisis - Jan Douwe van der Ploeg Neo-Endogenous Rural Development in the EU - Christopher Ray Power Global Capital and the Transformation of Rural Communities - Thomas A Lyson Regulating Rurality? Rural Studies and the Regulation Approach - Mark Goodwin The State and Rural Polity - Alessandro Bonanno New Consumerism The Rural Household as a Consumption Site - Sonya Salamon Consumption Culture - Mara Miele The Case of Food Tourism, Consumption and Rurality - David Crouch Identity Gender and Sexuality in Rural Communities - Jo Little Rurality and Racialized Others - Paul Cloke Out of Place in the Countryside Rural Change and the Production of Otherness - A I (Lex) Chalmers and Alun E Joseph The Elderly in New Zealand Exclusion Inclusions/Exclusions in Rural Space - David Sibley Rural Poverty - Ann R Tickamyer Rural Housing and Homelessness - Paul Milbourne PART THREE: NEW RURAL RELATIONS Rurality and Otherness - Paul Cloke Political Articulation - Michael Woods The Modalities of New Critical Politics of Rural Citizenship New Rural Social Movements and Agroecology - Eduardo Sevilla Guzman and Joan Martinez-Alier Performing Rurality - Tim Edensor

Decomposing socioeconomic inequality in infant mortality in Iran

Abstract: Background Although measuring socioeconomic inequality in population health indicators like infant mortality is important, more interesting for policy purposes is to try to explain infant mortality inequality. The objective of this paper is to quantify for the first time the determinants' contributions of socioeconomic inequality in infant mortality in Iran. Methods A nationally representative sample of 108875 live births from October 1990 to September 1999 was selected. The data were taken from the Iranian Demographic and Health Survey (DHS) conducted in 2000. Households' socioeconomic status was measured using principal component analysis. The concentration index of infant mortality was used as our measure of socioeconomic inequality and decomposed into its determining factors. Results The largest contributions to inequality in infant mortality were owing to household economic status (36.2%) and mother's education (20.9%). Residency in rural/urban areas (13.9%), birth interval (13.0%), and hygienic status of toilet (11.9%) also proved important contributors to the measured inequality. Conclusions The findings indicate that socioeconomic inequality in infant mortality in Iran is determined not only by health system functions but also by factors beyond the scope of health authorities and care delivery system. This implies that in addition to reducing inequalities in wealth and education, investments in water and sanitation infrastructure and programmes (especially in rural areas) are necessary to realize improvements of inequality in infant mortality across society. These findings can be instrumental for the recent 5 year Economic, Social and Cultural Development Plan of Iran, which identified the reduction of inequalities in social determinants of health.

A Dime a Day: The Possibilities and Limits of Private Schooling in Pakistan

Abstract: This paper looks at the private schooling sector in Pakistan, a country that is seriously behind schedule in achieving the Millennium Development Goals. Using new data, the authors document the phenomenal rise of the private sector in Pakistan and show that an increasing segment of children enrolled in private schools are from rural areas and from middle-class and poorer families. The key element in their rise is their low fees - the average fee of a rural private school in Pakistan is less than a dime a day (Rs.6). They hire predominantly local, female, and moderately educated teachers who have limited alternative opportunities outside the village. Hiring these teachers at low cost allows the savings to be passed on to parents through low fees. This mechanism - the need to hire teachers with a certain demographic profile so that salary costs are minimized - defines the possibility of private schools: where they arise, fees are low. It also defines their limits. Private schools are horizontally constrained in that they arise in villages where there is a pool of secondary educated women. They are also vertically constrained in that they are unlikely to cater to the secondary levels in rural areas, at least until there is an increase in the supply of potential teachers with the required skills and educational levels.

The poverty impact of rural roads : evidence from Bangladesh

Abstract: This brief summarizes the results of a gender impact evaluation study, entitled The poverty impact of rural roads : evidence from Bangladesh, conducted during the time period 1995 to 1996 in Bangladesh. The study observed that a rationale for public investment in rural roads is that households can better exploit agricultural and nonagricultural opportunities to employ labor and capital more efficiently. Significant knowledge gaps persist, however, as to how opportunities provided by roads actually filter back into household outcomes as well as distributional consequences. Rural road investments are found to reduce poverty significantly through higher agricultural production, higher wages, lower input and transportation costs, and higher output prices. Road investments are pro-poor, meaning the gains are proportionately higher for the poor than for the non-poor.

Defining rational hospital catchments for non-urban areas based on travel-time

Abstract: Cost containment typically involves rationalizing healthcare service delivery through centralization of services to achieve economies of scale. Hospitals are frequently the chosen site of cost containment and rationalization especially in rural areas. Socio-demographic and geographic characteristics make hospital service allocation more difficult in rural and remote regions. This research presents a methodology to model rational catchments or service areas around rural hospitals – based on travel time. This research employs a vector-based GIS network analysis to model catchments that better represent access to hospital-based healthcare services in British Columbia's rural and remote areas. The tool permits modelling of alternate scenarios in which access to different baskets of services (e.g. rural maternity care or ICU) are assessed. In addition, estimates of the percentage of population that is served – or not served -within specified travel times are calculated. The modelling tool described is useful for defining true geographical catchments around rural hospitals as well as modelling the percentage of the population served within certain time guidelines (e.g. one hour) for specific health services. It is potentially valuable to policy makers and health services allocation specialists.

HIV testing in national population-based surveys: experience from the Demographic and Health Surveys

Abstract: OBJECTIVES: To describe the methods used in the Demographic and Health Surveys (DHS) to collect nationally representative data on the prevalence of human immunodeficiency virus (HIV) and assess the value of such data to country HIV surveillance systems. METHODS: During 2001-04, national samples of adult women and men in Burkina Faso, Cameroon, Dominican Republic, Ghana, Mali, Kenya, United Republic of Tanzania and Zambia were tested for HIV. Dried blood spot samples were collected for HIV testing, following internationally accepted ethical standards. The results for each country are presented by age, sex, and urban versus rural residence. To estimate the effects of non-response, HIV prevalence among non-responding males and females was predicted using multivariate statistical models for those who were tested, with a common set of predictor variables. RESULTS: Rates of HIV testing varied from 70% among Kenyan men to 92% among women in Burkina Faso and Cameroon. Despite large differences in HIV prevalence between the surveys (1-16%), fairly consistent patterns of HIV infection were observed by age, sex and urban versus rural residence, with considerably higher rates in urban areas and in women, especially at younger ages. Analysis of non-response bias indicates that although predicted HIV prevalence tended to be higher in non-tested males and females than in those tested, the overall effects of non-response on the observed national estimates of HIV prevalence are insignificant. CONCLUSIONS: Population-based surveys can provide reliable, direct estimates of national and regional HIV seroprevalence among men and women irrespective of pregnancy status. Survey data greatly enhance surveillance systems and the accuracy of national estimates in generalized epidemics.