Urban-rural Gap Research Articles

Transformation of Urban–Rural Relationships in the Context of Global Challenges

AbstractThis article updates and further develops the reflections of “Urbanization and Sustainability after the COVID-19 Pandemic” (Motta 2020). It is now even more urgent to focus on the urban–rural relationships that are being modified by the pandemic, climate change, and the impacts of conflicts, causing serious human insecurities and increasing precarious circumstances worldwide. The fast-changing situation and recurrent emergencies confirm the need for a new urban development approach, related to the specificities of the surrounding environment and based on the revival of towns and settlements spread over territories. This should function as a complementary tool to mitigate urbanization flows and urban–rural gaps, identifying new relationships. This requires the review of current urban paradigms, which are no longer able to respond to modified conditions and demands with an innovative vision. This is actualized on the basis of the principles of the social quality theory (SQT) and approach (SQA) and their emphasis on processes in and between the four relevant dimensions of societal life. In the past decade, these principles have been developed tentatively in working papers about sustainability and urban issues from a social quality perspective.

What Barriers Does China’s System of Education Create to Social Mobility?

This paper analyses the barriers to social mobility created by China’s education system from the perspectives of China’s education history and current situation, education purpose and activities, urban-rural education gap, family economic and cultural capital, and the possibility of social mobility, and puts forward some thoughts on improving the possibility of social mobility from the perspective of education.

Access to Latrine Facilities and Associated Factors in India: An Empirical and Spatial Analysis

Access to adequate sanitation facilities is a basic human right and fundamental to good health. Inadequate and unhygienic sanitation practices have severe consequences for public health and socio-economic development. This study examines the levels and trends in access to latrine facilities, spatial variations and the associated socio-economic factors in India. Data drawn from the National Sample Survey Organization’s (NSSO) 69th (2012) and 76th rounds (2018) were used in this study. Moran’s ‘I’ statistic and Local Indicators of Spatial Association (LISA) were applied to assess the spatial variations in access to latrine facilities. Bivariate and multivariate logistic regressions were employed to examine the factors associated with latrine use. The findings revealed that access to sanitation facilities is unsatisfactory, and there is a huge rural–urban gap in latrine use. Unequal access among socio-economic groups is also very prominent. The study found substantial geographical variations in latrine use across the country; open defecation is highly prevalent in eastern and central regions of the country, while the north and north-eastern regions have better access to latrine facilities. Factors like education, occupation, socio-religious affiliation, water availability, and economic status are significant determinants of accessibility to latrine. It is recommended that targeted interventions for the socio-economically disadvantaged groups, spreading awareness about the importance of latrine use and hygienic practices, and proper assistance for construction and maintenance of toilets could be helpful to combat the harmful practice of open defecation and ensure adequate and equitable sanitation for all.

Has the COVID-19 Pandemic Widened the Urban-Rural Gap in Early Child Development in China? Evidence from the Rural Side

ABSTRACT Research Findings: This national survey study aims to investigate the impact of the COVID-19 Pandemic on early development of rural preschoolers in China and compare the urban-rural gap. Participants were 11,282 rural preschool teachers recruited through the stratified random sampling method. They completed the survey online via wjx.com, the dominating online survey platform in China. We compared the results with our previous research on 22,466 urban teachers and found: (1) most preschoolers in rural China had development improvement during the quarantine; (2) there were no significant urban-rural differences in early development; (3) three distinct profiles of rural preschoolers emerged: the low, medium, and high levels. Those 3–4 year-olds in public preschools in western China tended to have development loss or even development regression; and (4) increased parental involvement was found the significant predictor of rural preschoolers’ development improvement during the quarantine. Practice or Policy: The findings imply that more public support for rural families and communities should be provided to promote children’s early development.

Urban-rural difference in the costs of disability and its effects on poverty among people with disabilities in China.

The urban-rural difference in poverty is an important issue in China, particularly for people with disabilities. The extra costs of disability render this population susceptible to falling into poverty, where this can exacerbate the inequality among people with disabilities between urban and rural areas of the country. Previous studies have provided empirical evidence for the extra costs of disabilities in certain countries, but little scholarly attention has been devoted to the urban-rural gap in the costs of disability, particularly in countries like China that have a dual urban-rural system. This study explores changes in the extra costs of disability in China between urban and rural households with disabled members from 2008 to 2018 by using the standard of living approach. We apply the Foster-Greer-Thorbecke Poverty Index to measure the rates of poverty in urban and rural households with disabilities after considering the costs of disability. The results reveal that the costs of disability were not always lower for rural households than for urban households. At the same time, many rural households with disabled people were found to suffer from severe poverty owing to the high costs of their disabilities. The difference in health insurance and rehabilitation services between urban and rural China have led to an urban-rural gap in the costs of disability. This suggests that supplying more goods and services for disabled people in rural areas, especially free services, and raising the reimbursement due to them from their health insurance can help improve their standard of living.

Rural urban differences in self-rated health among older adults: examining the role of marital status and living arrangements

BackgroundThe rural–urban gap in socioeconomic and morbidity status among older adults is prevalent in India. These disparities may impact the levels and factors of self-rated health (SRH). The objective of the study is to compare the levels and determinants of SRH between rural and urban areas by considering the moderating effects of marital status and living arrangements.Subjects and methodsThe present study used data from the Longitudinal Ageing Study in India (LASI) wave 1 (2017–18). A total sample of 30,633 older adults aged 60 years and above were selected for the study. Descriptive statistics, bivariate chi-square test, the interaction effect of living arrangements and marital status, and logistic estimation were applied to accomplish the study objectives.ResultsThe prevalence of poor SRH was found 7% higher in rural areas compared to urban counterparts. A substantial rural–urban disparity in the patterns of poor SRH was also observed. The interaction effect of marital status and living arrangement on self-rated health suggested that older adults who were currently unmarried and living alone were 38% more likely to report poor SRH than those who were currently married and co-residing in rural India. In addition to marital status and living situation, other factors that significantly influenced SRH include age, socio-cultural background (educational attainment and religion), economic background (employment status), health status (ADLs, IADLs, multi-morbidities), and geographic background (region).ConclusionThe present study's findings demonstrated that, notwithstanding local variations, marital status and living circumstances significantly influenced SRH in India. In the present study, unmarried older people living alone were more susceptible to poor SRH in rural areas. The present study supports the importance of reinforcing the concepts of care and support for older individuals. There is a need for special policy attention to older individuals, particularly those unmarried and living alone. Although older individuals had difficulty performing ADLs and IADLs and had multi-morbidities, they reported poorer health. Therefore, offering them social support and top-notch medical assistance is crucial.

"Digital Dividend" or "Digital Divide": What Role Does the Internet Play in the Health Inequalities among Chinese Residents?

With the vigorous development of the medical industry in China, residents' health has been significantly improved. However, along with the income gap, urban-rural gap, and healthcare resource gap caused by economic development, health inequality has become a fundamental barrier to the promotion of residents' health. The popularity of the Internet has helped close the gap to some extent, but it also has drawbacks. Using data from the China Family Panel Studies (CFPS) from 2014 to 2018, we evaluated the effects of Internet usage on health disparities among residents using fixed effect models, mediation effect models, and other methodologies. The findings indicate that Internet usage can help to minimize health inequality since it lowers income inequality, promotes health consciousness, and reduces depression. Furthermore, Internet usage plays a greater role on the health improvement of the middle-aged, the elderly, urban residents, and females. Although the Internet has brought "digital dividends" in general, the Internet usage rates among different groups also reveal that there is a clear "digital gap" among rural residents, elderly groups, and low-income groups. These results have significant implications for promoting healthcare equality.

An update on explaining the rural-urban gap in under-five mortality in India

BackgroundRural Indians have higher mortality rates than urban Indians. However, the rural-urban gap in under-five mortality has changed is less researched. This paper aims to assess 1) whether the rural-urban gap in under-five mortality has reduced over time 2) Whether rural children are still experiencing a higher likelihood of death after eliminating the role of other socioeconomic factors 3) What factors are responsible for India’s rural-urban gap in under-five mortality.MethodsWe used all rounds for National Family Health Survey data for understanding the trend of rural-urban gap in under-five mortality. Using NFHS-2019-21 data, we carried out a binary logistic regression analysis to examine the factors associated with under-five mortality. Fairlie’s decomposition technique was applied to understand the relative contribution of different covariates to the rural–urban gap in under-five mortality.ResultsIndia has witnessed a more than 50% reduction in under-five mortality rate between 1992 and 93 and 2019–21. From 1992 to 93 to 2019–21, the annual decrease in rural and urban under-five mortality is 1.6% and 2.7%, respectively. Yet, rural population still contributes a higher proportion of the under-five deaths. The rural-urban gap in under-five mortality has reduced from 44 per thousand live births in 1992–1993 to 30 per thousand in 2004–2005 which further decreased to 14 per thousand in 2019–2021. There is no disadvantage for the rural children due to their place of residence if they belong to economically well-off household or their mothers are educated. It is wealth index rather than place of residence which determines the under-five mortality. Economic (50.82% contribution) and educational differential (28.57% contribution) are the main reasons for rural-urban under-five mortality gaps.ConclusionThe existing rural-urban gap in under-five mortality suggests that the social and health policies need to be need to reach rural children from poor families and uneducated mothers. This call for attention to ensure that the future programme must emphasize mothers from economically and educationally disadvantaged sections. While there should be more emphasis on equal access to health care facilities by the rural population, there should also be an effort to strengthen the rural economy and quality of education.

Provincial variations in catastrophic health expenditure and medical impoverishment in China: a nationwide population-based study

Financial protection, as a key dimension of Universal Health Coverage (UHC), has been under increasing attention in recent years. A series of studies have examined the nationwide extent of catastrophic health expenditure (CHE) and medical impoverishment (MI) in China. However, disparities in financial protection at the province level have rarely been studied. The aim of this study was to investigate provincial variations in financial protection as well as its inequality across provinces. Using data from the 2017 China Household Finance Survey (CHFS), this study estimated the incidence and intensity of CHE and MI for 28 Chinese provinces. Ordinary least square (OLS) estimation, using robust standard errors, was used to explore the factors associated with financial protection at the province level. Moreover, this study examined the urban-rural differences in financial protection within each province, and calculated the concentration index of CHE and MI indicators for each province using household income per capita. The study revealed large provincial variations in financial protection within the nation. The nationwide CHE incidence was 11.0% (95% CI: 10.7%, 11.3%), ranging from 6.3% (95% CI: 5.0%, 7.6%) in Beijing to 16.0% (95% CI: 14.0%, 18.0%) in Heilongjiang; the national MI incidence was 2.0% (95% CI: 1.8%, 2.1%), ranging from 0.03% (95% CI: 0.00%, 0.06%) in Shanghai to 4.6% (95% CI: 3.3%, 5.9%) in Anhui province. We also found similar patterns for provincial variations in intensity of CHE and MI. Moreover, substantial provincial variations in income-related inequality and urban-rural gap existed across provinces. Eastern developed provinces in general had much lower inequality within them, compared with central and western provinces. Despite the great advances towards UHC in China, substantial provincial variations exist in financial protection across provinces. Policymakers should pay special attention to low-income households in central and western provinces. Provision of better financial protection for these vulnerable groups will be key to achieving UHC in China. This research was supported by the National Natural Science Foundation of China (Grant Number: 72074049)and the Shanghai Pujiang Program (2020PJC013).

Agricultural production structure and inequality of educational development in China.

Unbalanced regional development in China has always been the focus of the government's attention. Agricultural development in China's main agricultural regions is characterized by relatively obvious features, which are mainly manifested in the excessive concentration of agricultural production on one crop or a few agricultural products. Whether this trend of concentration will help to improve the inequalities in China's educational development is an important question for this study. Based on China's population, education and agricultural data over the past 20 years, this paper provides an in-depth analysis of educational inequalities in five typical agricultural-producing provinces by calculating indicators such as the rationalization index of agricultural production structures, the average number of years of schooling of residents and the Gini coefficient of education, in order to analyze the essential reasons for the development of education inequality in major agricultural producing areas. The results show that the urban-rural gap is an important factor affecting the equality of educational development in the main agricultural production areas; the reduction of the rationalization index of agricultural production structure can promote the improvement of inequality in educational development and narrow the urban-rural educational development gap; it also shows that the improvement of specialization in major agricultural producing areas is conducive to reducing educational inequality in major agricultural producing provinces; these conclusions provide a useful reference for narrowing the urban-rural education gap in the main agricultural production areas.

The Impact of Payment Innovation on Narrowing the Urban-rural Gap

With the rapid development of fintech, mobile payments is rapidly being widely used in China. As a financial and economic connection point, vigorously developing the payment system is the inevitable choice to narrow the gap between urban and rural areas. Based on this, this study attempts to establish a random effect model in panel regression to analyse the impact of the development of third-party payment on the urban-rural income gap of 31 provinces and municipalities from 2013 to 2020 in China. The results show that the growth of third-party payment scale has a positive effect on narrowing the urban-rural income gap. Therefore, this paper suggests that increasing the construction of rural mobile payment is of great significance to improve farmers’ income. And finally puts forward the specific path of mobile payment construction.

The impact of agricultural disasters on child development in rural China.

China's uneven development under the urban-rural dichotomy has led to the discouraging development of children in rural areas. China is a large agricultural country and agricultural disasters are relatively common. Rural children aged 10-15 whose families depend on the agricultural economy may experience far-reaching negative effects from these disasters. This study explored the effects of agricultural disasters on rural children's development, including cognitive and noncognitive skills, and academic pressure. Survey data from the China Family Panel Survey and the National Meteorological Administration for 2010-2018 and a fixed-effect panel model with difference-in-differences regressions were used in the study. The fixed effects model results showed evidence that agricultural disasters have a negative impact on rural children's cognitive and noncognitive skills and a positive impact on academic pressure. The statistically significant coefficients are -0.092, -0.938, and 0.223, respectively. School and family environments also explain children's development. Robustness tests confirmed these results. Evidence shows that agricultural disasters have a significant negative impact on rural child development. It may be inferred that these will increase the difficulty of narrowing the urban-rural development gap. China is committed to promoting prosperity for all its people. Special attention should be paid to the consequences of disasters at the child level and appropriate measures should be taken to mitigate possible negative impacts.

Disease burden of ageing, sex and regional disparities and health resources allocation: a longitudinal analysis of 31 provinces in Mainland China

ObjectivesTo measure the disease burden of ageing based on age-related diseases (ARDs), the sex and regional disparities and the impact of health resources allocation on the burden in China.DesignA national...

Temporal and Spatial Differentiation and Driving Factors of China’s Agricultural Eco-Efficiency Considering Agricultural Carbon Sinks

Climate change, greenhouse gas emissions, and food security have put forward higher requirements for sustainable agricultural development. Agricultural ecological efficiency (AEE) is an important indicator to evaluate the sustainable development of agriculture. Low carbon agriculture promotes sustainable agricultural development. Agricultural carbon sinks are an important output of agricultural production, but they have not been fully reflected in the current research on agricultural ecological efficiency. In this study, agricultural carbon sinks are considered as one of the expected outputs of AEE. The data envelopment method was used to measure the AEE of 31 provincial-level administrative regions in China from 2000 to 2019, and the AEE of China was compared with and without carbon sinks. The Gaussian kernel function was used to estimate the time evolution of regional differences in AEE. A geodetector model was used to detect the drivers of spatial differentiation of AEE in China. The results showed that considering agricultural carbon sinks as one of the expected measurement outputs brings the estimated AEE closer to reality. From 2000 to 2019, China’s AEE showed an upward trend, and the efficiency value increased from 0.48 to 0.95, an increase of 97.92%. The spatial distribution pattern of AEE in China was Northeast > West > Central > East, with obvious differences among provinces. The industrialization level, urban–rural gap, agricultural economic level, agricultural disaster rate, and urbanization level were the leading driving forces for the spatial differentiation of AEE in China. The research will help to reveal the dynamic characteristics, spatial differentiation characteristics, and driving factors of China’s agricultural ecological efficiency, and provide a scientific reference for the realization of sustainable agricultural development and high-quality development.

Paediatric use of emergency medical services in India: A retrospective cohort study of one million children.

BackgroundMillions of children in low- and middle-income countries (LMICs) experience illness or trauma amenable to emergency medical interventions, but local resources are not sufficient to treat them. Emergency medical services (EMS), including ambulance transport, bridge the gap between local services and higher-level hospital care, and data collected by EMS could be used to elucidate patterns of paediatric health care need and use. Here we conducted a retrospective observational study of patterns of paediatric use of EMS services by children who used EMS in India, a leader in maternal and child EMS development, to inform public health needs and system interventions to improve EMS effectiveness.MethodsWe analysed three years (2013-2015) of data from patients <18 years of age from a large prehospital EMS system in India, including 1 101 970 prehospital care records across 11 states and a union territory.ResultsOverall, 38.3% of calls were for girls (n = 422 370), 40.5% were for adolescents (n = 445 753), 65.9% were from rural areas (n = 726 154), and most families were from a socially disadvantaged caste or lower economic status (n = 834 973, 75.8%). The most common chief complaints were fever (n = 247 594, 22.5%), trauma (n = 231 533, 21.0%), and respiratory difficulty (n = 161 120, 14.6%). However, transport patterns, including patient sex and age and type of destination hospital, varied by state, as did data collection.ConclusionsEMS in India widely transports children with symptoms of the leading causes of child mortality and provides access to higher levels of care for geographically and socioeconomically vulnerable populations, including care for critically ill neonates, mental health and burn care for girls, and trauma care for adolescents. EMS in India is an important mechanism for overcoming transport and cost as barriers to access, and for reducing the urban-rural gap found across causes of child mortality. Further standardisation of data collection will provide the foundation for assessing disparities and identifying targets for quality improvement of paediatric care.

Nonlinear Effect of Urbanization on the Gap between Urban and Rural Elementary Education in China

The urban-rural gap of elementary education seriously affects social fairness, so the study on the urban-rural gap of elementary education can help promote social fairness in China. China’s urbanization is an important variable affecting the social process, and its impact on the urban-rural gap of elementary education is worthy of further study. Based on China’s provincial panel data from 2006 to 2017, this paper uses the Theil index to measure the urban-rural gap in different aspects of elementary education and uses principal component analysis (PCA) to construct a comprehensive index to objectively measure the urban-rural gap of overall elementary education in China. Our results show that the gap between urban and rural areas in China’s elementary education showed an upward trend from 2006 to 2010, and the gap decreased year by year from 2010 to 2017. Then we used the panel smooth transition regression (PSTR) model to study the impact of urbanization on the urban-rural gap of elementary education in China and find evidence that urbanization has a nonlinear effect on the urban-rural gap of elementary education. That is, in economically underdeveloped areas, urbanization exacerbates the gap between urban and rural areas in elementary education, while in economically developed areas, urbanization narrows the gap between urban and rural areas in elementary education. Therefore, developing economy and continuing to promote urbanization are effective measures to narrow the gap between urban and rural areas in elementary education.

What kind of enterprises and residents bear more responsibilities in carbon trading? A step-by-step analysis based on the CGE model

This paper provides a new analytical framework interpreting the model results from a computable general equilibrium model. The study takes China's Emission Trading Scheme (ETS) as an example, applying the China Energy-Environment-Economy Analysis model to study the impact mechanism of the ETS. The study constructs three types of ETS coverage, analyzes the price fluctuation, considers the impact on macro indicators, and finally calculates the impact on residents, factor flow, enterprises, and households. The results show that the ETS only covering electricity may lead to the highest rise of consumer price index and most significant reduction of actual purchasing power; rural households may suffer more from ETS negative impact because of the consumption structure; ETS may create new job opportunities in the ETS-covered sectors, especially in energy-intensive industries for low carbon careers. However, the outputs of these industries still decrease. It should be noted that carbon trading may widen the urban-rural gap from both the source side and consumer side.

Fleshing out the olive? Observations on income polarization in China since 1981

In a rare example of a national goal for income distribution besides reducing poverty (for which there is a broad consensus), China's leadership committed in 2021 to attaining a less polarized “olive-shaped” distribution. The paper argues that the Foster-Wolfson polarization curve and index are well suited to quantifying this goal. New estimates indicate that polarization has been on a rising trend since 1981, but with a de-polarizing reversal emerging around 2009. There is no robust time-series evidence of polarizing effects of economic growth, poverty reduction or population urbanization. Larger urban-rural gaps in mean incomes have been strongly polarizing.

Delayed Childhood Immunization and its Associated Factors in Children under 2 Years of Age in Kelambakkam, Chengalpattu District

Introduction: Immunisation is the most effective public health intervention for reducing morbidity and mortality among young children. Even though we have witnessed an increase in immunization status, the lag in vaccinating younger children and the rural-urban gap in immunizing kids is still a matter of concern. Any disruption in the ongoing immunization services might even contribute to the initiation of the secondary outbreak of vaccine-preventable diseases. Methodology: A cross-sectional study was conducted to assess the immunization status of children under 2 years of age in Kelambakkam, along with the determinants of missed/delayed immunization using a semi-structured questionnaire to the parents of children below 2 years of age residing in Kelambakkam area of Chengalpattu district. Results: Delay in immunization was recorded in 34.28% of children among the entire study participants. Vaccines like MR1 (Measles, Rubella), and PCV Booster given at 9 months were delayed in 25% of children. Immunization delay and birth order of the baby were found to be significantly associated with each other. Conclusion: The delivery of basic health services like childhood immunization in Chengalpattu was majorly disrupted due to the ongoing pandemic. The findings of our study may be considered a basic reference for implementing any plan of action to improve childhood vaccination coverage during an epidemic or natural disaster or pandemic.

Differences in treatment for Alzheimer's disease between urban and rural areas in China.

IntroductionIn China, the increasing number of people with Alzheimer's disease (AD) poses a great challenge to families and the country. Economic and cultural differences cause a urban-rural gap in medical resources. This multicenter survey aimed to investigate the real-world practice of disease treatment among people with AD.MethodsPeople with AD and their caregivers from 30 provincial regions in mainland China were enrolled from October 2020 to December 2020 to be surveyed for their treatment experience. Logistic regression was used to explore the factors that influence medication adherence in all areas, urban areas, and rural areas.ResultsIn this survey, 1,427 participants came from urban areas, and 539 participants came from rural areas. Patients in urban areas were older (mean age 74 vs. 70, p = 0.001), less frequently had mild AD (36.0 vs. 52.1%, p < 0.001), and more often were cared for at professional institutions (8.8 vs. 3.2%, p < 0.001). In terms of pharmacotherapy, 77.8% of people accepted taking lifelong medication, whereas 61.3% of patients insisted on taking medications. Although 72.0% of rural people believed in taking lifelong medication, only 30.0% adhered to drug use. The major factors that influenced medication adherence for all patients with AD were regional distribution (p < 0.001, OR = 6.18, 95% CI: 4.93–7.74) and family earnings (p = 0.003, OR = 1.22, 95% CI: 1.07–1.38). In rural areas, family earnings (p = 0.008, OR = 1.44, 95% CI: 1.10–1.89) and severity of AD (p = 0.033, OR = 1.31, 95% CI: 1.02–1.68) were the main factors. Family earnings (p = 0.038, OR = 1.16, 95% CI: 1.01–1.34) was the only factor among urban areas. Among all non-pharmaceutical activities except for cognitive intervention, the participation rates of rural patients were significantly higher than those of urban patients (p < 0.05).ConclusionAlthough national progress has been made in the public awareness of disease treatment, adequate diagnosis and medication adherence need to be prompted, especially in rural areas. Furthermore, lifelong treatment should be improved based on regional characteristics through the joint efforts of the government, health workers, and social volunteers.