Definitions Of Rural Research Articles

Defining Rurality: Structural Relationships, Regional Differences, and Applications for Research With Older Adults

There is no universal definition of rurality due to the heterogeneity in what makes a place “rural” or “urban”. This study explored how elements of rurality are related to each other, and how the elements that define rurality vary by region. Data were abstracted for all 1948 non-metropolitan counties in the contiguous 48 states on rurality. K-means cluster analyses (k=4-8) were conducted to examine classification structures among component variables examining regional differences. In the South region, the majority (51.2%) were “Type 2” counties: low population size and density but higher urbanized population. The Midwest had a majority of “Type 3” counties (56.4%): intermediate for population size and density, but higher distances to metro areas. These exploratory findings underscore the heterogeneity and regional variability in rurality and how those measures are structurally related to each other, and essential to understanding those factors that truly drive rural-urban health disparities for older adults. Part of a symposium sponsored by the Rural Aging Interest Group.

Rurality as an analytic category: implications for public health.

Rurality as a concept was originated within the framework of the migration phenomena of the nineteenth century. During the post-war period, a dichotomic approach was established for this concept, along with the emerging notion of growth, which influenced the economic models of multiple countries worldwide. However, during the last 50 years, the rurality concept acquired a polysemic nature. Thus, the main objective of this article is analyzing several definitions of rurality from the perspective of some subdisciplines of the social sciences and their lines of thought to evaluate their implications for public health within different contexts.

Influence of the definition of rurality on geographic differences in HIV outcomes in British Columbia: a retrospective cohort analysis.

Improving rural health is often identified as a priority area for research and policy in Canada. We examined how findings on HIV outcomes (virologic suppression) can vary depending on the definition of rurality used. We performed retrospective cohort analyses using the Comparative Outcomes and Service Utilization Trends study population-based cohort of adults (age ≥ 19 yr) living with HIV in British Columbia between Apr. 1, 2012, and Mar. 31, 2013. We performed univariate logistic regression analyses using the following geographic variables to predict HIV virologic suppression: rurality defined by forward sortation area, by Statistical Area Classification and by health authority. We mapped suppression using geographic information systems. Virologic suppression was observed in 5605 (65.2%) of 8598 participants. In univariate analysis, rurality defined by Statistical Area Classification (odds ratio [OR] 0.73, 95% confidence interval [CI] 0.65-0.82), but not by forward sortation area, was associated with lower odds of suppression. When we examined suppression by health authority, Northern Health had the lowest odds of suppression (OR 0.46, 95% CI 0.36-0.58 compared to Vancouver Coastal Health). Geographic information systems mapping showed poorer suppression in northern areas. Health outcome findings can vary depending on the definition of the geographic variable. When including geographic variables, researchers should carefully consider variable definitions and whether other classification systems, such as north-south, are more appropriate than rurality for their analysis.

Getting rurality right: Investigating cancer across the rural-urban interface.

e19063 Background: Trends in oncology examine the influence of rural characteristics on cancer patient (pt) treatment and outcomes. Current definitions of rurality are broad and varied, with multiple standardized definitions. Few analyses exist to compare definitions and quality in assessing oncologic outcomes. We aim to determine which index is most suitable to define rurality in cancer research. Methods: 1,567 pancreatic cancer pts from the University of Wisconsin Cancer Registry, representing 84 Midwestern counties and 452 zip codes, were assigned rurality codes based on three indices spanning 1983-2013: Rural-Urban Continuum Code (RUCC), Rural-Urban Commuting Areas (RUCA), and Index of Relative Rurality (IRR). RUCC and IRR were assigned to pts at the county level and RUCA at the zip level. Pt rurality was compared across the three indices and over time via the median and interquartile range and inspected visually with violin plots. We compared indices with Spearman’s Rank Order Correlation (SROC). Results: RUCC 2003, RUCA 2004 (zip), and IRR 2000 were concordant in terms of metropolitan, micropolitan, and rural designations for 66.9% (1,049) of pancreatic cancer registry pts. The rural designation for almost one-third (489, 31.2%) of pts was discordant by one or two levels across the three indices (i.e. classified as metropolitan in one index and micropolitan or rural in another). SROC was 0.73 between RUCC 2003 and RUCA 2004 (zip) indices, 0.82 between IRR 2000 and RUCA 2004 (zip), and 0.85 between RUCC 2003 and IRR 2000. Across the 84 counties of registry pts’ residence, the median and interquartile range of RUCC decreased from 6 (3-7) in 1983 to 4 (2.25-6) in 2013 and of IRR decreased from 0.49 (0.44-0.53) in 2000 to 0.49 (0.43-0.53) in 2010. Across the 452 zip codes, RUCA decreased from 4 (1-10) in 1998 to 3 (1-8) in 2004. Pts’ median RUCC decreased from 3 (2-6) in 1983 to 3 (2-4) in 2013, median RUCA (zip) decreased from 2 (1-7) in 1990 to 1 (1-6) in 2000, and IRR remained constant at 0.42 (0.38-0.49) in 2000 and 2010. Conclusions: RUCC is preferable for state-level cancer studies incorporating rurality as it best distributes pts across the rural-urban interface compared to RUCA (skews urban) and IRR (skews central). County boundaries (RUCC) are consistent over time versus zip (RUCA) and census tract (RUCA). Our findings suggest that while the extremes of rural and urban are well-defined, rurality as a continuum is inconsistently measured. Researchers should continue to incorporate other measures of vulnerability to achieve health equity.

Collaboration and Virtual Learning in New Zealand Rural Primary Schools: A Review of the Literature

In this literature review, the authors examined three key areas that were chosen as relevant to the challenges faced by small rural schools, and collaborative practice between schools working in virtual learning environments in New Zealand. The first area was rural education, where definitions of rurality and the demographics and characteristics of small rural New Zealand schools were described, and the challenges and innovations in rural school setting were explored. The second area was collaborative practice, where features of effective collaboration were discussed as is the professional practice and theory that underpins collaboration across school networks. Finally, the third area was virtual learning, which was defined and described, along with the benefits and challenges of learning in virtual environments, and the growth of networked learning communities in New Zealand was chronicled. A comprehensive scope of the current New Zealand education landscape was included to provide the context in which this review resides.

Evaluating the prevalence of child psychosocial concerns in rural primary care.

Child psychosocial concerns in rural areas are assumed to be greater than national averages due to mental health provider shortages, however, there is minimal empirical support for this claim. The present study aimed to replicate findings showing a higher prevalence of child psychosocial concerns in rural areas. In addition, this study evaluated six distinct definitions of "rural" to determine whether the operational definition of rurality was associated with prevalence of psychosocial concerns.Caregivers presenting with their child at 8 pediatric primary care sites (N = 2,672) completed a demographic questionnaire and the Pediatric Symptom Checklist (PSC). Logistic regression models tested associations between operational definitions of rurality and prevalence of clinically significant child psychosocial concerns. Multiple logistic regression models were used to test additional independent effects of maternal education level while controlling for child age.The effects of rurality on prevalence of clinically significant psychosocial concerns were inconsistent across the six measures of rurality; when significant, however, effects were small and in the opposite direction than hypothesized.These findings highlight discrepancies in results based on disparate operational definitions and measures of rurality. When rurality was associated with child psychosocial concerns, children in more highly populated areas reported more psychosocial concerns than children in smaller rural areas.

Infant mortality in the Brazilian countryside: a proposal to overcome epidemiological and demographic invisibility

The study aimed to compare two concepts of rurality, one proposed by the Brazilian Institute of Geography and Statistics (IBGE) and the other by the World Bank, to determine which is better fitted to the territory's reality, besides analyzing the infant mortality profile of rural municipalities (counties) in the state of Paraíba, Brazil, according to the best criterion for rurality. This was an observational epidemiological study conducted in the state of Paraíba. The method for analyzing rural/urban typologies was based on data mining, using the Apriori algorithm of association. Infant mortality was analyzed with descriptive statistics. The data were obtained from the Mortality Information System of the Brazilian Ministry of Health, from 2007 to 2016, and municipal indicators were from IBGE. The World Bank definition of rurality showed kappa = 0.337, compared to the IBGE definition, with kappa = 0.616. Among the 223 municipalities that were analyzed, the World Bank classified 130 (65.66%) correctly, and the IBGE 183 (82.06%). The predominant epidemiological profile of infant mortality in rural municipalities in Paraiba state was male gender (57.4%), brown skin color (61.1%), age from 0 to 7 days (52.4%), low birthweight (44%), and gestational age less than 37 weeks (43.2%). Underlying cause of death was classified as avoidable death via interventions by the Brazilian Unified National Health System (65.2%). The urban/rural typology adopted by the IBGE was better than the World Bank at classifying the municipalities in Paraiba state. This classification allowed studying the infant mortality profile in rural municipalities, which was similar to the overall profile, except for maternal schooling.

The Incorporation of Women in the Agricultural Trade Union Struggle: The Case of the Galician Peasants’ Union Sindicato Labrego Galego

AbstractThis project investigates the participation of rural Galician women in social movements regarding labor and rural concerns from 1970 to 1990, with a comparative and interdisciplinary approach. Based on the studies we have analyzed we can conclude that the recognition of rural women and their roles in their organizations have been consolidated in recent years. Rural women have gradually become significant social players in the development of their communities and, consequently, their economies. This study also demonstrates that participation in organizations plays a major role in the development of women's identities by changing the rural definition of gender. In the case of Galician women, historical relegation is evident as the empowerment of rural women did not begin until a group of feminist women became members of the Executive Board of Sindicato Labrego Galego. The driving force behind this empowerment was the creation of organizations for women with clear and specific objectives.

Preparing Physicians for Rural Practice: Availability of Rural Training in Rural-Centric Residency Programs.

Exposing residents to rural training encourages future rural practice, but unified accreditation of allopathic and osteopathic graduate medical education under one system by 2020 has uncertain implications for rural residency programs. We describe training locations and rural-specific content of rural-centric residency programs (requiring at least 8 weeks of rurally located training) before this transition. In 2015, we surveyed residency programs that were rurally located or had rural tracks in 7 specialties and classified training locations as rural or urban using Rural-Urban Commuting Area (RUCA) codes. Of 1849 residencies in anesthesiology, emergency medicine, general surgery, internal medicine, obstetrics and gynecology, pediatrics, and psychiatry, 119 (6%) were rurally located or offered a rural track. Ninety-seven programs (82%) responded to the survey. Thirty-six programs required at least 8 weeks of rural training for some or all residents, and 69% of these rural-centric residencies were urban-based and 53% were osteopathic. Locations were rural for 26% of hospital rotations and 28% of continuity clinics. Many rural-centric programs (35%) reported only urban ZIP codes for required rural block rotations; 54% reported only urban ZIP codes for required rural clinic sessions, and 31% listed only urban ZIP codes in reporting rural full-time training locations. Programs varied widely in coverage of rural-specific training in 6 core competencies. In multiple specialties important for rural health care systems, little rurally located residency training and rural-specific content was available. Substantial proportions of training locations reported to be rural were actually urban according to a common rural definition.

Examination of cardiovascular risk factors and rurality in Appalachian children.

The prevalence of childhood cardiovascular disease (CVD) risk factors often increases in more rural geographic regions in the USA. However, research on the topic often has conflicting results. Researchers note differences in definitions of rurality and other factors that would lead to differences in inference, including appropriate use of statistical clustering analysis, representative data, and inclusion of individual-level covariates. The present study's objective was to examine CVD risk factors during childhood by geographic distribution in the US Appalachian region as a first step towards understanding the health disparities in this area. Rurality and CVD risk factors (including blood pressure, body-mass index (BMI), and cholesterol) were examined in a large, representative sample of fifth-grade students (N=73 014) from an Appalachian state in the USA. A six-category Rural-Urban Continuum Codes classification system was used to define rurality regions. Mixed modeling analysis was used to appropriately cluster individuals within 725 unique zip codes in each of these six regions, and allowed for including several individual-level socioeconomic factors as covariates. Rural areas had better outcomes for certain CVD risk factors (lowest low-density lipoprotein cholesterol (LDL-C), and blood pressure (BP) and highest high-density lipoprotein cholesterol (HDL-C)) whereas mid-sized metro and town areas presented with the worst CVD risk factors (highest BMI% above ideal, mean diastolic BP, LDL-C, total cholesterol, triglyceride levels and lowest HDL-C) outcomes in children and adolescence in this Appalachian state. Counter to the study hypothesis, mid-sized metro areas presented with the worst CVD risk factors outcomes in children and adolescence in the Appalachian state. This data contradicts previous literature suggesting a straightforward link between rurality and cardiovascular risk factors. Future research should include a longitudinal design and explore some of the mechanisms between cardiovascular risk factors and rurality.

Who are Rural Students? How Definitions of Rurality Affect Research on College Completion

Given a revived national discourse about rural populations, more educational research on rural students is necessary, including ways that rural students transition to college and the success (or lack thereof) that they experience once there. However, the National Center for Education Statistics (NCES) has changed the definition of rurality used in each iterative dataset over the last few decades, casting doubt on the consistency of what is meant by the term rural. The purpose of this study is to: (a) communicate to the educational research audience various ways of defining rural students, and specifically how NCES has changed their definition of rurality over their last three major data collections; (b) demonstrate how conclusions about rural students’ and their college degree completion may differ based on these alternate NCES definitions; and (c) discuss how this specific example using NCES data relates to the wider landscape of research on rural students. Results show that conclusions about college degree completion change depending on the definition of rurality used for analysis. Therefore, the education research community should consider the options for defining rural students, report transparently about the choices made, consider the sensitivity of results to the definition of rurality, and ultimately build a more robust body of literature concerning rural students’ college success. Gaining definitional clarity will be beneficial, particularly for those who wish to translate their research into practical action for the benefit of rural students.

Spatial-temporal variations of surface urban heat island intensity induced by different definitions of rural extents in China

Surface urban heat island intensity (SUHII) widely acknowledged as the primary indicator has been extensively utilized in previous SUHI spatiotemporal research. However, diverse rural definitions reported in previous studies possibly affect rural temperature and consequently lead uncertainty and incomparability to SUHII dynamics. Despite of previous efforts, there are still some issues in systematic analysis of significance and spatiotemporal variations of SUHII interpretations resulting from these different rural extents. In order to address these issues, this paper quantitvely characterized the significance and spatiotemporal dynamics of RE-induced △SUHII (Rural-extent induced SUHII variations) in 100 major cities across China mainland. Major findings are summarized in the following three aspects. First, considerable SUHII variating with rural buffers extending and majority of △SUHII exceeding 0.5 K especially in the daytime illustrated that different rural definitions can induce significant uncertainty to SUHII studies. Second, RE-induced △SUHII is found to be unevenly distributed across the study area. Moreover, dense distributions of great △SUHII in city agglomerations suggest that city is an inappropriate study object for SUHII urban-cluster research since multi-influences from aggregated urban and rural areas without clear boundaries. Third, RE-induced △SUHII experiences evident seasonal variations especially in the daytime spring and summer, and spoon-shape (peaks in the begins and ends, and bottom in the middle) buffer variations with relatively low correlations among five subdivided buffer rings. Additionally, six potential factors are selected to discuss their possible effects on △SUHII spatiotemporal characters. On the whole, this paper illustrated that diverse rural extents do induce conspicuous uncertainty and incomparability to SUHII interpretations and highlight the necessity to develop uniform rural defining standards in the future SUHII research.

Eurostat methodology applied to the characterization of rural and urban Brazilian spaces

Abstract The Brazilian official statistics show that the country is mainly urban, while authors including Veiga (2002) and Miranda and Silva (2013) present a more rural Brazil. The absence of a uniform way to define the rural areas in Brazil has led to diffused data about rural Brazil’s size. Therefore, are Brazilian regions predominantly urban, rural or intermediate? This paper applies the rural definition methodologies from Eurostat/European Union to the municipalities of Brazil. The results show the predominance of the intermediary category in Brazilian territory, while the population mostly lives in urban areas. However, due to methodological characteristics, this paper reinforces the necessity of developing other methodologies which would be able to identify rurality and urbanity, considering socioeconomic dimensions.

Perspectives of a Rural Music Educator: A Narrative Journey Through 'Sense of Place'

There is a scarcity of research in contemporary rural studies in Canada, particularly pertaining to education. Discrepancies exist in definitions of rural and rurality. What is the meaning of rural, and how do educators define their teaching praxes? This study explores how one music teacher negotiates her role identity in a rural setting through the conceptual framework of sense of place, and how ‘place’ influences her education praxis. Grounded in the narrative methodological perspectives of Connelly and Clandinin (2006), this study investigates the lived experiences of one educator from a place-based lens. Findings indicate that a place-based curriculum may highlight positive aspects of rural areas, address shortcomings, and encourage rural youth to return to their rural roots.

Successful Leadership in Rural Schools: Cultivating Collaboration

This article is a literature review of the professional competencies and personal qualities commonly associated with successful leadership in rural schools. Multiple definitions of the term rural are provided. A delimitation of this research is that findings reflect literature published from 2005–2015, positioning this document as a current analysis of rural leadership. A limitation of the article is that the research predominantly emanates from rural American, Canadian, and Australian settings, restricting a global application of results. The findings are represented via two overarching themes. Successful rural principals promote people focused relationships with staff, students, parents, and community members. Second, rural principals have the opportunity to be agents of change through balancing local and district policies and through enacting instructional leadership. At the root, both of these themes reveal the importance of rich collaboration with members of the school community. This research is pertinent to researchers, government leaders, policymakers, school leaders, teachers, parents, and community members interested in understanding and responding to the demands of rural schools.

Geographic Distribution and Survival Outcomes for Rural Patients With Cancer Treated in Clinical Trials

Studies showing that patients with cancer from rural areas have worse outcomes than their urban counterparts have relied on cancer population data and did not account for differences in access to care. Clinical trial patients receive protocol-directed care by design, so large clinical trial databases are ideal for examining the impact of rural vs urban residency on outcomes. To compare the geographic distribution and survival outcomes for rural vs urban patients with cancer treated in clinical trials. In this comparative effectiveness retrospective cohort analysis, 36 995 patients from all 50 states enrolled in 44 phase 3 and phase 2/3 SWOG (formerly the Southwest Oncology Group) treatment trials from January 1, 1986, to December 31, 2012, were examined. Seventeen different cancer-specific analysis cohorts were constructed. Data through January 30, 2018, were analyzed. Rural vs urban residency was defined using the Rural-Urban Continuum Codes developed by the US Department of Agriculture. Multivariate Cox regression was used to estimate the association of residency with overall survival, progression-free survival, and cancer-specific survival, controlling for major disease-specific prognostic factors and demographic variables and stratifying by study. Different definitions of rurality were examined. The distribution of rural vs urban patients by geographic region was described. Overall, 27.7% of patients were 65 years or older (range across 17 cohort analyses, 7.8%-74.5%), 40.3% were female in the non-sex-specific analyses (range across 17 cohort analyses, 28.1%-45.9%), and 10.8% were black (range across 17 cohort analyses, 1.9%-22.4%). Overall, 19.4% of patients (7184 of 36 995) were from rural locations. Rural patients were more likely to be aged 65 years or older (rural, 30.7% aged ≥65 years vs urban, 27.0% aged ≥65 years; difference, 3.7%; 95% CI, 2.5%-4.9%; P < .001), were less likely to be black (rural, 5.4% vs urban, 12.1%; difference, 6.7%; 95% CI, 6.1%-7.3%; P < .001), were similar with respect to sex (rural, 40.4% female vs urban, 39.7% female; difference, 0.6%; 95% CI, -1.4% to 2.6%; P = .53), and were well represented within major US geographic regions (West, Midwest, South, and Northeast). Clinical prognostic factors were similar. In multivariable regression, rural patients with adjuvant-stage estrogen receptor-negative and progesterone receptor-negative breast cancer had worse overall survival (hazard ratio, 1.27; 95% CI, 1.06-1.51; P = .008) and cancer-specific survival (hazard ratio, 1.26; 95% CI, 1.04-1.52; P = .02). No other statistically significant differences for overall, progression-free, or cancer-specific survival were found. Results were consistent regardless of the definition of rurality. Rural and urban patients with uniform access to cancer care through participation in a SWOG clinical trial had similar outcomes. This finding suggests that improving access to uniform treatment strategies for patients with cancer may help resolve the disparity in cancer outcomes between rural and urban patients.

Increased Prevalence of Obesity/Type 2 Diabetes and Lower Levels of Lithium in Rural Texas Counties May Explain Greater Alzheimer's Disease Risk.

To compare Alzheimer's disease (AD) mortality rates and coinciding risk factors in rural and urban Texas populations. 155 Texas counties were divided into 73 rural and 82 urban areas using the U.S. Census Bureau definition of rurality. Changes in age-adjusted AD mortality across these counties were calculated using a 7-year aggregation model from 2000-2006 and 2009-2015. Data pertaining to gender, race, education, obesity, diabetes, physical inactivity, and lithium concentrations in tap water were also collected from readily available databases. Change in age-adjusted AD mortality was higher in rural counties (9.5±1.4) versus urban (5.9±1.1) over the time period examined. Similarly, obesity (30.2±0.2% ), diabetes (11.0±0.1% ), and physical inactivity (29.4±0.2% ) levels were significantly higher in rural populations compared to urban (29.1±0.2%, 9.7±0.1%, and 26.7±0.3, respectively). In contrast, the percent of population with some college education (40.1±0.7% ) was lower compared to urban (29.4±0.2% and 44.4±0.9%, respectively). Lithium concentrations in tap water was significantly lower in rural counties compared to urban (63.3±8.2 and 33.4±4.7μg/L, respectively). No significant differences were observed among females and however, we did find significant differences in the percent of African American and Hispanics. Correlational analysis uncovered a negative association between education status and AD mortality over time (r = -0.17). Further analysis controlling for physical inactivity, education, and trace lithium concentrations results in a loss of statistical significance. AD mortality rates are higher in rural counties when compared to urban counties, and this may be linked to greater physical inactivity, obesity, and diabetes, as well as lower trace lithium levels in tap water.

Ni urbanos, ni rurales: cambios intergeneracionales en adscripción territorial subjetiva en la región del Maule, Chile

Utilizando los datos de una encuesta aplicada a 1634 personas de la región del Maule de Chile en 2014, se examina la evolución intergeneracional de las percepciones subjetivas de adscripción territorial y su vínculo con definiciones objetivas de ruralidad y urbanidad. El estudio tiene un alcance correlacional y utiliza el estadístico Chi cuadrado para determinar asociaciones entre variables. Se corrobora la hipótesis: las adscripciones territoriales subjetivas no siempre coinciden con las tipificaciones territoriales administrativas, y los cambios de adscripción entre generaciones sucesivas no transitan necesariamente desde lo rural a lo urbano, sino que dan lugar a perfiles con características diversas, siendo uno de los más importantes el que se asienta en la hibridación urbano-rural. Se concluye que la región del Maule es cada vez más mixta en términos identitarios; así, se aporta evidencia concreta para el cuestionamiento a la idea de que el avance de lo urbano es lineal y unívoco

Mapping rural–urban disparities in late-stage cancer with high-resolution rurality index and GWR

Effects of urban/rural residence on late-stage cancer have long been explored, but remained controversial. Spatial granularity of rural definition, temporal change of rurality, and local variability of such effects may contribute to inconsistent findings, but they have not been fully addressed. We proposed a spatially resolved and temporally comparable rurality index and a geographically weighted regression approach to re-examine this question. Taking Florida as an example, our analyses show that rural effects on late-stage cancer vary dramatically over locations (600-m cells). The odds ratios range from 0.9 to 1.10, and imply that one degree of rurality can increase/decrease local risk of late-stage cancer by up to 10%. Our study is an early attempt to explore local effects of rurality on cancer at a fine spatial scale, and reveals interesting patterns hidden by global multi-level analysis. The new framework and findings can better inform precision interventions to mitigate cancer disparities.

What People Say: Application of Rural Definitions and Descriptors of Community in Ingersoll, Ontario

A definition of rural is necessary to develop, implement, and evaluate policy, as well as to inform research. Definitions of rural are often sorted into four broad categories: descriptive, sociocultural, rural as a locality, and rural as a social representation. Within these categories various definitions exist, each with strengths and weaknesses. Researchers and policy makers debate the effectiveness and appropriateness of rural definitions in various situations. This research initiative seeks to understand how rural is used and defined by residents of Ingersoll, Ontario and explore the implications of this understanding for local development, public policy, and research. Ingersoll is the smallest still growing census agglomeration in Ontario with a population of 12,577. Based on this population, Ingersoll does not qualify as either census rural nor rural small town. Citizens of Ingersoll will be surveyed to understand how they describe their community and relate their community to the concept of rural. The survey results will be compared to common definitions of rural found in academic literature and government policy and programming.