Health Of Rural Populations Research Articles

Association of serum fatty acids with bone health in rural elderly population in Qingdao, China: A cross-sectional study.

As a type of macronutrient, fatty acids (FA) play significant roles in the bone health of elderly people. However, the specific association between different types of FA and bone health is not fully understood, especially in rural elderly populations. To address this gap, a study was conducted in rural areas of Qingdao, China. Participants aged 65 and older were randomly recruited from 11 rural villages in Licha town, Qingdao City. The levels of serum FA in their serum were measured to investigate the associations between FA and bone mass. The results showed that levels of saturated fatty acids (SFA), n-3 polyunsaturated fatty acids (n-3 PUFA), and n-6 polyunsaturated fatty acids (n-6 PUFA) were all significantly associated with bone mass. Specifically, higher levels of SFA were positively correlated with low bone mass (LBM), while PUFA levels were inversely correlated with LBM. Furthermore, the odds ratio (OR) for LBM exhibited a significant nonlinear dose-response relationship (pnonlinearity = 0.1989) with SFA levels, and a significant nonlinear dose-dependent relationship was also observed with the levels of n-3PUFA and n-6PUFA (pnonlinearity = 0.6183, 0.5808, respectively), indicating that increasing dietary PUFA intake appropriately and controlling SFA intake may benefit the bone health of elderly individuals in rural areas.

An overview of outputs of Aboriginal- and Torres Strait Islander-related publications from University Departments of Rural Health in Australia; 2010-2021.

Disparities in the health of Indigenous people and in the health of rural populations are well described. University Departments of Rural Health (UDRHs) in Australia are federally funded under a program to address ongoing challenges with health workforce distribution for rural and remote areas. They have a significant role in research in regional, rural and remote areas, including research related to Indigenous health. However, a comprehensive analysis of their contributions to original Indigenous health related to Indigenous health is lacking. This study examines the contributions of UDRHs to Indigenous issues through analysis of publications of UDRHs focused on Indigenous health during the period 2010-2021. This paper examines a database of UDRH Indigenous-related publications from 2010 to 2021. A total of 493 publications to which UDRHs contributed were analysed, including 354 original research articles. Health services research was the most common category, followed by epidemiology and papers exploring Indigenous culture and health. While health services research substantially increased over the period, the numbers of original research papers specifically focused on Indigenous workforce issues, whether related to Indigenous people, students or existing workforce was relatively small. This broad overview shows the nature and trends in Indigenous health research by UDRHs and makes evident a substantial contribution to Indigenous health research, reflecting their commitment to improving the health and well-being of Indigenous communities. The analysis can help direct future efforts, and future analyses should delve deeper into the impact of this research and further engage Indigenous researchers.

제주 농촌 노인의 자아통합감 증진을 위한 회상기법 기반 집단상담 프로그램 개발

Objectives: This study aimed to evaluate the effectiveness of a reminiscence-based group counseling program to enhance ego integrity in elderly individuals living in rural areas of Jeju. The program sought to improve participants' psychological well-being and quality of life through reflective practices. Methods: For this study, an eight-session program was developed using reminiscence-based media, including salt, clay, and collage. The program encouraged participants to reflect on their life experiences, promoting emotional expression and introspection. Data were collected through participant feedback and psychological assessments before and after the intervention. Results: The results demonstrated significant improvements in ego integrity among the participants. Enhanced psychological stability and social integration were observed as a result of the supportive environment created in the group counseling sessions. Conclusions: Participants benefited from the program by fostering a greater sense of ego integrity, emotional well-being, and social support. The findings suggest that reminiscence-based group counseling can significantly contribute to the psychological health of rural elderly populations. Future studies should explore its long-term effects and broader applicability across diverse demographics.

Practical Aspects of the Simulation Course "Dispensary Observation at a Feldsher-Obstetric Station" as an Improvement in the Quality of Education

Currently, the protection of rural population health is of particular importance. This article presents the experience of organizing a simulation course "Dispensary observation at a Feldsher-Obstetric Station ", it also considers practical issues of its implementation and results.

Diachronic changes in dental health of Bronze Age rural populations from Nahal Refaim, Israel

AbstractWe present the results of a study of dental pathology (specifically dental wear, caries, dental calculus, and enamel hypoplasia) carried out on 1108 teeth and empty alveoli of Bronze Age human populations that inhabited the rural settlement of Nahal Refaim, on the outskirts of the city of Jerusalem. The remains derive from a tomb complex that spans three phases of the period; Intermediate Bronze Age and the Middle Bronze Age I and Middle Bronze Age II village that replaced them (ca. 2500–1550 BC).Dental pathology can reflect diet and therefore offers a unique insight into the lifeways of past populations. The aim of this study was to investigate the extent to which the dental health of this rural population was influenced by the far‐reaching socioeconomic changes associated with the regional shift to urbanism by the Middle Bronze Age II. Although constrained by small sample sizes, we found that the pattern of dental pathology varied in a nonlinear fashion over time and discuss the factors that may have attributed to this variation.

Maternal Sleep Health, Social Support, and Distress: A Mixed–Methods Analysis of Mothers of Infants and Young Children in Rural US

ABSTRACT Objectives The purpose of this study was to explore sleep health in rural maternal populations through a social-ecological framework and identify risk and protective factors for this population. Methods 39 individuals who are mothers of infants or children under the age of 5 years completed an online survey, 35 of which completed a subsequent semi-structured interview. Recruitment was limited to one rural community and was in partnership with community healthcare providers. Results were integrated using a convergent, parallel mixed-methods design. Results Poor sleep health and high prevalence of insomnia symptoms in rural mothers were evident and associated with social support and maternal distress. Qualitative content from interviews indicated that well-established precipitating and perpetuating factors for insomnia may contribute to poor maternal sleep health. Results also revealed a gap in knowledge and language surrounding sleep health among rural mothers. Conclusions Sleep health is challenged during the transition to motherhood and rural mothers have less access to specialized perinatal and behavioral health care than their urban counterparts. In this sample, poor sleep was attributable to distress in addition to nocturnal infant and child sleep patterns which has implications for psychoeducation and promotion of sleep health in mothers. Sleep is a modifiable health indicator that is associated with several other maternal health outcomes and should be considered an element of a comprehensive maternal health for prevention and intervention across individual, interpersonal, and societal domains of the social-ecological model of sleep health.

Mapping Social Support Sources for Rural Patients with Chronic Illness

Objective: In this study, we evaluated social support sources for rural residents with chronic conditions and examined associations between support sources and self-reported health status. Methods: Adults in rural zip codes across the United States (N = 183; 48.6% female) participated in an online survey. Chronic disease status was determined through participant self-report of prior medical diagnoses. Support sources were elicited using scenarios that require illness assistance or emotional support. Self-rated physical and mental health were measured using 5-point Likert scales. Chi-square tests examined gender differences in preferred sources of social support. Ordinal logistic regressions assessed predictors of self-rated health status, including support source preferences. Results: Family and friends were found to be primary sources of social support for rural residents managing illness. Women tended to rely more heavily on close family members whereas men were open to more diverse sources. Gender differences were statistically significant (χ2(4) = 20.66, p < .001). Those relying on close friends rather than family when sick also reported better physical health (B = 1.79, Wald = 4.91, p = .02). Conclusion: Findings indicate informal social ties are central for the health of rural populations. Gender differences in help-seeking patterns may necessitate tailored chronic disease interventions. Fostering community linkages and leveraging natural supports will be vital for addressing rural health disparities.

Influence of cardiovascular risk factors on the health of rural population in Russia (review)

Objective: to assess the influence of medical and social risk factors for cardiovascular diseases on outcomes of patients living in rural and remote areas of the Russian Federation. Review writing methodology. A systematic review was carried out according to the PRISMA (The Preferred Reporting Items for Systematic reviews and Meta-Analyses) methodology using eLibrary, Google Scholar, and CyberLeninka databases. Search depth — from 2002 to 2022. The review included 19 original studies. It has been established that the prevalence of cardiovascular diseases risk factors in the rural population is not always higher than in the urban population, and the outcomes are worse. Conclusion. It has been shown that among the rural population, social determinants of health come to the fore, determining the ability of patients to follow recommendations for managing risk factors and receive timely and high-quality medical care.

Psychology of pregnant females regarding perinatal oral health

Aim: To evaluate the attitude, behaviour, experience and knowledge of pregnant females regarding perinatal oral health in rural population of Faridabad. Methodology: Data was collected through personal interview. Eleven questions related to knowledge, attitude, experience and behaviour were asked. Data was analysed using IBM SPSS version 21. Results: About one- fourth of the study population experienced adverse effects on oral health during pregnancy and their knowledge was also found to be poor with respect to perinatal oral health maintenance. They also reported ill behaviours to manage morning sickness. Despite this, their attitude towards maintenance of perinatal oral health was found to be positive. Conclusion: The dental status of the child is a direct reflection of maternal oral condition in pregnancy. Thus, there is a need for educational oral health interventions in pregnant women to improve their own and children oral health status. Keywords: Perinatal, Oral health, Pregnancy, Rural population

Advancing rural healthcare: A novel approach to designing blockchain-enabled IoB devices and integrating fuzzy intelligence systems for patient monitoring and record management

This research paper presents a novel approach to improving healthcare services in rural areas by leveraging the potential of Fuzzy Intelligence Systems, Internet of Bodies (IoB) devices, and Blockchain technology. It begins by exploring the design and development of a Blockchain-based Patients Record System (BPRS), which ensures secure, transparent, and tamper-proof storage of patient medical records. The paper then delves into the fabrication of advanced IoB devices, specifically designed to study and monitor the health of rural populations. These devices, integrated with Fuzzy Intelligence Systems, provide efficient and reliable data capture, interpretation, and decision-making support. The highlight of the study is the innovative integration of the IoB enabled Patient Monitoring System with the BPRS, which ensures real-time data synchronization and secure access to patient data for authorized personnel. The system collectively promotes efficient healthcare delivery, data privacy, and patient safety in rural areas.

A Study on Assessment of Rural Health Care System in India: Schemes and Implications

India’s rural healthcare system plays a pivotal role in ensuring access to quality healthcare for a significant portion of the population. This study aims to shed light on the state of rural healthcare infrastructure, the effectiveness of government healthcare initiatives, and the far-reaching implications for rural communities. Rural India presents unique healthcare challenges characterized by disparities in healthcare infrastructure, limited access to medical services, and varying health outcomes. The government of India has launched several healthcare schemes and initiatives over the years, such as the National Rural Health Mission (NRHM) and Ayushman Bharat, to address these challenges. Understanding the impact of these schemes and their consequences is essential to inform future healthcare strategies and policies. This study provides a holistic view of the primary healthcare infrastructure in rural India, offering insights into the effectiveness of government schemes and their implications for the health and well-being of rural populations. Its findings serve as a valuable resource for policymakers, stakeholders, and healthcare professionals working toward the improvement of rural healthcare in India.

Closing the Last Mile Gap in Access to Multimodality Imaging in Rural Settings: Design of the Imaging Core of the Risk Underlying Rural Areas Longitudinal Study.

Achieving optimal cardiovascular health in rural populations can be challenging for several reasons including decreased access to care with limited availability of imaging modalities, specialist physicians, and other important health care team members. Therefore, innovative solutions are needed to optimize health care and address cardiovascular health disparities in rural areas. Mobile examination units can bring imaging technology to underserved or remote communities with limited access to health care services. Mobile examination units can be equipped with a wide array of assessment tools and multiple imaging modalities such as computed tomography scanning and echocardiography. The detailed structural assessment of cardiovascular and lung pathology, as well as the detection of extracardiac pathology afforded by computed tomography imaging combined with the functional and hemodynamic assessments acquired by echocardiography, yield deep phenotyping of heart and lung disease for populations historically underrepresented in epidemiological studies. Moreover, by bringing the mobile examination unit to local communities, innovative approaches are now possible including engagement with local professionals to perform these imaging assessments, thereby augmenting local expertise and experience. However, several challenges exist before mobile examination unit-based examinations can be effectively integrated into the rural health care setting including standardizing acquisition protocols, maintaining consistent image quality, and addressing ethical and privacy considerations. Herein, we discuss the potential importance of cardiac multimodality imaging to improve cardiovascular health in rural regions, outline the emerging experience in this field, highlight important current challenges, and offer solutions based on our experience in the RURAL (Risk Underlying Rural Areas Longitudinal) cohort study.

Prevalence of Coronavirus Disease 2019 and its Impact on Public Mental Health in Rural versus Urban Population of Sindh, Pakistan: A Descriptive Cross-sectional Study

Abstract Background: The pandemic of coronavirus disease 2019 (COVID-19) is an immense public mental health threat. Asia has a great mix of rural and urban populations which differ in health-care facilities. Its virulence is escalating the psychological impact but its epidemiological dynamics are still needed to be explored. Therefore, we explored the prevalence of COVID-19 and its impact on public mental health in rural versus urban adults aged 18–65 years in the province of Sindh, Pakistan. Materials and Methods: A cross-sectional survey was conducted in Sindh, Pakistan, from April to July 2021. Stratified random sampling was used for 1494 respondents. Seven rural and urban districts were chosen. After informed consent, information on demographics, depression, and anxiety was collected through structured questionnaires. Statistical analyses were performed by SPSS version 26 with mean ± standard deviation for continuous and frequency (percentages) for categorical variables. t-test and Chi-square test were applied at P ≤ 0.05. Results: The prevalence of COVID-19 was found to be 20.9% in Sindh, Pakistan. Among 1494 respondents, the rural–urban distribution was 757 (50.7%) and 737 (49.3%) with females on the slightly higher side (774 [51.9%]). There was a statistically significant difference in age, household members, earning members, gender, marital status, and occupation. Prevalence of depression and anxiety was 42.2% and 85.5%, respectively. Both were statistically significant for rural–urban populations with P < 0.001 for depression and P = 0.003 for anxiety. Conclusion: The study showed a significant difference in the public mental health of the equitable rural versus urban population of Sindh, Pakistan, during the COVID-19 pandemic, which requires strategies by policymakers.

Implementation of digital health in rural populations with chronic musculoskeletal conditions: A scoping review protocol.

Musculoskeletal conditions are a major source of disability worldwide, and its burden have been rising in the last decades. Rural areas, in particular, are associated with higher prevalence of these conditions as well as higher levels of disability, which is likely related to other determinants that affect these communities. Although digital health has been identified as a potential solution to mitigate the impact of these determinants, it is also known that these populations may face barriers that limit the implementation of these interventions. Therefore, the aim of this scoping review is to comprehensively map the evidence regarding the implementation of digital health interventions in rural populations with chronic musculoskeletal conditions. We will include studies published from the year 2000; that report the use of digital interventions that promote prevention, treatment or monitoring of any chronic musculoskeletal condition or chronic pain from musculoskeletal origin, in patients that live in rural areas. This protocol follows the methodological framework for scoping reviews proposed by Arksey and O'Malley, as well as the Joana Briggs Institute (JBI) approach. We will conduct the search on Medline (PubMed), EMBASE, Web of Science and Scopus, as well as grey literature databases. Two independent reviewers will screen titles and abstracts followed by a full-text review to assess the eligibility of the articles. Data extracted will include the identification of the digital interventions used, barriers and enablers identified by the patients or healthcare providers, the patient-level outcomes measured, and the implementation strategies and outcomes reported. By mapping the evidence on the implementation of digital health interventions in rural communities with musculoskeletal conditions, this scoping review will enhance our understanding of their applicability in real-world settings.

The comparative evaluation of accessibility of stomatological care for municipal and rural population of the Belgorod Oblast

At the actual stage of becoming of Russian stomatology, the problem of sustainable development of rural stomatological care, as system of local formations of complex medical social nature belongs to national priorities and is considered as one of most important directions of public social policy. The stomatological health of rural population is to be considered as indicator of national stomatological health. This is confirmed by spatial structure: rural territories (inhabited territories outside cities) cover 2/3 of territory of the Russian Federation with population of 37.3 million or 1/4 of total population. The spatial structure of the Belgorod Oblast is reliably similar to the all-Russian one. The number of national and foreign studies proved that accessibility, quality and timeliness of insurance (state) stomatology is lower for rural residents that can be considered as one of signs of social inequality. Depending on the social economic status of region, signs of social inequality in the stomatology field are conditioned by broad spectrum of factors. Some of them are discussed in the article.

Impact of COVID-19 pandemic on the physical, mental and social health of the suburban and rural adult population in Bangladesh

Background and objectives: The COVID-19 pandemic caused a significant impact on health worldwide. Adverse effect of COVID-19 on health-related quality of life is significant. This study aimed to find out the impact of COVID-19 on the physical, mental and social health of suburban and rural adult population in Bangladesh. Methods: A suburban and a rural community were purposively selected. The suburban and rural areas were located about 40 km and 130 km north and north-east of Dhaka city respectively. People aged ≥20 years in the selected communities were enrolled in the study. The investigation procedure included socio-demographic and clinical history, anthropometry, and clinical examination and laboratory investigations. Depression, Anxiety and Stress Scale-21 (DASS-21) and 36-Item Short Form Health Survey (SF-36) questionnaires were used for assessing mental and social health respectively. Knowledge, attitude and practice (KAP) regarding the prevention and transmission of COVID-19 was assessed by a validated questionnaire and interview. Results: Total 385 individuals (suburban=201, rural=184) were enrolled in the study. Out of 385, 116 and 269 were male and female, respectively. Out of total 385 participants, depression, anxiety and stress were present in 113 (29.4%), 144 (37.4%) and 70 (18.2%) respectively, while 210 (54.5%) were normal. Extremely severe depression, anxiety and stress were present in 3.6%, 6% and 0.5%, respectively. Depression and anxiety did not differ between suburban and rural populations, though stress was significantly higher among the suburban (p<0.05) population. Social functioning was limited in more than 50% as opposed to excellent (5.5%) or good (39.8%). Almost 60% of the participants had to cut-down schedule of heavy work. Moderate to minimal physical activities were less affected, though weakness and nervousness predominantly hindered socialization. About the prevention and transmission of COVID-19, awareness and attitude were found satisfactory (≥45%), though practice was neglected (<30%). Conclusions: This is the first study in Bangladesh to report the impact of the COVID-19 pandemic on the physical, mental, and social health of adult suburban and rural populations. Physical and mental disabilities were evident among the studied people. Social functioning was affected by COVID-19 equally in suburban and rural participants. A well-designed cohort study is needed to obtain a real picture of the impact of COVID-19 pandemic on human health and society. IMC J Med Sci. 2024; 18(1):007. DOI: https://doi.org/10.55010/imcjms.18.007 *Correspondence: MA Sayeed, Department of Community Medicine and Public Health, Ibrahim Medical College, 1/A Ibrahim Sarani, Segunbagicha, Dhaka 1000, Bangladesh; Email: sayeed1950@gmail.com

Diet-Related Disease Prevention in a Rural Australian Setting: Understanding Barriers, Enablers, and the Role of Rural Health Services in Supporting Changes in Local Rural Food Environments

Bold and comprehensive action is needed to prevent diet-related diseases in rural areas, which includes improving food environments to enable healthier dietary practices. Rural health services are integral to the health of rural populations, yet their role in community disease prevention is not swell understood. This study sought to understand health service, local government, and food outlet stakeholders’ perspectives on (1) the drivers of unhealthy retail environments in a rural setting; (2) the role of rural health services in supporting changes in local food environments; and to (3) identify characteristics of potential interventions. Two Group Model Building workshops were held with health service and local government leaders (n = 9), and interviews were conducted with local food outlet participants (n = 13). Key themes included ‘enablers to healthier food environments’, ‘barriers to healthier food environments’, ‘Rural health services are a leading broker of knowledge for healthy food environments’, and ‘characteristics of desirable healthy food environment interventions.’. Rural health services can play a key role in addressing the current barriers to healthy food environments in rural areas. Effective promotion of healthier diets in rural populations will require consideration of key stakeholder perspectives and the development of further evidence on the role that rural health services can play in improving the healthiness of food environments.

Social determinants of health for moderate and severe periodontal disease in rural and urban populations.

We assessed the prevalence of moderate and severe periodontitis and its association with social determinants of health in rural and urban population from the State of Chiapas, in Southern Mexico. A cross-sectional population-based study was conducted in 2013 comprising people 20 years and older. The determinants were categorized as proximal (age, sex, indigenous origin, diabetes, smoking, diet), intermediate (level of schooling, occupation, medical and dental care), and structural (type of institution of health care provision, residence area). Periodontal status was assessed using the Periodontal Screening and Recording (PSR) Index. In total, 467 persons (72.4% women; mean age 43.0 years [s.d 14.7]) participated. Of them, 76.5% lived in rural areas and 56.7% were of indigenous origin. Participants with moderate and severe periodontitis had a significantly lower toothbrushing frequency (44.1% and 44.8%, respectively), and poorer oral hygiene (90% and 90.3%, respectively) compared with people without periodontitis (29.4% for toothbrushing frequency and 74.5% for oral hygiene). Moderate periodontitis was associated with poor oral hygiene (OR=2.63) and no schooling (OR=1.86). Severe periodontitis was associated with age (OR=1.05), poor oral hygiene (OR=3.99), no schooling (OR=2.08), and the interaction term of rural area and indigenous origin (RM=5.23). Social determinants of health play an important role in the development of periodontitis. Preventive oral health programs should thus focus on the specific social, economic, and geographical context of the population.

Efforts by critical access hospitals to increase health equity through greater engagement with social determinants of health.

Greater health care engagement with social determinants of health (SDOH) is critical to improving health equity. However, no national studies have compared programs to address patient social needs among critical access hospitals (CAHs), which are lifelines for rural communities. CAHs generally have fewer resources and receive governmental support to maintain operations. This study considers the extent to which CAHs engage in community health improvement, particularly upstream SDOH, and whether organizational or community factors predict involvement. Using descriptive statistics and Poisson regression, we compared 3 types of programs (screening, in-house strategies, and external partnerships) to address the patient social needs between CAHs and non-CAHs, independent of key organizational, county, and state factors. CAHs were less likely than non-CAHs to have programs to screen patients for social needs, address unmet social needs of patients, and enact community partnerships to address SDOH. When we stratified hospitals according to whether they endorsed an equity-focused approach as an organization, CAHs matched their non-CAH counterparts on all 3 types of programs. CAHs lag relative to their urban and non-CAH counterparts in their ability to address nonmedical needs of their patients and broader communities. While the Flex Program has shown success in offering technical assistance to rural hospitals, this program has mainly focused on traditional hospital services to address patients' acute health care needs. Our findings suggest that organizational and policy efforts surrounding health equity could bring CAHs in line with other hospitals in terms of their ability to support rural population health.

A qualitative exploration of barriers and facilitators to drug treatment services among people who inject drugs in West Virginia

BackgroundThe opioid overdose crisis in the USA has called for expanding access to evidence-based substance use treatment programs, yet many barriers limit the ability of people who inject drugs (PWID) to engage in these programs. Predominantly rural states have been disproportionately affected by the opioid overdose crisis while simultaneously facing diminished access to drug treatment services. The purpose of this study is to explore barriers and facilitators to engagement in drug treatment among PWID residing in a rural county in West Virginia.MethodsFrom June to July 2018, in-depth interviews (n = 21) that explored drug treatment experiences among PWID were conducted in Cabell County, West Virginia. Participants were recruited from locations frequented by PWID such as local service providers and public parks. An iterative, modified constant comparison approach was used to code and synthesize interview data.ResultsParticipants reported experiencing a variety of barriers to engaging in drug treatment, including low thresholds for dismissal, a lack of comprehensive support services, financial barriers, and inadequate management of withdrawal symptoms. However, participants also described several facilitators of treatment engagement and sustained recovery. These included the use of medications for opioid use disorder and supportive health care workers/program staff.ConclusionsOur findings suggest that a range of barriers exist that may limit the abilities of rural PWID to successfully access and remain engaged in drug treatment in West Virginia. Improving the public health of rural PWID populations will require expanding access to evidence-based drug treatment programs that are tailored to participants’ individual needs.