Differences in Social Isolation and Its Relationship to Health by Rurality

Henning‐Smith, Carrie; Moscovice, Ira; Kozhimannil, Katy B.

doi:10.1111/jrh.12344

Cited by 115 publications

(104 citation statements)

References 39 publications

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“…Although rural women were slightly older, urban patients presented higher comorbidity and reported more social isolation. This last finding concurs with a previous study reporting that in a rural environment it is easier to rely on family members 24 .…”

Section: Discussionsupporting

confidence: 93%

Effect of the Place of Living on Mortality in Patients with Advanced Heart Failure

Muñoz

García

Navas

et al. 2020

Preprint

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BackgroundSocial and environmental factors in advanced heart failure (HF) patients may be crucial to cope with the end stages of the disease. This study analyzes health inequalities and mortality according to place of residence (rural vs urban) in HF patients at advanced stages of the disease.MethodsPopulation-based cohort study including 1148 adult patients with HF attended in 279 primary care centers. Patients were followed for at least one year after reaching New York Heart Association IV, between 2010 and 2014.Data came from primary care electronic medical records. Cox regression models were applied to determine the hazard ratios (HR) of mortality.ResultsMean age was 81.6 (SD 8.9) years, and 62% were women. Patients in rural areas were older, particularly women aged >74 years (p=0.036), and presented lower comorbidity. Mortality percentages were 59% and 51% among rural and urban patients, respectively (p=0.030). Urban patients living in the most socio-economically deprived neighborhoods presented the highest rate of health service utilization, particularly with primary care nurses (p-trend <0.001). Multivariate analyses confirmed that men (HR 1.60, 95% confidence interval (CI) 1.34-1.90), older patients (HR 1.05, 95% CI 1.04-1.06), Charlson comorbidity index (HR 1.16, 95% CI 1.11-1.22), and residing in rural areas (HR 1.35, 95% CI 1.09 to 1.67) was associated with higher mortality risk.ConclusionsLiving in rural areas determines an increased risk of mortality in patients at final stages of heart failure.

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Section: Discussionsupporting

confidence: 93%

Effect of the Place of Living on Mortality in Patients with Advanced Heart Failure

Muñoz

García

Navas

et al. 2020

Preprint

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“…with a previous study reporting that in a rural environment it is easier to rely on family members [26].…”

Section: Discussionmentioning

confidence: 85%

Relationship between the place of living and mortality in patients with advanced heart failure

et al. 2020

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Background: Social and environmental factors in advanced heart failure (HF) patients may be crucial to cope with the end stages of the disease. This study analyzes health inequalities and mortality according to place of residence (rural vs urban) in HF patients at advanced stages of the disease. Methods: Population-based cohort study including 1148 adult patients with HF attended in 279 primary care centers. Patients were followed for at least 1 year after reaching New York Heart Association IV functional class, between 2010 and 2014. Data came from primary care electronic medical records. Cox regression models were applied to determine the hazard ratios (HR) of mortality. Results: Mean age was 81.6 (SD 8.9) years, and 62% were women. Patients in rural areas were older, particularly women aged > 74 years (p = 0.036), and presented lower comorbidity. Mortality percentages were 59 and 51% among rural and urban patients, respectively (p = 0.030). Urban patients living in the most socioeconomically deprived neighborhoods presented the highest rate of health service utilization, particularly with primary care nurses (p-trend < 0.001). Multivariate analyses confirmed that men (HR 1.60, 95% confidence interval (CI) 1.34-1.90), older patients (HR 1.05, 95% CI 1.04-1.06), Charlson comorbidity index (HR 1.16, 95% CI 1.11-1.22), and residing in rural areas (HR 1.35, 95% CI 1.09 to 1.67) was associated with higher mortality risk. Conclusions: Living in rural areas determines an increased risk of mortality in patients at final stages of heart failure.

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“…Women living in underprivileged rural areas are more prone to suffer from mental disorders, including depression and anxiety [7] (In this paper, we have used the World Health Organisation's, hereinafter WHO, definition of mental health as "a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community" [8]. These disorders often derive from feelings of loneliness [9]-by the way, social isolation in rural areas has become an urgent public health issue [10]-difficult access to services, which prevents them from receiving the necessary support [11], and a negative self-perception [12].…”

Section: Introductionmentioning

confidence: 99%

Women’s Well-Being and Rural Development in Depopulated Spain

Palma

Lorent-Bedmar

2020

IJERPH

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The threat of depopulation in the rural areas making up what has become to be known as “empty Spain” is currently an extremely urgent national issue. Women are a fundamental pillar of rural sustainability, but the lack of decent living conditions has led to their mass exodus to the country’s cities. We analysed the factors undermining their health and well-being, thus leading to their dissatisfaction and their subsequent desire to abandon the countryside for a better life. A mixed methodology was employed, combining qualitative and quantitative data collection techniques. For data collection, an ad hoc questionnaire was developed before being administered to members of the Rural Development Groups of the Celtiberian Highlands, while some of their number were also interviewed. Rural women experience personal dilemmas that prompt them to migrate. These include choosing between living in the place where they were born, close to their families and neighbours, and a decent productive job, the availability of basic services and a broader range of leisure opportunities, among other aspects. It is essential to acknowledge the socio-economic importance of women’s work, to identify invisible burdens and their risks and to adopt measures that facilitate the reconciliation of work and family life.

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Differences in Social Isolation and Its Relationship to Health by Rurality

Cited by 115 publications

References 39 publications

Effect of the Place of Living on Mortality in Patients with Advanced Heart Failure

Effect of the Place of Living on Mortality in Patients with Advanced Heart Failure

Relationship between the place of living and mortality in patients with advanced heart failure

Women’s Well-Being and Rural Development in Depopulated Spain

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