Self-reported health in urban–rural continuum: a grid-based analysis of Northern Finland Birth Cohort 1966

Lankila, Tiina; Näyhä, Simo; Rautio, Arja; Nordström, Tanja; Koiranen, Markku; Taanila, Anja; Rusanen, Jarmo

doi:10.1007/s00038-011-0286-0

Cited by 15 publications

(10 citation statements)

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“…In urban areas, income is less irregular than in rural areas, and sanitation, preventive medicine and health care are all more available [ 39 ]. However, as regards SRH, studies comparing urban and rural areas are rarer: studies carried out in Korea [ 40 ], Ghana [ 41 ] and Finland [ 42 ] show that rural dwellers are more likely to report they are in ill health than urban dwellers, which is consistent with the lower mortality observed in the latter environment.…”

Section: Introductionmentioning

confidence: 81%

Self-rated health in Senegal: A comparison between urban and rural areas

Duboz¹,

Boëtsch²,

Guéye³

et al. 2017

PLoS ONE

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IntroductionAlthough the relationship between mortality and self-rated health has been demonstrated in sub-Saharan Africa, information in this area is rudimentary. In Senegal, no study has been undertaken comparing self-rated health between urban and rural areas. The objective of this study is therefore to compare self-rated health and its main predictors in Dakar and in a rural isolated area, Tessekere municipality, taking into account socio-demographic and economic factors, social relations, as well as measures of physical and mental health.Material and methodsThis study was carried out in 2015 on a population sample of 1000 individuals living in Dakar and 500 individuals living in the municipality of Tessekere, constructed using the quota method. Self-rated health, health variables, psychosocial, sociodemographic and economic characteristics were collected during face-to-face interviews. Statistical analyses used were Chi-square tests and binary logistic regressions.ResultsResults show that self-rated health in Senegalese urban area (Dakar) is better than in rural area (Tessekere), but the determinants of self-rated health partly differ between these two environments. Age and gender play a fundamental role in self-rated health as much in Dakar as in Tessekere but diabetes and social support play a role in self-rated health only in urban environment, whereas economic well-being is associated to self-rated health only in rural area.ConclusionThe analyses carried out in these two environments show that despite the existence of common determinants (age, gender, stress), the determinants for formulating an answer to the question of self-rated health differ. People’s social and cultural environments thus play a fundamental role in the process of rating one’s health and, in the short and long term, in the mortality rate.

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Section: Introductionmentioning

confidence: 81%

Self-rated health in Senegal: A comparison between urban and rural areas

Duboz¹,

Boëtsch²,

Guéye³

et al. 2017

PLoS ONE

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“…Numerous empirical studies indicate the continuation of such a trend, with illness and mortality levels steadily increasing with levels of urbanisation (Chilvers, ; DEFRA, ; Kyte & Wells, ). In contrast, an alternative stream of research has argued that the rural idyll is progressively becoming a myth, as rural communities come to face issues impinging upon their health (Lankila et al, ). The hypothesis of a U‐shaped health continuum has also been proposed, with rural areas and large cities experiencing relatively poor health outcomes, compared to suburban and semirural areas, which lie in the middle (Barnett, Roderick, Martin, & Diamond, ).…”

Section: Introductionmentioning

confidence: 99%

Unravelling urban–rural health disparities in England

Allan

Williamson

Kulu

2017

Population Space and Place

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Previous research shows significant health and mortality variations by residential context. Numerous studies report better health and lower mortality among rural populations in comparison to urban residents, whereas other research shows the opposite, with poor health and high mortality in rural areas. This study investigates health variations in England by residential contexts and the causes of such differences. Further, it examines the sensitivity of results to different rural–urban classifications. Applying logistic regression models to individual‐level data from the 2001 UK census we demonstrate significant health variation by residential context. A clear urban–rural positive health gradient is apparent, with levels of ill health increasing parallel to levels of urbanisation. Briefly, people living in rural areas have better health than those living in cities and other urban contexts. However, the capital city (London) provides an exception to the gradient, with its inhabitants having better health than anticipated. Once we control for individual sociodemographic characteristics, including occupational status and educational level, the urban–rural health variations are reduced, but significant differences still persist. Most notably, Outer London residents have health expectations similar to those residing in the most rural locations. Clearly, our results support the existence of a positive urban–rural health gradient, with the exception of a protective “capital city” effect. These findings persist regardless of the precise urban–rural classification used. Finally we show that, having accounted for composition and the rural–urban context, there still remains a North–South divide in health outcomes.

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“…Some studies disagree with the concept of a rural advantage altogether, suggesting a negative association between health and rurality. Lankila et al (2012) go as far as to suggest that health decreases inversely to population density. Poor self rated health, LLTI's and age adjusted mortality rates were found to be inflated within the rural context of northern Finland, persisting once socio-demographic factors had been controlled.…”

Section: Urban-rural Health Gradientmentioning

confidence: 98%

“…Others propose the theory of a U-shaped health continuum, with large cities and remote rural locations experiencing poor health outcomes compared to suburban and semi-rural locations (Barnett et al, 2001;Levin, 2003). Finally, some studies refute the concept of a healthy rural population altogether, suggesting a negative urban-rural health gradient (e.g., Lankila et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Gendered mortality differentials over the rural-urban continuum: The analysis of census linked longitudinal data from England and Wales

Allan

Williamson

Kulu

2019

Social Science & Medicine

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Background. Previous research shows that mortality varies significantly by residential context; however, the nature of this variation is unclear. Some studies report higher mortality levels in urban compared to rural areas, whereas others suggest elevated mortality in rural areas or a complex U-shaped relationship. Further, it also remains unclear the extent to which compositional factors explain urban-rural mortality variation, the extent to which contextual factors play a role and whether and how the patterns vary by gender. This study investigates urban-rural mortality variation in England and Wales and the causes of this variation. Method. The study applies survival analysis to the Office for National Statistics Longitudinal Study. Population aged 20 and older in 2001 are followed 10 years. Results and Conclusions. The analysis shows a clear urban-rural mortality gradient, with the risk of dying increasing with each level of urbanisation. The exceptions are those living in areas adjacent to London who consistently exhibit lower mortality than anticipated. Once the models are adjusted to individuals' socioeconomic characteristics, the variation across the urban-rural continuum reduces substantially, yet the gradient persists suggesting contextual effects. Females are found to be influenced more by their surrounding environment and males by their socioeconomic position, although both experience lower mortality in rural compared to urban areas.

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Self-reported health in urban–rural continuum: a grid-based analysis of Northern Finland Birth Cohort 1966

Abstract: Poor self-reported health is associated with individual's residential area type, with the lowest occurrence in high-rise centres and higher elsewhere. The difference is likely explained, at least partly, by a complex of psychosocial factors, possibly different for women and men.

Cited by 15 publications

References 30 publications

Self-rated health in Senegal: A comparison between urban and rural areas

Self-rated health in Senegal: A comparison between urban and rural areas

Unravelling urban–rural health disparities in England

Gendered mortality differentials over the rural-urban continuum: The analysis of census linked longitudinal data from England and Wales

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