Rural South Research Articles

Capitals in artisanal and small-scale mining in Marmato, Colombia: Using the sustainable livelihoods framework to inform formalization

This paper applies the concept of capitals in the sustainable livelihoods framework (SLF) to examine artisanal and small-scale mining livelihoods in the municipality of Marmato, Colombia and discusses the relevance of these findings to formalization efforts. Artisanal and small-scale mining (ASM) is an important and often traditional livelihood in the rural global south where income generating alternatives are scarce. Marmato is one of South America's oldest gold mining sites, and ASM has been intermittently practiced there since about 500 B.C. The present study maps ASM onto the five capitals of the SLF and identifies several forms of capitals that miners cited as the most relevant for pursuing ASM activities. The results show that artisanal and small-scale gold miners in Marmato strategically combine different forms of capital that enable them to make a living from mining; however, there are key factors that may impact the longer-term viability of artisanal and small-scale mining livelihoods. Although human, social, and financial capital function to support ASM livelihoods, the finite nature of natural capital and deterioration of physical capital erode the potential for sustainability of those livelihoods. This research highlights the utility of closely examining the capitals in the SLF and suggests that a more comprehensive understanding of ASM capitals can better inform formalization policies and associated development interventions.

An Interview with Britt Halvorson and Josh Reno

An Interview with Britt Halvorson and Josh Reno Jon K. Lauck JL: Where are you from? BH: I grew up in western Michigan, in Muskegon, a mid-size industrial city along Lake Michigan. But my parents have no multi-generational ties to that area and, in fact, they grew up in Sweden and Madagascar. So I've actually long been curious about the cultural matter of "from-ness" or belonging, of how people form attachments to places, and of how circulating, dominant imagery of places can be linked to projects of race and ethnicity. That is actually the focus of our book. JR: I grew up in western New York, in Walworth, which is a small, rural hamlet south of Lake Ontario and East of the City of Rochester. However, my mother's side of the family, specifically my maternal Great Grandfather, came from Council Bluffs, Iowa originally. I heard stories about his life as a cowboy, herding cattle across the states. I grew up on these stories. So when I later moved with my family to Michigan to go to graduate school in anthropology part of me felt like I was returning to the Midwest, in a sense. And this sense of the Midwestern region, a place that you think you know even if you've never been there, is part of our focus. JL to BH: How did your parents from Sweden and Madagascar end up in Muskegon? BH: They ended up in Muskegon because my father got a job teaching philosophy at Muskegon Community College. He grew up in Tolagnaro/ [End Page 171] Ft. Dauphin, Madagascar, until age 16 as the son of Norwegian-American Lutheran expats. He finished out his final year of high school in the U.S., followed by college at St. Olaf's College in Northfield, Minnesota (a traditional Lutheran school, if there was one). My mother, on the other hand, grew up in Örebro, Sweden, and she was always interested in learning languages and what we would now call cultural immersion experiences. Though she grew up in a working-class family and never had the opportunity to go to college, she was a bit fearless about uprooting herself and coming to the U.S., the only one in her family. She first came to the U.S. aboard a Scandinavian cruise line, because plane fare was too expensive, and eventually settled in northern California in the early 1960s. In the meantime, my father was pursuing a master's degree and working as a firefighter for the National Forest Service in Idaho. My parents were introduced to each other by mutual friends, an unlikely scenario to be sure, even though they had never met. JH to BH: Were your Norwegian-American Lutheran expat grandparents missionaries in Madagascar? Were they from Minnesota? Does that explain the connection to St. Olaf? BH: My paternal grandparents were Lutheran missionaries in southeast Madagascar, with my grandfather having been trained as a minister. They actually weren't from Minnesota, though they had connections there through the Lutheran church. My paternal grandmother's family had only a few generations' ties to Iowa and, before that, came to the U.S. from western Norway. And, on my paternal grandfather's side, he actually grew up in southeast Madagascar as the son of a Norwegian-American Lutheran minister. In that male line, being a clerical missionary or missionary doctor was something of a multi-generational family business, which was not entirely unusual in the broader community of American Lutherans as I later learned. Prior to that, his immediate family had connections to Washington state and Norway, only stopping in Minnesota for religious training at the Luther Theological Seminary in St. Paul. JL to BH: I see you went to Albion College in Michigan? What was that like? Did you first study anthropology there? BH: I found Albion College much in the same way Josh found Cornell (though we've never compared notes on this before). I applied to schools [End Page 172] that sent me brochures in the mail, and Albion was one of them. Because of my good grades in high school, I received a substantial scholarship from Albion, the...

Self-Rated Health and Mental Health Among African Americans in the Rural South: The Influence of Social Determinants of Health.

The current study examines the influence of seven categories of social determinants of health (i.e., financial resource strain, food insecurity, transportation needs, housing instability, education and health literacy, social isolation, and interpersonal safety), as well as perceived race-related discrimination and disparities in received health care quality on self-rated health and mental health. Multiple linear regression was used to test whether social determinants of health and race-related stressors were associated with self-reported health status and self-reported mental health status in a sample of rural African Americans residing in the Southeastern United States. The results suggest that food insecurity was significantly associated with lower levels of self-rated health and mental health. In contrast, greater health literacy was significantly associated with higher levels of self-rated health and mental health. Surprisingly, greater transportation needs were also associated with higher levels of self-rated mental health status. Among the race-related stressors, racial discrimination was associated with lower levels of self-rated health status. Community-based interventions that seek to alter social determinants of health and reduce experiences with racial discrimination may improve self-rated health and mental health among rural African Americans.

Making Sense of Troubled Livelihoods: Gendered Expectations and Poor Health Narratives in Rural South Africa

When men and women cannot attain idealized gendered forms of economic provision and dependence, how do they make sense of this perceived failure? In this article, we posit that poor health narratives serve as a gendered tool to make sense of inadequate livelihoods, even when that inadequacy is attributable to structural conditions. We draw on survey and life-history interview data from middle-aged and older rural South Africans. The survey data show that even after adjusting for biometrically measured health differences, working-age (40–59 years) men report poorer health when they are unemployed, and women (age 40+) and pension-age men (age 60+) report poorer health when they live without household earners. Life-history interviews show parallel patterns: When their economic circumstance is not troubled, individuals regularly minimize health concerns; conversely, when they have a troubled livelihood, individuals draw on poor health to explain it. When women and men cannot perform idealized gendered practices in the family, poor health becomes a tool to reduce the resulting cognitive dissonance. Poor health narratives recast perceived gender failures to an individualized, biological explanation. Our study illustrates how the epidemiological context can be a resource that forestalls a redefinition of gender norms when the gender order is in crisis.

Operational Characteristics of Women Street Food Vendors in Rural South Africa.

ObjectiveTo characterize the operations of the street food enterprise in the Vhembe district, focusing on business profile, sold foods, inputs, pricing, record-keeping practices and total running cost.MethodsA descriptive cross-sectional face-to-face study of 511 vendors was done using a structured researcher-administered questionnaire comprising demographic and operational characteristics. Convenience sampling was used to choose the vending sites. Chi-square tests were conducted between four categorical variables (gender, age, marital status and citizenship) and operational characteristics. P-values were considered significant at p < 0.05. However, a Bonferroni adjustment decreased the significant value to p < 0.013.ResultsThe findings highlight the dominance of single middle-aged (35–44) women (63.1%) with some high school education. About 14% migrated from Zimbabwe. Most vendors were owners (86.1%), with 70.0% in business for at least 1–10 years. Food sold included mielie pap (stiff porridge) served with beef or chicken, sometimes with vegetables. Plate prices were R40.00 (2.6 USD) for a full plate and R30.00 (2 USD) for half a plate. The typical street food consumers were government officials, middlemen, and schoolchildren. Social media such as Whatsapp were used to communicate between the street food vendors and customers. The results highlight poor managerial skills as only 15.5% kept records, most of which were sales records (59.5%). On average, street vendors made a monthly profit of R3200.00 (213 USD) while spending R1800.00 (120 USD) on daily running expenses. There were statistically significant variations in some operational characteristics of vendor variables and gender, age, marital status, and citizenship.ConclusionsThere is a need for capital and management for small businesses and food training for rural street food vendors. Therefore, government officials, policymakers, and NGOs could target street vendors to offer training and microfinance to improve their business skills while promoting food safety and consumption of nutritious foods.

The Meaning of Health in Rural South Africa: Gender, the Life Course, and the Socioepidemiological Context

AbstractThis article examines the meaning of health among middle‐aged and older adults in a rural South African setting, where 72 percent of adults aged 40 and over are living with a major chronic condition, and 81 percent report good or very good health. We draw on a unique mixed‐methods dataset that includes a population‐based survey with disease biomarkers (hypertension, diabetes, HIV), self‐assessments of health including self‐rated health, functional ability and medication use, as well as nested qualitative life history interviews with survey participants including questions about lived experiences of health. We conduct survey trend analysis and ordinal logistic regression, as well as inductive and deductive coding of qualitative interviews, and triangulate findings across data sources. Overall, we find that self‐rated health and functional ability are not associated with biometric disease indicators; however, we find that gendered familial expectations, life course stage, and the socioepidemiological context work together to regulate the salience of illness as people age. The study highlights the utility of research with multiple measures of health in illuminating the challenges of aging amidst the complex epidemiological transitions that increasingly characterize low‐ and middle‐income countries.

Increased Mortality Trends in Patients With Chronic Non-communicable Diseases and Comorbid Hypertension in the United States, 2000-2019.

BackgroundAccording to the Sustainable Development Goals (SDGs), countries are required to reduce the mortality rates of four main non-communicable diseases (NCDs), including cardiovascular diseases (CVDs), diabetes mellitus (DM), chronic respiratory diseases (CRDs), and cancer (CA), by one-third in 2030 from the 2015 level. However, progress fell short of expectations, partly attributed to the high rates of hypertension-related NCD mortality. This study aimed to investigate the mortality trends of SDG-targeted NCDs with comorbid hypertension. In addition, the disparities in mortality rates among different demographic subgroups were further explored.MethodsMortality data from 2000 to 2019 were acquired from the Centers for Disease Control and Prevention in the United States. SDG-targeted NCDs were considered the underlying causes of death, and hypertension was considered a multiple cause of death. Permutation tests were performed to determine the time points of Joinpoints for mortality trends. The annual percent changes and average annual percent changes (AAPCs), as well as 95% confidence intervals (CIs), were calculated to demonstrate the temporary trend of mortality rates overall and by age, sex, ethnicity, and region.ResultsThe hypertension-related DM, CRD, and CA mortality rates increased over the 20 years, of which the AAPCs were 2.0% (95% CI: 1.4%, 2.6%), 3.2% (95% CI: 2.8%, 3.6%), and 2.1% (95% CI: 1.6%, 2.6%), respectively. Moreover, despite decreasing between 2005 and 2015, the hypertension-related CVD mortality rate increased from 2015 to 2019 [APC: 1.3% (95% CI: 0.7%, 1.9%)]. The increased trends were consistent across most age groups. Mortality rates among men were higher and increased faster than those among women. The hypertension-related CVD, DM, and CA mortality rates among African American people were higher than those among White people. The increased mortality rates in rural areas, especially in rural south, were higher than those in urban areas.ConclusionIn the United States, the hypertension-related DM, CRD, and CA mortality rates increased between 2000 and 2019, as well as hypertension-related CVD mortality between 2015 and 2019. Disparities existed among different sexes, ethnicities, and areas. Actions to prevent and manage hypertension among patients with NCDs are required to reduce the high mortality rates and minimize disparities.

The Characteristics of Obesogenic Environment and Their Association With BMI Among the Elderly Population in Rural South Korea

ObjectivesThe purpose of this research is to analyze the environmental factors affecting obesity in the elderly in rural South Korea. MethodsA survey and Geographical Information System(GIS) data analysis were conducted on 300 elderly people aged 65 and over living in four rural Counties in two Provinces. Formative research was conducted to develop the survey questionnaire. The perception of food environment was measured with five questions, mainly on availability, affordability, and accessibility. The perception of walking environment was measured with eleven questions on esthetics, safety, traffic and community. Social cohesion and the sense of community were asked for measuring social environment. T-test, chi-squared test and stepwise backward regression modeling were performed using Stata/SE 17.0 version. ResultsWe found that the participants from Gangwon-do had higher obesity prevalence than the ones from Jeollanam-do. There was no significant difference in the physical environment between the two Provinces using GIS data analysis; however, there were differences in the perception of the physical environment and the social environment. It was confirmed that the perceptions of the physical environment and social environment were more positive among participants from Jeollanam-do, where obesity prevalence was lower. In stratified stepwise regression models, better perception of food environment was associated with lower BMI in both Provinces. ConclusionsIn this study, various obesity-related environmental factors were explored in rural South Korea. The differences in obesity prevalence in four rural Counties may be explained by different perception on food, walking, and social environments, despite of the similar background factors, such as age distribution, sex ratio, educational level, and financial environment. These findings confirmed that even areas with similar physical settings have different environmental characteristics, which should be considered in developing effective obesity prevention programs. Future research should focus on the development of environmental evaluation tools and the effective measures to enhance the perception of social environment in rural South Korea. Funding SourcesMinistry of Health and Welfare, South Korea NRF of Korea (No. 2021R1A6A1A03044501, No. 2021R1I1A306024811).

Reclamation and Memory: Theological Roots of Decarceration in the Rural South

ABSTRACT This essay examines Growing Change, a decarceral, youth empowerment nonprofit based in rural North Carolina. To situate their work, the “human context” is presented, which details intersections of youth detention and state-imposed idleness. Following this, the “context of place” renders the history of prison labor that gave rise to campuses like the one Growing Change now occupies. In response, taken from an oral history given by the organization’s founder, the mutually reinforcing theological themes of memory and reclamation are foregrounded. Memory has to do with truth-telling, making legible the horror of prison labor as connected to its equally brutal and morally horrendous predecessor, chattel enslavement. Reclamation underscores the work of divine witness, the repurposing of land cultivated for domination into a place of care and community welcome. Drawing on this unique theological vision, the essay concludes with a series of reflections that imagine possibilities for extending this work beyond rural North Carolina.

Moving Out to Move Up: Higher Education as a Mobility Pathway in the Rural South

Mobility has become more constrained, and patterns of immobility are spatially concentrated in certain parts of the United States. Drawing on three years of ethnographic fieldwork in Mississippi, this article examines the role of college as a pathway out of this entrenched poverty and the social and structural barriers that limit the potential of higher education for poor students. It argues that for rural youth, especially rural youth of color, enrolling in college and finding employment that uses that education requires a permanent transition from one opportunity structure to another, a transition that is not often expected of students from more privileged backgrounds. This transition creates social, psychological, and cultural barriers that limit students’ ability to be mobile through education.

LOW GRADE LUMBAR SPONDYLOLISTHESIS AT L4&amp;L5 AND L5&amp;S1 VERTEBRAE IN RURAL SOUTH INDIAN POPULATION

Objectives: In heavy workers incidence of low back ache is common. Low grade spondylolisthesis has more options of treatment than high grade spondylilosthesis. Therefore, this study was done to find out clinical profile of low-grade spondylolisthesis at L4-L5 and L5-S1 vertebrae in rural south Indian population. Co-relation between Modic change (MC) and grades of spondylolisthesis was also assessed. Material and Methods: Study was carried out for a period of 2 years in 40 patients with age 20-70 years with single-level L4/L5 and L5/S1 low grade spondylolisthesis (Meyerding’s grade I and II), with clinical and neurological examination, assessment of pain by Visual Analogue Score (VAS) and investigations like X ray, CT scan &amp; MRI. Results: Out of 40 cases, 27.5% were males and female were 72.5%. The most affected age group was 40-60 years (65%). Lower back pain (LBP) was the most common symptom (100%). Straight leg raise test was positive in 81.25%. Sensory and motar deficit was seen in 45% of patients. L4-L5 level is affected in 60% of low grade spondylolisthesis cases. Incidence of Meyerding’s grade I &amp; II were 67.5% &amp; 32.5% respectively. In both grades females were more in distribution than males and L4-L5 vertebral level was involved significantly. Isthmic (IS) &amp; Degenerative (DS) spondylolisthesis was 82.5% &amp; 17.5% respectively and both incidences were more in females. In IS the level affected was L5-S1 and in DS L4-L5 level. Incidence of MC type1 is 15%, type 2 is 85% and in type3 incidence was not found in any cases. Females showed higher incidence in type1 (83.3%)&amp;type 2 (70.6%) as compared to Males (16.6% &amp; 29.4% respectively) but this difference was not significant(p value&gt;0.05).Type2 Modic changes were found significantlyhigh in grade II spondylolisthesis 70%compared to 30% intype 1(p value=0.02). Summary: Incidence of low spondylolisthesis was more in females and at L4-L5. Modic changes were gender non-specific and grade specific.This study elucidates the clinical presentations of low-grade spondylolisthesis and specific changes associated with it and that will help in tracing factors responsible for it and assessing treatment outcome.

IDF21-0145 Prevalence, awareness, treatment and control of hypertension among non-diabetics, prediabetics and diabetics in India

Background: Hypertension is the most common co-morbidity among people with diabetes. Prehypertension, hypertension, prediabetes and diabetes increase the risk of cardiovascular disease (CVD) which is the number one cause of death among adult Indians. Aim: To estimate the prevalence, awareness, treatment and control of hypertension among adults with no diabetes, prediabetes and diabetes in India. Method: We conducted a cross-sectional study in 2018 among 12284 participants aged ≥30 years residing in epidemiologically transitioning representative population in rural and urban north (Sonipat) and south (Vizag) India. Participants were selected using a multistage cluster random sampling technique. Trained data collectors administered the questionnaire and trained phlebotomists collected blood samples to estimate fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c). Blood pressure (BP) was measured following standard guidelines. Prediabetes was defined as FPG between 100 and 125 mg/dl or HbA1C between 5.7% and 6.4%. Diabetes was defined as FPG ≥ 126 mg/dl or HbA1C ≥ 6.5% or self-reported diagnosis. Hypertension was defined as Systolic BP ≥140 mmHg or Diastolic BP ≥90 mmHg or self-reported diagnosis. Awareness was defined as self-reported physician diagnosed hypertension among prevalent cases. Treatment was defined as currently taking anti-hypertensive medication. Control was defined as participants with SBP<140 mmHg and DBP<90mmHg and on anti-hypertensive medication. Bivariate logistic regression was used to measure associations. Results: The mean (±SD) age was 49.2 (±12.6) years. Nearly half of them were residing in rural areas and were women. The age standardized prevalence of hypertension was 26.0% (95% CI: 25.1–26.8), 35.8% (34.9–36.7) and 48.6% (47.7–49.6) in participants with no diabetes, prediabetes and diabetes respectively. The prevalence of hypertension was higher in males compared to females and also increased with increase in wealth index in all the three groups. Percentage aware, treated and controlled is given in Table 1. People with diabetes were more likely to be aware of their hypertension status if they were females [OR: 1.4 (1.1–1.6)], urban residents [1.6 (1.3–2)], from Vizag site [2.2 (1.8–2.6)], belonged to highest quintile of wealth index [1.5 (1.1 - 2.1)] compared to lowest, never consumed tobacco [1.6 (1.3–2.1)] or alcohol [1.4 (1.1–1.7)], had a family history of hypertension [2.3 (1.8–2.9)], diabetes [1.5 (1.2–1.8)] or heart disease [2.2 (1.4–3.4)].Table 1Proportion (with 95% CI) of participants aware of hypertension diagnosis, treated and controlledNo diabetesPrediabetesDiabetesAwareness38.5 (35.8–41.2)42.7 (40.1–45.3)63.8 (61.0–66.5)Treatment74.8 (71.0–78.7)82.3 (79.2–85.4)90.3 (88.2–92.4)Control45.0 (39.8–50.2)43.9 (39.5–48.4)44.2 (40.4–48.0) Open table in a new tab Discussion: Hypertension is very high in people with prediabetes and diabetes and its awareness, treatment and control is sub-optimal. Tailored and culturally relevant interventions to improve hypertention awareness and management among people with diabetes is urgently needed along with screening for prediabetes among those with hypertension.

It’s Pride Y’all: Mechanical and Organic Solidarity’s Impact on White LGBTQ+ Individuals in the Deep South

ABSTRACT To date, most research on LGBTQ+ individuals and communities tends to be based in metropolitan areas of the United States, largely in New York and California. This research analyzes data from 23 white LGBTQ+ individuals in the Deep South through the lens of Durkheim’s mechanical and organic solidarity. We argue that experiences of LGBTQ+ individuals in the rural south resemble the characteristics of Durkheim’s mechanical solidarity and analyzing their experiences through this lens will help us better understand how LGBTQ+ people in rural/non-metropolitan areas across the Deep South negotiate and resist being labeled deviant in small, isolated, homogeneous communities. We found that for some, the strongly held beliefs of rigid normative conformity was oppressive. However, for others, they were able to bond with likeminded people in their community and were accepted because of mechanical solidarity. Though oppressive experiences remain a feature of being LGBTQ+ in the Deep South, some respondents reported positive experiences and commented on increasing acceptance and tolerance in some areas. Finally, findings indicate while in some ways it is difficult or impossible to eschew the label of deviant, some LGBTQ+ individuals value rural living and can negotiate, resist, and thrive.

Evaluation Design for The Two Georgias Initiative: Assessing Progress Toward Health Equity in the Rural South.

As persistent inequities in health gained increased attention nationally due to COVID-19 and racial justice protests in 2020, it has become increasingly important to evaluate both the process and outcomes associated with coalition-based efforts to address health inequities. The Two Georgias Initiative supports coalitions in 11 rural counties to (1) achieve greater health equity, (2) improve health and health care, (3) build healthier rural communities and improve social conditions that impact the health of rural populations, and (4) build community, organizational, and individual leadership capacity for health equity. Rural communities suffer significant health disparities relative to urban areas, and also experience internal inequities by race and poverty level. The evaluation framework for The Two Georgias Initiative provides a comprehensive mixed methods approach to evaluating both processes and outcomes. Early results related to community readiness and capacity to address health inequities, measured through a coalition member survey (n = 236) conducted at the end of the planning phase, suggest coalitions were in the preparation stage, with higher levels of readiness among coalition members and organizations/groups similar to the coalition members' own, lower levels among public officials and other leaders, and the lowest levels among county residents. In addition, coalition members reported more experience with downstream drivers (e.g., access to care) of health than upstream drivers (e.g., affordable housing, environmental or racial justice). By providing a logic model, evaluation questions and associated indicators, as well as a range of data collection methods, this evaluation approach may prove practical to others aiming to evaluate their efforts to address health equity.

A History of Taiwan Literature transed. by Christopher Lupke

Reviewed by: A History of Taiwan Literature transed. by Christopher Lupke Géraldine Fiss (bio) Christopher Lupke, translator and editor. A History of Taiwan Literature by Ye Shitao. Cambria Press, 2020. 385 p. Ye Shitao 葉石濤 (1925-2008), a pioneering writer and historian, specialized in the literary history of Taiwan and the lives of ordinary Taiwanese people. A History of Taiwan Literature is his most important work that conveys the uniqueness of Taiwanese culture, ethnicity, and historical experience in contrast to mainland China. In this masterful translation of Ye Shitao's opus, which won the 2021 MLA Aldo and Jeanne Scaglione Prize for a translation of a scholarly study of literature, Christopher Lupke allows readers to gain insight into the evolution of Taiwan literature throughout centuries of colonization and subjugation by foreign powers. He highlights the crucial link between literature and "a new consciousness that reflects an awareness of the historical legacy" of Taiwan (12). Framed by Lupke's incisive introduction and epilogue, this book presents a rigorous, comprehensive treatment of Taiwan's literary history in a fair and even-handed way. It devotes attention to major and minor writers whose accomplishments were ignored for decades since there was a virtual denial or ignorance of their literary worth. The work foregrounds Ye Shitao's outlook as a "doubly marginalized" (4) bentu 本土 (of this land) writer of southern Taiwan who advocated an understanding of Taiwanese culture and literature as separate from mainland China. Due to Lupke's inclusion of extensive notes for each chapter, both by Ye Shitao and two Japanese scholars, as well as a rich bibliography and a helpful index, this work is a valuable resource for anyone interested in learning about the historical events, authors, literary journals, and texts that lie at the core of Taiwan's literary heritage. Published in the watershed year of 1987, when martial law in Taiwan was finally lifted, the ultimate goal of this history is to consider Taiwan's literature as a complex, variegated whole and to correct the unbalanced role Taipei had played in Taiwanese literary history. Evoking the "centripetal" effect of Taipei as a "cultural island within the island of Taiwan" (4), Lupke's introduction emphasizes Ye Shitao's life-long purpose to focus on and elucidate other locations and [End Page 145] cultural elements on the island, such as the rural south, that have little in common with the northern capital Taipei. What also becomes clear is Ye Shitao's strong concern with authentic realism that reflects the lived experiences of the vast majority of Taiwanese people. The book begins 220 million years ago "when land first protruded from the sea to form an island" (15) and then concisely traces millennia of contact with mainland China when "diplomats were sent to mollify, and troops to quash Taiwan" (17) while the dissemination and transplantation of traditional Chinese literature continued. Discussing travelogues, travel poems and essays by emissaries to Taiwan, Ye Shitao draws a clear distinction between travelers and native people, stating that texts by visiting officials "lacked the depth that could only be attained from the point of view of a native, whose works described hardship among the people" (23). This powerful sense of "native consciousness" (31) is a quality that Ye Shitao situates in the poetry and prose of Taiwanese writers. The heart of Ye Shitao's treatise is Chapter 2, where he describes the historical significance of the Taiwan New Literature Movement during the fifty-one years of the Japanese Colonial Period (1895-1945). During these years, the Taiwan cultural enlightenment movement, strongly influenced by May Fourth thinkers on the mainland, became linked to the Taiwan vernacular movement as well as Taiwan's striving for national self-determination and resistance to the Japanese. The problem of language comes to the foreground here since nativist writers sought to emulate the people's spoken vernacular to "penetrate the world of the broad masses" (70). Tracing the difficult tensions at the heart of this moment in Taiwan's literary history, Ye Shitao sheds light on thinkers like Zhang Wojun 張我軍 (1902-1955) and Lai He 賴和 (1894-1943), who sought to provide a theoretical foundation for the "essence, content, and style of New Taiwan...

Abstract P189: Leveraging Existing Cohort Study Infrastructure And Community Trust To Promote Covid Vaccination In Rural Mississippi: Experience From NHLBI’s RURAL Cohort Study

Background: The current surge in COVID-19 infections in the rural south is primarily due to the large number of unvaccinated individuals. Increasing the number of individuals getting vaccinated in rural areas remains a challenge due to multiple factors including education, vaccine literacy and hesitancy, and access to vaccination sites. Objective: Investigators in the Risk Underlying Rural Areas Longitudinal (RURAL) Study used existing community partnerships with local advisory boards and with state organizations to promote vaccinations in a pair of low-risk and high-risk rural counties in Mississippi. Methods: The Mississippi Core of the RURAL Study is responsible for community engagement, forming community advisory boards and promoting the RURAL Study among residents of Oktibbeha and Panola Counties. We partnered with community advisory board (CAB) members to identify geographic sites that have a need for increasing vaccinations and assessed the willingness of the facilities to serve as a site for ‘popup’ vaccination clinics. We partnered with the Mississippi State Medical Association and the Mississippi Department of Health to identify COVID 19 vaccination providers in these rural areas. Working with physicians on the CAB and local county hospitals, we secured staffing, vaccines and equipment and scheduled dates and times for popup vaccination clinics at 4 sites in Panola County and 5 sites in Oktibbeha County. Popup clinics were promoted locally by physicians and churches, and through RURAL investigators using both social media and news media. Investigators evaluated: 1) the success of popup clinics; 2) number of persons vaccinated at each clinic; and 3) sex, age range and race of those receiving vaccinations collected. Findings: All nine of the COVID19 popup vaccinations clinics were successfully set up and run. A total of 77 individuals received vaccinations (32 in Panola County and 45 in Oktibbeha County). In Panola County more men than women received vaccinations and all age ranges (12-19, 20-29, 30-39,40-49, 50-59, 60-69, ≥ 70 years) were represented. The majority of those receiving vaccinations in Panola County were Non-Hispanic Black Americans. In Oktibbeha County more men than women received vaccinations and older age ranges (&gt; 50 years) predominated. In Oktibbeha County there was a more even balance of Non-Hispanic Black and White Americans among those receiving vaccinations. Panola County vaccinations were mostly first-time vaccinations and Oktibbeha County vaccinations were mostly booster doses. Conclusion: Existing cohort study infrastructure and human resources offer a unique opportunity to leverage existing community collaborations to promote vaccinations in a national pandemic.

Applying a WASH Risk Assessment Tool in a Rural South African Setting to Identify Risks and Opportunities for Climate Resilient Communities.

Climate change threatens the health and well-being of populations. We conducted a risk assessment of two climate-related variables (i.e., temperature and rainfall) and associated water, sanitation and hygiene (WASH)-related exposures and vulnerabilities for people living in Mopani District, Limpopo province, South Africa. Primary and secondary data were applied in a qualitative and quantitative assessment to generate classifications of risk (i.e., low, medium, or high) for components of hazard/threat, human exposure, and human vulnerability. Climate-related threats were likely to impact human health due to the relatively high risk of waterborne diseases and WASH-associated pathogens. Vulnerabilities that increased the susceptibility of the population to these adverse outcomes included environmental, human, physical infrastructure, and political and institutional elements. People of low socio-economic status were found to be least likely to cope with changes in these hazards. By identifying and assessing the risk to sanitation services and water supply, evidence exists to inform actions of government and WASH sector partners. This evidence should also be used to guide disaster risk reduction, and climate change and human health adaptation planning.

“Do I want PrEP or do I want a roof?”: Social determinants of health and HIV prevention in the southern United States

ABSTRACT Scaling up use of Pre-Exposure Prophylaxis (PrEP) among young men who have sex with men and transgender women (YMSM/TGW) is a critical part of the Ending the HIV Epidemic plan. This qualitative study contextualized the social determinants of health (SDOH) that can impede HIV prevention in rural North and South Carolina with 14 key informant interviews with stakeholders and 3 focus groups with YMSM/TGW (N = 23). A deductive-inductive approach with multiple coders was employed to identify themes related to SDOH in rural areas, including economic challenges (e.g., housing and food insecurity), neighborhood characteristics (e.g., lack of transportation), healthcare-related issues (e.g., provider shortages) and educational barriers (e.g., lack of comprehensive and inclusive sexual education). The socio-environmental context of the rural South and prioritization of local, community-based partnerships are necessary to reduce the burden of HIV.

Non-alcoholic fatty liver disease (NAFLD): a significant predictor of gestational diabetes mellitus (GDM) and early pregnancy miscarriages—prospective study in Rajarata Pregnancy Cohort (RaPCo)

Background and aimsNon-alcoholic fatty liver disease (NAFLD) is increasing globally with a mounting body of evidence on various adverse effects on pregnancy. Yet, prospective studies, especially from low-income and middle-income...

Feasibility of an Adapted Community-Based Lifestyle Intervention to Prevent Cancer in the Rural South: Healthy Living Partnerships to Prevent Cancer (HELP PC).

Obesity increases risk of cancer onset and promulgates cancer mortality. Healthy Living Partnerships to Prevent Cancer (HELP PC) is an adapted intensive lifestyle intervention that is facilitated by community health workers (CHWs). The primary objective of this one-arm pilot study was to test the feasibility of evaluating HELP PC in a rural community by assessing participant recruitment, retention, and adherence to the intervention. The secondary objectives of this study were to evaluate the feasibility of collecting study measures and analyze intervention effects to inform future studies. Adults of all races and a BMI ≥ 25 kg/m2 who resided in the Dan River Region of Southern Virginia were recruited. Participants received 24 weekly (hour-long) group sessions led by a CHW and two consultations with a registered dietitian (RDN). Seventy-five percent (21/28) of eligible subjects were enrolled (n = 21; mean age = 46 years; 67% African American; 90% female; median BMI = 36.1), and recruitment was completed in 2 weeks. Fifty-two percent (11/21) of participants attended >70% of group sessions (adherence) and 98% of RDN consultations were attended. Eighty-six percent (n=18) of participants completed the 6-month follow-up visit (retention), and showed improvements in moderate physical activity, health literacy, general health, energy, and emotional well-being. Feasibility of HELP PC was established through efficient participant recruitment, modest attendance, high retention, and execution of data collection procedures. Importantly, findings can be applied to advance cancer prevention lifestyle interventions in rural communities.