Showing papers on "Rural area published in 2012"

Prevalence of Obesity among Adults from Rural and Urban Areas of the United States: Findings from NHANES (2005-2008).

Abstract: Purpose: Rural residents have higher rates of chronic diseases compared to their urban counterparts, and obesity may be a major contributor to this disparity. This study is the first analysis of obesity prevalence in rural and urban adults using body mass index classification with measured height and weight. In addition, demographic, diet, and physical activity correlates of obesity across rural and urban residence are examined. Methods: Analysis of body mass index (BMI), diet, and physical activity from 7,325 urban and 1,490 rural adults in the 2005-2008 National Health and Nutrition Examination Survey (NHANES). Findings: The obesity prevalence was 39.6% (SE = 1.5) among rural adults compared to 33.4% (SE = 1.1) among urban adults (P= .006). Prevalence of obesity remained significantly higher among rural compared to urban adults controlling for demographic, diet, and physical activity variables (odds ratio = 1.18, P= .03). Race/ethnicity and percent kcal from fat were significant correlates of obesity among both rural and urban adults. Being married was associated with obesity only among rural residents, whereas older age, less education, and being inactive was associated with obesity only among urban residents. Conclusions: Obesity is markedly higher among adults from rural versus urban areas of the United States, with estimates that are much higher than the rates suggested by studies with self-reported data. Obesity deserves greater attention in rural America.

Residents’ Attitudes toward Existing and Future Tourism Development in Rural Communities

Abstract: Building on the model by Perdue, Long, and Allen, this study examined residents’ attitudes toward existing and future tourism development in several rural areas at different stages of tourism and economic development. Social exchange theory and destination life cycle model were used to examine the impacts of tourism development on residents’ attitudes when considered in conjunction with a community’s total economic activity. New social predictors and endogenous factors were tested in the model. Overall, residents of three distinct rural county-level areas were supportive of tourism development, and little evidence was found that suggests that attitudes toward tourism become negative with higher levels of tourism. After considering the level of tourism development in conjunction with the total economic activity, residents of the three county-level areas showed some signs of destination life cycle influencing their own relationship with tourism.

Profile: Agincourt Health and Socio-demographic Surveillance System

Abstract: The Agincourt health and socio-demographic surveillance system (HDSS), located in rural northeast South Africa close to the Mozambique border, was established in 1992 to support district health systems development led by the post-apartheid ministry of health. The HDSS (90 000 people), based on an annual update of resident status and vital events, now supports multiple investigations into the causes and consequences of complex health, population and social transitions. Observational work includes cohorts focusing on different stages along the life course, evaluation of national policy at population, household and individual levels and examination of household responses to shocks and stresses and the resulting pathways influencing health and well-being. Trials target children and adolescents, including promoting psycho-social well-being, preventing HIV transmission and reducing metabolic disease risk. Efforts to enhance the research platform include using automated measurement techniques to estimate cause of death by verbal autopsy, full 'reconciliation' of in- and out-migrations, follow-up of migrants departing the study area, recording of extra-household social connections and linkage of individual HDSS records with those from sub-district clinics. Fostering effective collaborations (including INDEPTH multi-centre work in adult health and ageing and migration and urbanization), ensuring cross-site compatibility of common variables and optimizing public access to HDSS data are priorities.

Child Development in Rural China: Children Left behind by Their Migrant Parents and Children of Nonmigrant Families.

Abstract: Using recent cross-sectional data of rural children aged from 8 to 18 in Hunan Province of China, this article examines psychological, behavioral, and educational outcomes and the psychosocial contexts of these outcomes among children left behind by one or both of their rural-to-urban migrant parents compared to those living in nonmigrant families. The results showed that left-behind children were disadvantaged in health behavior and school engagement but not in perceived satisfaction. The child’s psychosocial environment, captured by family socioeconomic status, socializing processes, peer and school support, and psychological traits, were associated with, to varying extent, child developmental outcomes in rural China. These influences largely remain constant for the sampled children regardless of their parents’ migrant status.

Development at the Urban Fringe and Beyond: Impacts on Agriculture and Rural Land

Abstract: Land development in the United States is following two routes: expansion of urban areas and large-lot development (greater than 1 acre per house) in rural areas. Urban expansion claimed more than 1 million acres per year between 1960 and 1990, yet is not seen as a threat to most farming, although it may reduce production of some high-value or specialty crops. The consequences of continued large-lot development may be less sanguine, since it consumes much more land per unit of housing than the typical suburb. Controlling growth and planning for it are the domains of State and local governments. The Federal Government may be able to help them in such areas as building capacity to plan and control growth, providing financial incentives for channeling growth in desirable directions, or coordinating local, regional, and State efforts.

Effect of mother’s education on child’s nutritional status in the slums of Nairobi

Abstract: Malnutrition continues to be a critical public health problem in sub-Saharan Africa. For example, in East Africa, 48 % of children under-five are stunted while 36 % are underweight. Poor health and poor nutrition are now more a characteristic of children living in the urban areas than of children in the rural areas. This is because the protective mechanism offered by the urban advantage in the past; that is, the health benefits that historically accrued to residents of cities as compared to residents in rural settings is being eroded due to increasing proportion of urban residents living in slum settings. This study sought to determine effect of mother’s education on child nutritional status of children living in slum settings. Data are from a maternal and child health project nested within the Nairobi Urban Health and Demographic Surveillance System (NUHDSS). The study involves 5156 children aged 0–42 months. Data on nutritional status used were collected between October 2009 and January 2010. We used binomial and multiple logistic regression to estimate the effect of education in the univariable and multivariable models respectively. Results show that close to 40 % of children in the study are stunted. Maternal education is a strong predictor of child stunting with some minimal attenuation of the association by other factors at maternal, household and community level. Other factors including at child level: child birth weight and gender; maternal level: marital status, parity, pregnancy intentions, and health seeking behaviour; and household level: social economic status are also independently significantly associated with stunting. Overall, mothers’ education persists as a strong predictor of child’s nutritional status in urban slum settings, even after controlling for other factors. Given that stunting is a strong predictor of human capital, emphasis on girl-child education may contribute to breaking the poverty cycle in urban poor settings.

Labor Market Outcomes and Reforms in China

Abstract: Over the past few decades of economic reform, China's labor markets have been transformed to an increasingly market-driven system. China has two segregated economies: the rural and urban. Understanding the shifting nature of this divide is probably the key to understanding the most important labor market reform issues of the last decades and the decades ahead. From 1949, the Chinese economy allowed virtually no labor mobility between the rural and urban sectors. Rural-urban segregation was enforced by a household registration system called "hukou." Individuals born in rural areas receive "agriculture hukou" while those born in cities are designated as "nonagricultural hukou." In the countryside, employment and income were linked to the commune-based production system. Collectively owned communes provided very basic coverage for health, education, and pensions. In cities, state-assigned life-time employment, centrally determined wages, and a cradle-to-grave social welfare system were implemented. In the late 1970s, China's economic reforms began, but the timing and pattern of the changes were quite different across rural and urban labor markets. This paper focuses on employment and wages in the urban labor markets, the interaction between the urban and rural labor markets through migration, and future labor market challenges. Despite the remarkable changes that have occurred, inherited institutional impediments still play an important role in the allocation of labor; the hukou system remains in place, and 72 percent of China's population is still identified as rural hukou holders. China must continue to ease its restrictions on rural–urban migration, and must adopt policies to close the widening rural-urban gap in education, or it risks suffering both a shortage of workers in the growing urban areas and a deepening urban-rural economic divide.

Agriculture and the Generation Problem: Rural Youth, Employment and the Future of Farming

Abstract: Youth unemployment and underemployment are serious problems in most countries, and often more severe in rural than in urban areas. Small-scale agriculture is the developing world's single biggest source of employment, and with the necessary support it can offer a sustainable and productive alternative to the expansion of large-scale, capital-intensive, labour-displacing corporate farming. This, however, assumes a generation of young rural men and women who want to be small farmers, while mounting evidence suggests that young people are uninterested in farming or in rural futures. The emerging field of youth studies can help us understand young people's turn away from farming, pointing to: the deskilling of rural youth, and the downgrading of farming and rural life; the chronic neglect of small-scale agriculture and rural infrastructure; and the problems that young rural people increasingly have, even if they want to become farmers, in getting access to land while still young.

A self-system perspective on young adolescents' motivation to learn English in urban and rural settings.

Abstract: This study examined the motivation to learn English of Indonesian junior high school pupils, aged 13-14, in three distinct contexts: a metropolitan city, a provincial town, and a rural district. Utilizing Dornyei’s (2009) L2 motivational self-system as the theoretical framework, it employed a 50-item questionnaire to sample the views of 527 learners, and a C-test to measure their current proficiency in English. Motivation was found to be similar in strength and character in the two urban settings but significantly different in the rural setting. A positive view of the experience of learning English was the strongest predictor of both motivated learning behaviour and L2 proficiency, whereas the ideal L2 self was only a significant factor among the metropolitan group.

Determinants of Maternity Care Services Utilization among Married Adolescents in Rural India

Abstract: BACKGROUND: Coupled with the largest number of maternal deaths adolescent pregnancy in India has received paramount importance due to early age at marriage and low contraceptive use. The factors associated with the utilization of maternal healthcare services among married adolescents in rural India are poorly discussed. METHODOLOGY/PRINCIPAL FINDINGS: Using the data from third wave of National Family Health Survey (2005-06) available in public domain for the use by researchers this paper examines the factors associated with the utilization of maternal healthcare services among married adolescent women (aged 15-19 years) in rural India. Three components of maternal healthcare service utilization were measured: full antenatal care safe delivery and postnatal care within 42 days of delivery for the women who gave births in the last five years preceding the survey. Considering the framework on causes of maternal mortality proposed by Thaddeus and Maine (1994) selected socioeconomic demographic and cultural factors influencing outcome events were included as the predictor variables. Bi-variate analyses including chi-square test to determine the difference in proportion and logistic regression to understand the net effect of predictor variables on selected outcomes were applied. Findings indicate the significant differences in the use of selected maternal healthcare utilization by educational attainment economic status and region of residence. Muslim women and women belonged to Scheduled Castes Scheduled Tribes and Other Backward Classes are less likely to avail safe delivery services. Additionally adolescent women from the southern region utilizing the highest maternal healthcare services than the other regions. CONCLUSIONS: The present study documents several socioeconomic and cultural factors affecting the utilization of maternal healthcare services among rural adolescent women in India. The ongoing healthcare programs should start targeting household with married adolescent women belonging to poor and specific sub-groups of the population in rural areas to address the unmet need for maternal healthcare service utilization.

Immigration and the New Racial Diversity in Rural America

Abstract: This article highlights the new racial and ethnic diversity in rural America, which may be the most important but least anticipated population shift in recent demographic history. Ethnoracial change is central to virtually every aspect of rural America over the foreseeable future: agro-food systems, community life, labor force change, economic development, schools and schooling, demographic change, intergroup relations, and politics. The goal here is to plainly illustrate how America's racial and ethnic transformation has emerged as an important dimension of ongoing U.S. urbanization and urbanism, growing cultural and economic heterogeneity, and a putative "decline in community" in rural America. Rural communities provide a natural laboratory for better understanding the implications of uneven settlement and racial diversity, acculturation, and economic and political incorporation among Hispanic newcomers. This article raises the prospect of a new racial balkanization and outlines key impediments to full incorporation of Hispanics into rural and small town community life. Immigration and the new ethnoracial diversity will be at the leading edge of major changes in rural community life as the nation moves toward becoming a majority-minority society by 2042.

Factors influencing rising caesarean section rates in China between 1988 and 2008

Abstract: Objective To identify factors driving the rapid increase in caesarean section in China between 1988 and 2008. Methods Data from four national cross-sectional surveys (1993, 1998, 2003 and 2008) and modified Poisson regression were used to determine whether changes in household income, access to health insurance or women’s education accounted for the rise in caesarean sections in urban and rural areas. Findings In 2008, 64.1% of urban women and 11.3% of women in the poorest rural region reported giving birth by caesarean section. A fast rise was occurring in all socioeconomic groups. Between 1993 and 2008, the risk of caesarean section had increased more than threefold in urban areas (relative risk, RR: 3.63; 95% confidence interval, CI: 2.61–5.04) and more than 15-fold in rural areas (RR: 15.46; 95% CI: 10.46–22.86). After adjustment for improvements in income, education and access to health insurance over the study period, the RR dropped minimally in urban areas (RR: 3.07; 95% CI: 2.32–4.07), which suggests that these factors do not explain the rise; in rural areas, the adjusted RR dropped to 7.18 (95% CI: 4.82–10.69), which shows that socioeconomic change is only partly responsible for the rise. Socioeconomic region of residence was a more important driver of the caesarean section rate than individual socioeconomic status. Conclusion The large variation in caesarean section rate by socioeconomic region – independent of individual income, health insurance or education – suggests that structural factors related to service supply have influenced the increasing rate more than a woman’s ability to pay.

Psychosocial well-being and supportive care needs of cancer patients living in urban and rural/regional areas: a systematic review

Abstract: Purpose The aim of this study was to describe what is known about levels of morbidity and the experience and needs of people with cancer, and their informal caregivers, living in rural areas.

Wealth and antenatal care use: implications for maternal health care utilisation in Ghana

Abstract: The study investigates the effect of wealth on maternal health care utilization in Ghana via its effect on Antenatal care use. Antenatal care serves as the initial point of contact of expectant mothers to maternal health care providers before delivery. The study is pivoted on the introduction of the free maternal health care policy in April 2005 in Ghana with the aim of reducing the financial barrier to the use of maternal health care services, to help reduce the high rate of maternal deaths. Prior to the introduction of the policy, studies found wealth to have a positive and significant influence on the use of Antenatal care. It is thus expected that with the policy, wealth should not influence the use of maternal health care significantly. Using secondary data from the 2008 Ghana Demographic and Health survey, the results have revealed that wealth still has a significant influence on adequate use of Antenatal care. Education, age, number of living children, transportation and health insurance are other factors that were found to influence the use of Antenatal care in Ghana. There also exist considerable variations in the use of Antenatal care in the geographical regions and between the rural and urban dwellers. It is recommended that to improve the use of Antenatal care and hence maternal health care utilization, some means of support is provided especially to women within the lowest wealth quintiles, like the provision and availability of recommended medication at the health center; secondly, women should be encouraged to pursue education to at least the secondary level since this improves their use of maternal health services. Policy should also target mothers who have had the experience of child birth on the need to use adequate Antenatal care for each pregnancy, since these mothers tend to use less antenatal care for subsequent pregnancies. The regional disparities found may be due to inaccessibility and unavailability of health facilities and services in the rural areas and in some of the regions. The government and other service providers (NGOs, religious institutions and private providers) may endeavor to improve on the distribution of health facilities, human resources, good roads and necessary infrastructure among other things in order to facilitate easy access to health care providers especially for the rural dwellers.

Population-based incidence of typhoid fever in an urban informal settlement and a rural area in Kenya: implications for typhoid vaccine use in Africa.

Abstract: Background High rates of typhoid fever in children in urban settings in Asia have led to focus on childhood immunization in Asian cities, but not in Africa, where data, mostly from rural areas, have shown low disease incidence. We set out to compare incidence of typhoid fever in a densely populated urban slum and a rural community in Kenya, hypothesizing higher rates in the urban area, given crowding and suboptimal access to safe water, sanitation and hygiene. Methods During 2007-9, we conducted population-based surveillance in Kibera, an urban informal settlement in Nairobi, and in Lwak, a rural area in western Kenya. Participants had free access to study clinics; field workers visited their homes biweekly to collect information about acute illnesses. In clinic, blood cultures were processed from patients with fever or pneumonia. Crude and adjusted incidence rates were calculated. Results In the urban site, the overall crude incidence of Salmonella enterica serovar Typhi (S. Typhi) bacteremia was 247 cases per 100,000 person-years of observation (pyo) with highest rates in children 5–9 years old (596 per 100,000 pyo) and 2–4 years old (521 per 100,000 pyo). Crude overall incidence in Lwak was 29 cases per 100,000 pyo with low rates in children 2–4 and 5–9 years old (28 and 18 cases per 100,000 pyo, respectively). Adjusted incidence rates were highest in 2–4 year old urban children (2,243 per 100,000 pyo) which were >15-fold higher than rates in the rural site for the same age group. Nearly 75% of S. Typhi isolates were multi-drug resistant. Conclusions This systematic urban slum and rural comparison showed dramatically higher typhoid incidence among urban children <10 years old with rates similar to those from Asian urban slums. The findings have potential policy implications for use of typhoid vaccines in increasingly urban Africa.

Diet, Physical Activity, and Sedentary Behaviors as Risk Factors for Childhood Obesity: An Urban and Rural Comparison

Abstract: Background:The aim of this study was to examine the differences in diet, physical activity, and weight status among children living in rural and urban America and to study the roles of obesity-related behaviors in residence-based differences in childhood obesity.Methods:We performed cross-sectional analysis of the 1999–2006 National Health and Nutrition Examination Survey data, restricted to 14,332 children aged 2–19 years old (2771 rural, 13,766 urban). Residence was measured at the census tract level using Rural-Urban Commuting Areas. Age-specific questions were used to assess physical activity, and the 24-hour diet recall was used to measure dietary intake.Results:Among 2- to 11-year-olds, rural children consumed 90 more kcal/day on average than urban children (p < 0.05) and were more likely to consume the recommended two to three cups of dairy per day (p < 0.05). More 2- to 11-year-old rural children also reported participating in exercise five or more times per week than urban children of the same ag...

Who benefits most from rural electrification ? evidence in India

Abstract: This paper applies an econometric analysis to estimate the average and distribution benefits of rural electrification using rich household survey data from India. The results support that rural electrification helps to reduce time allocated to fuelwood collection by household members and increases time allocated to studying by boys and girls. Rural electrification also increases the labor supply of men and women, schooling of boys and girls, and household per capita income and expenditure. Electrification also helps reduce poverty. But the larger share of benefits accrues to wealthier rural households, with poorer ones having more limited use of electricity. The analysis also shows that restricted supply of electricity, due to frequent power outages, negatively affects both household electricity connection and its consumption, thereby reducing the expected benefits of rural electrification.

Exploring inequalities in access to and use of maternal health services in South Africa

Abstract: South Africa’s maternal mortality rate (625 deaths/100,000 live births) is high for a middle-income country, although over 90% of pregnant women utilize maternal health services. Alongside HIV/AIDS, barriers to Comprehensive Emergency Obstetric Care currently impede the country’s Millenium Development Goals (MDGs) of reducing child mortality and improving maternal health. While health system barriers to obstetric care have been well documented, “patient-oriented” barriers have been neglected. This article explores affordability, availability and acceptability barriers to obstetric care in South Africa from the perspectives of women who had recently used, or attempted to use, these services. A mixed-method study design combined 1,231 quantitative exit interviews with sixteen qualitative in-depth interviews with women (over 18) in two urban and two rural health sub-districts in South Africa. Between June 2008 and September 2009, information was collected on use of, and access to, obstetric services, and socioeconomic and demographic details. Regression analysis was used to test associations between descriptors of the affordability, availability and acceptability of services, and demographic and socioeconomic predictor variables. Qualitative interviews were coded deductively and inductively using ATLAS ti.6. Quantitative and qualitative data were integrated into an analysis of access to obstetric services and related barriers. Access to obstetric services was impeded by affordability, availability and acceptability barriers. These were unequally distributed, with differences between socioeconomic groups and geographic areas being most important. Rural women faced the greatest barriers, including longest travel times, highest costs associated with delivery, and lowest levels of service acceptability, relative to urban residents. Negative provider-patient interactions, including staff inattentiveness, turning away women in early-labour, shouting at patients, and insensitivity towards those who had experienced stillbirths, also inhibited access and compromised quality of care. To move towards achieving its MDGs, South Africa cannot just focus on increasing levels of obstetric coverage, but must systematically address the access constraints facing women during pregnancy and delivery. More needs to be done to respond to these “patient-oriented” barriers by improving how and where services are provided, particularly in rural areas and for poor women, as well as altering the attitudes and actions of health care providers.

Impact Analysis of Rural Electrification Projects in Sub-Saharan Africa

Abstract: The author reviews trends in rural electrification over the past 30 years in Sub-Saharan Africa. In particular, it is shown that motivations for rural electrification programs have evolved significantly over the years, following changes in development paradigms. The author finds, that knowledge of the impact of this has only marginally improved: low connection rates and weak productive utilization identified in the 1980s remain true today, and impacts on such dimensions as health, education, or income, though often used to justify projects, are largely undocumented. Indeed impact evaluations are methodologically challenging in the field of infrastructures and have been limited thus far. Nevertheless examples of recent or ongoing impact evaluations of rural electrification programs offer promising avenues for identifying both the effect of electricity per se and the relative effectiveness of approaches to promoting it.

Factors Contributing to Urban Malaria Transmission in Sub-Saharan Africa: A Systematic Review

Abstract: Sub-Saharan Africa suffers by far the greatest malaria burden worldwide and is currently undergoing a profound demographic change, with a growing proportion of its population moving to urban areas. Urbanisation is generally expected to reduce malaria transmission; however the disease still persists in African cities, in some cases at higher levels than in nearby rural areas. Objective. This paper aims to collate and analyse risk factors for urban malaria transmission throughout sub-Saharan Africa and to discuss their implications for control. Methods. A systematic search on malaria and urbanisation was carried out focusing on sub-Saharan Africa. Particular interest was taken in vector breeding sites in urban and periurban areas. Results. A variety of urban vector breeding sites were catalogued, the majority of which were artificial, including urban agriculture, tyre tracks, and ditches. Natural breeding sites varied according to location. Low socioeconomic status was a significant risk factor for malaria, often present in peri-urban areas. A worrying trend was seen in the adaptation of malaria vector species to the urban environment. Urban malaria is highly focused and control programs should reflect this. Conclusion. As urbanisation continues and vector species adapt, continued monitoring and control of urban malaria in sub-Saharan Africa is essential.

The Elderly and Old Age Support in Rural China

Abstract: Although average incomes in China have risen dramatically since the 1980s, concerns are increasing that the rural elderly have not benefited from growth to the same extent as younger people and the urban elderly. Concerns about welfare of the rural elderly combine spatial and demographic issues. Large gaps exist between conditions in coastal and interior regions and between conditions in urban and rural areas of the country. In addition to differences in income by geography, considerable differences exist across demographic groups in the level of coverage by safety nets, in the benefits received through the social welfare system, and in the risks of falling into poverty. This book aims to do two things: first, it provides detailed empirical analysis of the welfare and living conditions of the rural elderly since the early 1990s in the context of large-scale rural-to-urban migration, and second, it explores the evolution of the rural pension system in China over the past two decades and raises a number of issues on its current implementation and future directions. Although the two sections of the book are distinct in analytical terms, they are closely linked in policy terms: the first section demonstrates in several ways a rationale for greater public intervention in the welfare of the rural elderly, and the second documents the response of policy to date and options to consider for deepening the coverage and effects of the rural pension system over the longer term.