Urban Subsample Research Articles

Marriage as an Argument for Energy Poverty Reduction: The Moderating Role of Financial Inclusion

ABSTRACTThe present research extends the extant literature by investigating the hypothesis on whether marriage can be a substitute for financial inclusion in energy poverty reduction in Ghana. Pooled data and two‐stage least‐squares techniques are used in the estimation process; the validity of the tested hypothesis (i.e., that marriage is a substitute for financial inclusion in energy poverty mitigation) is based on three main criteria: (i) a positive interactive effect relative to the negative unconditional effect of marriage; (ii) a marriage net effect lower in magnitude compared to the unconditional effect of marriage; and (iii) an insignificant interactive effect when both unconditional effects are negative. The investigated hypothesis is not valid in the full sample, urban subsample, and female subsample while it is valid in the rural and male subsamples. Policy implications are discussed.

Physical Activity in Underserved Preadolescents

Drawing insights from the theory of fundamental causes of disease, this study examined the relationships between socioeconomic status (SES) and selected risk factors in transitional urban China. Specifically, under China’s distinct institutional and sociocultural environment, we examined how contextualized SES (i.e., party membership, hukou status, housing ownership, and subjective social status) and conventional SES indicators (i.e., education, income, and occupation) were associated with physical inactivity and body mass index (BMI). Utilizing the urban subsample of the 2017 Chinese General Social Survey (CGSS), we found that individuals with higher education, income, Communist Party membership, and urban hukou status had lower risks of physical inactivity. However, higher SES with Community party membership, urban hukou, and government jobs also increased the risks of being overweight, which may be explained by potential countervailing mechanisms. These findings revealed intricate relationships among SES and risk factors in China. Our study helped contextualize the theory of fundamental causes, furnished new empirical evidence, and served as a useful reference for future health inequality research in non-Western societies.

Access to Health Care for Transgender and Gender-Diverse Adults in Urban and Rural Areas in the United States.

The objective of this study is to examine access to care based on gender identity in urban and rural areas, focusing on transgender and gender diverse (TGD) populations. Data on TGD (n = 1,678) and cisgender adults (n = 403,414) from the 2019 to 2020 Behavioral Risk Factor Surveillance System were used. Outcome measures were four barriers to care. We conducted bivariate and multivariable logistic regressions to assess associations between access, rurality, and gender identity. Bivariate results show that TGD adults were significantly more likely to experience three barriers to care. In multivariable models, TGD adults were more likely to delay care due to cost in the full sample (adjusted odds ratio [AOR]: 2.00, p < .001), rural subsample (AOR: 2.14, p < .01), and urban subsample (AOR: 1.97, p < .01). This study revealed greater barriers to care for TGD adults, with the most frequent barriers found among rural TGD adults. Increased provider awareness and structural policy changes are needed to achieve health equity for rural TGD populations.

Changing environment, rising new media: Retesting the exposure-acceptance model in China

Based on the China data from the World Values Survey (WVS) 2000, Kennedy found a significant curvilinear relationship between education and regime support in the rural subsample but not in the urban subsample, partially verifying the exposure-acceptance model. He attributed this phenomenon to the “urban–rural gap” in educational opportunities in China. In the past two decades, China has narrowed this gap. Has this changed the patterns of regime support? To revisit this question, we replicate Kennedy’s analyses using the WVS 2018 data. The results fail to support the exposure-acceptance model in either the rural or the urban subsample. This inconsistency may stem from the explosive growth of new media in China over the past 20 years, which has made criticism more accessible. New media can affect people’s media exposure patterns in a way that goes beyond the scope of the exposure-acceptance model. Therefore, we introduce the measure of new media usage into Kennedy’s models and find a linear negative effect on regime support at the national level. We conclude that the applicability of the exposure-acceptance model may have declined in China due to the rise of new media. The long-term influence of new media on regime support in authoritarian nations should be explored in further research.

Depression among survivors of 1988 Spitak earthquake in Armenia: a prospective cohort study

Abstract Background Mental health-related consequences of disasters can be very long lasting. Depression is one of the most prevalent psychopathologies among disaster survivors. Yet, compared to PTSD, it is studied much less among disaster victims. Studies of depression decades after the exposure are extremely rare. This study evaluated the prevalence and predictors of depression in a prospective cohort of Spitak earthquake survivors 23 years after the event. Methods A geographically stratified urban sub-sample of 1785 individuals underwent all three baseline waves of the cohort study during 1990-1992 and provided detailed sociodemographic, earthquake exposure and physical and mental health-related information. In 2012, 83.3% (n = 1487) of this subsample was traced and 40.6% (n = 725) interviewed. Depression status was measured via validated and adapted Armenian-language CES-D scale. A fitted linear regression model identified predictors of depression score in 2012. Results Twenty-three years after the exposure, the rate of depression in this cohort was 25.4%. Depression was highly comorbid with anxiety (62.0%) and PTSD (36.8%). Factors positively associated with depression score included number of stressful life events (95% CI 0.33, 1.20), poor self-rated health (95% CI 2.45, 5.40), earthquake-related deaths in the family (95% CI 0.12, 3.80), and strong phobia and fear at baseline (95% CI 0.51, 2.96). Age (95% CI -0.15, -0.06), social support score (95% CI -0.83, -0.55), quality of life score (95% CI -15.83, -10.77), and being married (95% CI -2.61, -0.35) were protective for depression. The fitted model explained 46.6% of the variance in the depression score. Conclusions This study found an increased prevalence of depression among earthquake survivors over two decades after the exposure. The identified potentially modifiable predictors of long-term depression create prerequisites for planning better targeted mental health recovery interventions among disaster survivors. Key messages

Does residential mobility affect child development at age five? A comparative study of children born in U.S. and U.K. cities.

Residential mobility is a normal feature of family life but thought to be a source of disruption to a child's development. Mobility may have its own direct consequences or reflect families' capabilities and vulnerabilities. This article examines the association between changes of residence and verbal and behavioral scores of children aged 5, contributing to the literature in three ways. First, it compares two countries, by drawing on the Fragile Families and Child Wellbeing study in the United States (N = up to 1,820) and an urban subsample of the U.K. Millennium Cohort study (N = up to 7,967). Second, beside taking into account an extensive range of demographic characteristics, it applies inverse probability weights to minimize observable selection bias associated with residential mobility and further controls for a wide range of family changes that often co-occur with moves. Third, the article adds to extant research on residential mobility by incorporating the type of locality from and into which families move. Individual-level longitudinal data are linked to objective measures of neighborhood socioeconomic status to gauge the quality of moves families make. Results show that residential moves are not inevitably deleterious to children. In both countries the poorer outcomes of some moves result not from moving per se but rather from the context in which they occur. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Neighborhood and Child Development at Age Five: A UK-US Comparison.

Early childhood is a critical period in the life course, setting the foundation for future life. Early life contexts—neighborhoods and families—influence developmental outcomes, especially when children are exposed to economic and social disadvantage. Residential mobility, frequent among families with pre-school children, may reduce or increase exposure to adverse surroundings. We examine children’s cognitive and behavioral outcomes at age five, in relation to neighborhood composition, family circumstances and residential moves, using two longitudinal micro datasets: an urban subsample of the UK Millennium Cohort Study (N up to 7967), and the Fragile Families and Child Wellbeing Study in the US (N up to 1820). Each is linked to an index of neighborhood advantage, created to make UK/US comparisons, based on census and administrative information. A series of estimates indicate a strong association, in both countries, between cognitive scores and neighborhood advantage, attenuated but not eliminated by family circumstances. Children’s behavior problems, on the other hand, show less association with neighborhood advantage. There are minor and mixed differences by residential mobility particularly when neighborhood disadvantage changes. Notwithstanding the primacy of the family in predicting preschool development, the findings support the notion of neighborhood as potentially advantageous at least in relation to cognitive outcomes.

Employment status and other predictors of mental health and cognitive functions in older Croatian workers.

The aim of this study was to examine mental health and cognitive functions in older Croatian workers (50-65 years) taking into account their employment status, self-assessed health, and a set of demographic characteristics. We analysed the data collected on 650 older workers (71 % employed) in the Wave 6 of the Survey of Health, Ageing and Retirement in Europe (SHARE). Unemployed workers reported symptoms of loneliness more often than the employed, while in rural areas unemployment was additionally associated with more pronounced symptoms of depression. Feeling of loneliness was also higher in those living without a partner in the household and in those with poorer health. In urban residents symptoms of depression were more severe in women, respondents with higher education, those living without a partner, and those who rated their health as poorer. As for cognitive functions, unemployment significantly predicted poorer subtraction in the rural subsample. Women in general showed less efficient numerical abilities. In the urban subsample poorer numerical abilities were also associated with lower education and living without a partner in the household. Better verbal recall was predicted by higher education and better self-rated memory. Higher scores in verbal fluency were predicted by urban residency and better self-rated health. Our results indicate that the protective factors for good mental health and cognitive functioning in older Croatian workers are being employed, having more education, living with a partner in the household, and being healthier. These findings stress the importance of implementing broader social policy strategies covering employment, education, and health.

The Frequencies of Working with the Internet and Urban-Rural Wage Income Gap

Based on the China Family Panel Study (CFPS) 2014, this paper studied the relationship between the frequencies of working with the Internet and the wage income gap between urban and rural areas. The study found that the frequencies of working with the Internet has a significant effect on wage income through separate analyses of urban and rural areas; the frequencies of working with the Internet has no significant effect on the wage income gap between urban and rural areas; when using quantile regression, the frequencies of working with the Internet still has no significant impact on the wage income gap between urban and rural areas except at the 75th quantile. These conclusions are different from the conclusions of direct comparison of regression coefficients. The FGLS method was used to solve the problem of heteroscedasticity in the urban subsample.

Investigating the Spatial Dimension of Food Access.

The purpose of this article is to investigate the sensitivity of food access models to a dataset’s spatial distribution and the empirical definition of food access, which contributes to understanding the mixed findings of previous studies. Data was collected in the Dan River Region in the United States using a telephone survey for individual-level variables (n = 784) and a store audit for the location of food retailers and grocery store quality. Spatial scanning statistics assessed the spatial distribution of obesity and detected a cluster of grocery stores overlapping with a cluster of obesity centered on a grocery store suggesting that living closer to a grocery store increased the likelihood of obesity. Logistic regression further examined this relationship while controlling for demographic and other food environment variables. Similar to the cluster analysis results, increased distance to a grocery store significantly decreased the likelihood of obesity in the urban subsample (average marginal effects, AME = −0.09, p-value = 0.02). However, controlling for grocery store quality nullified these results (AME = −0.12, p-value = 0.354). Our findings suggest that measuring grocery store accessibility as the distance to the nearest grocery store captures variability in the spatial distribution of the health outcome of interest that may not reflect a causal relationship between the food environment and health.

Disparities in dietary intake and physical activity patterns across the urbanization divide in the Peruvian Andes

BackgroundDiet and activity are thought to worsen with urbanization, thereby increasing risk of obesity and chronic diseases. A better understanding of dietary and activity patterns across the urbanization divide may help identify pathways, and therefore intervention targets, leading to the epidemic of overweight seen in low- and middle-income populations. Therefore, we sought to characterize diet and activity in a population-based study of urban and rural residents in Puno, Peru.MethodsWe compared diet and activity in 1005 (503 urban, 502 rural) participants via a lifestyle questionnaire. We then recruited an age- and sex-stratified random sample of 50 (25 urban, 25 rural) participants to further characterize diet and activity. Among these participants, diet composition and macronutrient intake was assessed by three non-consecutive 24-h dietary recalls and physical activity was assessed using Omron JH-720itc pedometers.ResultsAmong 1005 participants, we found that urban residents consumed protein-rich foods, refined grains, sugary items, and fresh produce more frequently than rural residents. Among the 50 subsample participants, urban dwellers consumed more protein (47 vs. 39 g; p = 0.05), more carbohydrates (280 vs. 220 g; p = 0.03), more sugary foods (98 vs. 48 g, p = 0.02) and had greater dietary diversity (6.4 vs 5.8; p = 0.04). Rural subsample participants consumed more added salt (3.1 vs 1.7 g, p = 0.006) and tended to consume more vegetable oil. As estimated by pedometers, urban subsample participants burned fewer calories per day (191 vs 270 kcal, p = 0.03).ConclusionsAlthough urbanization is typically thought to increase consumption of fat, sugar and salt, our 24-h recall results were mixed and showed lower levels of obesity in rural Puno were not necessarily indicative of nutritionally-balanced diets. All subsample participants had relatively traditional lifestyles (low fat intake, limited consumption of processed foods and frequent walking) that may play a role in chronic disease outcomes in this region.

Schooling effects on intelligence development: evidence based on national samples from urban and rural China

The current research investigated the variability of school effects on intelligence development in considering two economically and socially distinct groups of children. The data came from a nationally representative sample of primary school children from urban and rural areas of China. Two standardised reasoning tests were used to assess fluid intelligence. The between-grade regression discontinuity approach was applied to disentangle the schooling effect from the age effect. Results showed that the combined effects of schooling and age were 5.09 intelligence points per year, in which the schooling effect (4.37 points) was larger than the age effect (.72 points). The patterns of schooling and age effects were different in urban and rural subsamples. For the urban subsample, the schooling effect was smaller than the age effect for children from grade 1 to 3, but the schooling effect became larger than the age effect from grade 4 to 6. For the rural subsample, however, the schooling effect was always larger than the age effect. The effect of one year of schooling for rural children (5.59 points) was larger than that for urban children (3.15 points). These results suggest that schooling effects are closely related to the context where children are growing up.

Active commuting to school: a test of a modified integrative model.

To test a modified integrative model (IM) in explaining parents' intention toward active commuting to school (ACS) and children's ACS. Parents of fourth graders (N = 857) completed a survey assessing factors associated with ACS. A modified IM was developed and tested using structural equation modeling. The IM demonstrated good model fit (RMSEA = .04, CFI = .97, TLI = .97). Perceived barriers, self-efficacy, and health beliefs/outcome evaluation predicted parents' intention directly and children's ACS indirectly, with self-efficacy as the strongest predictor. Intention, in turn, predicted children's ACS. Similar findings emerged in a replication using the urban subsample data. The IM may enable health behavior researchers to design effective interventions to promote ACS.

Fertility and household consumption expenditure in Ethiopia: a study in the Amhara region.

Eradication of extreme poverty and hunger has been identified as the number one priority for the Millennium Development Goals (MDGs). Theoretical work on the effect of the number of children on household well-being suggests a negative effect, since the resources available are divided among more household members. The vast majority of empirical studies find results consistent with this expectation, but some fail to link high fertility to lower well-being of the household. The purpose of this paper is to document the effect of the number of children on the consumption expenditure of Ethiopian households. The study uses data from a household sample survey of rural and urban married women and employs a Two-Stage Least Squares (2SLS) model. Analysis is made separately for per capita consumption and equivalized consumption. Results suggest that while the relationship is negative and statistically significant for all expenditure scenarios for the rural sub-sample and for the full sample, this is not the case for the urban sub-sample. Our results confirm the theoretical prediction that the effect of a large number of children on consumption expenditure of households is negative for rural households, whereas results for urban households are not as clear.

1227 – Differences in eating habits/behaviours and eating disorders symptoms in adolescents from a rural and a urban school

Differences in eating habits/behaviours and eating disorders (ED) symptoms in adolescents from rural and urban schools has not been very considered, particularly in Portugal. explore differences between students who attend rural and urban schools in eating habits/behaviors and ED symptoms; verify if there are differences regarding Body Mass Index (BMI) by school area. 282 adolescents students (mean age = 14,5; SD = 1,69; variation = 12-18 years old; urban subsample = 126, 44,7%), studying in two schools, one from an urban area and another from a rural area answered sociodemographic questions, eating habits/behaviours items and EAT-25 (Eating Attitudes Test-25). Most of the adolescents from both schools have breakfast and drink milk daily. Moreover, they eat vegetables and fruits daily or weekly and only rarely fast-food. Adolescents that practice a sport eat more fruits/vegetables. Adolescents attending a rural school ingest more vegetables and less fast-food. ED symptoms (EAT-25) present a lower prevalence, comparing to a young adults sample. There were no significant differences in all the EAT-25 dimensions, EAT total score and BMI by school area. Eating habits/behaviours seem to be positive in both schools (e.g. most adolescents have breakfast daily). There were only some small differences between the two schools in particular eating habits but adolescents from the two areas do not seem to differ in ED symptoms and BMI, which is not in accordance with the literature that tends to signal urban areas as a “risk factor” for dysfunctional eating behaviors.

Fourteen years of surveillance of HIV-1 prevalence among pregnant women attending antenatal care clinics in western Uganda

This study monitored long-term temporal trends in HIV-1 prevalence in antenatal clinic attendees living in western Uganda. Semi-annual data collection was done from 1991 to 2004. For each woman the following data were recorded: HIV-1 status, age, educational status, marital status, occupation and parity. The results show that the overall HIV-1 prevalence was 15.3% during the entire time period (urban 21.3%, semi-urban 12.7% and rural 7.1%). Between 1991 and 2004, we observed a gradual decline in the HIV-1 prevalence. The decline was most pronounced in urban women aged 15-19 years old and least pronounced in rural women aged 20-24 years. Women above 25 years of age did not show any decline in HIV-1 prevalence over time. The declining HIV-1 prevalence in the younger age groups (15-24 years) likely represents a declining risk for acquiring HIV infection as we have previously shown in the urban sub-sample of this data set.

Community competence in cardiopulmonary resuscitation

The aim of this study was to determine community application of cardiopulmonary resuscitation (CPR) skills in an emergency, and, thus, assess the value of training programmes in raising community competence. A cross-sectional telephone survey of the Western Australian population was chosen randomly ( n=803). An urban sub-sample ( n=100) performed a practical demonstration of CPR skills using a simulated collapse scenario using a recording manikin as the victim. Performance was assessed by two observers using pre-determined criteria. Of all respondents, 64% had been trained in CPR. Practical and theoretical assessment scores were significantly better in trained versus untrained participants. The number of times a person was trained in CPR was more effective for retention and competence than time since last trained. Degree of training and theoretical competence were less in those aged over 65 years or with heart disease in the household. Theoretical competence poorly reflected practical performance in many tasks. This study provides a comprehensive database of CPR training and performance, and highlights future directions to ensure appropriate and cost-effective training. Specific factors to be addressed include increasing frequency of training, targeting of high-risk groups, simplification in teaching, and emphasising early activation of the emergency medical system.

Severe malaria in Burkina Faso: influence of age and transmission level on clinical presentation.

We analyzed the clinical presentation of 800 severe malaria cases six months to 15 years of age (mean +/- SD = 4.3 +/- 3.0) recruited at the pediatric ward of the Ouagadougou University Hospital, and at the Sourou and Nayala District Hospitals in Burkina Faso. Inclusion criteria followed the World Health Organization (WHO) definition of severe and complicated malaria. The children were treated according to WHO guidelines with a complete regimen of drugs that were provided free of charge as part of the study. The case fatality rate of each sign and symptom of severe malaria was calculated on the 686 children whose outcomes were known. A total of 95 patients (13.8%) died while in the hospital; the mean +/- SD age of these children was 3.2 +/- 2.1 years. The age distribution and the clinical patterns of severe malaria was compared in patients from the urban areas of Ouagadougou characterized by relatively low transmission, and from rural areas where the mean inoculation rates are at least 20-fold higher. The mean +/- SD age of the urban and rural patients was 4.8 +/- 3.0 and 2.2 +/- 1.9 years, respectively (P < 0.001). The prevalence of coma was higher in the urban subsample (53.6% versus 28.9%; P << 0.001) while that of severe anemia (hemoglobin < 5 g/dL) was higher in rural patients (47.4% versus 14.8%; P < 0.001). Our data, in line with previous results obtained comparing rural areas characterized by different inoculation rates, show that the epidemiologic context influences the clinical presentation of severe malaria.

Spouses or babies? Race, poverty and pathways to family formation in urban America

This article analyses the Urban Poverty and Family Life Survey of Chicago and an urban subsample of the National Survey of Families and Households to examine race and ethnic variation in the occurrence and consequences of birth versus marriage pathways to family formation. Results based on multiple‐decrement life table analysis and multi‐variate life table regression analysis reveal strong race and poverty effects on pathways to family formation, but Hispanic origin does not systematically influence the odds that women will enter family life via marriage versus birth. We show stronger race effects on pathways to family formation for the Chicago sample owing to the much higher incidence of teen parenting among black inner‐city residents. Results also suggest lasting economic consequences of non‐marital fertility, irrespective of whether women eventually marry or divorce subsequent to a premarital birth.

Dietary intake changes associated with post-cyclone food aid in Western Samoa.

This study examines dietary intake responses to a food aid program in Western Samoa, which consisted primarily of rice and flour supplements. Using a semi-quantitative food frequency questionnaire, intake estimates were made for 147 Samoans (72 men, 75 women), 5 months before and 8 months after a tropical cyclone. Study participants were from urban Apia (n = 34) and three rural, more traditional villages (n = 113). For the total sample, consumption of rice and pancakes more than doubled, and the contribution of these foods to total carbohydrate and kilocalorie intake increased approximately three-fold (p < 0.0001, for paired t-tests). Significant decreases were noted for the nutrient contribution from breadfruit and coconut products. These dietary changes were significantly less in the urban sub-sample. These results indicate the food aid may have accelerated an existing modernizing trend in the diet of Samoans. The nutritional and economic implications are discussed within the context of Western Samoa.