Showing papers on "Rural area published in 2010"

Systems Approach to a Theory of Rural‐Urban Migration

Abstract: Few of the theoretical models provided thus far have considered migrations especially rural urban migration as a spatial process whose dynamics and spatial impact must form part of any comprehensive understanding of the phenomenon. It is the main contention of this discussion that this can best be realized within the framework of general systems theory. This approach requires that a particular complex of variables be recognized as a system possessing certain properties which are common to many other systems. It has the fundamental advantage of providing a conceptual framework within which a whole range of questions relevant to an understanding of the structure and operation of other systems can be asked of the particular phenomenon under study. Emphasis is on a verbal analysis of the ways in which the system operates. A systems approach to rural urban migration is concerned with why people migrate and with all the implications and ramifications of the process. The approach is designed to answer such questions as: why and how does an essentially rural person become a permanent city resident; what changes does he/she undergo in the process; and what effects have these changes both on the rural area from which he/she comes and on the city to which the individual moves. The basic elements in the system of migration are shown in a figure which identifies first the potential migrant who is being encouraged to migrate by stimuli from the environment. Within the systems framework attention is focused not only on the migrant but also on the various institutions (subsystems) and the social economic and other relationships (adjustment mechanisms) which are an integral part of the process of the migrants transformation. The 2 most important subsystems are the rural and urban control subsystems. A system comprises not only matter (the migrant the institutions the various organizations) but also energy. In the physical sense energy is simply the capacity of a given body to do work. 2 forms of energy are relevant here: potential energy and kinetic energy. In a theory of rural urban migration potential energy can be likened to the stimuli acting on the rural individual to move. Once a person has been successfully dislodged from the rural area it can be assumed that he/she is translating potential energy into its kinetic form. The major issues concern not only the act of moving but also the cost distance and the direction of the movement. Rural urban migration is an open system involving not only an exchange of energy but also of matter (in this case persons) with the environment. 1 of the concomitants of the continued interaction between the system and its environment will be the phenomenon of growth in the system.

Women's autonomy in household decision-making: a demographic study in Nepal

Abstract: How socio-demographic factors influence women's autonomy in decision making on health care including purchasing goods and visiting family and relatives are very poorly studied in Nepal This study aims to explore the links between women's household position and their autonomy in decision making We used Nepal Demographic Health Survey (NDHS) 2006, which provided data on ever married women aged 15-49 years (n = 8257) The data consists of women's four types of household decision making; own health care, making major household purchases, making purchase for daily household needs and visits to her family or relatives A number of socio-demographic variables were used in multivariable logistic regression to examine the relationship of these variables to all four types of decision making Women's autonomy in decision making is positively associated with their age, employment and number of living children Women from rural area and Terai region have less autonomy in decision making in all four types of outcome measure There is a mixed variation in women's autonomy in the development region across all outcome measures Western women are more likely to make decision in own health care (12-16), while they are less likely to purchase daily household needs (06-09) Women's increased education is positively associated with autonomy in own health care decision making (p < 001), however their more schooling (SLC and above) shows non-significance with other outcome measures Interestingly, rich women are less likely to have autonomy to make decision in own healthcare Women from rural area and Terai region needs specific empowerment programme to enable them to be more autonomous in the household decision making Women's autonomy by education, wealth quintile and development region needs a further social science investigation to observe the variations within each stratum A more comprehensive strategy can enable women to access community resources, to challenge traditional norms and to access economic resources This will lead the women to be more autonomous in decision making in the due course

Sustainable urban agriculture in developing countries. A review

Abstract: The population living in cities is continuously increasing worldwide. In developing countries, this phenomenon is exacerbated by poverty, leading to tremendous problems of employment, immigration from the rural areas, transportation, food supply and environment protection. Simultaneously with the growth of cities, a new type of agriculture has emerged; namely, urban agriculture. Here, the main functions of urban agriculture are described: its social roles, the economic functions as part of its multi-functionality, the constraints, and the risks for human consumption and the living environment. We highlight the following major points. (1) Agricultural activity will continue to be a strong contributor to urban households. Currently, differences between rural and urban livelihood households appear to be decreasing. (2) Urban agricultural production includes aquaculture, livestock and plants. The commonest crops are perishable leafy vegetables, particularly in South-east Asia and Africa. These vegetable industries have short marketing chains with lower price differentials between farmers and consumers than longer chains. The city food supply function is one of the various roles and objectives of urban agriculture that leads to increasing dialogue between urban dwellers, city authorities and farmers. (3) One of the farmers’ issues is to produce high quality products in highly populated areas and within a polluted environment. Agricultural production in cities faces the following challenges: access to the main agricultural inputs, fertilizers and water; production in a polluted environment; and limitation of its negative impact on the environment. Urban agriculture can reuse city wastes, but this will not be enough to achieve high yields, and there is still a risk of producing unsafe products. These are the main challenges for urban agriculture in keeping its multi-functional activities such as cleansing, opening up the urban space, and producing fresh and nutritious food.

The Effect of Rural-to-Urban Migration on Obesity and Diabetes in India: A Cross-Sectional Study

Abstract: Background: Migration from rural areas of India contributes to urbanisation and may increase the risk of obesity and diabetes. We tested the hypotheses that rural-to-urban migrants have a higher prevalence of obesity and diabetes than rural nonmigrants, that migrants would have an intermediate prevalence of obesity and diabetes compared with life-long urban and rural dwellers, and that longer time since migration would be associated with a higher prevalence of obesity and of diabetes. Methods and Findings: The place of origin of people working in factories in north, central, and south India was identified. Migrants of rural origin, their rural dwelling sibs, and those of urban origin together with their urban dwelling sibs were assessed by interview, examination, and fasting blood samples. Obesity, diabetes, and other cardiovascular risk factors were compared. A total of 6,510 participants (42% women) were recruited. Among urban, migrant, and rural men the age- and factory-adjusted percentages classified as obese (body mass index [BMI] .25 kg/m 2 ) were 41.9% (95% confidence interval [CI] 39.1–44.7), 37.8% (95% CI 35.0–40.6), and 19.0% (95% CI 17.0–21.0), respectively, and as diabetic were 13.5% (95% CI 11.6–15.4), 14.3% (95% CI 12.2–16.4), and 6.2% (95% CI 5.0–7.4), respectively. Findings for women showed similar patterns. Rural men had lower blood pressure, lipids, and fasting blood glucose than urban and migrant men, whereas no differences were seen in women. Among migrant men, but not women, there was weak evidence for a lower prevalence of both diabetes and obesity among more recent (#10 y) migrants. Conclusions: Migration into urban areas is associated with increases in obesity, which drive other risk factor changes. Migrants have adopted modes of life that put them at similar risk to the urban population. Gender differences in some risk factors by place of origin are unexpected and require further exploration. Please see later in the article for the Editors’ Summary.

The impact of parental migration on health status and health behaviours among left behind adolescent school children in China.

Abstract: Background: One out of ten of China’s population are migrants, moving from rural to urban areas. Many leave their families behind resulting in millions of school children living in their rural home towns without one or both their parents. Little is known about the health status of these left behind children (LBC). This study compares the health status and health-related behaviours of left behind adolescent school children and their counterparts in a rural area in Southern China. Methods: A cross-sectional study was conducted among middle school students in Fuyang Township, Guangdong, China (2007-2008). Information about health behaviours, parental migration and demographic characteristics was collected using a self-administered questionnaire. Overweight/obesity and stunting were defined based on measurements of height and weight. Univariate and multivariate analyses were used to estimate the differences in health outcomes between LBC and non-LBC. Results: 18.1% of the schoolchildren had one or both parents working away from home. Multivariate analysis showed that male LBC were at higher risk of skipping breakfast, higher levels of physical inactivity, internet addiction, having ever smoked tobacco, suicide ideation, and being overweight. LBC girls were more likely to drink excessive amounts of sweetened beverage, to watch more TV, to have ever smoked or currently smoke tobacco, to have ever drunk alcohol and to binge drinking. They were also more likely to be unhappy, to think of planning suicide and consider leaving home. Conclusions: Our findings suggest that parental migration is a risk factor for unhealthy behaviours amongst adolescent school children in rural China. Further research is required in addition to the consideration of the implications for policies and programmes to protect LBC.

Systematic review of effective retention incentives for health workers in rural and remote areas: Towards evidence-based policy

Abstract: Background: Poor retention of health workers is a significant problem in rural and remote areas, with negative consequences for both health services and patient care. Objective: This review aimed to synthesise the available evidence regarding the effectiveness of retention strategies for health workers in rural and remote areas, with a focus on those studies relevant to Australia. Design: A systematic review method was adopted. Six program evaluation articles, eight review articles and one grey literature report were identified that met study inclusion/exclusion criteria. Results: While a wide range of retention strategies have been introduced in various settings to reduce unnecessary staff turnover and increase length of stay, few have been rigorously evaluated. Little evidence demonstrating the effectiveness of any specific strategy is currently available, with the possible exception of health worker obligation. Multiple factors influence length of employment, indicating that a flexible, multifaceted response to improving workforce retention is required. Conclusions: This paper proposes a comprehensive rural and remote health workforce retention framework to address factors known to contribute to avoidable turnover. The six components of the framework relate to staffing, infrastructure, remuneration, workplace organisation, professional environment, and social, family and community support. In order to ensure their effectiveness, retention strategies should be rigorously evaluated using appropriate pre- and post-intervention comparisons.

The process and driving forces of rural hollowing in China under rapid urbanization

Abstract: Rural hollowing is a recent geographic phenomenon that has received significant attention in China, which is experiencing rapid urbanization. It has led to the wasteful use of rural land resources, and imposed obstacles on the optimization of land use and coordinated urban-rural development. Rural hollowing has various forms of manifestation, which refers to the neglect and vacancy of rural dwellings, both of which can lead to damage and ultimate abandonment of rural dwellings. Damaged dwellings have different degrees of destruction, ranging from slight, moderate to severe. The evolutive process of rural hollowing in general has five stages, i.e., emergence, growth, flourishing, stability, and decline. Based on the combination of both regional economic development level and its physiographic features, the types of rural hollowing can be categorised as urban fringe, plain agricultural region, hilly agricultural region, and agro-pastoral region. Especially, the plain agricultural region is the most typical one in rural hollowing, which shows the spatial evolution of rural hollowing as a “poached egg” pattern with a layered hollow core and solid shape. Furthermore, the driving forces behind rural hollowing are identified as the pull of cities and push of rural areas. In particular, this paper identifies contributors to rural hollowing that include rural depopulation in relation to rapid urbanisation and economic change, land ownership and land use policy, and institutional barriers.

Evaluated Strategies to Increase Attraction and Retention of Health Workers in Remote and Rural areas/Evaluation De Strategies Pour Attirer Davantage et Retenir le Personnel Medical Dans Les Zones Rurale Ou reculees/Evaluacion De Estrategias De Aumento De la Captacion Y Permanencia De Trabajadores Sanitarios En Zonas Remotas V Rurales

Abstract: Introduction The availability of well trained and motivated health workers in underserved areas will improve access to essential health services to achieve the health-related United Nations' Millennium Development Goals within the framework of a primary health care renewal (1-3) Yet there are stark imbalances in the geographical distribution of health workers, both in developed and developing countries Approximately one half of the world's population lives in rural areas but these areas are served by only 38% of the total nursing workforce and by less than 25% of the total physicians' workforce (2) At the country level, imbalances in the distribution of health workers are even more prominent (4,5) In recent years, there has been increased interest from both researchers and policy-makers to identify and implement effective solutions to address the shortages of health workers in remote and rural areas (6-11) In response to this increased interest and perceived need, the World Health Organization has recently launched a programme of work on "Increasing access to health workers in remote and rural areas through improved retention" The programme aims to expand the knowledge base in this domain and to provide evidence-based global recommendations to address this problem, while at the same time to provide technical cooperation to countries that need to address this problem (12) As part of this programme of work, this paper builds on and expands earlier work on assessing the evidence on effectiveness of interventions to increase access to health workers in rural and remote areas (13) This paper expands the original search to focus mainly on studies that evaluated such interventions, and attempts to analyse the impact of such interventions on certain dimensions of health workforce and health systems performance It also discusses the quality of the evidence from evaluation studies and identifies the evidence gaps in this domain It is expected that evaluations would give policy-makers additional information with regards to the effectiveness and applicability of various interventions in their own context (14) Conceptual framework The analysis in this paper is based on the assumption that the final result of having health workers in remote and rural areas depends on two inter-linked aspects (8): (i) the factors that influence the decision or choice of health workers to relocate to, stay in or leave those areas, and (ii) the extent to which health system policies and interventions respond to these factors These responses are usually grouped into four main categories: education, regulatory, financial and personal and professional support interventions (6-10) There is a wealth of descriptive literature highlighting the extent of geographical imbalances and deficits in health personnel in rural and remote areas, (4,5) or reporting on the factors that influence health workers' preferences or choices with regards to practicing in remote and rural areas (15,16) There are also studies that describe or recommend potential interventions, without analysing the effects of these interventions (17-19) However, there is very limited research on comprehensive evaluations of specific retention strategies We set out to conduct a review of this type of study with the aim of further informing the methodology in conducting evaluations of rural health workforce retention strategies Methods We conducted an extensive review of the literature that reported on evaluations of interventions to increase the availability of health workers in remote and rural areas Electronic searches were conducted in August and September 2009 in PubMed, the Cochrane database, Embase[R] and LILACS Reference lists of the retrieved studies were also searched to complement the final list of articles Further evidence was gathered from experts in the field of human resources for health, and from grey literature, through searches in Google, the Human Resources for Health Global Resource Centre and various web sites of government ministries …

Multifunctional ‘quality’ and rural community resilience

Abstract: The aim of this paper is to contribute towards emergent debates on the ‘quality’ of multifunctional trajectories in rural development. The focus will be placed on the local rural community level, as it is at this level that multifunctionality is most often implemented. There has been an identified need for a new concept of multifunctionality that is conceptually and theoretically better anchored in current debates on agricultural/rural change, and for a globally applicable model that draws on existing holistic debates. The paper will suggest a conceptual framework for understanding rural community trajectories based on economic, social and environmental resilience and vulnerability of rural areas. The notion of multifunctional quality will emerge not only as a conceptual model for understanding rural pathways of change, but also as an explanatory tool and as a normative ideal for rural development. The paper builds on debates on multifunctionality extensively shaped by human geographers with the aim to extend the conceptual boundaries of the notion of multifunctionality, to further refine existing understandings of multifunctional transitions in rural communities, and to critically interrogate the components for strong multifunctionality. The paper concludes with a discussion of the complex policy implications associated with a transition from weak to strong multifunctionality.

The Food, Fuel, and Financial Crises Affect the Urban and Rural Poor Disproportionately: A Review of the Evidence

Abstract: The vulnerability of the urban poor to the recent food and fuel price crisis has been widely acknowledged. The unfolding global financial crisis, which brings higher unemployment and underemployment, is likely to further intensify this vulnerability. This paper reviews the evidence concerning the disproportionate vulnerability of the urban compared with the rural poor to these types of shocks. It reviews some of the unique characteristics of urban life that could make the urban poor particularly susceptible to price and financial shocks and summarizes the evidence regarding the disproportionate vulnerability of the urban poor. The focus is on impacts on poverty, food insecurity, and malnutrition. The review shows that although the urban poor are clearly one of the population groups most affected by the current (and previous) crises, the rural poor, landless, and net buyers are in no better position to confront the crisis without significant suffering. The poorest of the poor are the ones who will be most affected, irrespective of the continent, country, or urban or rural area where they live. The magnitude and severity of their suffering depends on their ability to adapt and on the specific nature, extent, and duration of the coping strategies they adopt. A better understanding of how these coping strategies are used and staggered is critical to help design triggers for action that can prevent households from moving to more desperate measures. Using these early coping strategies as early warning indicators could help prevent dramatic losses in welfare.

Evaluated strategies to increase attraction and retention of health workers in remote and rural areas

Abstract: The lack of health workers in remote and rural areas is a worldwide concern. Many countries have proposed and implemented interventions to address this issue, but very little is known about the effectiveness of such interventions and their sustainability in the long run. This paper provides an analysis of the effectiveness of interventions to attract and retain health workers in remote and rural areas from an impact evaluation perspective. It reports on a literature review of studies that have conducted evaluations of such interventions. It presents a synthesis of the indicators and methods used to measure the effects of rural retention interventions against several policy dimensions such as: attractiveness of rural or remote areas, deployment/recruitment, retention, and health workforce and health systems performance. It also discusses the quality of the current evidence on evaluation studies and emphasizes the need for more thorough evaluations to support policy-makers in developing, implementing and evaluating effective interventions to increase availability of health workers in underserved areas and ultimately contribute to reaching the United Nations' Millennium Development Goals.

Socioeconomic factors differentiating maternal and child health-seeking behavior in rural Bangladesh: A cross-sectional analysis

Abstract: Background There has been an increasing availability and accessibility of modern health services in rural Bangladesh over the past decades. However, previous studies on the socioeconomic differentials in the utilization of these services were based on a limited number of factors, focusing either on preventive or on curative modern health services. These studies failed to collect data from remote rural areas of the different regions to examine the socioeconomic differentials in health-seeking behavior.

The impoverishing effect of healthcare payments in India: new methodology and findings.

Abstract: High private healthcare spending as well as high out of pocket spending in India are placing a considerable financial burden on households. The 60th national morbidity and healthcare survey of the National Sample Survey Organisation provides an opportunity to examine the impoverishing effect of healthcare spending in India. This paper presents an analysis of the nsso survey data with some new approaches to correcting some of the biases in previous assessments of the ”impoverishing” effect of health spending. Despite these corrections, the results suggest that the extent of impoverishment due to healthcare payments is higher than previously reported. Furthermore, outpatient care is more impoverishing than inpatient care in urban and rural areas alike. The analysis of the extent of impoverishment across states, regions (urban and rural areas), income quintile groups, and between outpatient care and inpatient care yields some interesting results. I n India, not only is the private healthcare spending much higher than government spending in comparison to what is observed in many developing countries, but also within the private health spending, the share of out-of-pocket (OOP) health spending in India is much higher (Table 1, p 66). The share of OOP in total expenditure on health is the highest in India in comparison to the selected developing countries, except Pakistan. The high share of private healthcare spending, which is mainly OOP spending, reflects on considerable financial burden on households. Indeed, the healthcare costs are believed to be one of the important causes of impoverishment in India – a country that is home to the largest number of the world’s poor. 1

Assessment and evaluation of PV based decentralized rural electrification: An overview

Abstract: The challenges of providing electricity to rural households are manifold. Ever increasing demand–supply gap, crumbling electricity transmission and distribution infrastructure, high cost of delivered electricity are a few of these. Use of renewable energy technologies for meeting basic energy needs of rural communities has been promoted by the Governments world over for many decades. Photovoltaic (PV) technology is one of the first among several renewable energy technologies that was adopted globally as well as in India for meeting basic electricity needs of rural areas that are not connected to the grid. This paper attempts at reviewing and analyzing PV literature pertaining to decentralized rural electrification into two main categories—(1) experiences from rural electrification and technology demonstration programmes covering barriers and challenges in marketing and dissemination; institutional and financing approaches; and productive and economic applications, (2) techno-economic aspects including system design methodologies and approaches; performance evaluation and monitoring; techno-economic comparison of various systems; and environmental implications and life cycle analysis. The paper discusses the emerging trends in its concluding remarks.

Institutional delivery in rural India: the relative importance of accessibility and economic status

Abstract: Skilled attendance at delivery is an important indicator in monitoring progress towards Millennium Development Goal 5 to reduce the maternal mortality ratio by three quarters between 1990 and 2015. In addition to professional attention, it is important that mothers deliver their babies in an appropriate setting, where life saving equipment and hygienic conditions can also help reduce the risk of complications that may cause death or illness to mother and child. Over the past decade interest has grown in examining influences on care-seeking behavior and this study investigates the determinants of place of delivery in rural India, with a particular focus on assessing the relative importance of community access and economic status. A descriptive analysis of trends in place of delivery using data from two national representative sample surveys in 1992 and 1998 is followed by a two-level (child/mother and community) random-effects logistical regression model using the second survey to investigate the determinants. In this investigation of institutional care seeking for child birth in rural India, economic status emerges as a more crucial determinant than access. Economic status is also the strongest influence on the choice between a private-for-profit or public facility amongst institutional births. Greater availability of obstetric services will not alone solve the problem of low institutional delivery rates. This is particularly true for the use of private-for-profit institutions, in which the distance to services does not have a significant adjusted effect. In the light of these findings a focus on increasing demand for existing services seems the most rational action. In particular, financial constraints need to be addressed, and results support current trials of demand side financing in India.

Inequities in Access to Health Services in India: Caste, Class and Region

Abstract: Despite India’s impressive economic performance after the introduction of economic reforms in the 1990s, progress in advancing the health status of Indians has been slow and uneven. Large inequities in health and access to health services continue to persist and have even widened across states, between rural and urban areas, and within communities. Three forms of inequities have dominated India’s health sector. Historical inequities that have their roots in the policies and practices of British colonial India, many of which continued to be pursued well after independence; socio-economic inequities manifest in caste, class and gender differentials; and inequities in the availability, utilisation and affordability of health services. Of these, critical to ensuring health for all in the immediate future will be the effectiveness with which India addresses inequities in provisioning of health services and assurance of quality care. I ndia, over the last two decades, has enjoyed accelerated economic growth, but has fared poorly in human development indicators and health outcomes. Population averages of health status indicators, such as child health and maternal mortality, remain unacceptably high compared with countries in the south and east Asian region that have similar income levels and rates of economic growth. Underlying the low population level indicators, worrisome inequities coincide with the multiple axes of caste, class, gender and regional differences (Deaton and Dreze 2009; Claeson et al 2000; Subramanian et al 2006). In India, an important determinant of socio-economic inequities in nearly all spheres of well-being is caste. The official classi fication defines four categories of caste: scheduled castes ( SCs), scheduled tribes (STs), Other Backward Classes (OBCs), and others. The SCs, the lowest level in the hierarchy, constitute around 16% of the Indian population, a large percentage of who live in rural areas and are landless agricultural labourers. The STs, or adivasis, often like SCs, suffer economic and social deprivation. They comprise around 8% of India’s population. OBCs and forward castes together comprise 76% of India’s total population (RGI 2001).

Validation of the Household Food Insecurity Access Scale in rural Tanzania.

Abstract: Objective The purpose of the present study was to test the construct validity, internal consistency and convergent validity of the Household Food Insecurity Access Scale (HFIAS) in measuring household food insecurity in rural Tanzania, and to determine socio-economic characteristics associated with household food insecurity. Design Key informant interviews and a cross-sectional survey were conducted in February and March 2008. Setting Rural Iringa, Tanzania. Subjects Key informant interviews were conducted with twenty-one purposively selected male and female village leaders. For the household surveys, a sample of 237 households with mothers (caregivers) and at least one child between 1 and 5 years of age were included. Results Approximately 20.7 % of the households were categorized as food-secure, 8.4 % as mildly food-insecure, 22.8 % as moderately food-secure and 48.1 % as severely food-insecure. Two main factors emerged from the rotated principal component factor analysis: (i) insufficient food quality; and (ii) insufficient food intake. Both factors explained 69 % of the total variance. The full food insecurity scale and the two subscales had good internal consistency (Cronbach's alpha = 0.83-0.90). Food security, as measured by HFIAS, was positively associated with maternal education, husband's education, household wealth status, being of an agricultural rather than pastoral tribe and animal-source food consumption; it was negatively associated with maternal age and household size. Conclusions The HFIAS measurement instrument shows validity and reliability in measuring household food insecurity among poor households in rural Tanzania.

The Energy-Poverty-Climate Nexus

Abstract: Close to two-thirds of the world's poorest people live in rural areas ( 1 ). Eradication of rural poverty depends on increased access to goods, services, and information, targets detailed in the United Nations Millennium Development Goals. However, alleviating poverty is hindered by two interlinked phenomena: lack of access to improved energy services and worsening environmental shocks due to climate change. Mitigating climate change, increasing energy access, and alleviating rural poverty can all be complementary, their overlap defining an energy-poverty-climate nexus. We describe interventions in a rural Nicaraguan community to show that energy services can be provided in cost-effective manners, offering the potential to address aspects of rural poverty while also transitioning away from fossil fuel dependence.

Knowledge, Health Seeking Behavior and Perceived Stigma towards Tuberculosis among Tuberculosis Suspects in a Rural Community in Southwest Ethiopia

Abstract: Background Perceived stigma and lack of awareness could contribute to the late presentation and low detection rate of tuberculosis (TB). We conducted a study in rural southwest Ethiopia among TB suspects to assess knowledge about and stigma towards TB and their health seeking behavior.

Rural electrification and energy poverty: Empirical evidences from Brazil

Abstract: The aim of this article is to evaluate the impact of rural electrification on the reduction of energy poverty in Brazil through the analysis of 23,000 rural domiciles or rural properties between the years 2000 and 2004. The results indicate a fast change in the profile of energy consumption and a reduction of energy poverty. This new approach works as a complement, among other variables, to analyze and quantify the real economic, social and energy impacts in rural electrification programs, generally applied in developing countries.

A qualitative examination of perceived barriers and facilitators of physical activity for urban and rural youth

Abstract: Many adolescents, both rural and urban, are not meeting the recommended levels for physical activity (PA). This investigation was designed to elicit socioecologic barriers and facilitators for PA in rural and urban middle school youth and their parents. Thirteen focus groups were conducted with 41 youth and 50 parents from eastern North Carolina. Distance, cost, crime/danger and television were mentioned as the primary barriers among parents. Youth mentioned school policies related to PA and crime/danger as the main PA barriers. The most salient facilitators discussed by parents were social/peer facilitators, facilities available and parental role modeling of PA. The primary facilitators mentioned by youth were social outlets and facilities available. Results indicate that intrapersonal, interpersonal, environmental and policy factors related to PA resonated with both youth and parents. Since rural and urban residents often perceive and interact differently with PA environments, more research is needed to properly adapt interventions.

A national view of rural health workforce issues in the USA.

Abstract: A B S T R A C T Introduction: Regional or state studies in the USA have documented shortages of rural physicians and other healthcare professionals that can impact on access to health services. The purpose of this study was to determine whether rural hospital chief executive officers (CEOs) in the USA report shortages of health professions and to obtain perceptions about factors influencing recruiting and retention. Methods: A nationwide US survey was conducted of 1031 rural hospital CEOs identified by regional/state Area Health Education Centers. A three-page survey was sent containing questions about whether or not physician shortages were present in the CEO's community and asking about physician needs by specialty. The CEOs were also asked to assess whether other health professionals were needed in their town or within a 48 km (30 mile) radius. Analyses from 335 respondents (34.4%) representative of rural hospital CEOs in the USA are presented. Results: Primary care shortages based on survey responses were very similar to the pattern for all rural areas in the USA (49% vs 52%, respectively). The location of respondents according to ZIP code rurality status was similar to all rural areas in the USA (moderately rural, 29.3% vs 27.6%, respectively), and 69.1% were located in highly rural ZIP codes (vs 72.4% of highly rural ZIP codes for all USA). Physician shortages were reported by 75.4% of the rural CEOs, and 70.3% indicated shortages of two or more primary care specialties. The most frequently reported shortage was family medicine (FM, 58.3%) followed by general internal medicine (IM, 53.1%). Other reported shortages were: psychiatry (46.6%); general surgery (39.9%); neurology (36.4%); pediatrics

Effects of the built environment on physical activity of adults living in rural settings

Abstract: Objective To conduct a systematic review of the literature to examine the influence of the built environment (BE) on the physical activity (PA) of adults in rural settings. Data Source Key word searches of Academic Search Premier, PubMed, CINAHL, Web of Science, and Sport Discus were conducted. Study Inclusion and Exclusion Criteria Studies published prior to June 2008 were included if they assessed one or more elements of the BE, examined relationships between the BE and PA, and focused on rural locales. Studies only reporting descriptive statistics or assessing the reliability of measures were excluded. Data Extraction Objective(s), sample size, sampling technique, geographic location, and definition of rural were extracted from each study. Methods of assessment and outcomes were extracted from the quantitative literature, and overarching themes were identified from the qualitative literature. Data Synthesis Key characteristics and findings from the data are summarized in Tables 1 through 3. Re...

Hollowing out the Middle: The Rural Brain Drain and What It Means for America

Abstract: Hollowing Out the Middle: The Rural Brain Drain and What It Means for America Citation: Harmon, H. (2010) Book Review "Hollowing out the middle: The rural brain drain and what it means for America." Journal of Research in Rural Education 25(3). Retrieved from http://jrre.psu.edu/articles/25-3.pdf Hollowing out the Middle represents what should be a critically influential study for guiding education reform in rural America. Using survey data from 275 former high school students, in-depth interviews with more than 100 young adults across the nation who attended the high school in the late 1980s and early 1990s, coupled with intensive community-level fieldwork, the husband-wife team of sociology professors, Patrick Carr and Maria Kefalas chronicle the "coming-of-age" experiences of youth who formerly attended high school in "Ellis," Iowa. In the process they uncover how a high school and its community inadvertently contribute to the brain drain and "hollowing out" of a small town in America's heartland. According to Carr and Kefalas, the paths students take are not random, but fairly predictable as "Achievers," "Stayers," "Seekers," and "Returners." Achievers are the high achieving, most-likely-to-succeed youth who are destined for highly regarded colleges-the "best and brightest" kids of Ellis. They spent their adolescence being cultivated by well-intended adults within the school and community who never gave them a chance to settle for the easy route. Singled out for futures that would take them far from the countryside, Achievers receive special treatment. They realize that "earning good grades, displaying good behavior, and being praised...grant special privileges and access to adults who can help them break free of small town life" (p. 31). Stayers, however, are raised to value work, develop responsibility, become independent, and usually marry at a young age. These former students of Ellis High School rationalize it as unwise to spend hard-earned money, or to go seriously in debt, to acquire a higher education when so few local jobs or benefits are available as the reward for the investment in a post-secondary degree. Thus, living in the places where they were raised is reasonable. They like the town, enjoy living in a place where their children can grow up and play freely, and prefer being surrounded by like-minded people. Stayers could not really imagine living anywhere else. Carr and Kefalas note however, that "Stayers are blind to the reality of blue-collar work in a postindustrial economy, forged in their unwavering belief in the work ethic" (p. 66), and as a consequence place themselves in positions of limited economic mobility and frequently at significant economic risk. In Ellis, the Seekers tend to be average students with little interest in remaining in their small town as adults. They come from families of modest means and grow up "into a sort of unselfconscious patriotism" (p. 93), influenced by a culture that highly honors military veterans and includes a large number of them. Seekers aren't encouraged as enthusiastically by their teachers as are Achievers. Their class rank at Ellis High School is above the Stayers, but below the Achievers. Hungry to experience life some place else, restless and impatient in their wishes, Seekers have an eagerness for the unknown pushing them to see the world beyond Ellis. Many Seekers thus become prime targets of military recruiters, who view Ellis High School as a "feeder school." Seekers may join the military as the only viable way to both see the world and afford additional education. "Now that the military markets itself as a cross between an employment service and a scholarship program" (p.104), enlisting into the military is a practical means to an end for many Seekers of Ellis High School, with hopes of college and a good job later in life. Last, the Returners, are comprised of two categories: Boomerangs and High-Fliers. …

A Century of Research on Rural Development and Regional Issues

Abstract: Rural North America has undergone a major economic transformation over the past century due to labor-saving technological progress, reductions in transport costs, and rising household incomes. The results are greater rural economic diversity, selected rural population decline, increased rural-urban interdependence, emergent exurban areas, and amenity-led rural growth. We summarize key research insights and provide a selected review of the economics literature over the past 100 years with a focus on this economic transformation of rural places, its implications for rural communities, and key modeling innovations and applications. The many important contributions by agricultural economists are highlighted.