Urban–Rural Inequalities in Ischemic Heart Disease in Scotland, 1981–1999

Levin, Kate Ann; Leyland, Alastair H.

doi:10.2105/ajph.2004.051193

Cited by 32 publications

(34 citation statements)

References 27 publications

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“…Indeed studies have shown that limiting long term illnesses (LLTI) are more prevalent in more remote rural areas in the South West (Barnett, Roderick, Martin, & Diamond, 2001) and the East of England (Haynes & Gale, 2000) than in rural areas located on the urban fringe. Similar within-rural variations regions were also observed for overall mortality (Bentham, 1984) and for the risk of ischemic heart disease mortality in the hospital or within 28 days of discharge (Levin & Leyland, 2006a). Other studies have reported variation in LLTI (Levin, 2003) and mental health (Weich et al, 2006) across rural areas but this variation was generally smaller than that observed across urban areas.…”

Section: Introductionsupporting

confidence: 63%

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

Riva

Curtis

Gauvin

et al. 2009

Social Science & Medicine

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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

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Section: Introductionsupporting

confidence: 63%

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

Riva

Curtis

Gauvin

et al. 2009

Social Science & Medicine

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“…Therefore, we performed analyses that examined the association between time to transplantation and distance from the closest transplant center after stratifying on these potential confounders. The time to transplantation was not significantly lower among remote dwellers for any of these subgroups than for those (14) 4862 (14) 3812 (14) 511 (15) 572 (16) (1) 1580 (1) 1908 (2) 1021 (3) 1746 (6) 508 (14) 440 (13) Other 20 096 (6) 8161 (5) 1746 (2) 549 (2) 649 (2) 49 (1) (14) 5097 (15) 3845 (14) 529 (15) 501 (14) Ͻ.001 CVD 24 275 (7) 12 676 (7) 8754 (8) 3020 (9) 2139 (8) 290 (8) (6) 1938 (7) 240 (7) 643 (19) Abbreviations: BMI, body mass index, calculated as weight in kilograms divided by height in meters squared; CAD, coronary artery disease; CHF, congestive heart failure; COPD, chronic obstructive pulmonary disease; CVD, cerebrovascular disease; eGFR, estimated glomerular filtration rate; ESRD, end-stage renal disease; PVD, peripheral vascular disease; RUCA, rural-urban commuting area. Conversion factor: To convert miles to kilometers, multiply by 1.6. a Totals do not always add to 100% because of rounding.…”

Section: Likelihood Of Transplantation By Distance Categorymentioning

confidence: 99%

Access to Kidney Transplantation Among Remote- and Rural-Dwelling Patients With Kidney Failure in the United States

Tonelli

Klarenbach²,

Rose³

et al. 2009

JAMA

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“…The results presented were for a unit change in deprivation as measured by the SIMD score divided by ten, with the assumption that each additional unit carries an equivalent effect. Rurality was included as a categorical variable as defined by the 2008 Scottish Household Survey urban-rural classification (35) and used in similar analyses elsewhere (13)(14)(15)36) . Of the original 3577 young people surveyed, 894 (25 %) were excluded due to missing postcode information, 54 % boys and 46 % girls.…”

Section: Explanatory Variablesmentioning

confidence: 99%

Urban–rural differences in adolescent eating behaviour: a multilevel cross-sectional study of 15-year-olds in Scotland

Levin

2013

Public Health Nutr.

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Objective: Improving the diet of the Scottish population has been a government focus in recent years. Population health is known to vary between geographies; therefore alongside trends and socio-economic inequalities in eating behaviour, geographic differences should also be monitored. Design: Eating behaviour data from the 2010 Scotland Health Behaviour in School-aged Children survey were modelled using multilevel linear and logistic modelling. Setting: Data were collected in schools across urban and rural Scotland. Subjects: Schoolchildren aged 15 years. Results: Adolescents living in remote rural Scotland had the highest consumption frequency of vegetables (on average consumed on 6?68 d/week) and the lowest consumption frequency of sweets and crisps (on 4?27 and 3?02 d/week, respectively). However, it was not in the major four cities of Scotland (Glasgow, Edinburgh, Dundee and Aberdeen) but in the geography described by the classification 'other urban' areas (large towns of between 10 000 and 125 000 residents) that adolescents had the poorest diet. Deprivation and rurality were independently associated with food consumption for all but fruit consumption. Sharing a family meal, dieting behaviour, food poverty and breakfast consumption did not differ by rurality. Variance at the school level was significant for fruit and vegetable consumption frequencies and for irregular breakfast consumption, regardless of rurality. Conclusions: Young people from rural areas have a healthier diet than those living in urban areas. The eating behaviours examined did not explain these differences. Future research should investigate why urban-rural differences exist for consumption frequencies of 'healthy' and 'unhealthy' foods. Keywords Urban-rural Eating behaviour Adolescent ScotlandThe Scottish Government, in accordance with international guidelines such as the WHO Global Strategy on Diet, Physical Activity and Health (1) and the WHO 2008-2013 Action Plan for the Global Strategy for the Prevention and Control of Noncommunicable Diseases (2) , has in recent years prioritised improving the diet of the Scottish population by increasing healthy eating and reducing unhealthy eating (3)(4)(5) . As with many health outcomes, however, some members of the population fare better than others. Within Scotland, gender and age differences have been shown in eating behaviour, with fruit and vegetable consumption more prevalent among girls and younger children, and sweets, chips and crisps consumption less prevalent (6) . Socio-economic inequalities in health have also been shown for many adolescent outcomes in Scotland and have widened over time for both adult (7,8) and adolescent health measures (9,10) . A recent study of adolescent eating behaviour showed that socio-economic inequalities in adolescent eating habits exist in Scotland, with those from higher social class reporting a more favourable diet (11) . Scotland has a population of approximately 5 250 000 with a land mass of 78 772 km 2 , resulting in a relatively low average...

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Urban–Rural Inequalities in Ischemic Heart Disease in Scotland, 1981–1999

Cited by 32 publications

References 27 publications

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

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

Access to Kidney Transplantation Among Remote- and Rural-Dwelling Patients With Kidney Failure in the United States

Urban–rural differences in adolescent eating behaviour: a multilevel cross-sectional study of 15-year-olds in Scotland

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