Urban-rural differences in daily time-activity patterns, occupational activity and housing characteristics

Abstract

BackgroundThere is evidence that rural residents experience a health disadvantage compared to urban residents, associated with a greater prevalence of health risk factors and socioeconomic differences. We examined differences between urban and rural Canadians using data from the Canadian Human Activity Pattern Survey (CHAPS) 2.MethodsData were collected from 1460 respondents in two rural areas (Haldimand-Norfolk, Ontario and Annapolis Valley-Kings County, Nova Scotia) and 3551 respondents in five urban areas (Vancouver, Edmonton, Toronto, Montreal, and Halifax) using a 24-h recall diary and supplementary questionnaires administered using computer-assisted telephone interviews. We evaluated differences in time-activity patterns, occupational activity, and housing characteristics between rural and urban populations using multivariable linear and logistic regression models adjusted for design as well as demographic and socioeconomic covariates. Taylor linearization method and design-adjusted Wald tests were used to test statistical significance.ResultsAfter adjustment for demographic and socioeconomic covariates, rural children, adults and seniors spent on average 0.7 (p < 0.05), 1.2 (p < 0.001), and 0.9 (p < 0.001) more hours outdoors per day respectively than urban counterparts. 23.1 % (95 % CI: 19.0–27.2 %) of urban and 37.8 % (95 % CI: 31.2–44.4 %) of rural employed populations reported working outdoors and the distributions of job skill level and industry differed significantly (p < 0.001) between urban and rural residents. In particular, 11.4 % of rural residents vs. 4.9 % of urban residents were employed in unskilled jobs, and 11.5 % of rural residents vs. <0.5 % of urban residents were employ in primary industry. Rural residents were also more likely than urban residents to report spending time near gas or diesel powered equipment other than vehicles (16.9 % vs. 5.2 %, p < 0.001), more likely to report wood as a heating fuel (9.8 % vs. <0.1 %; p < 0.001 for difference in distribution of heating fuels), less likely to have an air conditioner (43.0 % vs. 57.2 %, p < 0.001), and more likely to smoke (29.1 % vs. 19.0 %, p < 0.001). Private wells were the main water source in rural areas (68.6 %) in contrast to public water systems (97.6 %) in urban areas (p < 0.001). Despite these differences, no differences in self-reported health status were observed between urban and rural residents.ConclusionsWe identified a number of differences between urban and rural residents, which provide evidence pertinent to the urban–rural health disparity.

Airborne Fine Particles and Risk of Hospital Admissions for Understudied Populations: Effects by Urbanicity and Short-Term Cumulative Exposures in 708 U.S. Counties

“…Lifestyle factors and activity patterns may also play a role: compared with nonurban residents, urban residents are more likely to engage in physical activity (Parks et al 2003). Research in Canada found that rural populations spent significantly more time working outdoors (Matz et al 2015). Such differences may affect not only susceptibility but also exposure levels.…”

“…Populations’ baseline health status and comorbidities (e.g., obesity), demographic and behavioral risk factors (e.g., tobacco use), and other factors differ between urban and nonurban communities. For example, rural communities have greater barriers to health care access (Vanasse et al 2010), higher rates of many chronic diseases (Eberhardt and Pamuk 2004; Hartley 2004), and different activity patterns (Matz et al 2015) than urban communities. Thus, PM 2.5 exposures and susceptibility may differ between urban and nonurban populations, but such differences are not captured in currently available health effect estimates.…”

A growing geographic disparity: Rural and urban cigarette smoking trends in the United States

“…Given the limited set of covariates used by Droescher and colleagues (2006), and the lack of controls in a visual comparison of unadjusted (except for age) plots from the chartbooks, it remains unclear whether there is a unique contribution from rural residence on cigarette use after controlling for a comprehensive set of potentially confounding covariates including outdoor labor (Matz et al, 2015), marital status (Lindström, 2010), substance abuse and mental health variables (Substance Abuse and Mental Health Services Administration, 2013), health insurance (Centers for Disease Control and Prevention, 2015), and smokeless tobacco use (Roberts et al, 2016), all of which are related to tobacco use, could vary between urban and rural populations, and should be controlled in a comparative rural versus urban analysis in addition to variables included in similar previous work (Droescher, 2006). …”

Rural‐Urban Difference in Workplace Supports and Impacts for Employed Caregivers

“…This may be more problematic for rural caregivers, however, given that they reported lower access to paid leave and being less able to work remotely. Additionally, given differences between rural and urban areas in income and industry, rural caregivers may be more likely to be dependent on hourly wages, where taking time off may have a more direct impact on one's take‐home pay. Employed caregivers in rural areas were less likely than urban caregivers to have turned down a promotion because of caregiving responsibilities (1.5% vs 6.5%); however, that difference may be as indicative of rural caregivers’ access to promotion and career ladders in the first place, as it is of the impact of caregiving.…”