Showing papers on "Rural area published in 2021"

Impacts of the COVID-19 pandemic on rural America.

Abstract: Despite considerable social scientific attention to the impacts of the COVID-19 pandemic on urbanized areas, very little research has examined its impact on rural populations. Yet rural communities-which make up tens of millions of people from diverse backgrounds in the United States-are among the nation's most vulnerable populations and may be less resilient to the effects of such a large-scale exogenous shock. We address this critical knowledge gap with data from a new survey designed to assess the impacts of the pandemic on health-related and economic dimensions of rural well-being in the North American West. Notably, we find that the effects of the COVID-19 pandemic on rural populations have been severe, with significant negative impacts on unemployment, overall life satisfaction, mental health, and economic outlook. Further, we find that these impacts have been generally consistent across age, ethnicity, education, and sex. We discuss how these findings constitute the beginning of a much larger interdisciplinary COVID-19 research effort that integrates rural areas and pushes beyond the predominant focus on cities and nation-states.

Shifts in office and virtual primary care during the early COVID-19 pandemic in Ontario, Canada.

Abstract: BACKGROUND: Globally, primary care changed dramatically as a result of the coronavirus disease 2019 (COVID-19) pandemic We aimed to understand the degree to which office and virtual primary care changed, and for which patients and physicians, during the initial months of the pandemic in Ontario, Canada METHODS: This population-based study compared comprehensive, linked primary care physician billing data from Jan 1 to July 28, 2020, with the same period in 2019 We identified Ontario residents with at least 1 office or virtual (telephone or video) visit during the study period We compared trends in total physician visits, office visits and virtual visits before COVID-19 with trends after pandemic-related public health measures changed the delivery of care, according to various patient and physician characteristics We used interrupted time series analysis to compare trends in the early and later halves of the COVID-19 period RESULTS: Compared with 2019, total primary care visits between March and July 2020 decreased by 280%, from 766 to 551 per 1000 people/day The smallest declines were among patients with the highest expected health care use (83%), those who could not be attributed to a primary care physician (102%), and older adults (191%) In contrast, total visits in rural areas increased by 64% Office visits declined by 791% and virtual care increased 56-fold, comprising 711% of primary care physician visits The lowest uptake of virtual care was among children (576%), rural residents (606%) and physicians with panels of ≥ 2500 patients (660%) INTERPRETATION: Primary care in Ontario saw large shifts from office to virtual care over the first 4 months of the COVID-19 pandemic Total visits declined least among those with higher health care needs The determinants and consequences of these major shifts in care require further study

Disparities in COVID-19 Vaccination Coverage Between Urban and Rural Counties - United States, December 14, 2020-April 10, 2021.

Abstract: Approximately 60 million persons in the United States live in rural counties, representing almost one fifth (19.3%) of the population.* In September 2020, COVID-19 incidence (cases per 100,000 population) in rural counties surpassed that in urban counties (1). Rural communities often have a higher proportion of residents who lack health insurance, live with comorbidities or disabilities, are aged ≥65 years, and have limited access to health care facilities with intensive care capabilities, which places these residents at increased risk for COVID-19-associated morbidity and mortality (2,3). To better understand COVID-19 vaccination disparities across the urban-rural continuum, CDC analyzed county-level vaccine administration data among adults aged ≥18 years who received their first dose of either the Pfizer-BioNTech or Moderna COVID-19 vaccine, or a single dose of the Janssen COVID-19 vaccine (Johnson & Johnson) during December 14, 2020-April 10, 2021 in 50 U.S. jurisdictions (49 states and the District of Columbia [DC]). Adult COVID-19 vaccination coverage was lower in rural counties (38.9%) than in urban counties (45.7%) overall and among adults aged 18-64 years (29.1% rural, 37.7% urban), those aged ≥65 years (67.6% rural, 76.1% urban), women (41.7% rural, 48.4% urban), and men (35.3% rural, 41.9% urban). Vaccination coverage varied among jurisdictions: 36 jurisdictions had higher coverage in urban counties, five had higher coverage in rural counties, and five had similar coverage (i.e., within 1%) in urban and rural counties; in four jurisdictions with no rural counties, the urban-rural comparison could not be assessed. A larger proportion of persons in the most rural counties (14.6%) traveled for vaccination to nonadjacent counties (i.e., farther from their county of residence) compared with persons in the most urban counties (10.3%). As availability of COVID-19 vaccines expands, public health practitioners should continue collaborating with health care providers, pharmacies, employers, faith leaders, and other community partners to identify and address barriers to COVID-19 vaccination in rural areas (2).

Willingness to vaccinate against COVID-19 among Bangladeshi adults: Understanding the strategies to optimize vaccination coverage.

Abstract: BACKGROUND: Although the approved COVID-19 vaccine has been shown to be safe and effective, mass vaccination in Bangladeshi people remains a challenge. As a vaccination effort, the study provided an empirical evidence on willingness to vaccinate by sociodemographic, clinical and regional differences in Bangladeshi adults. METHODS: This cross-sectional analysis from a household survey of 3646 adults aged 18 years or older was conducted in 8 districts of Bangladesh, from December 12, 2020, to January 7, 2021. Multinomial regression examined the impact of socio-demographic, clinical and healthcare-releated factors on hesitancy and reluctance of vaccination for COVID-19. RESULTS: Of the 3646 respondents (2212 men [60.7%]; mean [sd] age, 37.4 [13.9] years), 74.6% reported their willingness to vaccinate against COVID-19 when a safe and effective vaccine is available without a fee, while 8.5% were reluctant to vaccinate. With a minimum fee, 46.5% of the respondents showed intent to vaccinate. Among the respondents, 16.8% reported adequate adherence to health safety regulations, and 35.5% reported high confidence in the country's healthcare system. The COVID-19 vaccine refusal was significantly high in elderly, rural, semi-urban, and slum communities, farmers, day-laborers, homemakers, low-educated group, and those who had low confidence in the country's healthcare system. Also, the prevalence of vaccine hesitancy was high in the elderly population, low-educated group, day-laborers, people with chronic diseases, and people with low confidence in the country's healthcare system. CONCLUSION: A high prevalence of vaccine refusal and hesitancy was observed in rural people and slum dwellers in Bangladesh. The rural community and slum dwellers had a low literacy level, low adherence to health safety regulations and low confidence in healthcare system. The ongoing app-based registration for vaccination increased hesitancy and reluctancy in low-educated group. For rural, semi-urban, and slum people, outreach centers for vaccination can be established to ensure the vaccine's nearby availability and limit associated travel costs. In rural areas, community health workers, valued community-leaders, and non-governmental organizations can be utilized to motivate and educate people for vaccination against COVID-19. Further, emphasis should be given to the elderly and diseased people with tailored health messages and assurance from healthcare professionals. The media may play a responsible role with the vaccine education program and eliminate the social stigma about the vaccination. Finally, vaccination should be continued without a fee and thus Bangladesh's COVID vaccination program can become a model for other low and middle-income countries.

Rural and Urban Differences in COVID-19 Prevention Behaviors.

Abstract: PURPOSE: To examine whether the adoption of COVID-19-related preventive health behaviors vary in rural versus urban communities of the United States while accounting for the influence of political ideology, demographic factors, and COVID-19 experiences. METHODS: We rely on a representative survey of 5009 American adults collected from May 28 to June 8, 2020. We analyze the influence of rural status, political ideology, demographic factors, and COVID-19 experiences on self-reported adoption of 8 COVID-19-related preventive health behaviors. FINDINGS: Rural residents are significantly less likely to have worn a mask in public, sanitized their home or workplace with disinfectant, avoided dining at restaurants or bars, or worked from home. These findings, with the exception of dining out, are robust to the inclusion of measures accounting for political ideology, demographic factors, and COVID-19 experiences. CONCLUSIONS: Rural residents are significantly less likely to participate in several COVID-19-related preventive health behaviors. This reality could exacerbate existing disparities in health access and outcomes for rural Americans. Health messaging targeted at improving COVID-19 preventive behavior adoption in rural America is warranted.

Asthma Surveillance - United States, 2006-2018.

Abstract: PROBLEM Asthma is a chronic disease of the airways that requires ongoing medical management. Socioeconomic and demographic factors as well as health care use might influence health patterns in urban and rural areas. Persons living in rural areas tend to have less access to health care and health resources and worse health outcomes. Characterizing asthma indicators (i.e., prevalence of current asthma, asthma attacks, emergency department and urgent care center [ED/UCC] visits, and asthma-associated deaths) and determining how asthma exacerbations and health care use vary across the United States by geographic area, including differences between urban and rural areas, and by sociodemographic factors can help identify subpopulations at risk for asthma-related complications. REPORTING PERIOD 2006-2018. DESCRIPTION OF SYSTEM The National Health Interview Survey (NHIS) is an annual cross-sectional household health survey among the civilian noninstitutionalized population in the United States. NHIS data were used to produce estimates for current asthma and among them, asthma attacks and ED/UCC visits. National Vital Statistics System (NVSS) data were used to estimate asthma deaths. Estimates of current asthma, asthma attacks, ED/UCC visits, and asthma mortality rates are described by demographic characteristics, poverty level (except for deaths), and geographic area for 2016-2018. Trends in asthma indicators by metropolitan statistical area (MSA) category for 2006-2018 were determined. Current asthma and asthma attack prevalence are provided by MSA category and state for 2016-2018. Detailed urban-rural classifications (six levels) were determined by merging 2013 National Center for Health Statistics (NCHS) urban-rural classification data with 2016-2018 NHIS data by county and state variables. All subregional estimates were accessed through the NCHS Research Data Center. RESULTS Current asthma was higher among boys aged <18 years, women aged ≥18 years, non-Hispanic Black (Black) persons, non-Hispanic multiple-race (multiple-race) persons, and Puerto Rican persons. Asthma attacks were more prevalent among children, females, and multiple-race persons. ED/UCC visits were more prevalent among children, women aged ≥18 years, and all racial and ethnic groups (i.e., Black, non-Hispanic Asian, multiple race, and Hispanic, including Puerto Rican, Mexican, and other Hispanic) except American Indian and Alaska Native persons compared with non-Hispanic White (White) persons. Asthma deaths were higher among adults, females, and Black persons. All pertinent asthma outcomes were also more prevalent among persons with low family incomes. Current asthma prevalence was higher in the Northeast than in the South and the West, particularly in small MSA areas. The prevalence was also higher in small and medium metropolitan areas than in large central metropolitan areas. The prevalence of asthma attacks differed by MSA category in four states. The prevalence of ED/UCC visits was higher in the South than the Northeast and the Midwest and was also higher in large central metropolitan areas than in micropolitan and noncore areas. The asthma mortality rate was highest in non-MSAs, specifically noncore areas. The asthma mortality rate was also higher in the Northeast, Midwest, and West than in the South. Within large MSAs, asthma deaths were higher in the Northeast and Midwest than the South and West. INTERPRETATION Despite some improvements in asthma outcomes over time, the findings from this report indicate that disparities in asthma indicators persist by demographic characteristics, poverty level, and geographic location. PUBLIC HEALTH ACTION Disparities in asthma outcomes and health care use in rural and urban populations identified from NHIS and NVSS can aid public health programs in directing resources and interventions to improve asthma outcomes. These data also can be used to develop strategic goals and achieve CDC's Controlling Childhood Asthma and Reducing Emergencies (CCARE) initiative to reduce childhood asthma hospitalizations and ED visits and prevent 500,000 asthma-related hospitalizations and ED visits by 2024.

Spatial Variability and Temporal Heterogeneity of Surface Urban Heat Island Patterns and the Suitability of Local Climate Zones for Land Surface Temperature Characterization

Abstract: This study investigated monthly variations of surface urban heat island intensity (SUHII) and the applicability of the local climate zones (LCZ) scheme for land surface temperature (LST) differentiation within three spatial contexts, including urban, rural and their combination, in Shenyang, China, a city with a monsoon-influenced humid continental climate. The monthly SUHII and LST of Shenyang were obtained through 12 LST images, with one in each month (within the period between 2018 and 2020), retrieved from the Thermal InfraRed Sensor (TIRS) 10 in Landsat 8 based on a split window algorithm. Non-parametric analysis of Kruskal-Wallis H test and a multiple pairwise comparison were adopted to investigate the monthly LST differentiations with LCZs. Overall, the SUHII and the applicability of the LCZ scheme exhibited spatiotemporal variations. July and August were the two months when Shenyang underwent strong heat island effects. Shenyang underwent a longer period of cool than heat island effects, occurring from November to May. June and October were the transition months of cool–heat and heat–cool island phenomena, respectively. The SUHII analysis was dependent on the definition of urban and rural boundaries, where a smaller rural buffering zone resulted in a weaker SUHI or surface urban cool island (SUCI) phenomenon and a larger urban area corresponded to a weaker SUHI or SUCI phenomenon as well. The LST of LCZs did not follow a fixed order, where in July and August, the LCZ-10 (Heavy industry) had the highest mean LST, followed by LCZ-2 (Compact midrise) and then LCZ-7 (Lightweight low-rise). In comparison, LCZ-7, LCZ-8 (Large low-rise) and LCZ-9 (Sparsely built) had the highest LST from October to May. The LST of LCZs varied with urban and rural contexts, where LCZ-7, LCZ-8 and LCZ -10 were the three built LCZs that had the highest LST within urban context, while LCZ-2, LCZ-3 (Compact low-rise), LCZ-8, LCZ-9 and LCZ-10 were the five built LCZs that had the highest LST within rural context. The suitability of the LCZ scheme for temperature differentiation varied with the month, where from July to October, the LCZ scheme had the strongest capability and in May, it had the weakest capability. Urban context also made a difference to the suitability, where compared with the whole study area (the combination of urban and rural areas), the suitability of built LCZs in either urban or rural contexts weakened. Moreover, the built LCZs had a higher level of suitability in an urban context compared with a rural context, while the land-cover LCZs within rural had a higher level of suitability.

Urban-rural differences in COVID-19 exposures and outcomes in the South: A preliminary analysis of South Carolina.

Abstract: As the COVID-19 pandemic moved beyond the initial heavily impacted and urbanized Northeast region of the United States, hotspots of cases in other urban areas ensued across the country in early 2020. In South Carolina, the spatial and temporal patterns were different, initially concentrating in small towns within metro counties, then diffusing to centralized urban areas and rural areas. When mitigation restrictions were relaxed, hotspots reappeared in the major cities. This paper examines the county-scale spatial and temporal patterns of confirmed cases of COVID-19 for South Carolina from March 1st-September 5th, 2020. We first describe the initial diffusion of the new confirmed cases per week across the state, which remained under 2,000 cases until Memorial Day weekend (epi week 23) then dramatically increased, peaking in mid-July (epi week 29), and slowly declining thereafter. Second, we found significant differences in cases and deaths between urban and rural counties, partially related to the timing of the number of confirmed cases and deaths and the implementation of state and local mitigations. Third, we found that the case rates and mortality rates positively correlated with pre-existing social vulnerability. There was also a negative correlation between mortality rates and county resilience patterns, as expected, suggesting that counties with higher levels of inherent resilience had fewer deaths per 100,000 population.

COVID-19 in Portugal: exploring the immediate psychological impact on the general population.

Abstract: Like previous pandemics, the coronavirus disease 2019 (COVID-19) has direct and indirect effects, including in mental health. To evaluate the immediate psychological impact of COVID-19, we conducted an online survey in Portugal (24-27 March 2020), using the Impact of Event Scale-Revised (IES-R) and the Depression, Anxiety and Stress Scale (DASS-21). From the 10,529 participants (M = 31.33; SD = 9.73), 83.4% were women, had a mean age of 31.2 years, and 70.9% were active workers. Depression, anxiety, and stress were rated as moderate to severe in 11.7%, 16.9%, and 5.6% of the sample, respectively. Moreover, 49.2% of participants reported a moderate or severe psychological impact of the outbreak. Women, the unemployed, those with lower education, living in rural areas, and with flu-like symptoms or chronic disorders were risk factors. Further research is needed to identify vulnerable groups to better inform and adapt mental health policies and interventions.

Integrating multicriteria decision-making analysis for a GIS-based settlement area in the district of Atakum, Samsun, Turkey

Abstract: The last century witnessed a boom in the world population, reaching an unprecedented level. In particular, in recent decades, the population has concentrated in cities. Migration from rural areas to urban areas brings many problems to urban areas, necessitating the opening of new settlement areas. These new settlement areas that are needed are mostly determined in line with the initiatives of local authorities based on the situation of infrastructure facilities, not scientific evaluations. If the wrong places are selected, various natural events each year may cause the loss of property and lives, in addition to significant amounts of energy consumption. This study uses various parameters and creates a method for place selection based on multiple criteria. The district of Atakum in the city of Samsun, which has been subject to continuous migration and where new settlement areas have been established, is selected as the study area. Within the scope of this study, in addition to landslide and flood risks, which constitute the most important natural disasters in the region, situations of high voltage electricity transmission lines in places where the establishment of a residential area would be objectionable are evaluated. The situation of biocomfort, which is significantly important, especially with respect to energy efficiency as well as human health, peace, and comfort, is also evaluated. This study is conducted based on these criteria, and as a result, it calculates that only 15.11% of the district of Atakum is appropriate for use as a settlement area. In addition to serving as a reference for the short- and long-term area planning studies that will be conducted in the region, this study also holds significance due to the new perspective it offers regarding urban planning studies.

Urban poverty and nutrition challenges associated with accessibility to a healthy diet: a global systematic literature review

Abstract: There is an increasing global trend towards urbanization. In general, there are less food access issues in urban than rural areas, but this “urban advantage” does not benefit the poorest who face disproportionate barriers to accessing healthy food and have an increased risk of malnutrition. This systematic literature review aimed to assess urban poverty as a determinant of access to a healthy diet, and to examine the contribution of urban poverty to the nutritional status of individuals. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) methodology, our review included quantitative and qualitative studies published in English or in Spanish between 2000 and 2019. The articles were eligible if they focused on nutrition access (i.e. access to a healthy diet) or nutrition outcomes (i.e., anemia, overweight and obesity, micronutrient deficiency, micronutrient malnutrition) among urban poor populations. Articles were excluded if they did not meet pre-established criteria. The quality of the quantitative studies was assessed by applying Khan et al.’s methodology. Similarly, we assessed the quality of qualitative articles through an adapted version of the National Institute for Health and Care Excellence (NICE) methodology checklist. Finally, we systematically analyzed all papers that met the inclusion criteria based on a qualitative content and thematic analysis. Of the 68 papers included in the systematic review, 55 used quantitative and 13 used qualitative methods. Through the analysis of the literature we found four key themes: (i) elements that affect access to healthy eating in individuals in urban poverty, (ii) food insecurity and urban poverty, (iii) risk factors for the nutritional status of urban poor and (iv) coping strategies to limited access to food. Based on the systematization of the literature on these themes, we then proposed a conceptual framework of urban poverty and nutrition. This systematic review identified distinct barriers posed by urban poverty in accessing healthy diets and its association with poorer nutrition outcomes, hence, questioning the “urban advantage”. A conceptual framework emerging from the existing literature is proposed to guide future studies and policies. PROSPERO Registration number: CRD42018089788 .

Connecting the Countryside via E-Commerce: Evidence from China

Abstract: This paper estimates the impact of the first nation-wide e-commerce expansion program on rural households. To do so, we combine a randomized control trial with new survey and administrative microdata. In contrast to existing case studies, we find little evidence for income gains to rural producers and workers. Instead, the gains are driven by a reduction in cost of living for a minority of rural households who tend to be younger, richer and in more remote markets. These effects are mainly due to overcoming logistical barriers to e-commerce, rather than to additional investments to adapt e-commerce to the rural population.

Does Internet use reduce chemical fertilizer use? Evidence from rural households in China

Abstract: Although numerous studies have explored various impacts of Internet use, few have investigated the linkage between Internet use and chemical fertilizer use in developing economies. This study examines the influences of Internet use and related promotion policy on chemical fertilizer use based on a nationwide dataset including China’s 7766 rural households. The baseline regression results show that Internet use reduced chemical fertilizer use significantly. The mechanism analysis unveils the mediation role of human capital; Internet use increased farmers’ human capital and then reduced chemical fertilizer use. In addition, the difference-in-difference method is employed to examine the effects of Internet promotion policy and the findings reveal that the promotion policy could help reduce farmers’ use of chemical fertilizer. Finally, both propensity score matching-DID model and a two-stage instrumental variable model are used to address potential endogeneity issues associated with Internet use, and results indicate that the empirical results are robust. Our findings suggest that improving the availability of broadband access in a rural area, promoting Internet-related training and education, and more government’s investment in rural ICTs infrastructure can contribute to the reduction of chemical fertilizer use.

Rural household food waste characteristics and driving factors in China

Abstract: Household has been widely considered as the top contributor to food waste generation in industrialized countries. However, the characteristics and driving factors of household food waste generation in developing countries, particularly in rural areas, remain less understood. In the present work, we reported a case study for rural households in China, where food consumption structure has been undergoing rapid transformation, to explore the scales and drivers of rural household food waste generation. A direct-weighing method was used in a field survey for 207 rural households in 21 villages of 3 prefecture-level cities in Shandong province, northern China. We determined the average rural household food waste generation as 8.74 g/cap/meal (more than 90% was plant-based food waste in which nearly half was vegetable waste), a number much lower than that in high-income countries and the Chinese urban restaurants. We also found that such a number varies considerably by household (0–126.21 g/cap/meal), and almost half of surveyed households generated almost no food waste. Among the surveyed prefectural areas, food waste in Jinan was significantly higher than that in Dezhou and Weifang (P

Implementation, adoption and perceptions of telemental health during the COVID-19 pandemic: a systematic review.

Abstract: BACKGROUND: Early in 2020, mental health services had to rapidly shift from face-to-face models of care to delivering the majority of treatments remotely (by video or phone call or occasionally messaging) due to the COVID-19 pandemic. This resulted in several challenges for staff and patients, but also in benefits such as convenience or increased access for people with impaired mobility or in rural areas. There is a need to understand the extent and impacts of telemental health implementation, and barriers and facilitators to its effective and acceptable use. This is relevant both to future emergency adoption of telemental health, and to debates on its future use in routine mental health care. OBJECTIVE: To investigate the adoption and impacts of telemental health approaches during the COVID-19 Pandemic, and facilitators and barriers to optimal implementation. METHODS: Four databases (PubMed, PsycINFO, CINAHL and Web of Science) were searched for primary research relating to remote working, mental health care, and the COVID-19 pandemic. Preprint servers were also searched. Results of studies were synthesised using framework synthesis. RESULTS: A total of 77 papers met our inclusion criteria. In most studies, the majority of contacts could be transferred to a remote form during the pandemic, and good acceptability to service users and clinicians tended to be reported, at least where the alternative to remote contacts was interrupting care. However, a range of impediments to dealing optimal care by this means were also identified. CONCLUSIONS: Implementation of telemental health allowed some continuing support to the majority of service users during the COVID-19 pandemic and has value in an emergency situation. However, not all service users can be reached by this means, and better evidence is now needed on long-term impacts on therapeutic relationships and quality of care, and on impacts on groups at risk of digital exclusion and how to mitigate these. CLINICALTRIAL:

The Integration of New-Type Urbanization and Rural Revitalization Strategies in China: Origin, Reality and Future Trends

Abstract: New-type urbanization and rural revitalization have gradually become national strategies, and are an objective requirement for China to be able to enter into a new era of socialism with Chinese characteristics and also an inevitable result of the integration of new-type urbanization and rural development in the new stage. This paper reviews the classic theories and cognition of the research on urban–rural relations at home and abroad, and outlines the stage evolution characteristics of urban–rural relations in China. It is believed that urban-biased urbanization has widened the development gap between urban and rural areas since reform and opening up. Under the guidance of the two strategies of new-type urbanization and rural revitalization, urban and rural areas have transitioned from “one-way flow” to “bilateral interaction”, and from “urban bias” to “urban–rural integration”. This paper puts forward a research framework and scientific issues regarding the integration of new-type urbanization and rural revitalization from multidisciplinary perspectives. The integration of these two major strategies will contribute to a new situation of the coordinated and high-quality development of urban and rural areas in the new era.

Rural-urban and within-rural differences in COVID-19 vaccination rates.

Abstract: Purpose COVID-19 mortality rates are higher in rural versus urban areas in the United States, threatening to exacerbate the existing rural mortality penalty. To save lives and facilitate economic recovery, we must achieve widespread vaccination coverage. This study compared adult COVID-19 vaccination rates across the US rural-urban continuum and across different types of rural counties. Methods We retrieved vaccination rates as of August 11, 2021, for adults aged 18+ for the 2,869 counties for which data were available from the CDC. We merged these with county-level data on demographic and socioeconomic composition, health care infrastructure, 2020 Trump vote share, and USDA labor market type. We then used regression models to examine predictors of COVID-19 vaccination rates across the USDA's 9-category rural-urban continuum codes and separately within rural counties by labor market type. Findings As of August 11, 45.8% of adults in rural counties had been fully vaccinated, compared to 59.8% in urban counties. In unadjusted regression models, average rates declined monotonically with increasing rurality. Lower rural rates are explained by a combination of lower educational attainment and higher Trump vote share. Within rural counties, rates are lowest in farming and mining-dependent counties and highest in recreation-dependent counties, with differences explained by a combination of educational attainment, health care infrastructure, and Trump vote share. Conclusion Lower vaccination rates in rural areas is concerning given higher rural COVID-19 mortality rates and recent surges in cases. At this point, mandates may be the most effective strategy for increasing vaccination rates.

Assessment of the sustainable development of rural minority settlements based on multidimensional data and geographical detector method: A case study in Dehong, China

Abstract: In a developing country, paying attention to the sustainable development of rural areas is conducive to the development of the entire country. Ethnic minority areas are an important part of China's economic and social development. Owing to a lack of relevant statistical data, most previous studies in this area have focused on the sustainable development of rural areas or the development of ethnic minorities, but have not studied the sustainable development of rural ethnic minorities. The development of rural ethnic minorities is worthy of attention. In this study, we took Dehong as the study area. First used toponyms to accurately identify the rural minority areas and then calculated a grid of settlement density. Second, we considered the digital number (DN) value of the visible infrared imaging radiometer suite (VIIRS) as a measure of the development of the region and digital elevation model (DEM), net primary productivity (NPP), normalized difference vegetation index (NDVI), and gross domestic product (GDP) data as the indicators of terrain, climate, ecological, and economic factors, respectively. Finally, linear regression and the geographical detector method were used to determine the weight of the factors for constructing a sustainable development index (SDI) to quantitatively analyze the sustainable development and influencing factors of each minority nationality. The factors evaluated using linear regression and the geographical detector method were ranked as follows: NDVI > elevation > GDP > slope > NPP > settlement density. The results demonstrate that of the five main ethnic minorities in Dehong, Dai and Jingpo have higher SDI, followed by Achang, Lisu and De'ang. In addition, we provide some suggestions for ethnic minorities in Dehong.

The Intersection of Rural Residence and Minority Race/Ethnicity in Cancer Disparities in the United States.

Abstract: One in every twenty-five persons in America is a racial/ethnic minority who lives in a rural area. Our objective was to summarize how racism and, subsequently, the social determinants of health disproportionately affect rural racial/ethnic minority populations, provide a review of the cancer disparities experienced by rural racial/ethnic minority groups, and recommend policy, research, and intervention approaches to reduce these disparities. We found that rural Black and American Indian/Alaska Native populations experience greater poverty and lack of access to care, which expose them to greater risk of developing cancer and experiencing poorer cancer outcomes in treatment and ultimately survival. There is a critical need for additional research to understand the disparities experienced by all rural racial/ethnic minority populations. We propose that policies aim to increase access to care and healthcare resources for these communities. Further, that observational and interventional research should more effectively address the intersections of rurality and race/ethnicity through reduced structural and interpersonal biases in cancer care, increased data access, more research on newer cancer screening and treatment modalities, and continued intervention and implementation research to understand how evidence-based practices can most effectively reduce disparities among these populations.

Providing diagnosis on diabetes using cloud computing environment to the people living in rural areas of India

Abstract: Diabetes is one of the major diseases prevalent today affecting around 400 million people worldwide. Approximately one in ten adult people worldwide have diabetes. Unfortunately, about half of them live in rural areas and are not aware about the severity of the disease. Treatment of diabetes is feasible, but also challenging and expensive. Our contribution is to develop a reference model in assisting rural people suffering from diabetes. It helps the rural people of India in characterizing the victims of diabetes 2 at the earlier stages. This model improves the communication and interaction between patients and doctors. The target of analysis made in the present research is to list the risks factors and correlation that exist among those risk factors. In this work, logistic regression, support vector machine, random forest, decision tree, Naive Bayes, K nearest neighbor classifiers are used for prediction, and their accuracy is compared to choose the better machine learning model. SVM provides higher accuracy (96.0) among the choosen algorithms.

Global mapping of urban-rural catchment areas reveals unequal access to services.

Abstract: Using travel time to cities of different sizes, we map populations across an urban–rural continuum to improve on the standard dichotomous representations of urban–rural interactions. We extend existing approaches by 1) building on central place theory to capture the urban hierarchy in access to services and employment opportunities provided by urban centers of different sizes, 2) defining urban–rural catchment areas (URCAs) expressing the interconnection between urban centers and their surrounding rural areas, and 3) adopting a global gridded approach comparable across countries. We find that one-fourth of the global population lives in periurban areas of intermediate and smaller cities and towns, which challenges the centrality of large cities in development. In low-income countries, 64% of the population lives either in small cities and towns or within their catchment areas, which has major implications for access to services and employment opportunities. Intermediate and small cities appear to provide catchment areas for proportionately more people gravitating around them than larger cities. This could indicate that, for countries transitioning to middle income, policies and investments strengthening economic linkages between urban centers and their surrounding rural areas may be as important as investing in urbanization or the rural hinterlands. The dataset provided can support national economic planning and territorial development strategies by enabling policy makers to focus more in depth on urban–rural interactions.

Can Social Innovation Make a Change in European and Mediterranean Marginalized Areas? Social Innovation Impact Assessment in Agriculture, Fisheries, Forestry, and Rural Development

Abstract: Social innovation (SI) impacts are long-term changes that affect different dimensions of territorial capital (i.e., economy, society, environment, governance) for the territory in which SI occurs. Yet, systematic empirical evidence and theoretically sound assessments of the impacts of SI are scarce. This paper aims to fill the gap and assess the different aspects of SI’s impacts in European and Mediterranean areas that are characterized by marginalization processes. To assess the impacts of SI in marginalized areas, we use the evaluation framework developed within the Social Innovation in Marginalized Rural Areas (SIMRA) Horizon 2020 project and apply it to nine SI initiatives related to the fields of agriculture, fisheries, forestry, and rural development. Our findings show that SI produces cross-sectoral (societal, economic, environmental, and governmental) and multi-level impacts (on individuals, community, and society), which have improved the societal well-being, and contributed to the reduction of certain forms of marginality, mainly inside the territory in which SI occurred.

Rural-Urban Disparity in Mortality in the US From 1999 to 2019

Abstract: This study analyzes all deaths occurring in the US using the US Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database from 1999-2019 and the National Center for Health Statistics Urban-Rural Classification Scheme to create population categories per the 2013 US Census classification (large, small- or medium-sized, and rural areas).