A meta-analysis of human health differences in urban and rural environments

Abstract

Human health outcomes are known to be affected not only by individual physical and socio-economic status, but also by external environmental conditions, as well as by place-based economic and geographical circumstances. In recent decades, a large number of studies have addressed the background of differences in health outcomes between rural and urban areas. Are rural ways of living healthier than urban ways of living? This has led to a wealth of studies on human health and the geographical differences of living and working. The effects of regional or urban characteristics on health outcomes are often inconsistent among different studies/countries. An important factor that seems to be important is the ambiguous definition of both health and urbanism, as well as the presence of intra-regional heterogeneity (e.g. inner-city areas). In the present study, we conduct a systematic review of the existing literature on space and health indicators, based on a broad, but concise overview of the underlying mechanisms involved. Next, we provide a quantitative research synthesis with the help of a meta-analysis of published studies on self-rated/self-reported physical health conditions in rural and urban areas. The results from our meta-analytical regression analysis indicate that there is not a clearly convincing difference between rural and urban areas; however, people in rural areas appear to rate themselves slightly healthier than their urban counterparts. In addition, we observe that self-rated/reported fair/poor health is also highly dependent on a number of personal and socio-economic factors; from a personal perspective, education, addiction, physical activity, and duration of residence appear to play a significant role, while, from a socio-economic perspective, in particular, community predictor measures (e.g. gross domestic product, population, unemployment rate) appear to exert a substantial influence.