Unravelling the extent of inequalities in health across urban and rural areas: Evidence from a national sample in England

Abstract

Studies of inequalities in health between rural and urban settings have produced mixed and sometimes conflicting results, depending on the national setting of the study, the level of geographic detail used to define rural areas and the health indicators studied. By focusing on morbidity data from a national sample of individuals, this study aims to examine the extent of inequalities in health between urban and rural areas, as well as inequalities in health across rural areas of England. Multilevel analyses for poor self-rated health, overweight and obesity, and common mental disorders are reported for a sample of 30,776 individuals aged 18 years and older (obtained from the Health Survey for England years 2000-2003 combined) and distributed across 3645 small areas classed in four categories: two groups of urban areas (Greater London area or 'other cities') and two types of rural settings (semi-rural areas or villages). Results show that rural dwellers were significantly less likely than residents of urban areas to report their health as being fair or poor and to report common mental disorders, independent of their socio-demographic characteristics. However, as for urban settlements, there were significant variations in health across semi-rural areas and across villages, indicating the presence of health inequalities within rural settings in England. These inequalities were not fully explained by the individual composition of the areas or by the available measures of area socioeconomic conditions, indicating that in rural

Socioeconomic Influence on Caries Susceptibility in Juvenile Individuals with Limited Dental Care: Example from an Early Middle Age Population (Great Moravia, 9th-10th Centuries A.D., Czech Republic)

“…To our point of view, in past population, we should take into account the global lifestyle rather than searching to define a clear socioeconomic status. Besides we found in our last studies clear differences between rural and urban lifestyle, what was confirmed by many studies (Betsinger, 2007;Budnik & Liczbinska, 2006;Riva et al, 2009;Van de Poel et al, 2007;Williams & Galley, 1995). We also must take in mind that in past population, we must deal with the "osteological paradox" (Byers, 1994;Wood et al, 1992;Wright & Yoder, 2003).…”

Towards an understanding of the relationship of functional literacy and numeracy to geographical health inequalities

“…These linkages are better established for deprivation (Williams, 2003;Jama andDugdale, 2012: Marmot et al, 2010). Evidence on associations with regard to rurality is more mixed (Riva et al, 2009). Smith et al (2008), in an international comparative review, note that rurality can link to access to and provision of health services but may not confer health disadvantage, while Midouhas and Flouri (2013) suggest that UK children do not vary in numeracy skills with respect to urban or rural residence but reading age tends to be higher in major urban areas.…”

Prevalence of life-limiting conditions in children and young people in England: Time trends by area type

“…Geographic inequalities in health are regularly found in the UK (Thomas et al, 2010;Norman et al, 2011), with different levels of mortality and self-reported health found in rural and urban areas (Levin and Leyland, 2005;Levin, 2003;Riva et al, 2009;Riva et al, 2011) and in deprived and more affluent areas (Rees et al, 2003;Shaw et al, 2004;Norman et al, 2005;Romeri et al, 2006). Whilst levels of infant mortality are steadily reducing in England and Wales, gradients across differently deprived areas largely persist (Norman et al, 2008).…”