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.

Highlights

  • There 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 evaluated potential sources of urban–rural disparities in health status, using the data collected in Canadian Human Activity Pattern Survey (CHAPS) 2, including daily time-activity patterns, occupational activity, and housing characteristics that may influence exposure to environmental and occupational hazards

  • Time-activity patterns For each age group, urban and rural populations reported spending a majority of daily time (>15 h/day) indoors at home (Fig. 1 and Table 1)

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Summary

Introduction

There 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. Life expectancy at birth is at least 2 yrs less for men in rural areas compared to urban areas and the risks of death from circulatory disease or respiratory disease are as much as 10 % higher in rural areas [1] This health disparity may be the result of differences in health risk factors, including health behaviours and socioeconomic status (SES) [1,2,3,4,5]. The Canadian Human Activity Pattern Survey (CHAPS) 2 was conducted by Health Canada to provide information on daily time-activity patterns, potential exposures to environmental contaminants, occupational activities, and housing characteristics [7]. While many studies are limited to urban areas, the target population for CHAPS 2 included residents from five major urban centres and two rural regions, allowing for comparisons between these groups to identify potential differences in risks or vulnerability

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