Urban-rural Variations Research Articles

Refractive errors in Tianjin youth aged 6-18 years: exploring urban-rural variations and contributing factors.

Refractive errors, particularly myopia, constitute a significant global public health concern, contributing to morbidity and disability. A more comprehensive understanding of the determinants of refractive errors and the differences between urban and rural areas is essential to develop effective preventive measures for youth. This study aimed to compare the prevalence and risk factors of refractive errors among youth in urban and rural Tianjin, China. This school-based cross-sectional study was conducted in 2022. Elementary, middle, and high school students aged 6-18 years from both urban and rural areas of Tianjin were included. All participants underwent visual acuity testing and refractive measurement and completed comprehensive questionnaires. A total of 346,146 participants (176,628 boys) were included in this investigation (50.36% for urban and 49.64% for rural, respectively). Myopia, hyperopia, astigmatism, and anisometropia were present in 56.8, 9.7, 56.64, and 21.3% of urban students, respectively. Similarly, rural students had a prevalence of 57.6, 11.5, 56.48, and 22.0% for the respective conditions. Compared to rural students, after adjusting for age, sex, and other significant variables, urban students were 1.05 times more likely to have myopia (95% CI: 1.03-1.07, p < 0.0001), 0.71 times less likely to have hyperopia (95% CI: 0.69-0.73, p < 0.0001), and 1.02 times more likely to have astigmatism (95% CI: 0.69-0.73, p < 0.0001). There was no significant association between anisometropia and residence (OR: 1.00, 95% CI: 0.98-1.02, p = 0.9850). Sociodemographic and physiological factors contribute to the disparities in the prevalence of refractive errors between urban and rural areas. Age, increased near-work activities, and Decreased outdoor time were identified as risk factors for myopia, astigmatism, and anisometropia. Conversely, the absence of a parental history of refractive errors emerged as a protective factor for myopia and astigmatism among students. Lower parental education levels were negatively correlated with the risk of myopia and anisometropia in their children. Specifically, the lower the parental education, the greater the risk of myopia in their offspring. For urban students only, lower parental education was associated with an increased risk of astigmatism. Crude prevalence estimates May not accurately reflect the true burden of refractive error due to confounding factors such as age and sex. Accounting for these factors revealed that urban students were more likely to have myopia and astigmatism but less likely to have hyperopia compared to their rural counterparts. These disparities highlight the importance of considering geographical variations when implementing strategies for myopia control and prevention.

Malaria Prevalence Rates among Pregnant Women in East Africa: National and Regional Perspectives

Malaria remains a critical public health issue in East Africa, with pregnant women particularly vulnerable to its severe consequences. This review examines the prevalence rates of malaria among pregnant women, providing a comprehensive analysis of national and regional perspectives as well as urban-rural and age-specific variations. By integrating national data with regional insights, the review highlights overarching trends and identifies specific hotspots where malaria transmission is most intense. The study reveals that while national data can guide broad resource allocation and policy decisions, regional data is crucial for pinpointing high-risk areas and tailoring localised interventions. We examine the impact of seasonal variations on pregnant women, including increased transmission during rainy seasons and the geographic distribution of high-risk areas and hotspots. The review also explores the influence of socioeconomic factors, education, housing conditions, and biological determinants on malaria risk among pregnant women. Additionally, it addresses the challenges associated with diagnosing malaria, including the limitations of conventional methods and the need for more sensitive diagnostic tools. The impact of malaria during different trimesters of pregnancy and the complications arising from coinfections, particularly with HIV, receive special attention. The review underscores the necessity of integrated care approaches, improved diagnostic infrastructure, and targeted interventions to mitigate the effects of malaria on maternal and foetal health. The findings advocate for a comprehensive strategy that encompasses geographic and seasonal variations, addresses risk factors, and integrates robust diagnostic and treatment approaches to reduce malaria prevalence and improve health outcomes for pregnant women in East Africa. Keywords: malaria, pregnant women, East Africa, national and regional perspectives

Long-term spatiotemporal variations of ammonia in the Yangtze River Delta region of China and its driving factors

This study focuses on the spatiotemporal distribution, urban-rural variations, and driving factors of ammonia Vertical Column Densities (VCDs) in China's Yangtze River Delta region (YRD) from 2008 to 2020. Utilizing data from the Infrared Atmospheric Sounding Interferometer (IASI), Generalized Additive Models (GAM), and the GEOS-Chem chemical transport model, we observed a significant increase of NH3 VCDs in the YRD between 2014 and 2020. The spatial distribution analysis revealed higher NH3 concentrations in the northern part of the YRD region, primarily due to lower precipitation, alkaline soil, and intensive agricultural activities. NH3 VCDs in the YRD region increased significantly (65.18%) from 2008 to 2020. The highest growth rate occurs in the summer, with an annual average growth rate of 7.2% during the period from 2014 to 2020. Agricultural emissions dominated NH3 VCDs during spring and summer, with high concentrations primarily located in the agricultural areas adjacent to densely populated urban zones. Regions within several large urban areas have been discovered to exhibit relatively stable variations in NH3 VCDs. The rise in NH3 VCDs within the YRD region was primarily driven by the reduction of acidic gases like SO2, as emphasized by GAM modeling and sensitivity tests using the GEOS-Chem model. The concentration changes of acidic gases contribute to over 80% of the interannual variations in NH3 VCDs. This emphasizes the crucial role of environmental policies targeting the reduction of these acidic gases. Effective emission control is urgent to mitigate environmental hazards and secondary particulate matter, especially in the northern YRD.

Rural-urban differentials in child body mass index over time

BackgroundThe body mass index is a simple index based on weight and height that can be used to screen children and adults for potential weight problems. The objective of this study was to investigate urban-rural variations in child BMI and its distribution from 2006 to 2016 in four low and middle-income countries.MethodsThis study used data from the Young Lives prospective cohort study conducted in Ethiopia, India, Peru, and Vietnam to assess the BMI change for children aged 5 to 15 between 2006 and 2016. We adopted a mixed-effect model to analyze the data.ResultsThe study revealed substantial changes and rises in BMI in Vietnam, Peru, India, and Ethiopia between 2006 and 2016. Peru had the highest BMI changes in both urban-rural areas. A low BMI was observed in Ethiopia and India. Urban-rural differences had a significant role in determining BMI variation. In urban Ethiopia, the mean BMI increased from 14.56 kg/m2 to 17.52 kg/m2, and in rural areas, it increased from 14.57 kg/m2 to 16.67 kg/m2. Similarly, in urban Vietnam, the BMI increased from 16 kg/m2 to 20.3 kg/m2, and in rural areas, it increased from 14.69 kg/m2 to 18.93 kg/m2.ConclusionsThe findings showed an increase in BMI changes in Ethiopia, India, Peru, and Vietnam from 2006 to 2016. Urban-rural differences have a significant contribution to determining BMI variation.

Epidemiology and outcomes of choledocholithiasis and cholangitis in the United States: trends and urban-rural variations

BackgroundGallstone disease poses a significant health burden in the United States. Choledocholithiasis and cholangitis are common complications of gallstone disease for which data on current epidemiological trends are lacking. We aimed to evaluate temporal changes in hospitalization, management, and outcomes for patients with choledocholithiasis and cholangitis.MethodsThe National Inpatient Sample was used to identify discharges for choledocholithiasis and cholangitis between 2005 and 2014. Temporal trends were evaluated via annual percent changes (APCs). Joinpoint regression was used to assess inflection points. Multivariable regression models were used to evaluate associations of interest.ResultsFrom 189,362 unweighted discharges for choledocholithiasis and/or cholangitis, there was an increase in discharges for choledocholithiasis (APC 2.3%, 95% confidence intervals, CI, 1.9–2.7%) and cholangitis (APC 1.5%, 95% CI 0.7–2.2%). Procedural interventions were more likely at urban hospitals for choledocholithiasis (adjusted odds ratio, aOR, 2.94, 95% CI 2.72 to 3.17) and cholangitis (aOR 2.97, 95% CI 2.50 to 3.54). In-hospital mortality significantly decreased annually for choledocholithiasis (aOR 0.90, 95% CI 0.88 to 0.93) and cholangitis (aOR 0.93, 95% CI 0.89 to 0.97). In-hospital mortality between rural and urban centers was comparable for choledocholithiasis (aOR 1.16, 95% CI 0.89 to 1.52) and cholangitis (aOR 1.12, 95% CI 0.72 to 1.72).ConclusionsHospitalizations for choledocholithiasis and cholangitis have increased between 2005 and 2014, reflecting a growing burden of gallstone disease. Hospital mortality between urban and rural centers is similar, however urban centers have a higher rate of procedural interventions suggesting limitations to accessing procedural interventions at rural centers.

Evolution of farmland landscape fragmentation and its driving factors in the Beijing-Tianjin-Hebei region

Farmland landscape fragmentation has become one of the main manifestations of global land use changes during the last century. Since the reform and opening-up in China, the Beijing-Tianjin-Hebei region, as the representative region in China, has exhibited a continuous process of farmland landscape fragmentation. Scientifically revealing the spatiotemporal dynamics of farmland landscape fragmentation is of great significance for sustainable land management. Although the characteristics of farmland landscape fragmentation have been widely studied, measuring the dynamics of farmland landscape fragmentation from the perspectives of landforms and urban-rural variations remains poorly understood. This study relies on the comprehensively theoretical models to spatiotemporally identify farmland landscape fragmentation and applies a comprehensive index method that includes ArcGIS, FRAGSTATS landscape pattern analysis and the multiscale geographically weighted regression model to empirically analyse the spatial-temporal characteristics of farmland landscape fragmentation in China from 1980 to 2020. The results indicate that the value of the farmland landscape fragmentation index in the Beijing-Tianjin-Hebei region is characterised by process of ‘slight increase-rapid decrease-continuous increase’. High farmland landscape fragmentation index values were observed in the northern and western Beijing-Tianjin-Hebei regions. Moreover, significant differences in farmland landscape fragmentation were observed under different macro landforms. The farmland landscape fragmentation index in the mountainous regions is much higher than in the plains. Furthermore, as the distance to Beijing's centre increases, the farmland landscape fragmentation index decreases in suburban and peri-urban areas. Finally, the results also reveal the driving factors of farmland landscape fragmentation. The results showed that the natural environment is always the crucial driver of farmland landscape fragmentation. Besides, social activities play an important role in the past, but economic development has a more significant coefficient these days. The findings of this study not only verify that the proposed theoretical framework is valid and provides a reference for future policy measures to protect farmland but also provide a basis for farmland landscape fragmentation from a multiscale perspective by, more precisely, identifying the heterogeneity of drivers.

Atmospheric ammonia in China: Long-term spatiotemporal variation, urban-rural gradient, and influencing factors

In recent years, atmospheric ammonia (NH3) concentrations have increased in China. Ammonia control has become one of the next hot topics in air pollution mitigation with the increasing cost of acid gas emission reduction. In this study, using Infrared Atmospheric Sounding Interferometer (IASI) satellite observations, we analyzed the spatiotemporal distribution, the urban-rural gradient of the vertical column densities (VCDs) of NH3 and the contribution of influencing factors (meteorology, social, atmospheric acid gases, and NH3 emissions) in China from 2008 to 2019 using hotspot analysis, circular gradient analysis, geographical and temporal weighted regression, and some other methods. Our results showed that NH3 VCDs in China have significantly increased (31.88 %) from 2008 to 2019, with the highest occurring in North China Plain. The average NH3 VCDs in urban areas were significantly higher than those in rural areas, and the urban-rural gap in NH3 VCDs was widening. The results of circular gradient analysis showed an overall decreasing trend in NH3 VCDs along the urban-rural gradient. We used a geographically and temporally weighted regression model to analyze the contribution of various influencing factors to NH3 VCDs: meteorology (30.13 %), social (27.40 %), atmospheric acid gases (23.20 %), and NH3 emissions (19.28 %) factors. The results showed substantial spatiotemporal differences in the influencing factors. Atmospheric acid gas was the main reason for the increase in NH3 VCDs from 2008 to 2019. A more thorough understanding of the spatiotemporal distribution, urban-rural variations, and factors influencing NH3 in China will aid in developing control strategies to reduce PM2.5.

Epidemiology and Outcomes of Symptomatic Cholelithiasis and Cholecystitis in the USA: Trends and Urban–Rural Variations

BackgroundGallstone disease remains a major health issue. There have been significant changes in the management and demographics of patients with these conditions. We aimed to evaluate trends in hospitalization, management, and post-procedural adverse events for patients with gallstone disease. MethodsThe National Inpatient Sample was used to identify discharges for symptomatic cholelithiasis and cholecystitis between 2005 and 2014. Temporal trends were evaluated by calculating annual percent changes (APCs). Joinpoint regression was used to assess inflection points. Multivariable regression models were used to evaluate associations between urban and rural divisions and mortality, use of interventional procedures, and post-procedural adverse events. ResultsFrom 77,394,755 unweighted discharges, there was a decline in discharges for cholelithiasis (APC − 5.5%, 95% confidence intervals, CI, − 7.6 to − 3.4%) and cholecystitis from 2012 to 2014 (APC − 4.5%, 95% CI − 7.2 to − 1.7%). Interventions were more likely at urban hospitals for symptomatic cholelithiasis (odds ratio, OR, 1.49, 95% CI 1.24 to 1.66) and cholecystitis (OR 1.96, 95% CI 1.86 to 2.05). In-hospital mortality significantly decreased annually for patients with cholecystitis (OR 0.92, 95% CI 0.91 to 0.93). In-hospital mortality between rural and urban centers was comparable for symptomatic cholelithiasis (OR 1.27, 95% CI 0.79 to 2.03) and cholecystitis (OR 0.93, 95% CI 0.84 to 1.04). ConclusionsHospitalizations for gallstone disease have decreased since the 2010s. In-hospital mortality between urban and rural centers is similar, but urban hospitals utilize a higher rate of procedural interventions. Future studies should evaluate practice trends and costs across inpatient and ambulatory settings between rural and urban divisions.

The Gender Gap in Life Expectancy in Urban and Rural China, 2013–2018

BackgroundGender differences in mortality are embedded within mortality transitions. Rural residents generally lag behind their urban counterparts in the transitions. The study objective is to identify major causes of death that drive gender differences in mortality in urban and rural China.MethodsWe use age-, gender-, urban-rural- and cause-specific mortality data (2013–2018) derived from the national mortality surveillance system that covered about 24% of the Chinese population. We apply Arriaga's method to decompose age- and cause-specific contributions to the gender gap in life expectancy at birth. Analyses are stratified by urban-rural residence.ResultsWomen had a higher life expectancy at birth than men in both urban and rural areas. Cancers, cardiovascular disease, external causes, and respiratory disease accounted for more than 90% of the gender gap in both areas during 2013–2018. In urban areas, the gender gap decreased from 5.17 years in 2013–2015 to 4.98 years in 2016–2018. In rural areas, the gender gap stayed rather constant (2013–2015: 5.68 years; 2016–2018: 5.65 years). Traffic accidents, among external causes, contributed the most to decreasing the gender gap (urban: −0.07 years; rural: −0.10 years), especially in the 0–44 age group. However, the decrease in the gender gap was counteracted by an increase in the gender gap attributable to ischemic heart disease (urban: +0.05 years; rural: +0.08 years) and lung cancer (urban: +0.02 years; rural: +0.05 years) in older age groups. The gender gap attributable either to cerebrovascular disease or to chronic lower respiratory disease decreased in urban areas but increased in rural areas.ConclusionsThe urban-rural variations in the cause-specific contributions to the gender gap in China suggest the necessity of implementing urban-rural-specific interventions to improve population health and health equity.

Multilevel Analysis of Urban-Rural Variations of Body Weights and Individual-Level Factors among Women of Childbearing Age in Nigeria and South Africa: A Cross-Sectional Survey.

Background: An unhealthy body weight is an adverse effect of malnutrition associated with morbidity among women of childbearing age. While there is increasing attention being paid to the body weights of children and adolescents in Nigeria and South Africa, a major surge of unhealthy body weight in women has received less attention in both countries despite its predominance. The purpose of this study was to explore the prevalence of body weights (underweight, normal, overweight, and obese) and individual-level factors among women of childbearing age by urban–rural variations in Nigeria and South Africa. Methods: This study used the 2018 Nigeria Demographic Health Survey data (n = 41,821) and 2016 South Africa Demographic Health Survey (n = 8514). Bivariate, multilevel, and intracluster correlation coefficient analyses were used to determine individual-level factors associated with body weights across urban–rural variations. Results: The prevalence of being overweight or obese among women was 28.2% and 44.9%, respectively, in South Africa and 20.2% and 11.4% in Nigeria. A majority, 6.8%, of underweight women were rural residents in Nigeria compared to 0.8% in South Africa. The odds of being underweight were higher among women in Nigeria who were unemployed, with regional differences and according to breastfeeding status, while higher odds of being underweight were found among women from poorer households, with differences between provinces and according to cigarette smoking status in South Africa. On the other hand, significant odds of being overweight or obese among women in both Nigeria and South Africa were associated with increasing age, higher education, higher wealth index, weight above average, and traditional/modern contraceptive use. Unhealthy body weights were higher among women in clustering areas in Nigeria who were underweight (intracluster correlation coefficient (ICC = 0.0127), overweight (ICC = 0.0289), and obese (ICC = 0.1040). Similarly, women of childbearing age in clustering areas in South Africa had a lower risk of experiencing underweight (ICC = 0.0102), overweight (ICC = 0.0127), and obesity (ICC = 0.0819). Conclusions: These findings offer a deeper understanding of the close connection between body weights variations and individual factors. Addressing unhealthy body weights among women of childbearing age in Nigeria and South Africa is important in preventing disease burdens associated with body weights in promoting Sustainable Development Goal 3. Strategies for developing preventive sensitization interventions are imperative to extend the perspectives of the clustering effect of body weights on a country level when establishing social and behavioral modifications for body weight concerns in both countries.

Urban–Rural Variations in Quality of Care Among Patients With Cancer in California

Previous research suggests cancer patients living in rural areas have lower quality of care, but population-based studies have yielded inconsistent results. This study examines the impact of rurality on care quality for 7 cancer types in California. Breast, ovarian, endometrial, cervix, colon, lung, and gastric cancer patients diagnosed from 2004 to 2017 were identified in the California Cancer Registry. Multivariable logistic regression and proportional hazards models were used to assess effects of residential location on quality of care and survival. Stratified models examined the impact of treatment at National Cancer Institute designated cancer centers (NCICCs). Quality of care was evaluated using Commission on Cancer measures. Medical Service Study Areas were used to assess urban/rural status. Data were collected in 2004-2019 and analyzed in 2020. 989,747 cancer patients were evaluated, with 14% living in rural areas. Rural patients had lower odds of receiving radiation after breast conserving surgery compared to urban residents. Colon and gastric cancer patients had 20% and 16% lower odds, respectively, of having optimal surgery. Rural patients treated at NCICCs had greater odds of recommended surgery for most cancer types. Survival was similar among urban and rural subgroups. Rural residence was inversely associated with receipt of recommended surgery for gastric and colon cancer patients not treated at NCICCs, and for receiving recommended radiotherapy after breast conserving surgery regardless of treatment location. Further studies investigating the impact of care location and availability of supportive services on urban-rural differences in quality of care are warranted.

Postnatal Care Service Utilisation in Ethiopia: Reflecting on 20 Years of Demographic and Health Survey Data.

Background: Most maternal deaths in the world occur during the postpartum period, especially within the first two days following delivery. This makes postnatal care (PNC) critical to improving the chances of maternal and child survival. Over the past 20 years, the proportion of women receiving antenatal care (ANC) in Ethiopia has increased while the proportion of those receiving PNC has remained low. This study aimed to understand the trends, determinants and urban–rural variations of PNC service utilisation. Methods: This study draws on the Ethiopian Demographic and Health Survey (EDHS) data for the years 2000 (n = 4552), 2005 (n = 4467), 2011 (n = 4445) and 2016 (n = 4275) to estimate the trends and determinants of PNC service utilisation. Multivariate logistic regression models with adjustment for clustering and sampling weights were used to investigate the association between the independent factors, the study factors and PNC service utilisation. Results: Over the twenty-year period of the EDHS, the proportion of Ethiopian women who received PNC services increased from 5.6% (95% CI: 4.6–6.9%) in 2000 to 18.5% (95% CI: 16.4–20.7%) in 2016. Similarly, women who received PNC services in urban areas increased from 15.2% (95% CI: 23.6–30.7%) in 2000 to 47% (95% CI: 60.4–67.3%) in 2016. Women who were in the wealthy quintile, had ANC visits, delivered in a health facility, and delivered by caesarean section were most likely to have PNC. The present study also showed that whilst birth spacing was a significant factor among urban women, wealth index, ANC visits, and perception of health facility distance were significant factors among rural women. Conclusions: The study suggests low levels of utilisation of PNC among Ethiopian women from rural districts. Geographically targeted interventions with a focus on low-socioeconomic rural women, and those with no previous contacts with the health system during pregnancy, are needed to improve PNC in Ethiopia.

Self-perceived health, availability of medical care and health attitudes among rural population in Russia

Health promotion, reduction of mortality and increase in life expectancy are among the national priorities in the Russian Federation. The aim of the study was to assess self-perceived health, availability of healthcare services and attitudes towards health among rural residents of Russia. Methods: This descriptive study is a part of the nationally representative population survey conducted by Rosstat in 2017 (n = 115 155). For the purpose of this study, a subsample of 65 046 individuals was taken with 11 063 of them being residents of rural areas. Results: A smaller proportion of rural respondents perceived their health as good (40.3 %) and very good (3.3 %) compared to their urban counterparts (47.7 % and 3.7 % respectively). Rural residents reported seeking medical care less often than urban residents, which is largely due to the low availability of medical services for the rural population. Residents of rural areas both free and fee-based medical care. The main reasons for using private clinics include lack of specialists or equipment at the rural polyclinics (35.4 %), long queues (28.3 %) and the remoteness of free medical care organizations (5.1 %). Rural residents were mostly dissatisfied with rising prices for medicines and the increased number of paid medical services. At the same time, rural residents were more satisfied with medical institutions than their urban counterparts. Conclusions: We observed substantial urban-rural variations in the availability of health care services. urban residents have greater demands on the quality and conditions for the provision of medical services, while rural residents are more concerned with the availability of medical care.

Influence of the proportion, height and proximity of vegetation and buildings on urban land surface temperature

Urban areas are characterised by the dominance of impervious surfaces and decreased presence of vegetation compared to their rural surroundings. The resultant increase in temperature is known to amplify global warming, with negative impacts on health and increased energy requirements for cooling. Intra-urban variations in temperature have received less attention than urban–rural variations, although the former can be even larger than the latter. Land cover composition is known to influence surface temperature, while the influence of heights, of buildings and vegetation, is less explored. There are also fewer studies in high-latitude cities although extreme heat events are increasing in frequency and severity in these cities, and high-resolution geospatial datasets are often available for detailed analysis. The aim of this study is therefore to assess the influence of selected land cover variables on the estimated surface temperature in the four largest cities in Denmark—Copenhagen, Aarhus, Odense and Aalborg.Land surface temperatures (LST) of the four cities were estimated using Band 10 (10.60–11.19 μm) from Landsat 8 imagery. Vegetation cover, building cover, vegetation height and building height were estimated using 4-band aerial imagery, building footprints and LiDAR-based elevation models, and their correlations with LST were estimated. Moving average filters, with window sizes from 3 × 3 (90 m × 90 m) to 11 × 11 (330 m × 330 m), were used to understand the area of influence of surrounding land cover on the LST within 30-m cells. When vegetation cover and building cover increased from 0–5% to 95–100%, median values of LST decreased by 4.16 ± 0.76 °C and increased by 4.31 ± 0.69 °C, respectively. Land cover variables within 7 × 7 windows (210 m × 210 m) are shown to have strong correlations with the LST of 30-m cells. The area of influence of building heights on the LST of 30-m cells was the largest in Copenhagen, which also has the tallest buildings among the cities. LST reduced by 4.10 °C when the mean vegetation height within a 30-m cell increased from 0–2 m to 20–22 m, and by 5.75 °C for 210 m × 210 m patches with the same height range. A combination of increased vegetation cover and height could therefore be used to regulate temperature in or close to hot spots in cities depending on the availability of space.

An epidemiology of self-reported cancer in India: A Decomposition analysis based on women in late-reproductive age-group

Background/ObjectivesCancer is a leading cause of adult deaths globally. Among women, breast cancer is a predominant cause of cancer mortality, accounting for almost a quarter (23%) of all cancer deaths worldwide. India has huge underlying regional and sectoral (urban-rural) variations, which extend even up to lifestyles and variations in age-specific death rates. This study aims to assess the social and regional variations and the contributions of selected cancer indicators in the country among women in the late reproductive age-group. MethodsNational Family Health Survey (2015–16) data (Demographic Health Survey of India) has been used for this study. ResultsThe age-adjusted prevalence of cancer among women in India is 250 per 100,000 women. The results of the concentration indices show an overall concentration of cancer towards the richer quintiles. Decomposition of the concentration index shows significant contribution from factors like a higher age, years of schooling between 5 and 9 years, rural places of residence, bearing of 1 or more children, and contraceptive use like IUD, hysterectomy or sterilization. ConclusionA comprehensive strategy to combat chronic diseases like cancer includes actions minimizing exposure to risk factors at the population level, as well as reducing the risk for individuals at the higher risk level and can aid in furnishing early, medium-term and long-term effects.

Neighbourhood Environment and Cognitive Vulnerability—A Survey Investigation of Variations Across the Lifespan and Urbanity Levels

Background: Understanding the impact of local communities on wellbeing is a paramount Sustainable Development Goal. In order to inform people-centred planning interventions, it is important to understand what demographic groups need supportive communities the most and where. This study explored associations between perceived neighbourhood characteristics and cognitive vulnerability, and the moderating role of age and urbanity of the place of residence. Methods: A convenience sample of 224 Irish adults completed a survey assessing cognitive vulnerability and perceptions of neighbourhood qualities, together with sociodemographic and residential information. Correlational analyses explored bivariate associations as well as moderating effects. A subsample (n = 142) provided qualitative accounts of their preferences of neighbourhood characteristics. Results: Regression analyses showed that controlling for sociodemographic factors, higher self-reported neighbourhood pleasantness was associated with lower cognitive vulnerability, particularly in older adults who lived in the most rural and urban areas (p = 0.006). Qualitative accounts suggested urban–rural variations in perceived accessibility and perceptual stressors, and age-related variations in social preferences. Conclusions: Our findings indicate a complex association between neighbourhood characteristics and cognitive wellbeing, highlighting the potential benefits of neighbourhood pleasantness for cognition particularly for older people in very rural or very urbanised places. Implications for research and environmental interventions are discussed.

Fatty acids and cardiometabolic health: a review of studies in Chinese populations

Rapid nutrition transition from plant-based traditional diet to westernized diet has led to dramatically heightening burdens of cardiometabolic diseases in China in past decades. Recently, national surveys reported that poor dietary quality including low marine n-3 fatty acids and high intakes of red meat and processed meat was associated with considerably elevated cardiometabolic deaths. Previous studies mainly from Western population-based cohorts have indicated that not only fat quantity but also quality linked with different cardiometabolic outcomes. Compared with Western peoples, Asian peoples, including Chinese, are known to have different dietary patterns and lifestyle, as well as genetic heterogeneities, which may modify fatty acid metabolism and disease susceptibility in certain degree. To date, there were limited prospective studies investigating the relationships between fatty acids and cardiometabolic disease outcomes in Chinese, and most existing studies were cross-sectional nature and within one or two region(s). Notably, shifting dietary patterns could change not only amount, types, and ratio of fatty acids accounting for overall energy intake, but also their food sources and ratio to other macronutrients. Moreover, large geographic and urban-rural variations in prevalence of cardiometabolic diseases among Chinese may also reflect the effects of socioeconomic development and local diets on health status. Therefore, current review will summarize available literatures with more focus on the Chinese-based studies which may extend current knowledge about the roles of fatty acids in pathogenesis of cardiometabolic diseases for Asian populations and also provide useful information for trans-ethnic comparisons with other populations.

Spatial Dichotomy in Incidence and Impacts of Abandoned Structures on Residents in Ilorin, Nigeria

The paper examined the spatial variation in the incidence, causes and impacts of abandoned structures in Ilorin, Nigeria. Primary data was collected through questionnaire from 581 residents in selected localities in urban and rural areas. Direct observation and physical counting were carried out to determine the incidence of abandoned structures in the study area. Data on incidence, prevalence and categories of abandoned structures in the study area were summarized using descriptive statistics such as frequencies and percentages. Chi-square was used to test the differences between incidence and causes of abandoned structures in urban and rural areas. Z-score was used to analyze the physical counting of the abandoned buildings and compared the relative raw scores from different localities in the study area on categories of abandonment. Analysis of Variance (ANOVA) was used to determine urban-rural variations in the incidence, causes and impacts of abandoned structures in the study area. Four indices were developed: Causes of Abandoned Structures Index’ (CASI), Environmental Impact of Abandonment Index (EIAI), Psycho-Social Impact of Abandoned Structures Index (PSIASI) and Economic Impact of Abandonment Index (EcIAI). CASI, EIAI and PSIASI were employed respectively to measure causes, environmental and psycho – social impacts of abandonment in Ilorin. It is established that there is significant variation in the incidence and causes of abandoned structures between urban and rural areas of Ilorin. The most pronounced psychosocial effect of abandonment in the study area is ‘theft’ (PSIASI = 4.38). Prominent economic variables of abandonment in the study area range from ‘affecting communal development levy’ (EcIAI = 3.88) to ‘property value decline’ (EcIAI = 3.61) to property vandalization’ (EcIAI = 3.60). The study concluded that environmental impacts of abandonment in the study area varied spatially. The study therefore suggests that abandoned structure should be identified and compiled by Town Planning Authorities after which the owners could be contacted and mandated to work on the structures based on the level of negative impacts associated with such structures. Some of the government owned abandoned properties could be auctioned or donated to the respective community for better usage. Keywords: Abandonment, Development, Environmental Impacts, Residents DOI : 10.7176/JAAS/58-09 Publication date :September 30 th 2019

The Indian middle class, its size, and urban-rural variations

ABSTRACTThis paper provides one of the most accurate estimates of the size of the Indian middle class, using an eclectic set of variables rooted in three major theories of class; Marxist, Weberian, and Bourdieuian. Using this original and theoretically inclusive method offers a solution to the problem of capturing the conceptual complexities of the middle class and provides a holistic examination of its composition. Through statistical analysis of the India Human Development Survey II (2011–12), the paper reveals three significant findings: firstly, it calculates the size of the middle class to be 28.05% of the urban and rural population in India. Secondly, it demonstrates that despite the occupational diversity that exists among middle classes, a large proportion of the middle class are salaried employees. Thirdly, and most importantly, it demonstrates that contrary to common assumptions in the growing literature on the middle class, a considerable segment of the Indian middle class resides in rural areas.

Decoupling forest characteristics and background conditions to explain urban-rural variations of multiple microclimate regulation from urban trees.

BackgroundRapid urbanization in semi-arid regions necessitates greater cooling, humidifying, and shading services from urban trees, but maximizing these services requires an exact understanding of their association with forest characteristics and background street and weather conditions.MethodsHere, horizontal and vertical air cooling, soil cooling, shading, and humidifying effects were measured for 605 trees from 152 plots in Changchun. Additionally, weather conditions (Tair, relative humidity, and light intensity), forest characteristics (tree height, diameter at breast height (DBH), under-branch height, canopy size, tree density, and taxonomic family of trees) and background conditions (percentage of building, road, green space, water, and building height, building distance to measured trees) were determined for three urban-rural gradients for ring road development, urban settlement history, and forest types. Multiple analysis of variance and regression analysis were used to find the urban-rural changes, while redundancy ordination and variation partitioning were used for decoupling the complex associations among microclimate regulations, forest characteristics, background street and weather conditions.ResultsOur results show that horizontal cooling and humidifying differences between canopy shade and full sunshine were <4.5 °C and <9.4%, respectively; while vertical canopy cooling was 1.4 °C, and soil cooling was observed in most cases (peak at 1.4 °C). Pooled urban-rural data analysis showed non-monological changes in all microclimate-regulating parameters, except for a linear increase in light interception by the canopy (r2 = 0.45) from urban center to rural regions. Together with the microclimate regulating trends, linear increases were observed in tree density, Salicaceae percentage, Tair, light intensity outside forests, tree distance to surrounding buildings, and greenspace percentage. Redundancy ordination demonstrated that weather differences were mainly responsible for the microclimate regulation variation we observed (unique explanatory power, 65.4%), as well as background conditions (12.1%), and forest characteristics (7.7%).DiscussionIn general, horizontal cooling, shading, and humidifying effects were stronger in dry, hot, and sunny weather. The effects were stronger in areas with more buildings of relatively lower height, a higher abundance of Ulmaceae, and a lower percentage of Leguminosae and Betulaceae. Larger trees were usually associated with a larger cooling area (a smaller difference per one unit distance from the measured tree). Given uncontrollable weather conditions, our findings highlighted street canyon and forest characteristics that are important in urban microclimate regulation. This paper provides a management strategy for maximizing microclimate regulation using trees, and methodologically supports the uncoupling of the complex association of microclimate regulations in fast urbanization regions.