Widening Rural–Urban Disparities in Life Expectancy, U.S., 1969–2009

Singh, Gopal K.; Siahpush, Mohammad

doi:10.1016/j.amepre.2013.10.017

Cited by 372 publications

(338 citation statements)

References 25 publications

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“…2,[11][12][13] There is also concern that community-level factors including living environment, community context, distance to providers, and local economic prospects could influence hospital mortality. 14 -16 Community factors such as the number of primary care doctors per capita, and the average proportion of high-risk, long-stay nursing home patients have been demonstrated to explain over half of the variability in hospital readmission rates between counties, but it is not clear how these factors relate to recent trends in hospital mortality.…”

Section: Discussionmentioning

confidence: 99%

Worsening Rural-Urban Gap in Hospital Mortality

2017

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Background: One out of every 5 Americans live in rural communities. Rural Americans have higher rates of early and preventable deaths outside of the hospital than their urban counterparts. How rurality relates to hospital mortality is unknown. We sought to determine the association between rural versus urban residence and hospital mortality.Methods: This is a retrospective observational study of 4,412,942 nonmaternal, nonneonatal hospitalizations in 2008, and 3899,464 nonmaternal, nonneonatal hospitalizations in 2013 using all-payer, all-age data from the National Inpatient Sample of the Health care Cost and Utilization Project. Using multivariable logistic regression, we report the association between rural versus urban location of residence and hospital mortality, adjusting for chronic disease burden, age, income, and insurance status.Results: The unadjusted probability of hospital mortality for urban patients decreased from 2.51% (95% CI ,

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Section: Discussionmentioning

confidence: 99%

Worsening Rural-Urban Gap in Hospital Mortality

2017

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“…Examining life expectancy alone shows an almost 2.5 year imbalance in years lived, with those residing in metropolitan areas having a life expectancy of 79.1 years as compared to 76.7 years among those residing in rural areas [1].…”

Section: Introductionmentioning

confidence: 99%

Meeting Recommended Levels of Physical Activity and Health-Related Quality Of Life in Rural Adults

Hart¹

2015

Medicine &Amp; Science in Sports &Amp; Exercise

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Background: Little is known about physical activity (PA) and health-related quality of life (HRQOL) among rural adults.The purpose of this study was to investigate the relationship between meeting recommended levels of PA and HRQOL in a rural adult population.Methods: This study analyzed data from 6,103 rural adults 18 years of age and older participating in a 2013 survey.Respondents reporting at least 150 minutes a week of moderate-intensity (or moderate-vigorous combination) PA during the past month were categorized as meeting PA guidelines. Five health variables were used to assess HRQOL. A continuous HRQOL ability score was also created using item response theory (IRT).Results: Rural adults who met recommended levels of PA were significantly more likely to report good HRQOL in adjusted models of physical health (OR: 1.99; 95% CI: 1.54-2.56), mental health (OR: 1.96; 95% CI: 1.46-2.64), inactivity health (OR: 2.14; 95% CI: 1.54-2.97), general health (OR: 1.69; 95% CI: 1.35-2.13), and healthy days (OR: 1.98; 95% CI: 1.58-2.47), compared to those who did not meet recommended levels. Furthermore, rural adults meeting recommended levels of PA also had a significantly greater HRQOL ability score (51.7 ± 0.23, Mean ± SE), compared to those not meeting recommended levels (48.4 ± 0.33, p ＜ .001).Conclusion: This study found that meeting recommended levels of PA increases the likelihood of reporting good HRQOL in rural adults. These results should be used to promote the current PA guidelines for improved HRQOL in rural populations.

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“…Several studies have reported higher lung function in specific nonnative ethnic groups born and living in developed countries as opposed to first-generation immigrants or those residing in their native country (16,17). Gaps in health-related outcomes between the rich and poor are large, with widening urban-rural disparities in life expectancy (18), particularly in developing countries such as India (19). Few studies have investigated disparities in lung health in healthy children across the urban-rural continuum with different socioeconomic and environmental exposures that could affect lung development (20,21).…”

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confidence: 99%

Disparities in Pulmonary Function in Healthy Children across the Indian Urban–Rural Continuum

Sonnappa

Lum²,

Kirkby³

et al. 2015

Am J Respir Crit Care Med

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Rationale: Marked socioeconomic health-care disparities are recognized in India, but lung health inequalities between urban and rural children have not been studied.Objectives: We investigated whether differences exist in spirometric pulmonary function in healthy children across the Indian urban-rural continuum and compared results with those from Indian children living in the UK.Methods: Indian children aged 5 to 12 years were recruited from Indian urban, semiurban, and rural schools, and as part of the Size and Lung Function in Children study, London. Anthropometric and spirometric assessments were undertaken.Measurements and Main Results: Acceptable spirometric data were obtained from 728 (58% boys) children in India and 311 (50% boys) UK-Indian children. As an entire group, the India-resident children had significantly lower z FEV 1 and z FVC than UK-Indian children (P , 0.0005), when expressed using Global Lung FunctionInitiative-2012 equations. However, when India-resident children were categorized according to residence, there were no differences in z FEV 1 and z FVC between Indian-urban and UK-Indian children. There were, however, significant reductions of z0.5 z scores and 0.9 z scores in both FEV 1 and FVC (with no difference in FEV 1 /FVC) in Indian-semiurban and Indian-rural children, respectively, when compared with Indian-urban children (P , 0.0005). z Body mass index, socioeconomic circumstances, tobacco, and biomass exposure were individually significantly associated with z FEV 1 and z FVC (P , 0.0005). Conclusions:The presence of an urban-rural continuum of lung function within a specific ethnic group emphasizes the impact of environmental factors on lung growth in emerging nations such as India, which must be taken into account when developing ethnic-specific reference values or designing studies to optimize lung health.

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Widening Rural–Urban Disparities in Life Expectancy, U.S., 1969–2009

Cited by 372 publications

References 25 publications

Worsening Rural-Urban Gap in Hospital Mortality

Worsening Rural-Urban Gap in Hospital Mortality

Meeting Recommended Levels of Physical Activity and Health-Related Quality Of Life in Rural Adults

Disparities in Pulmonary Function in Healthy Children across the Indian Urban–Rural Continuum

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