Rural Adult Population Research Articles

Prevalence of Hypertension Among the Rural Adult Population in India: A Systematic Review and Meta-Analysis.

Hypertension is a major cause of premature death worldwide. Studies have shown that the rural adult population in India is also experiencing this burden. To determine the overall pooled prevalence of primary hypertension in the adult rural population of India, an extensive search was conducted in various databases such as MEDLINE/PubMed, IndMED, EBSCO, CINAHL, and Google Scholar from 01/01/2014 to 16/05/2024. The studies were reviewed by two authors independently, assessing their quality and extracted data using pre-coded spreadsheets. The pooled estimates of hypertension prevalence were calculated using the Der Simonian-Laird random effects model, and subgroup, sensitivity analyses, and meta-regression were performed. In the final review, a total of 10 studies involving 30757 subjects were included. The combined pooled estimate of hypertension prevalence was 24% (95% CI: 19, 29) and there was a significant level of heterogeneity observed among the studies (I2=98%, Q=572.07, df=9, p<0.01). Subgroup analyses found that factors such as the year of study, region, type of BP apparatus used, sampling strategy, and BP measurement techniques had a significant impact on the prevalence of hypertension. Further analysis by meta-regression revealed that none of these covariates had a substantial influence on the prevalence (R2=0.21, Q=572.07, df=9, p-value<0.01). The prevalence of hypertension in adult rural populations exhibited a consistent upward trend over a period of 10 years from 2014 to 2024. Concerned policymakers should focus on the changing health needs of the rural adult population of India.

Associations between obstructive sleep apnea and sleep characteristics with chronic kidney disease in rural Pennsylvania

Study objectivesTo examine the association between moderate-severe obstructive sleep apnea (msOSA) and sleep characteristics with chronic kidney disease (CKD) in a population of rural and urban adults in Pennsylvania. MethodsA cross-sectional study of 23,643 adults who underwent polysomnography (PSG) at a rural healthcare system in Pennsylvania between 2009 and 2019. Serum creatinine was abstracted from electronic health records to calculate estimated glomerular filtration rate (eGFR). CKD was defined as an eGFR <60 mL/min/1.73 m2. msOSA was defined as an apnea-hypoxia index (AHI) ≥15 events/hour. Poisson regression was performed to estimate the prevalence ratio (PR) of CKD for various sleep measures while adjusting for age, sex, race, smoking (never, former, current), body mass index, diabetes, and hypertension at time of PSG. ResultsIn this clinically-referred sample comprised of over one-third (35 %) rural individuals, the prevalence of CKD and msOSA was 9.4 % and 32.1 %, respectively. Patients with CKD had more severe OSA based on AHI and intermittent hypoxia profile and presented worse sleep quality across all studied measures. Having OSA was associated with a 13 % higher prevalence of CKD (95%CI: 1.04, 1.22). In addition, for every 5 % increment in sleep efficiency, the prevalence of CKD was 3 % lower (PR = 0.97, 95%CI: 0.96, 0.98). Significant associations that were in the expected direction were observed across most sleep characteristics in adjusted models. ConclusionsModerate-severe OSA, nocturnal hypoxemia, and disruptions to normal sleep duration, continuity, and architecture are associated with increased CKD prevalence in Pennsylvania adults. Management of OSA and/or sleep disturbances may be an opportunity to improve CKD outcomes. The unique health disparities among vulnerable rural populations are deserving of future study.

Prevalence of Non-alcoholic Fatty Liver Disease - A Population Based Study

Background: Non alcoholic fatty liver disease (NAFLD) is defined as the accumulation of excess fat in the liver in the absence of significant alcohol consumption. NAFLD is a common cause of chronic liver disease. The overall prevalence of NAFLD in western countries varies from 15-40% and in Asian 9-40%. Its prevalence has not been determined in population based study in Bangladesh. The objective of the study was to determine the prevalence and risk factors of NAFLD in adult rural population. Methods: This cross-sectional study was performed among adult population of two villages of Comilla district, Bangladesh from January to December 2015. Persons with alcohol consumption and other liver diseases were excluded. Individuals were undergone anthropometric, blood pressure measurements, thorough medical history and physical examinations. Laboratory measurements included were fasting blood sugar (FBS), fasting lipid profile, and liver function tests. NAFLD was diagnosed by transabdominal ultrasonography. Statistical analyses were performed using the SPSS software, version16.0. Results: Among 665 subjects, 213 were males (32%) and 452 were females (68%) with the mean age of 42.2 ± 15.04 years. NAFLD was diagnosed in 33% subjects. NAFLD were high in 41-60 age group (48.7%) and in female gender (P=&lt;0.175). Subjects with NAFLD had higher BMI (P&lt;0.001), higher prevalence of hypertension (P&lt;0.001), high FBS (P&lt;0.001), high cholesterol (P=0.026), high triglyceride (P&lt;0.001) and high waist circumference (P&lt;0.001). Subjects with NAFLD had significantly higher prevalence of metabolic syndrome when compared to healthy subjects (P&lt;0.001). Conclusion: The prevalence of NAFLD in rural adult population of Bangladesh is 33% and is associated with female gender, obesity and features of metabolic syndrome. J Com Med Col Teachers Asso Jan 2024; 28(1): 27-32

Recruitment in Appalachian, Rural and Older Adult Populations in an Artificial Intelligence World: Study Using Human-Mediated Follow-Up.

Participant recruitment in rural and hard-to-reach (HTR) populations can present unique challenges. These challenges are further exacerbated by the need for low-cost recruiting, which often leads to use of web-based recruitment methods (eg, email, social media). Despite these challenges, recruitment strategy statistics that support effective enrollment strategies for underserved and HTR populations are underreported. This study highlights how a recruitment strategy that uses email in combination with follow-up, mostly phone calls and email reminders, produced a higher-than-expected enrollment rate that includes a diversity of participants from rural, Appalachian populations in older age brackets and reports recruitment and demographic statistics within a subset of HTR populations. This study aims to provide evidence that a recruitment strategy that uses a combination of email, telephonic, and follow-up recruitment strategies increases recruitment rates in various HTR populations, specifically in rural, older, and Appalachian populations. We evaluated the overall enrollment rate of 1 recruitment arm of a larger study that aims to understand the relationship between genetics and substance use disorders. We evaluated the enrolled population's characteristics to determine recruitment success of a combined email and follow-up recruitment strategy, and the enrollment rate of HTR populations. These characteristics included (1) enrollment rate before versus after follow-up; (2) zip code and county of enrollee to determine rural or urban and Appalachian status; (3) age to verify recruitment in all eligible age brackets; and (4) sex distribution among age brackets and rural or urban status. The email and follow-up arm of the study had a 17.4% enrollment rate. Of the enrolled participants, 76.3% (4602/6030) lived in rural counties and 23.7% (1428/6030) lived in urban counties in Pennsylvania. In addition, of patients enrolled, 98.7% (5956/6030) were from Appalachian counties and 1.3% (76/6030) were from non-Appalachian counties. Patients from rural Appalachia made up 76.2% (4603/6030) of the total rural population. Enrolled patients represented all eligible age brackets from ages 20 to 75 years, with the 60-70 years age bracket having the most enrollees. Females made up 72.5% (4371/6030) of the enrolled population and males made up 27.5% (1659/6030) of the population. Results indicate that a web-based recruitment method with participant follow-up, such as a phone call and email follow-up, increases enrollment numbers more than web-based methods alone for rural, Appalachian, and older populations. Adding a humanizing component, such as a live person phone call, may be a key element needed to establish trust and encourage patients from underserved and rural areas to enroll in studies via web-based recruitment methods. Supporting statistics on this recruitment strategy should help researchers identify whether this strategy may be useful in future studies and HTR populations.

Prevalence and influencing factors of metabolic syndrome among rural adult population in a district of South India.

Metabolic syndrome has increased globally due to sedentary lifestyles, unhealthy diets and obesity, which is posing a substantial burden on healthcare systems. Understanding the determinants of metabolic syndrome like lifestyle factors, socioeconomic status and the environment are vital for devising effective prevention and management. Research into these determinants helps to identify high-risk populations and develop interventions to reduce its occurrence. i. To estimate the prevalence of metabolic syndrome among the adult population. ii. To determine the factors associated with metabolic syndrome among the adult population. A cross-sectional study was carried out among 410 adults (≥18 years). A semi-structured questionnaire was used to collect data and National Cholesterol Education Program's Adult Treatment Panel III criteria was used to diagnose metabolic syndrome. Continuous and categorical data were represented as mean and proportion, respectively. The strength of the association was determined using the prevalence ratio and adjusted prevalence ratio. The mean age of the participants was 44.97 ± 14.7, about 58.3% of them were females. Metabolic syndrome prevalence was 39.8%. Multivariate regression analysis demonstrated that being over 40 years old, marital status, higher socioeconomic status, skilled workers, physical inactivity and obesity were independently linked to metabolic syndrome. The burden can be reduced by identifying the risk factors at the early stage through screening and by adopting a healthy lifestyle.

Primary Care Models and Depression Outcomes in Rural Adult Populations: A Systematic Review.

Rural populations rely on primary care services for depression care due to shortages and maldistributions of specialty mental health care favoring urban areas. Yet, it is unknown which primary care models are effective at reducing depressive symptoms and emergency department (ED) use for depression among rural populations. The purpose of this systematic review is to synthesize the effectiveness of primary care models on depressive symptoms and ED utilization for depression in rural populations. PubMed, PsycINFO, CINAHL, and reference lists of included studies were searched. Eligible articles focused on the impact of primary care models on depressive symptoms or ED utilization for depression among rural populations in the United States. Seventeen studies met the inclusion criteria. Three care models were identified in the studies, including collaborative care (i.e., team-based integrated care that tracks patient populations with a registry; n = 7), tele-psychotherapy (i.e., identification of patients in primary care and referral to virtual psychotherapy; n = 6), or self-management support (i.e., identification of patients in primary care and referral to community support for depression self-management; n = 4). These care models were associated with improved patient-reported depressive symptoms such as Patient-Health Questionnaire reported remission of depression (score < 5). No studies assessed depression ED utilization as an outcome. Collaborative care, tele-psychotherapy, and self-management support may be effective at reducing depressive symptoms, specifically in rural populations and should be implemented at the practice level. Research focused on primary care models and ED utilization for depression among rural populations is needed.

Awareness and Attitude Towards Tobacco Products and Tobacco Industry and Perception about Government's Role in Tobacco Control among the Adult Rural Population: A Cross-sectional Study in the Indian State of Bihar.

Attitudes and impressions toward the tobacco industry and tobacco products among the general public are important determinants for curbing the menace of the tobacco epidemic. Accordingly, this study aimed to assess the knowledge and perceptions about the tobacco industry and tobacco products and analyze attitudes towards social denormalization (SD) of tobacco use and tobacco industry denormalization (TID) among the rural population of Bihar, India. This community-based cross-sectional survey was conducted on 421 adults aged 18 to 65 years who were selected using multistage systematic random sampling in a rural area of Bihar State in India from January to March 2022. Results were presented as proportions and the factors associated with support for TID and SD were identified using the chi-square test and binary logistic regression. Out of 421 participants, 342 (81.2%) did not consider smokeless tobacco to be very dangerous. Nearly half (192, 45.6%) of the individuals believed that tobacco companies never tell the truth about the ill effects of tobacco use on health. Maximum, 345 (89.5%) also believed that the tobacco industry is responsible for adverse health effects of tobacco use and that the government should sue them. The prevalence of favorable attitudes toward TID and SD was found to be 55.1% [95% CI: 50.3% - 59.8%] and 38.2% [95% CI: 33.7% - 42.9%], respectively. One out of every two and one out of every three individuals showed favorable attitudes toward TID and SD, respectively. There is a need to inform and educate the public on the ill effects of tobacco and the deceptive strategies used by the tobacco industry to help them choose health over tobacco.

PREDICTIVITY OF ESTIMATED PULSE WAVE VELOCITY FOR FATAL AND NONFATAL OUTCOMES IN RURAL POPULATION

Objective: Our study assesses the predictive value of arterial stiffness measured by estimated pulse wave velocity (ePWV) for fatal and nonfatal outcomes in general rural adult population. Design and method: This was a prospective observational study (1175 adult subjects) from the ENAH rural project in Croatia. Subjects were followed up for an average of 11.3 (8.3-13.65) years. Mortality data were collected from the National Institute for Public Health, and data for morbidity from the medical records of local physicians. ePWV was calculated using a validated equation. Results: In total, there were 264 deaths (22.5%), and 171 (14.5%) subjects experienced one of the non-fatal outcomes (myocardial infarction, atrial fibrilation, heart failure, stroke, TIA, dialysis). Kaplan Meier analysis (KMa) showed that survival is lower in group with ePWV&gt;10m/s compared with group with ePWV&lt;10m/s (HR=12.8, 95%CI 9.9-16.6, p&lt;0.001) (Figure 1A). Similarly, KMa showed that survival to non-fatal outcome is lower in group with ePWV&gt;10m/s compared to group with ePWV&lt;10m/s (HR=1.50, 95%CI 1.0-2.1, p=0.008), Figure 1B. In the multivariate analysis of predictors for fatal outcome, male gender and ePWV maintained statistical significance in predicting increased risk for death (HR 1.75, 95%CI 1.18-2.61, p=0.006 and HR 1.81, 95%CI 1.08-3.04, p=0.030, respectively). In the multivariate analysis, significance was not confirmed for any predictor for non-fatal outcomes, however, in the multivariate analysis for composite fatal and non-fatal outcome results showed that men were exposed to a greater risk compared to women (HR=1.54; 95%CI 1.14-2.08, p=0.006), and ePWV showed to be a risk factor (HR=1.94, 95%CI 1.50-2.51, p&lt;0.001). Conclusions: ePWV was found to be significant independent predictor for cardiovascular deaths and composite fatal and non-fatal outcomes suggesting that this simple and reliable measure of arterials stiffness could be recommended for clinical work at least in remote rural areas where measurements of arterial stiffness is not feasible.

Association of triglyceride glucose index and risk of incident hypertension: a prospective cohort study

Objective: To explore the relationship between the triglyceride glucose (TyG) index and the risk of developing hypertension among rural Chinese adults. Methods: A prospective cohort study was conducted from 2007 to 2008, involving 20 194 adults selected through random cluster sampling from a rural community in Luoyang City, Henan Province. Follow-ups were carried out in 2013-2014 and 2018-2020. After excluding participants with hypertension at baseline, those with missing TyG index data, individuals who passed away during follow-up, and those with incomplete hypertension status at the second visit, 9 802 participants were included in the analysis. Baseline and follow-up assessments included questionnaire interviews, physical measurements (including blood pressure), and blood sample collection for fasting lipid and glucose levels. Participants were divided into four groups according to TyG index quartiles, and a modified Poisson regression model was utilized to assess the association between TyG index quartiles and hypertension risk. Results: The study cohort comprised 9 802 participants with a median age of 48 (39, 57) years, including 3 803 males (38.80%). Participants were distributed across TyG index quartiles as follows: TyG<8.2 group (2 224 individuals), TyG 8.2-8.5 group (2 653 individuals), TyG 8.6-8.9 (2 441 individuals), and TyG≥9.0 (2 484 individuals). Over a follow-up period of (11.1±1.3) years, 3 378 subjects developed hypertension, resulting in a cumulative incidence of 34.46% (3 378/9 802). The risk of hypertension increased with higher TyG index quartiles (Ptrend<0.05). Compared to the TyG<8.2, the TyG 8.2-8.5 (RR=1.11, 95%CI 1.01-1.22, P=0.023), TyG 8.6-8.9 (RR=1.16, 95%CI 1.06-1.27, P=0.023), and TyG≥9.0 (RR=1.20, 95%CI 1.10-1.31, P=0.023) exhibited increased hypertension risk after adjusting for age, gender, educational level, and other potential confounders. Subgroup analyses based on gender and age at baseline yielded results consistent with the main analysis. Conclusions: The TyG index is positively correlated with the risk of developing hypertension in the rural adult population.

Vaccination coverage against COVID-19 among rural population in Haryana, India: A cross-sectional study.

Conducting a study in rural pre-dominant areas will help to understand the penetration of the vaccination campaign during the COVID-19 health crisis. This study aimed to investigate vaccination coverage against COVID-19 among the rural adult population in India and to identify factors associated with vaccination coverage. A population-based cross-sectional study was conducted among the rural population in one district of north India from January to February 2023. A semi-structured questionnaire was designed on the SurveyMonkey digital platform for interviewing the participants, which consisted of questions related to socio-demographic profile, health problems, vaccination status, types of vaccine, re-infection after vaccination, and functional difficulties. The data regarding infection with COVID-19 was collected based on self-reported positive testing for SARS-CoV 2 on RT-PCR. A total of 3700 eligible individuals were enumerated for the survey, out of which 2954 (79.8%) were interviewed. The infection rate of past COVID-19 infection, based on self-report of testing positive, was 6.2% (95%CI: 5.3-7.1). Covishield vaccine was received by most participants (81.3%, 2380) followed by Covaxin (12.3%, 361) and Pfizer manufactured vaccine (0.03,1). The coverage for first, second, and booster doses of the vaccine was 98.2% (2902), 94.8% (2802), and 10.7% (315) respectively. The risk of reinfection at 12 months or more among participants with two doses of vaccine was 1.6% (46/2802, 95%CI: 1.2-2.1). The coverage among those with severe functional difficulties was lesser as compared to those with some or no difficulties. Vaccination coverage against COVID-19 in rural Haryana, India is not dependent on factors like gender or occupation but is dependent on age and education. Although the full and partial vaccination coverage is high, the booster dose coverage is poor. In addition, the presence of severe disability was significantly associated with reduced vaccination coverage.

A Study on Awareness and Attitude of Organ Donation among Rural Adult Population in Ranga Reddy District, Telangana

A Study on Awareness and Attitude of Organ Donation among Rural Adult Population in Ranga Reddy District, Telangana

Oral Health and Lifestyle Factors in Rural Adults of Jharkhand, India.

There is a lack of health care facilities and poor oral health awareness among the rural adult population of Jharkhand which may significantly influence oral health status and lifestyle scores. To assess the oral hygiene status, lifestyle factors, and various risk factors associated with poor lifestyle scores in the rural adult population of Jharkhand. This cross-sectional study included 400 rural adults (35-44 years) populations. Face-to-face interviews were used to collect sociodemographic data and data on oral hygiene practices. Lifestyle factors were assessed using Health Practice Index (HPI). Oral health status was assessed using the oral health assessment proforma provided by the World Health Organization (WHO). A significantly higher (p value < 0.0001) prevalence of tobacco consumption was reported by males (94.0%) compared to females (4.0%). The males (54.0%) reported significantly higher (p value < 0.0001) poor lifestyle scores compared to females (38.0%). A significantly higher (p value < 0.0001) number of oromucosal lesions (13.0%) was found in males compared to females (1.0%). There was a significant difference (p value < 0.0001) in the oral hygiene status between males and females with majority of males (60.0%) having poor oral hygiene. A bivariate analysis was performed, and unadjusted odds ratio was computed. The factors that became significant were then entered into logistic regression model (enter method). The results of logistic regression analysis showed that education (OR = 0.3, p value = 0.003), systemic diseases/long-term medication (OR = 2.9, p value = 0.004), tobacco consumption (OR = 2.9, p value = 0.006), oral hygiene status (OR = 2.4, p value = 0.007), and dental caries (OR = 2.9, p value = 0.004) were significant predictors of poor lifestyle scores. The rural adult population in Jharkhand has poor oral hygiene status and poor lifestyle scores. It is important to raise awareness regarding good oral hygiene and the negative effects of tobacco consumption. The dental visit should be encouraged, and the concept of preventive care needs to be instilled.

Cognitive Functioning Among Community-dwelling Older Adults in Rural Population of Lucknow and Its Association with Comorbidities.

The transitional state between normal aging and dementia is known as Cognitive impairment (CI) where a person has memory complaints and objective evidence of CI but no evidence of dementia. With the globe undergoing a "demographic transition," the magnitude of neurodegenerative disorders is rising. In India, 27.3% of older persons with comorbidities had CI. Early identification of CI will likely help initiate proper remedial intervention, leading to better overall outcomes. In order to determine the prevalence of CI in older persons and whether it is associated with co-morbid conditions, this study was designed. A descriptive cross-sectional study was conducted among 350 older adults aged ≥60 residing in rural areas of Lucknow, selected using multistage cluster sampling. The Hindi Mental State Examination (HMSE) scale was used to assess cognitive function. A pretested semi-structured questionnaire was used to collect information on sociodemographic characteristics and comorbidity status. Among 350 participants, with mean ± SD age 70.66 ± 9.53 years, the prevalence of CI as per HMSE (<23) was 24.9%. Overall, the mean HMSE score was less in individuals with (25.2) than without (27.19) comorbidities. Those with comorbidities had significantly lower mean scores in all individual domains of HMSE. CI affects one-fourth of the older adult population. Risk increases with the presence of comorbidities. Hence, screening, and early treatment are recommended.

Feasibility and acceptability of a contextualized physical activity and diet intervention for the control of hypertension in adults from a rural subdistrict: a study protocol (HYPHEN)

IntroductionIn rural and remote South Africa, most strokes and ischaemic heart diseases are as a consequence of hypertension, which is a modifiable risk factor. The widely recommended therapeutic approaches to control hypertension are through physical activity and diet modifications. However, there is a lack of culturally sensitive community-based, lifestyle interventions to control hypertension among rural African adult populations. We designed an intervention which recommends adjusting daily routine physical activity and dietary behaviour of adults with hypertension. This study aims to evaluate the feasibility and acceptability of HYPHEN in a rural community setting.MethodsWe aim to recruit 30 adult participants with a self-report hypertension diagnosis. A one-arm, prospective design will be used to assess the feasibility and acceptability of recruitment, uptake, engagement, and completion of the 10-week intervention. Recruitment rates will be assessed at week 0. Intervention uptake, engagement, and adherence to the intervention will be assessed weekly via telephone. Blood pressure, body mass index, waist-hip ratio, urinary sodium, accelerometer-measured physical activity, and 24-h diet recall will be assessed at baseline and at 10 weeks. Qualitative semi-structured interviews will be conducted at 10 weeks to explore feasibility and acceptability.DiscussionThis study offers a person-centred, sociocultural approach to hypertension control through adaptations to physical activity and dietary intake. This study will determine whether HYPHEN is feasible and acceptable and will inform changes to the protocol/focus that could be tested in a full trial.Trial registration numberPACTR202306662753321.

Supplemental Material for Primary Care Models and Depression Outcomes in Rural Adult Populations: A Systematic Review

Supplemental Material for Primary Care Models and Depression Outcomes in Rural Adult Populations: A Systematic Review

Prevalence and sociodemographic determinants of common mental disorders (CMDs) symptoms in a rural adult population of Haryana, North India.

Common mental disorders (CMDs), including depression, anxiety, and somatoform disorders, affect all stages of life and impact individuals, families, and communities. This study aimed to determine the magnitude of CMDs and their sociodemographic determinants in the adult population of a rural block in North India. A cross-sectional, quantitative, community-based study was conducted among adult residents of a rural block in Haryana, North India, using a multistage random sampling technique. The Hindi version of the General Health Questionnaire (GHQ-12), a well-validated tool, was used to screen participants for CMDs. Scores of 4 or above denoted the presence of CMDs. Bivariate analyses were performed to determine the associations between CMDs and sociodemographic characteristics. Of the 180 residents selected for the study, most were women (60.0%) and aged between 31 and 50 years (52.3%). The prevalence of CMDs symptoms in the study population was 20.0%. The presence of CMDs symptoms was significantly higher among those who were aged 60 years or older [OR=12.33, 95% CI 3.21-47.38], widowed, divorced or separated [OR=7.50, 95% CI 1.09-51.52], illiterate [OR= 6.25, 95% CI 2.84-13.77], had monthly family income below 10,000 INR [OR=3.33, 95% CI 1.54-7.20], had any chronic physical illness [OR=8.28, 95% CI 3.70-18.56] and had a family history of any psychiatric illness [OR=5.56, 95% CI 1.52-19.42]. The burden of CMDs was quite high among adults in rural North India. The presence of CMDs was closely associated with sociodemographic characteristics. Primary care and community-based settings need to screen for, diagnose, and manage CMDs to address this growing problem.

Prevalence of Obesity and Associated Risk Factors among Rural Adult Population of Puthia Upazilla, Rajshahi

Introduction: Obesity is a major public health concern in Bangladesh, driven by socioeconomic factors, lifestyle choices, physical activity levels, and demographics. The influence of technology and industrialization has disrupted behavioral patterns among rural residents, leading to increased susceptibility to weight gain and non-communicable diseases. To gain precise insights, a cross-sectional study was conducted to assess the prevalence of obesity and identify specific risk factors among rural adults. Methods: From September to November 2022, this study was carried out at the Rajshahi Medical College's Department of Community Medicine. Data were gathered by conducting face-to-face interviews with the rural adult population of Puthia Upazilla, Rajshahi, aged 18 to 59.In all, 548 people from Rajshahi's Puthia Upazilla took part in the survey. Result: In this study, respondents had a mean age of 38.84 (±12) years. About 39.78% were overweight, and 14.23% were obese based on BMI. The mean BMI was 25.07 (±5.17) kg/m². Around 20.9% of males and 27.9% of females had a higher risk based on waist-hip ratio. Approximately 43.6% were highly active, while 36.86% had low physical activity levels. About 1.6% reported taking anti-depressant drugs. Around 31.4% consumed fried food 1 to 3 times weekly, and 35.2% drank milk occasionally. Regarding salt intake, 32.1% added salt daily to their meals. The relationship between physical activity and BMI (p&lt;.001) and between physical activity and waist-hip ratio (p&lt;.001) was statistically significant in the analysis. Conclusion: This study's findings can inform policymakers about rural obesity rates and related factors. They can then take steps to raise awareness among rural populations about physical activity and healthy eating. TAJ 2023; 36: No-2: 47-56

Urban digital economy, environmental pollution, and resident's health-empirical evidence from China.

In light of China's rapid advancement in the digital economy and the implementation of the "Healthy China" initiative, it is crucial to assess the impact of the digital economy on residents' health. This study analyzes data from the 2012, 2014, and 2016 China Labor Force Dynamics Survey (CLDS) to evaluate the health of residents using both subjective and objective criteria. Furthermore, it calculates the digital economy development index for Chinese cities and investigates its influence on the subjective and objective health of residents, along with the underlying mechanisms. The empirical results reveal a U-shaped pattern in the effect of the digital economy on health levels, initially detrimental but subsequently beneficial. The analysis of mechanisms shows that the digital economy's development initially increases and then decreases environmental pollution, impacting health through environmental changes. Additionally, the study finds variations in this impact based on age and urban-rural differences, with more pronounced effects on rural and older adult populations, who also experience the U-shaped curve's turning point more rapidly. These findings highlight the necessity of advancing digital economy infrastructure to positively influence environmental quality and improve public health. The study emphasizes the urgent need for policymakers to invest in digital infrastructure to foster a sustainable and healthy future. This requires a holistic approach to development, focusing on both urban and rural areas, to promote inclusive growth and reduce the digital divide.

Assessment of Oral Mucosal Lesions (OML), Periodontal Health Conditions, and Unmet Dental Treatment Needs in the Rural Adult Population of Jharkhand, North India.

Background Dental diseases like caries, periodontal diseases, and oral mucosal lesions (OML) are common findings in rural adult populations that greatly impact their quality of life. Aim To assess OML, periodontal health conditions, and unmet dental treatment needs in the rural adult population in Jharkhand. Methodology A total of 700 permanent residents of Bero Block, Jharkhand, North India, in the age group of 35-44 years, participated in this cross-sectional study. Both men and women were equally represented. Their socio-demographic characteristics and previous dental visits were collected using standardized proforma. An assessment of periodontal health conditions, OML, and unmet dental treatment needs was done using the World Health Organization (WHO) Oral Health Assessment Proforma of 1997. Results It was found that over half (54.3%) of the studypopulation had the adverse habit of smoking and chewingpaan. Males were more likely to experience leukoplakia (18.87%), whereas females were more likely to experience abscesses (9.43%). The majority of males and females had a community periodontal index (CPI) score and loss of attachment (LOA) score greater than two, which indicated poor periodontal health as assessed by the periodontal index. Both males and females needed extraction of the diseased teethas their primary treatment. Conclusion The rural adult population residing in the Bero block of Jharkhand showed poor periodontal health and high unmet dental treatment needs. These people need effective oral health promotion policies and dental health education to improve their oral health.

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&lt;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 (&lt;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