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The book "Invisible China: How the Urban-Rural Divide Threatens China's Rise" by Scott Rozelle and Natalie Hell explores the urban-rural divide in China and its impact on the country's development. The authors argue that the deficiency of human capital in rural areas poses a significant risk to China's modernization and could trap the country in the middle-income country trap. They also highlight the educational injustices stemming from China's urban-rural dual structure. While the book has received praise for its contributions to the discourse on educational inequality in China, some limitations are noted, such as occasional verbosity and neglect of historical intricacies. The authors also express concerns about China following a similar path as Mexico, but the unique characteristics of China, such as its strong national capabilities and unique land system, may mitigate this risk. The book provides insights into the weaknesses of rural education and vocational education in China and offers recommendations for improvement. [Extracted from the article]

Background and Study Purpose. The use of basketball in curricular and extracurricular activities is common in most countries. The research aims to identify the opinions of high school students and the effects and usefulness of basketball on multiple levels: socialization, stress reduction, health and fitness optimization, personality formation, body harmony, etc. Material and Methods. A sample of 259 high school students (124 females and 135 males) from Gorj county, Romania, were included in a sociometric cross-sectional study in the first part of the 2023-2024 school year. All investigated participants partook in physical education lessons with basketball topics. The factor analysis of the applied questionnaire included 14 items within the usefulness dimension, with responses reported on a Likert scale with 5 levels of intensity of opinions. The independent Gender, Area variables and the interaction Gender *Area variables were defined and analysed. Results. Gender differences indicate higher values for males, but not statistically significant (P > 0.05). Only for flexibility is the opinion of females superior and statistically significant (P < 0.05). Differences between urban and rural are in favour or urban for most items, but still statistically insignificant (P > 0.05). The only items where F values are significant are those related to the role of basketball in the formation of fair-play attitude and the accessibility of basketball as a leisure activity (P < 0.05). The Gender *Area variables interaction indicates only 3 situations where significant differences of opinion are reported (P < 0.05): accessibility of basketball as a leisure activity, effect on effort capacity and fitness level, and effect of basketball on coordination. All these cases indicate higher values of urban males vs rural males and vice versa for females, where rural females score higher than urban females. Conclusions. For the utility dimension, we noted the majority of opinions in favour of basketball, through its various effects on students in adolescence. The most optimistic scores were for the benefits of coordination and speed (components of skill-related physical fitness). This is followed by beneficial effects on health, the formation of fair-play attitudes, physical development and body harmony, facilitating socialization, communication and group integration. The influence of basketball on stress reduction is also viewed with confidence. The effect on improving effort capacity and general level of physical fitness scores moderately. Weaker values are given for influences on intellectual abilities and level of segmental muscle strength. Students give the lowest confidence in the effects of basketball on flexibility and endurance levels. In contrast to the attractiveness factor, for the usefulness dimension, we found less significant differences in opinion between rural and urban females and males. This is an indicator of critical thinking ability and reflects a good level of understanding of the effects of playing basketball on multiple levels in the sample surveyed. [ABSTRACT FROM AUTHOR]

Transportation accessibility has been treated as an important means of reducing the urban-rural income disparity. However, only a few studies have examined the effects of different types of transportation accessibility on urban-rural income disparity and their spatial heterogeneity. Based on data from 285 prefecture-level (and above) Chinese cities in 2000, 2005, 2010, 2015, and 2020, this study uses spatial econometric models to examine how highway accessibility and railway accessibility influence the urban-rural income disparity and to identify their spatial heterogeneity. The result reveals that highway accessibility and railway accessibility have 'coreperiphery' ring-like circle structures. The urban-rural income disparity exhibits strong spatial clustering effects. Both highway accessibility and railway accessibility are negatively associated with urban-rural income disparity, and the former having a greater effect size. Moreover, there is a substitution effect between highway accessibility and railway accessibility in the whole sample. Furthermore, these associations differ in geographic regions. In the central region, highway accessibility is more important in reducing the urban-rural income disparity, but its effect is weakened with the increase of railway accessibility. In the western region, railway accessibility has a larger effect on narrowing the urban-rural income disparity, and this effect is strengthened by the increase of highway accessibility. We conclude that improving transportation accessibility is conducive to reducing the urban-rural income disparity but its effect is spatial heterogenetic. Highways and railways should be developed in a coordinated manner to promote an integrated transport network system. [ABSTRACT FROM AUTHOR]

Recently, an emerging body of research has diagnosed a 'crisis of trust' in rural and peripheral areas. Yet, the majority of these works overlook local institutions as a potential alternative source of governance. Relying on original, nationally representative survey data from nine European countries, this article suggests that local institutions act as a safe haven for individuals with high levels of place-based resentment. Substantially, for these individuals, political trust in the local level significantly exceeds political trust in the national level. This dynamic is largely driven by concerns over representation. The stronger citizens feel that their place is overheard, the more they trust local relative to national institutions. This nuances the narrative of the 'crisis of trust' in an important way. Rather than conceiving it as a crisis haunting the political system in general, it seems to be better understood as a crisis of the national level specifically. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate time trends in distance and near vision at the national and regional levels during 2000–2017 in Finland. Methods: We used three cross‐sectional, nationwide health examination surveys representing the Finnish adult population aged 30 years or older in 2000, 2011 and 2017. Bilateral, habitual distance and near visual acuity (VA) were measured in all three surveys. Results: The prevalence of good distance vision (VA ≥ 1.0) increased from 76.7% to 81.3% during 2000–2017 while the prevalence of weak or worse distance vision (VA ≤ 0.5) decreased from 7.6% to 3.7%. The improvements were largest among those aged 85 years and older: the prevalence of distance VA ≤ 0.5 decreased from 71.8% to 28.3%. Near vision showed improvement to a lesser extent in the total population; nevertheless, among those aged 85 years and older the prevalence of weak or worse near vision (VA ≤ 0.5) decreased from 62.3% to 27.1%. A similar positive time trend was observed in all main regions of Finland, and differences between urban and rural regions were small. Conclusion: During the past two decades, the overall vision level has improved among the adult population. This is explained mostly by a positive shift from lower to higher vision levels among older age groups, indicating that people live longer with good or adequate vision. This positive trend showed remarkable similarity throughout different regions in Finland, highlighting the importance of equal and accessible eye care throughout the country. [ABSTRACT FROM AUTHOR]

Despite being an agrarian economy, food insecurity is pervasive in Pakistan. This study examines the impact of multiple dimensions of household vulnerability and socio-economic resilience on food insecurity. The results of ordinary least squares and Logistic regression based on data from Pakistan Standard and Living Measurement Survey (2018–2019) and Food Insecurity Experience Scale showed that vulnerabilities like age and employment dependency, household size, and gender composition play a significant role in food insecurity. The key policy interventions that can prevent households from experiencing food insecurity would be investments in human capital, empowering women, and reduction in rural–urban disparity. [ABSTRACT FROM AUTHOR]

Background: With the appearance and aggravation of the aging society, cancer has become one of the major problems that threaten the life and health of Chinese residents seriously. Objective: To explore the cancer epidemiological characteristics among the elderly in China from 2005 to 2016, and to provide strategies for cancer prevention and treatment. Methods: Stratified analysis was conducted on the cancer mortality data of the elderly aged ≥60 years in China, which were selected from the Chinese Cancer Registry Annual Report. Joinpoint regression model was used to calculted average annual percentage change (AAPC) to estimate the time trends. Age-period-cohort (APC) model was used to explore the age, period and birth cohort effect on the risk of cancer death. Bayesian age-period-cohort (BAPC) model was used to predict trends in cancer mortality among elderly by gender and region to 2035. Results: 2005–2016, cancer mortality in the elderly in China showed a decreasing trend (AAPC = -1.2%, P<0.001). Cancer mortality in rural areas was higher than that in urban areas, but the urban-rural difference gradually narrowed (t = 6.1, P<0.01). The APC model showed that cancer mortality increased with age. The relative risk (RR) for the period effect decreased. RR was lower for the later- born cohort than that for the earlier-born cohort in rural areas. Lung cancer mortality ranked first in both male and female, and showed an increasing trend among female in the 60–64, 80–84 and ≥85 age groups (AAPC60-64 = 1.0%, AAPC80-84 = 0.8%, AAPC≥85 = 2.0%, all P<0.05). By 2035, cancer mortality for the elderly was predicted to decline nationally, by sex and in rural areas, while rising in urban areas. Conclusion: Cancer mortality in the elderly in China showed a decreasing trend from 2005 to 2016, but it was still higher than the world average. Early cancer screening is important, especially in the elderly male and in rural areas. [ABSTRACT FROM AUTHOR]

Background: There is limited access to diabetes care services at primary care facilities in Malawi. Assessing the capacity of facilities to provide diabetes care is an initial step to integrating services at primary care. Aim: To assess the preparedness for delivering diabetes services at primary care level within the Blantyre District Health Office (DHO) to support the response to NCD epidemic in Malawi. Setting: Blantyre DHO primary care facilities. Materials and methods: A mixed methods approach nested in a national needs assessment for NCD response in Malawi was used. Fourteen primary healthcare facilities from Blantyre DHO were assessed. A tool adapted from the WHO rapid assessment questionnaire was used to identify human resource, equipment, supplies, and medication needed for comprehensive diabetes care. Descriptive statistics were done to analyze the quantitative data. Fisher's exact test was used to assess if there was a statistically significant difference between urban and rural facilities. Seventeen health care workers from the selected facilities participated in key informant interviews. Framework analysis method guided the qualitative data analysis. The quantitative and qualitative data were merged and displayed jointly. Results: The quantitative assessment showed that none of the facilities assessed had capacity to provide all the interventions recommended by WHO for diabetes care at primary level. Eight (57%) of the facilities had the capacity to diagnose diabetes, monitor glucose, prevent limb amputations and manage hypoglycemia and hyperglycemia. Four themes emerged from the qualitative data: differences in level of preparedness and implementation of diabetes care; disparities in resources between urban and rural facilities; low utilization of diabetes services; and strategy and policy recommendations for improvement of diabetes care. Conclusion: Inadequate health financing resulted in significant disparities in the available resources between the rural and urban facilities to offer diabetes care services. There is need to develop national policies and guidelines for diabetes care to strengthen the capacity of primary care facilities to facilitate achievement of universal health coverage. [ABSTRACT FROM AUTHOR]

Background: Over the past three decades, China has experienced significant changes in urban-rural, gender, and age-specific suicide mortality patterns. This study aimed to investigate the long-term trends in suicide mortality in China from 1987 to 2020. Methods: Suicide mortality data were obtained from China's National Health Commission. Joinpoint regression analysis was used to examine changes in trends and age-period-cohort modeling to estimate age, period, and cohort effects on suicide mortality from 1987 to 2020. Net drift, local drift, longitudinal age curves, and period relative risks were also calculated. Results: Crude and age-standardized suicide mortality in China showed continuing downward trends from 1987 to 2020, with a more pronounced decrease in rural areas (net drift = -7.07%, p<0.01) compared to urban areas (net drift = -3.41%, p<0.01). The decline curve of urban areas could be divided into three substages. Period and cohort effects were more prominent in rural areas. Suicide risk was highest among individuals aged 20–24 and gradually increased after age 60. Females, particularly those of childbearing age, had higher suicide risk than males, with a reversal observed after age 50. This gender reversal showed distinct patterns in urban and rural areas, with a widening gap in urban areas and a relatively stable gap in rural areas. Conclusions: Suicide mortality in China has consistently declined over the past three decades. However, disparities in age, gender, and urban-rural settings persist, with new patterns emerging. Targeted suicide prevention programs are urgently needed for high-risk groups, including females of childbearing age and the elderly, and to address the slower decrease and reversing urban-rural gender trends. [ABSTRACT FROM AUTHOR]

Background We compared long-term mortality and readmission rates after COVID-19 hospitalization based on rural-urban status and assessed the impact of COVID-19 vaccination introduction on clinical outcomes by rurality. Methods The study comprised adults hospitalized for COVID-19 at 17 hospitals in 4 US states between March 2020 and July 2022, followed until May 2023. The main analysis included all patients, whereas a sensitivity analysis focused on residents from 4 states containing 17 hospitals. Additional analyses compared the pre- and postvaccination periods. Results The main analysis involved 9325 COVID-19 hospitalized patients: 31% were from 187 rural counties in 31 states; 69% from 234 urban counties in 44 states; the mean age was 65 years (rural, 66 years; urban, 64 years); 3894 women (rural, 41%; urban, 42%); 8007 Whites (rural, 87%; urban, 83%); 1738 deaths (rural, 21%; urban, 17%); and 2729 readmissions (rural, 30%; urban, 29%). During a median follow-up of 602 days, rural residence was associated with a 22% higher all-cause mortality (log-rank, P <.001; hazard ratio, 1.22; 95% confidence interval, 1.10-1.34, P <.001), and a trend toward a higher readmission rate (log-rank, P =.038; hazard ratio, 1.06; 95% confidence interval,.98-1.15; P =.130). The results remained consistent in the sensitivity analysis and in both pre- and postvaccination time periods. Conclusions and Relevance Patients from rural counties experienced higher mortality and tended to be readmitted more frequently following COVID-19 hospitalization over the long term compared with those from urban counties, a difference that remained even after the introduction of COVID-19 vaccines. [ABSTRACT FROM AUTHOR]

Although rural residence has been related to health disparities in cancer patients, little is known about how rural residence impacts mental health and quality of life (QOL) in ovarian cancer patients over time. This prospective longitudinal study investigated mental health and QOL of ovarian cancer patients in the first-year post-diagnosis. Women with suspected ovarian cancer completed psychosocial surveys pre-surgery, at 6 months and one-year; clinical data were obtained from medical records. Histologically confirmed high grade epithelial ovarian cancer patients were eligible. Rural/urban residence was categorized from patient counties using the USDA Rural-Urban Continuum Codes. Linear mixed effects models examined differences in psychosocial measures over time, adjusting for covariates. Although disparities were not observed at study entry for any psychosocial variable (all p -values >0.22), urban patients showed greater improvement in total distress over the year following diagnosis than rural patients (p = 0.025) and were significantly less distressed at one year (p = 0.03). Urban patients had a more consistent QOL improvement than their rural counterparts (p = 0.006). There were no differences in the course of depressive symptoms over the year (p = 0.17). Social support of urban patients at 12 months was significantly higher than that of rural patients (p = 0.04). Rural patients reported less improvement in psychological functioning in the year following diagnosis than their urban counterparts. Clinicians should be aware of rurality as a potential risk factor for ongoing distress. Future studies should examine causes of these health disparities and potential long-term inequities and develop interventions to address these issues. • Rural residence is a known risk factor for health disparities in cancer patients. • Rural ovarian cancer patients show worse recovery in quality of life and distress levels in the year following diagnosis. • Education levels do not explain differences in trajectories between rural and urban patients. [ABSTRACT FROM AUTHOR]

Objective: Rurality is associated with higher incidence and higher disease-specific mortality for most cancers. Outcomes for rural and ultrarural ("frontier") patients with thyroid cancer are poorly understood. This study aimed to identify actionable deficits in thyroid cancer outcomes for rural patients. Methods: We queried linked California Cancer Registry and California Office of Statewide Health Planning and Development databases for patients diagnosed with thyroid cancer (1999–2017). We analyzed time from disease stage at diagnosis, time from diagnosis to surgery, receipt of appropriate radioactive iodine ablation, surveillance status, and overall and disease-specific mortality for urban, rural, and frontier patients. Cox and logistic regression models controlled for clinical and demographic covariates a stepwise manner. All incidence figures are expressed as a proportion of newly diagnosed cases. Results: Our cohort comprised 92,794 subjects: (65,475 women [70.6%]; mean age 50.0 years). Compared to urban patients, rural and frontier patients were more likely to be American Indian, White, uninsured, and from lower quintiles of socioeconomic status (p < 0.01). Distant disease at diagnosis was more common in rural (56.0 vs. 50.4 cases per 1000 new cases, p < 0.01) and frontier patients (80.9 vs. 50.4 per 1000, p < 0.01) compared to urban patients. The incidence of medullary thyroid cancer was greater in rural patients (17.9 vs. 13.6 cases per 1000, p < 0.01) and frontier patients (31.0 vs. 13.6 per 1000, p < 0.01) compared to urban patients. The incidence of anaplastic thyroid cancer was higher in frontier versus urban patients (15.5 vs. 7.1 per 1000, p < 0.01). When compared to urban patients, rural and frontier patients were more often lost to follow-up (odds ratio [OR] 1.69 [confidence interval, CI 1.54–1.85], and OR 3.03 [CI 1.89–5.26], respectively) and had higher disease-specific mortality (OR 1.18 [CI 1.07–1.30], and OR 1.92 [CI 1.22–2.77], respectively). Rural and frontier residence was independently associated with being lost to follow-up, suggesting that it is a key driver of disparities. Conclusion: Compared to their urban counterparts, rural and frontier patients with thyroid cancer present with later-stage disease and experience higher disease-specific mortality. They also are more often lost to follow-up, which presents an opportunity for targeted outreach to reduce the observed disparities in outcomes. [ABSTRACT FROM AUTHOR]

Purpose: Recent literature has highlighted the overlapping contribution of demographic characteristics and spatial factors to urban-rural disparities in SARS-CoV-2 transmission and outcomes. Yet the interplay between individual characteristics, hospitalisation, and spatial factors for urban-rural disparities in COVID-19 mortality have received limited attention. Methods: To fill this gap, we use national surveillance data collected by the European Centre for Disease Prevention and Control and we fit a generalized linear model to estimate the association between COVID-19 mortality and the individuals' age, sex, hospitalisation status, population density, share of the population over the age of 60, and pandemic wave across urban, intermediate and rural territories. Findings: We find that in what type of territory individuals live (urban-intermediate-rural) accounts for a significant difference in their probability of dying given SARS-COV-2 infection. Hospitalisation has a large and positive effect on the probability of dying given SARS-CoV-2 infection, but with a gradient across urban, intermediate and rural territories. For those living in rural areas, the risk of dying is lower than in urban areas but only if hospitalisation was not needed; while for those who were hospitalised in rural areas the risk of dying was higher than in urban areas. Conclusions: Together with individuals' demographic characteristics (notably age), hospitalisation has the largest effect on urban-rural disparities in COVID-19 mortality net of other individual and regional characteristics, including population density and the share of the population over 60. [ABSTRACT FROM AUTHOR]

Background: Coronary artery disease (CAD) among CVDs is the largest killer in the developed world and is rapidly becoming one in the developing countries. CAD is a leading cause of mortality, morbidity and disability with high healthcare costs. CAD is caused by atherosclerosis of the coronary arteries that leads to a restriction of blood flow to the heart. Depending on the degree of stenosis (narrowing) and plaque characteristics, patients may experience stable angina (angina pectoris) or remain asymptomatic until a plaque ruptures and thrombosis occurs, causing acute Coronary syndrome. Materials and methods: It was hospital based cross sectional study, conducted at our Hospital over a period of 1 year. Study subjects consisted of old and newly diagnosed CAD cases attending Hospital. Information was collected on a pre-structured, well designed scheduled questionnaire. New and old cases of CAD attending Hospital were included in the study and patients who were unconscious and not giving consent were not included in the study. The subjects were explained with purpose of the study and assured for secrecy and confidentiality of the information which they provided us. It was decided to include 90 study subjects in the study. First case was selected randomly then further every case was selected till 90 study subjects were covered. If any patient did not agree, then the next case was included in the study. Result: The gender influence when studied separately, it was observed that the mean age of the study subjects among females 56.75 ± 2.008 was slightly lower than males 57.68 ± 2.188. Only 11 of the CAD subjects had post graduate education, while only 2 had professional degrees. The majority of smokers and Ex-smoker were males as compared to females. The overall 37 subjects of CAD had hypertension. There were 38 males and 18 females those who had both the comorbid disease (HTN + DM). On the other side 22 patients had no history of co-morbid disease. The majority 31 of study subjects of coronary artery disease were current smokers, followed by 21 Ex-smokers and 38 nonsmokers. The majority of smokers and Ex-smoker were males as compared to females. Conclusion: The findings corroborate existing literature, highlighting gender disparities and urban-rural differences in CAD prevalence and risk factors. This study contributes valuable insights into CAD epidemiology in India, particularly in the North Eastern Zone. [ABSTRACT FROM AUTHOR]

Rural patients face known healthcare disparities and worse cardiovascular outcomes compared to urban residents due to inequitable access and delayed care. Few studies have assessed rural-urban differences in outcomes following Transcatheter Aortic Valve Implantation (TAVI). We compared short-term post-TAVI outcomes between rural and urban patients. We performed a retrospective analysis of n = 413 patients who underwent TAVI at our large academic medical center, between 2011 and 2020 (rural/urban patients = 93/320. Rural/urban males = 53/173). Primary outcomes were all-cause mortality and cardiovascular mortality. Secondary outcomes included stroke/transient ischemic attack, myocardial infarction, atrial fibrillation, acute kidney injury, bleeding, vascular complications, and length of stay. The mean age in years was 77 [IQR 70–82] for rural patients and 78 [IQR 72–84] for urban patients. Baseline characteristics were similar between groups, except for a greater frequency of active smokers and diabetics as well as a greater body mass index in the rural group. There were no statistically significant differences in all-cause or cardiovascular mortality between the groups. There was also no statistically significant difference in secondary outcomes. Rural and urban patients had no statistically significant difference in all-cause mortality or cardiovascular mortality following TAVI. Given its minimally invasive nature and quality-centric, multidisciplinary care provided by the TAVI Heart Teams, TAVI may be the preferred modality for the treatment of severe aortic stenosis in rural populations. • Rural patients face known healthcare disparities and worse outcomes compared to urban residents due to inequitable access and delayed care. • Few studies have assessed rural-urban differences in outcomes following transcatheter aortic valve implantation. • This study compared all-cause and cardiac mortality between rural and urban patients following transcatheter aortic valve implantation. • Rural and urban patients had no statistically significant difference in all-cause mortality or cardiovascular mortality. • Transcatheter aortic valve implantation may be the preferred modality for the treatment of severe aortic stenosis in rural populations. [ABSTRACT FROM AUTHOR]

Objective: High‐speed rail is not well utilized in the United States. This study examines public interest in high‐speed rail and the role the apparent urban–rural political divide may play in its establishment. Methods: Data from a sample of 1648 U.S. residents and 515 Texas residents surveyed in Fall 2020 and Spring 2021 were analyzed to determine their likelihood of choosing high‐speed rail if it was available. Results: Results found that 35 percent of national respondents and 52 percent of Texas respondents indicated they are likely to choose high‐speed rail. Characteristics such as age, education, gender, and political party affiliation had a statistically significant relationship with a respondent's likelihood of choosing high‐speed rail. Conclusion: This analysis indicates an interest in high‐speed rail in both samples. Many of the characteristics of those likely to choose high‐speed rail are consistent with typical early adopters of innovation. Democrats seem more likely to consider high‐speed rail, however identifying as either a Republican or a Democrat resulted in a positive, statistically significant relationship with an interest in high‐speed rail in the Texas sample. While this discussion does appear to have a partisan divide, other characteristics seem to be a strong predictor of interest in high‐speed rail. [ABSTRACT FROM AUTHOR]

While the impact of transport infrastructure on regional disparity has been widely examined, its effect on intra-regional inequality has received less attention. Based on panel data at China's prefecture-city level during 2007–2018, we adopt the Difference-in-Differences model to investigate whether high-speed rail affects one type of intra-regional inequality, the urban-rural income gap. The results show that high-speed rail operation has widened the urban-rural income gap by boosting the agglomeration of population, financial capital, and economic activities in urban areas adjacent to high-speed rail stations. Furthermore, the effect varies across cities. The impact of high-speed rail on the urban-rural income gap is more evident in small and less developed cities due to the polarization effect. In contrast, this is not observed in large and developed cities. One possible reason is that, in the latter, the diffusion effect is much stronger. [ABSTRACT FROM AUTHOR]

The individual debates on housing poverty, energy poverty, and mobility poverty for the most part overlook the interwoven nature of all three cost burdens, especially for low-income households. This study examines how the three cost factors interact on a household level, the consequences for those affected by cost burdens, and how they cope and negotiate their expenses. Our research comprises two sets of semi-structured interviews, one before and one during the energy crisis, to gain insight into household experiences and constraints. We found that the freedom to choose where and how to live largely determines how households heat their homes and organize their mobility. The housing crisis together with housing market mechanisms appears to be the main driver of this cost trap; and from here, a complex interplay of causal factors unfolds. Location, often conceived of in terms of an urban–rural divide, seems to be of secondary importance. The intersection of cost burdens results in stress, anxiety, and social exclusion, further limiting the capacity for coping. [ABSTRACT FROM AUTHOR]

Urbanization remains an important factor affecting the mental health of people. Currently, there is insufficient research on depression among the offspring of women who have children at an advanced maternal age (AMA). The objective of this study is to investigate the urban and rural disparities in depressive symptoms among the offspring of AMA and related influencing factors. In this study, a total of 1273 offspring born to AMA were selected from the fourth wave of the China Health and Retirement Longitudinal Study (CHARLS) database. The questionnaire used in the study included demographic information and the Center for Epidemiologic Studies Depression Scale (CES D). Chi-square tests and logistic regression analysis were employed to examine the urban-rural differences. The likelihood of developing depressive symptoms of the offspring of AMA in rural areas was 1.633 times higher (AOR = 1.633; 95%CI: 1.211–2.202) compared to their urban counterparts. Several factors including gender, education, marital status, disability, chronic diseases, and sleep duration showed a linkage with depression among rural based offspring of AMA. For the urban offspring of AMA, only disability and sleep duration exhibited a significant association with depressive symptoms. This study cannot establish a causal relationship between depressive symptoms and the influencing factors for the offspring of AMA. Age range and variables of the respondents needs further consideration. This study has brought to light the elevated risk of depressive symptoms among rural-based offspring of AMA. Thus, emphasizing the urgent need for targeted interventions and measures to address the negative impact. • The prevalence of depressive symptoms among offspring of AMA was found to be high; • The prevalence of depressive symptoms was significantly higher among offspring of AMA in rural areas than in urban areas; • There are more influencing factors for depressive symptoms among offspring of AMA in rural areas than in urban areas. [ABSTRACT FROM AUTHOR]

Background: An accelerated epidemiological transition, spurred by economic development and urbanization, has led to a rapid transformation of the disease spectrum. However, this transition has resulted in a divergent change in the burden of infectious diseases between urban and rural areas. The objective of our study was to evaluate the long-term urban–rural disparities in infectious diseases among children, adolescents, and youths in China, while also examining the specific diseases driving these disparities. Methods and findings: This observational study examined data on 43 notifiable infectious diseases from 8,442,956 cases from individuals aged 4 to 24 years, with 4,487,043 cases in urban areas and 3,955,913 in rural areas. The data from 2013 to 2021 were obtained from China's Notifiable Infectious Disease Surveillance System. The 43 infectious diseases were categorized into 7 categories: vaccine-preventable, bacterial, gastrointestinal and enterovirus, sexually transmitted and bloodborne, vectorborne, zoonotic, and quarantinable diseases. The calculation of infectious disease incidence was stratified by urban and rural areas. We used the index of incidence rate ratio (IRR), calculated by dividing the urban incidence rate by the rural incidence rate for each disease category, to assess the urban–rural disparity. During the nine-year study period, most notifiable infectious diseases in both urban and rural areas exhibited either a decreased or stable pattern. However, a significant and progressively widening urban–rural disparity in notifiable infectious diseases was observed. Children, adolescents, and youths in urban areas experienced a higher average yearly incidence compared to their rural counterparts, with rates of 439 per 100,000 compared to 211 per 100,000, respectively (IRR: 2.078, 95% CI [2.075, 2.081]; p < 0.001). From 2013 to 2021, this disparity was primarily driven by higher incidences of pertussis (IRR: 1.782, 95% CI [1.705, 1.862]; p < 0.001) and seasonal influenza (IRR: 3.213, 95% CI [3.205, 3.220]; p < 0.001) among vaccine-preventable diseases, tuberculosis (IRR: 1.011, 95% CI [1.006, 1.015]; p < 0.001), and scarlet fever (IRR: 2.942, 95% CI [2.918, 2.966]; p < 0.001) among bacterial diseases, infectious diarrhea (IRR: 1.932, 95% CI [1.924, 1.939]; p < 0.001), and hand, foot, and mouth disease (IRR: 2.501, 95% CI [2.491, 2.510]; p < 0.001) among gastrointestinal and enterovirus diseases, dengue (IRR: 11.952, 95% CI [11.313, 12.628]; p < 0.001) among vectorborne diseases, and 4 sexually transmitted and bloodborne diseases (syphilis: IRR 1.743, 95% CI [1.731, 1.755], p < 0.001; gonorrhea: IRR 2.658, 95% CI [2.635, 2.682], p < 0.001; HIV/AIDS: IRR 2.269, 95% CI [2.239, 2.299], p < 0.001; hepatitis C: IRR 1.540, 95% CI [1.506, 1.575], p < 0.001), but was partially offset by lower incidences of most zoonotic and quarantinable diseases in urban areas (for example, brucellosis among zoonotic: IRR 0.516, 95% CI [0.498, 0.534], p < 0.001; hemorrhagic fever among quarantinable: IRR 0.930, 95% CI [0.881, 0.981], p = 0.008). Additionally, the overall urban–rural disparity was particularly pronounced in the middle (IRR: 1.704, 95% CI [1.699, 1.708]; p < 0.001) and northeastern regions (IRR: 1.713, 95% CI [1.700, 1.726]; p < 0.001) of China. A primary limitation of our study is that the incidence was calculated based on annual average population data without accounting for population mobility. Conclusions: A significant urban–rural disparity in notifiable infectious diseases among children, adolescents, and youths was evident from our study. The burden in urban areas exceeded that in rural areas by more than 2-fold, and this gap appears to be widening, particularly influenced by tuberculosis, scarlet fever, infectious diarrhea, and typhus. These findings underscore the urgent need for interventions to mitigate infectious diseases and address the growing urban–rural disparity. Li Chen, Yi Xing, and colleagues examine the long-term urban-rural disparities in 43 infectious diseases among children, adolescents, and youths in China. Author summary: Why was this study done?: ➢ Despite national health priorities and immunization programs, the urban–rural disparity in infectious diseases in children and adolescents is often overlooked. ➢ To our knowledge, while some studies have evaluated infectious diseases burdens in children, adolescents, and youths, none have conducted a comprehensive comparison of disease patterns between urban and rural areas in China or other countries. What did the researchers do and find?: ➢ We used the incident cases of infectious diseases aged 4 to 24 years old from China to study the urban–rural disparity in infectious diseases and its long-term change over time. ➢ The burden of infectious diseases in urban areas was more than double that of rural areas, and this disparity widened over time, particularly for tuberculosis and scarlet fever among vaccine-preventable diseases, and infectious diarrhea among gastrointestinal and enterovirus diseases. ➢ Among Chinese youth, overall infectious diseases were unequally distributed, with vaccine-preventable diseases showing the highest inequality. What do these findings mean?: ➢ The substantial burden of infectious diseases in urban areas, underscores the unique health challenges faced by urban populations. ➢ The urban–rural disparities and inequality underscore the need for nuanced strategies in addressing infectious diseases, influenced by factors like socioeconomic development and urbanization, across diverse disease types and geographical contexts. ➢ Study limitations involve using annual average population data without considering population mobility for incidence calculations. [ABSTRACT FROM AUTHOR]

The decline in the total fertility rate (TFR) is a key driver of population change and has important implications for population health and social development. However, China's TFR has been a considerable controversy due to a lack of high-quality data. Therefore, this study used the 2020 national population census of China (NPCC) data and reverse survival method to reassess temporal trends in the TFRs and to reexamine rural–urban differences and regional variations in TFRs from 2000 to 2020 in China. Overall, there were significant gaps between the estimated and reported TFRs before 2020, and the estimated TFRs based on the 2020 NPCC data remained higher than the reported TFRs from government statistics. Although TFRs rebounded shortly in the years after the two-child policy, they have shown a wavelike decline since 2010. Additionally, the estimated TFRs fluctuated below 1.5 children per woman in urban areas compared to above 1.8 in rural areas, but the rural–urban differences continued to decrease. Regarding geographic regional variations, the estimated TFRs in all regions displayed a declining trend during 2010–2020, especially in rural areas. Large decreases of over 25% in TFRs occurred in the north, east, central, and northwest regions. In addition to changing the birth policy, the government and society should adopt comprehensive strategies, including reducing the costs of marriage, childbearing, and child education, as well as promoting work-family balance, to encourage and increase fertility levels. [ABSTRACT FROM AUTHOR]

Objective: To estimate the prevalence of Type 2 Diabetes (T2D) in urban and rural settings and identify the specific risk factors for each location. Method: We conducted this study using data from the 2017–18 Bangladesh Demographic and Health Survey (BDHS), sourced from the DHS website. The survey employed a stratified two-stage sampling method, which included 7,658 women and 7,048 men aged 18 and older who had their blood glucose levels measured. We utilized chi-square tests and ordinal logistic regression to analyze the association between various selected variables in both urban and rural settings and their relationship with diabetes and prediabetes. Results: The prevalence of T2D was 10.8% in urban areas and 7.4% in rural areas, while pre-diabetes affected 31.4% and 27% of the populations in these respective settings. The study found significant factors influencing diabetes in both urban and rural regions, particularly in the 55–64 age group (Urban: AOR = 1.88, 95% CI [1.46, 2.42]; Rural: AOR = 1.87, 95% CI [1.54, 2.27]). Highly educated individuals had lower odds of T2D, while wealthier and overweight participants had higher odds in both areas. In rural regions, T2D risk was higher among caffeinated drink consumers and those not engaged in occupation-related physical activity, while these factors did not show significant influence in urban areas. Furthermore, urban participants displayed a significant association between T2D and hypertension. Conclusion: Our study outlines a comprehensive strategy to combat the increasing prevalence of T2D in both urban and rural areas. It includes promoting healthier diets to control BMI level, encouraging regular physical activity, early detection through health check-ups, tailored awareness campaigns, improving healthcare access in rural regions, stress management in urban areas, community involvement, healthcare professional training, policy advocacy like sugary drink taxation, research, and monitoring interventions. These measures collectively address the T2D challenge while accommodating the distinct features of urban and rural settings. [ABSTRACT FROM AUTHOR]

Background: Overweight/obesity remains a major risk factor for non-communicable diseases and their associated morbidities and mortalities. Yet, limited studies have comprehensively examined factors contributing to the rural–urban disparities in overweight/obesity among women in sub-Saharan Africa. Thus, our study sought to decompose the rural–urban disparities in overweight/obesity among women in sub-Saharan Africa (SSA) using nationally representative datasets. Methods: We performed a cross-sectional analysis of data from the Demographic and Health Surveys of 23 sub-Saharan African countries conducted from 2015 to 2022. A sample of 177,329 women was included in the analysis. Percentages with confidence intervals (CIs) were used to summarize the prevalence of overweight/obesity per rural–urban strata and pooled level. A multivariate non-linear decomposition analysis was used to identify the factors contributing to the rural–urban disparities in overweight/obesity. The results were presented using coefficients and percentages. Results: The pooled prevalence of overweight/obesity among the women was higher in urban areas (38.9%; 95% CI = 38.2–39.6) than rural areas (19.1%; 95% CI = 18.7–19.6). This pattern was observed in all the countries surveyed, except in South Africa, where women in rural areas (53.1%; 95% CI = 50.0–56.4) had a higher prevalence of overweight/obesity than those in urban areas (46.0%; 95% CI = 43.2–48.9). Approximately 54% of the rural–urban disparities in overweight/obesity was attributable to the differences in the women's characteristics or explanatory variables. More than half of the rural–urban disparities in overweight/obesity would be reduced if the disparities in women's characteristics were levelled. Among the women's characteristics, frequency of watching television (29.03%), wealth index (26.59%), and level of education (9.40%) explained approximately 65% of the rural–urban differences in overweight/obesity. Conclusion: The prevalence of overweight/obesity among women in SSA remains high and skewed towards women in urban areas. Increased frequency of watching television, high wealth index, and higher educational attainment contributed largely to the rural-urban disparities in overweight/obesity among women in SSA. Thus, interventions aimed at reducing overweight/obesity among women in SSA could be targeted at reducing the frequency of television watching as well as promoting physical activities among wealthy women and those with higher education, particularly in urban areas. [ABSTRACT FROM AUTHOR]

This piece presents an interview conducted by Karène Sanchez Summerer and Sary Zananiri with Salim Tamari and Yair Wallach about the Frank Scholten photographic collection (now available with Creative Commons access), discussing the archive's significance and use for researchers of the history of Mandate Palestine.During the turbulence of the period after the First World War, Dutch photographer Frank Scholten (1881-1942) travelled to Palestine with the aim of producing an 'illustrated Bible'. He arrived in Palestine in 1921, where he stayed for two years. While the bulk of his photo collection consists of images of Palestine, his camera lens gives a snapshot into modernity in the Eastern Mediterranean more broadly. The entire Frank Scholten collection, consisting of 12,000 negatives and 14,000 prints, represents a work in progress towards a 16-volume set of books on the 'Holy Land', only two volumes of which were ever published.One of the hallmarks of Scholten's collected work is the thoroughness with which he imaged Palestine. His images of people cut across religious and confessional lines, ethnic backgrounds, and class and urban-rural divides. He imaged people at work as well as in their leisure time, but most of all, he imaged people in the context of their daily life, rather than divorced from the landscape. [ABSTRACT FROM AUTHOR]

The police occupy a central role in the functioning of the state by being tasked with upholding security, law and order. Across the African continent, the public has little trust in the police, but such perceptions are subject to considerable subnational variation. In this study, we are interested in how the different contexts in which the police operate affect police-citizen relations. We ask: How does an urban versus rural environment shape citizens' trust in the police? We address this question within the context of Kenya, using geocoded survey data from Afrobarometer. We theorise that the rural versus urban environment will shape citizens' experience with the police in ways that affect their attitudes toward the police. Specifically, we argue that in a context where the police have frequently been employed to repress specific sociopolitical groups, urban residents, living in denser and more diverse environments compared to rural residents, are more prone to have first- or second-hand experiences of the police that result in diminished trust towards them. Our results support these propositions: We find a strong and robust relationship between urban residence and lower levels of trust in the police. The relationship holds when controlling for respondents' political alignment, which likely conditions people's perceptions of state institutions. Qualitative evidence from interviews provide additional understanding of the urban-rural divide we identify. Our results provide important insights into the contextual dynamics that shape individuals' trust in the police, and underline the importance of efforts to improve police-community relations in urbanising contexts. [ABSTRACT FROM AUTHOR]

The urban–rural temperature difference is widely used in measuring surface urban heat island intensity (SUHII), where the accurate determination of rural background is crucial. However, traditionally, the entire permeable rural surface has been selected to represent the background temperature, leaving uncertainty about the impact of non-uniform rural surfaces with multiple land covers on the accuracy of SUHII quantification. In this study, we proposed two quantifications of SUHII derived from the primary (SUHII1) and secondary (SUHII2) land types, respectively, which successively occupy over 40–50% of whole rural regions. The spatial integration and temporal variation of SUHII1 and SUHII2 were compared with the result from whole rural regions (SUHII) within 34 urban agglomerations (UAs) in China. The results showed that the SUHII1 and SUHII2 differed slightly with SUHII, and the correlation coefficients of SUHII and SUHII1/SUHII2 are generally above 0.9 in most (32) UAs. Regarding the long-term SUHII between 2003 and 2019, the three methods demonstrated similar seasonal patterns, although SUHII1 (or SUHII2) tended to overestimate or underestimate compared to SUHII. As for the multi-year integration at the regional scale, the day–night cycle and monthly variations of SUHII1 and SUHII were found to be identical for each geographical division separately, indicating that the spatiotemporal pattern revealed by SUHII is minimally affected by the diversity of rural landcover types. The findings confirmed the viability of the urban–rural LST difference method for measuring long-term regional SUHII patterns under non-uniform rural land cover types. [ABSTRACT FROM AUTHOR]

Despite rapid economic growth in China since 1978, rural-urban inequality has widened. High levels of socioeconomic inequality can have profound implications for child development and lifelong educational equity. Using a dataset containing early childhood development (ECD) outcomes of 0- to 3-year-olds (N = 9,053) from study sites in Eastern, Central, and Western China, the study finds that the risks of cognitive, language, and motor delay are, respectively, 43.2, 18.3, and 20.7 percentage points higher in rural study sites than in urban Shanghai (ps <.01). Impact evaluation of cluster-randomized experiments shows that parental training (focusing on child psychosocial stimulation and caregiver-child interaction) can improve parenting beliefs and practices (or investments) and ECD outcomes of disadvantaged rural children (p<.01). Such programs can play an important role in advancing progress toward more social equality and economic equity, the stated goals of China's "Common Prosperity" policy. [ABSTRACT FROM AUTHOR]

Rapid urbanization is a major trend in global population migration. There is growing debate about whether this urban-rural disparity exacerbate depression at the individual level. This study aims to investigate how urban living has a beneficial impact on individual mental health. Based on the data of 15,764 participants in the 2018 China Health and Retirement Longitudinal Study (CHARLS), we perform analysis of variance to identify the gap in depression levels between urban and rural areas. Extensive comparisons and detailed statistical analyses are carried out to demonstrate the differences in social participation between urban and rural residents. Finally, we conduct a series of mediation and moderation analyses to reveal the underlying mechanisms of depressive disorder benefits of cities. The results indicate that those who lived in urban areas were less likely to suffer from depression (β = −1.461, 95 % CI = [−1.691, −1.235], p < 0.001). Social engagement is found to mediate the relationship between residence type (β = 0.164, 95 % CI = [0.136, 0.193], p < 0.001) and individual depression (β = −0.462, 95 % CI = [−0.587, −0.337], p < 0.001). City size plays a moderating role in the association between urban living and social engagement. The mechanism is conducted through cross-sectional data. Self-reported depression status is accessed in this study, which could lead to measurement error. This study demonstrates the beneficial effects of urban living on individual depression, and reveals the mechanism by which urbanization at different scales affects the prevalence of depression. • This study fueled the debate about depressive disorder from growing cities with a nationwide empirical analysis. • We identified the underlying mechanism by which urban living could protect residents from the obnoxious depression. • Our observation also revealed the contingency of the protective effect of cities against depression. [ABSTRACT FROM AUTHOR]

While political scientists have long studied citizens' political efficacy as an important indicator of attitudes toward government, less attention has been devoted to the efficacy of rural or urban residents, which is important given the intensifying rural-urban divide in American society. This study fills this gap by analyzing the 2020 American National Election Studies. Using ordered logistic regression, this study finds that (1) city residents tend to believe that small towns and rural areas have too much influence on government; (2) residents of small towns and rural areas demonstrate lower levels of external efficacy than city residents; and (3) people who believe that small towns and rural areas have too much influence tend to demonstrate high external and internal efficacies, a tendency that is clearer in cities than in other community types. These findings reflect mutual in-group bias and place-based resentment between rural and urban residents in American society. [ABSTRACT FROM AUTHOR]

We provide a mixed-methods, comparative analysis of the development of the urban-rural electoral cleavage in Canada, Great Britain, and the United States from the early 20th century to the present. Using aggregate election results, electoral district boundary files, and electoral district population measures, we construct a new comparable dataset of district election results and urbanity for the lower house of the legislature in each country. We use this dataset to measure the importance of the urban-rural divide for election outcomes across countries and time. We find that the cleavage has widened over time in each country, each arrived at its current urban-rural divide via a distinct developmental trajectory, which we interpret with reference to secondary literature. We conclude by discussing the significance of our findings for theories of both the causes and consequences of urban-rural divides and discuss the implications of our work for the comparative study of urban-rural cleavages. [ABSTRACT FROM AUTHOR]

Background: Rural-urban differences in health service use among persons with prevalent dementia are known. However, the extent of geographic differences in health service use over a long observation period, and prior to diagnosis, have not been sufficiently examined. The purpose of this study was to examine yearly rural-urban differences in the proportion of patients using health services, and the mean number of services, in the 5-year period before and 5-year period after a first diagnosis of dementia. Methods: This population-based retrospective cohort study used linked administrative health data from the Canadian province of Saskatchewan to investigate the use of five health services [family physician (FP), specialist physician, hospital admission, all-type prescription drug dispensations, and short-term institutional care admission] each year from April 2008 to March 2019. Persons with dementia included 2,024 adults aged 65 years and older diagnosed from 1 April 2013 to 31 March 2014 (617 rural; 1,407 urban). Matching was performed 1:1 to persons without dementia on age group, sex, rural versus urban residence, geographic region, and comorbidity. Differences between rural and urban persons within the dementia and control cohorts were separately identified using the Z-score test for proportions (p < 0.05) and independent samples t-test for means (p < 0.05). Results: Rural compared to urban persons with dementia had a lower average number of FP visits during 1-year and 2-year preindex and between 2-year and 4-year postindex (p < 0.05), a lower likelihood of at least one specialist visit and a lower average number of specialist visits during each year (p < 0.05), and a lower average number of all-type prescription drug dispensations for most of the 10-year study period (p < 0.05). Rural-urban differences were not observed in admission to hospital or short-term institutional care (p > 0.05 each year). Conclusions: This study identified important geographic differences in physician services and all-type prescription drugs before and after dementia diagnosis. Health system planners and educators must determine how to use existing resources and technological advances to support care for rural persons living with dementia. [ABSTRACT FROM AUTHOR]

In recent years, the rapid advancement of digital technology has supported the growth of the digital economy. The transformation towards digitization in the public health sector serves as a key indicator of this economic shift. Understanding how the digital economy continuously improves the efficiency of public health services and its various pathways of influence has become increasingly important. It is essential to clarify the impact mechanism of the digital economy on public health services to optimize health expenditures and advance digital economic construction. This study investigates the impact of digital economic development on the efficiency of public health services from a novel perspective, considering social media usage and urban–rural healthcare disparities while constructing a comprehensive index of digital economic development. The findings indicate that the digital economy reduces the efficiency of public health services primarily through two transmission mechanisms: the promotion of social media usage and the widening urban–rural healthcare gap. Moreover, these impacts and transmission pathways exhibit spatial heterogeneity. This study unveils the intrinsic connection and mechanisms of interaction between digital economic development and the efficiency of public health services, providing a theoretical basis and reference for government policy formulation. However, it also prompts further considerations on achieving synergy and interaction between the digital economy and public health services. [ABSTRACT FROM AUTHOR]

Addressing South Asia's poverty, this research presents an exhaustive case study of Pakistan, exploring poverty dynamics at national and provincial levels, emphasizing the urban–rural divide. The study uses the most recent income and expenditure surveys from 2013 and 2015 and applies the Cost of Basic Needs methodology based on strong theoretical and empirical grounds. The research adjusts for price variation within and among provinces. It uses traditional Foster-Greer-Thorbecke measures and innovative measures like the Watts and Sen indices. Findings reveal a poverty decline in Pakistan between 2013 and 2015, with significant provincial variations in this decline. Despite a minor decline in the headcount ratio of the larger provinces, their poverty shares increased in 2013–15, showing a regional convergence trend with growing disparities in poverty headcount and depth. Using indices like Watts and Sen gives a more complete, nuanced poverty understanding, highlighting the need for their adoption alongside traditional measures. The research ends with policy implications, emphasizing the importance of targeted poverty reduction strategies to address regional disparities effectively. This research offers insights into South Asia's poverty dynamics and contributes significantly to SDG 1—ending poverty. The Pakistan case study is a valuable reference for other countries, guiding accurate poverty measurement, effective policy-making, and efficient SDGs performance tracking. [ABSTRACT FROM AUTHOR]

Background: Cancer incidence and mortality vary across the globe, with nearly two-thirds of cancer-related deaths occurring in low- and middle-income countries. The rural-urban disparity in socio-demographic, behavioural, and lifestyle-related factors, as well as in access to cancer care, is one of the contributing factors. Population-based cancer registries serve as a measure for understanding the burden of cancer. We aimed to evaluate the rural-urban disparity in cancer burden and care of patients registered by an Indian population-based cancer registry. Methods: This study collected data from Varanasi, Uttar Pradesh, India, between 2017 and 2019. Sex and site-specific age-standardised rates for incidence and mortality per 100,000 population were calculated. Rural-urban disparities in cancer incidence and mortality were estimated through rate differences and standardised rate ratios (with 95% confidence intervals). Univariable and multivariable regressions were applied to determine any significant differences in socio-demographic and cancer-related variables according to place of residence (rural/urban). Crude and adjusted odds ratios with 95% confidence intervals were calculated. Results: 6721 cancer patients were registered during the study duration. Urban patients were older and had better literacy and socioeconomic levels, while rural patients had higher odds of having unskilled or semi-skilled professions. Diagnostic and clinical confirmation for cancer was significantly higher in urban patients, while verbal autopsy-based confirmation was higher in rural patients. Rural patients were more likely to receive palliative or alternative systems of medicine, and urban patients had higher chances of treatment completion. Significantly higher incidence and mortality were observed for oral cancer among urban men and for cervical cancer among rural women. Despite the higher incidence of breast cancer in urban women, significantly higher mortality was observed in rural women. Conclusions: Low- and middle-income countries are facing dual challenges for cancer control and prevention. Their urban populations experience unhealthy lifestyles, while their rural populations lack healthcare accessibility. The distinctness in cancer burden and pattern calls for a re-evaluation of cancer control strategies that are tailor-made with an understanding of urban-rural disparities. Context-specific interventional programmes targeting risk-factor modifications, cancer awareness, early detection, and accessibility to diagnosis and care are essential. [ABSTRACT FROM AUTHOR]

Many studies in Western societies show a pattern of discriminative grandparental investment as follows: maternal grandmothers (MGMs) > maternal grandfathers (MGFs) > paternal grandmothers (PGMs) > paternal grandfathers (PGFs). This pattern is in line with the expectation from evolutionary reasoning. Yet whether or not this pattern applies in China is in question. The present study was based on a questionnaire survey at a university in Central China (N = 1,195). Results show that (1) when grandparent–grandchild residential distance during grandchildren's childhood is controlled, in the case of grandsons and granddaughters as a whole and granddaughters only, both grandparental caregiving and grandchildren's emotional closeness to grandparents display a rank order of MGM > MGF > PGM > PGF, but in the case of grandsons only, this order is not statistically significant. (2) There are stable relationships between grandparental caregiving/grandchildren's emotional closeness and residential distance/similarity in appearance. (3) The effects of residential distance on either PGFs' or PGMs' caregiving exceed those on either MGFs' or MGMs'. (4) The PGF and PGM prefer grandsons to granddaughters in their caregiving, whereas the MGF and MGM do not have a sex preference, and (5) the fact that the PGF and PGM invest more in grandsons than in granddaughters does not depend on grandsons' duration of living in a rural area. Our results suggest that (1) in general, the Chinese display a pattern of differential grandparental investment predicted by an evolutionary perspective, (2) the evolutionary perspective that combines the two factors of paternal uncertainty and sex-specific reproductive strategies is applicable to grandparental investment in China, and (3) the traditional son-preference culture also plays some role in affecting grandparental investment in China, though the roles of culture and urban–rural cultural difference should not be exaggerated. [ABSTRACT FROM AUTHOR]

Understanding the social feasibility of wildlife conservation approaches is essential to reducing social conflicts over wildlife and public backlash toward wildlife agencies and organizations. The Potential for Conflict Index2 (PCI2) and geospatial analyses of conflict can help wildlife practitioners strategically engage their publics, but these two tools have yet to be combined. Using data from a 2021 survey about white‐tailed deer in Indiana (n = 1806), we analyzed conflict levels among stakeholder self‐identities and political ideologies regarding the acceptability of six possible management methods, three lethal and three nonlethal. We then conducted a hotspot analysis of gridded PCI2 values to map areas of high and low social conflicts across the state. Conflict potentials showed more consistent covariation with political ideologies than with stakeholder self‐identities, aligning with urban–rural divides in wildlife experiences. Data on political leanings and residency may thus be more reliable than stakeholder categories to predict social conflicts over wildlife management. Hotspots of conflict over lethal methods clustered around urban areas, indicating that agencies should focus on engaging urban residents about deer management. Our conflict hotspots can be combined with other spatial data to create social units of analysis, which can help practitioners develop targeted and socially accepted strategies for wildlife conservation and management. [ABSTRACT FROM AUTHOR]

This paper explores and interrogates existing approaches to urban-rural digital divide reduction. The EU and its member states are applying fragmented and diverse digitalization of territories. Any systematic review of best practice and the juxtaposition of urban and rural areas is lacking. The authors present a taxonomy of key European rural digitalization approaches and determined EU country clusters according to the extent of their use, with a critical analysis of the context of their successes or failures. The key finding is identification of digital infrastructure and virtual sphere coherence as a challenge for bridging the urban-rural digital divide. [ABSTRACT FROM AUTHOR]

Globally, rural areas suffer from less infrastructure relative to urban areas. Political and development economists have mainly attributed this disparity in infrastructure distribution to governance. The literature has sufficiently discussed the role that rural-urban infrastructure inequality plays in development outcomes such as poverty. However, not much is known about the effect of the rural-urban infrastructure gap on the environment. To contribute to knowledge and policy discussions, we investigate the impact of rural-urban energy access (in)equality on environmental degradation and the role governance plays using data from 47 sub-Saharan African countries from 2000–2020. Evidence from the heteroskedasticity-based instrumental variable regression consistent with Driscoll and Kraay's estimation revealed that bridging rural-urban energy access inequality is associated with reduction in environmental degradation. We also documented that the direct effect of the governance-related variables used is mixed. The moderation and marginal effect estimates showed that improving governance quality conditions equality in rural-urban energy access to reduce environmental degradation. From a policy perspective, these findings suggest that the implementation of rural electrification policies supported by a good governance system would play a crucial role in mitigating environmental degradation in developing countries. [ABSTRACT FROM AUTHOR]

There is an evident research gap in the literature on the geography of innovation: very little is known about the innovation activities of rural enterprises in times of crisis. The topic is addressed here by analysing space–time differences in the receipt of research, development and innovation (RDI) funding by Finnish firms before and during the COVID-19 pandemic as a major economic shock. Using firm- and municipal-level panel regression analyses, the main goal was to identify key differences and temporal changes in RDI funding patterns across different region types. The empirical results show that firms located in urban regions have been generally more successful in applying for competitive public RDI funding than firms located in rural regions, but that rural firms have caught up to their urban counterparts during the COVID-19 pandemic. This narrowing of the rural–urban RDI funding gap (1) shows that easy and flexible access to RDI funding during the COVID-19 pandemic appears to be especially attractive for small rural enterprises, (2) points to the strategic flexibility of small rural enterprises in times of crisis, and (3) indicates that the innovation capacity of these firms/regions is more resilient to economic shocks than typically thought. [ABSTRACT FROM AUTHOR]

Objective To understand the current situation, influencing factors, and urban-rural heterogeneity of overweight/ obesity among the elderly in China, so as to provide basis for formulating corresponding intervention measures. Methods The data of people age ! 60 years old in China Family Panel Studies (CFPS) database in 2020 were used. Unconditional binary logistic regression was used to analyze the influencing factors of overweight/obesity in the elderly. Results A total of 4 870 eligible samples were included in this study, of which 1 903 were overweight/obese, and the overweight/obesity rate was 39.08% (33.10% in rural areas and 36.56% in urban areas). People aged 60-69 (OR = 2.145, 95%CI: 1.559-2.951), 70-79 years old (OR = 1.752, 95%CI: 1.270-2.416), suffering from chronic diseases (OR = 1.215, 95%CI: 1.061-1.392), smoking (OR = 0.651, 95%CI: 0.556-0.763), living in the central China (OR = 1.255, 95%CI: 1.052-1.498), eastern China (OR = 1.378, 95%CI: 1.169-1.623), living in town (OR = 1.366, 95%CI: 1.193-1.565), with primary school education (OR = 1.214, 95%CI: 1.034-1.427), retirement pension (OR = 1.342, 95%CI: 1.126-1.599), and endowment insurance (OR = 0.841, 95% CI: 0.739-0.956) were the influencing factors of overweight/obesity in the elderly. People aged 60- 69 (OR = 2.333, 95%CI: 1.561-3.487), 70-79 years old (OR = 2.057, 95%CI: 1.372-3.084), suffering from chronic diseases (OR = 1.364, 95%CI: 1.132-1.645), smoking (OR = 0.705, 95%CI: 0.563-0.881), living in the eastern region (OR = 1.278, 95%CI: 1.006-1.623). with primary school education (OR = 1.397, 95%CI: 1.104-1.768), and retirement pension (OR = 1.284, 95%CI: 1.046¬1.577) were the influencing factors of overweight/obesity of the urban elderly. People aged 60-69 years old (OR = 1.779, 95%CI: 1.048-3.021), smoking (OR = 0.594, 95%CI: 0.473-0.747), living in central China (OR = 1.28, 95%CI: 1.010¬1.647), eastern China (OR = 1.481, 95%CI: 1.176-1.867), retirement pension (OR = 1.424, 95%CI: 1.003-2.022), and new rural cooperative medical system (NCMS) (OR = 0.475, 95%CI: 0.261-0.862) and health insurance for urban/rural residents (OR = 0.615, 95%CI: 0.380-0.995) were the influencing factors of overweight/obesity of the rural elderly. Conclusion The in¬fluencing factors of overweight/obesity in the elderly are multi-level and multi-dimensional and vary between urban and rural areas. Timely and targeted preventive strategies and preventive measures should be taken from individual to macro dimen¬sions, based on the current situation of urban-rural differences in China. [ABSTRACT FROM AUTHOR]

Introduction: Patients living in rural areas have worse cancer‐specific outcomes. This study examines the effect of family‐based social capital on genitourinary cancer survival. We hypothesized that rural patients with urban relatives have improved survival relative to rural patients without urban family. Methods: We examined rural and urban based Utah individuals diagnosed with genitourinary cancers between 1968 and 2018. Familial networks were determined using the Utah Population Database. Patients and relatives were classified as rural or urban based on 2010 rural–urban commuting area codes. Overall survival was analyzed using Cox proportional hazards models. Results: We identified 24,746 patients with genitourinary cancer with a median follow‐up of 8.72 years. Rural cancer patients without an urban relative had the worst outcomes with cancer‐specific survival hazard ratios (HRs) at 5 and 10 years of 1.33 (95% CI 1.10–1.62) and 1.46 (95% CI 1.24–1.73), respectively relative to urban patients. Rural patients with urban first‐degree relatives had improved survival with 5‐ and 10‐year survival HRs of 1.21 (95% CI 1.06–1.40) and 1.16 (95% CI 1.03–1.31), respectively. Conclusions: Our findings suggest rural patients who have been diagnosed with a genitourinary cancer have improved survival when having relatives in urban centers relative to rural patients without urban relatives. Further research is needed to better understand the mechanisms through which having an urban family member contributes to improved cancer outcomes for rural patients. Better characterization of this affect may help inform policies to reduce urban–rural cancer disparities. [ABSTRACT FROM AUTHOR]

Background: School bullying is a global problem. Although previous studies showed rural adolescents were at higher risk of being bullied compared to their urban counterparts, the rural–urban differences in the risk of bullying or poly-bullying victimization in relation with different characteristics and the joint association of internet addiction and depressive symptoms with the observed urban–rural disparities are unclear. Objective: We aim to investigate the rural–urban differences in bullying or poly-bullying victimization among adolescents and whether the observed rural–urban differences are associated specifically with internet addiction or depression. Methods: This cross-sectional study considered a total of 25,377 Grade 7 to 12 adolescents from the 'Surveillance for Common Disease and Health Risk Factors among Students' project implemented in Jiangsu Province in 2019. Rurality of residence was ascertained via the Regulation of Statistical Classification. We used Poisson regression to estimate the age–sex adjusted rate ratios (RRs) and 95% confidence interval (CI) for bullying and poly-bullying victimization. Results: Approximately 20.26% (95%CI: 16.11–25.47%) and 7.67% (5.48–10.74%) rural adolescents experienced bullying and poly-bullying, in comparison with 16.50% (12.65–21.52%) and 5.81% (4.34–7.78%) urban adolescents, respectively. Rural adolescents had 14% and 23% higher rates of bullying victimization (RR: 1.14, 95%CI: 1.03–1.26) and poly-victimization (RR: 1.23, 95%CI: 1.05–1.44) than their urban counterparts. When further controlled for internet addiction, the observed rural–urban disparities increased among adolescents with depressive symptoms, whereas diminished among those without depressive symptoms. [ABSTRACT FROM AUTHOR]

Urban grime refers to films made of a complex chemical mixture of organics and inorganics deposited on outdoor surfaces. The specific chemical composition of such films can vary considerably due to geographic and seasonal influences. We compared the seasonal change of grime's water-soluble inorganic ion content in a rural (Thamesford), suburban (Oshawa), and urban city (Toronto) in southern Ontario, Canada. Sodium, calcium, chloride, nitrate, and sulfate amounts in grime were collected and quantified over four seasons in Oshawa, ON and Thamesford, ON and compared with results from a previous study in Toronto to elucidate differences. We found that all three regions displayed a clear seasonality in sodium and chloride consistent with winter road salt inputs and chloride loss in summer. Mole fractions of sulfate were consistently the lowest of the measured ions, and NO3−/SO42− ratios showed a winter–spring minimum and summer–fall maximum. Urban–rural differences in the seasonal changes of ionic mole ratios suggest that additional chloride displacement by nitrate occurs within grime in Toronto that is not present in the two other rural/suburban cities in the same region. [ABSTRACT FROM AUTHOR]

Depopulation is caused by low fertility rates and out-migration, and it applies to countries, regions and smaller areas. Rural depopulation is defined as a sharp population decline that falls well below an adequate population size and indicates that an area has lost its demographic reproductive capacity. This paper discusses the socioeconomic and territorial aspects of rural depopulation, attempting to do justice to the spatial dimensions of the phenomenon. Greece exhibits all the symptoms of demographic transition, leading to labour shortages, declining economic productivity, and increasing demands on the health and welfare system. The study on rural depopulation in Greece focuses on the changes and dynamics observed at the municipal and regional levels. A typology has been developed to identify rural communities in Greece. The main source of demographic data for our study is the Greek censuses (1991, 2001, 2011, and 2021). Demographic and socioeconomic trends in Greece are interlinked and show different regional and local dynamics. Rural depopulation is closely related to the study of (international and internal) migration, even though the latter does not provide a permanent solution to depopulation. An empirical analysis has shown that there is a need to revitalise rural areas through socioeconomic improvements, infrastructure investments, and policies that directly impact rural communities. [ABSTRACT FROM AUTHOR]

The purpose of this research is to investigate the prediction effect of future self-continuity (FSC) on health-promoting behaviors (Health Responsibility, Physical Activity, and Nutritional Habits) and the impact of urban-rural differences in Chinese college students, further verifying the effect of mental imagery practice on enhancing FSC and promoting health-promoting behaviors among students from rural areas. Study 1 used the Future Self-Continuity Questionnaire and a sub-scale of the Health Promotion Lifestyle Profile-II to examine the relationship between FSC and health-promoting behaviors among 788 college students (430 from rural areas and others from urban areas). Study 2 was designed to examine the impact of intervention on FSC and health-promoting behaviors among Chinese rural students. The intervention activities lasting 4 wk. 162 freshmen were randomly divided into intervention or control groups to practice the mental imagery about the future self or meditation in the present once a week. FSC and health-promoting behaviors were tested for 3 times. The results demonstrated that: (1) Rural students had lower scores in FSC and health-promoting behaviors than urban students; (2) Urban-rural differences of students moderated the effect of FSC on health-promoting behaviors; (3) The mental imagery practiced increased FSC; and (4) FSC played a complete mediating role in the effect of condition (intervention or not) on health-promoting behaviors for rural college students. Overall, these findings contribute to a deeper understanding of the relationship between FSC and health-promoting behaviors, and suggest that mental imagery practice can increase Chinese rural college students' health-promoting behaviors by enhancing their FSC. [ABSTRACT FROM AUTHOR]

[Display omitted] Household consumption in China is associated with substantial PM 2.5 pollution, through activities directly (i.e., fuel use) and/or indirectly (i.e., consumption of goods and services) causing pollutant emissions. Urban and rural households exhibit different consumption preferences and living areas, thus their contributions to and suffering from air pollution could differ. Assessing this contrast is crucial for comprehending the environmental impacts of the nation's ongoing urbanization process. Here we quantify Chinese urban and rural households' contributions to ambient PM 2.5 pollution and the health risks they suffer from, by integrating economic, atmospheric, and health models and/or datasets. The national premature deaths related to long-term exposure to PM 2.5 pollution contributed by total household consumption are estimated to be 1.1 million cases in 2015, among which 56% are urban households and 44% are rural households. For pollution contributed indirectly, urban households, especially in developed provinces, tend to bear lower mortality risks compared with the portions of deaths or pollution they contribute. The opposite results are true for direct pollution. With China's rapid urbanization process, without adequate reduction in emission intensity, the increased indirect pollution-associated premature deaths could largely offset that avoided by reduced direct pollution, and the indirect pollution-associated urban–rural inequalities might become severer. Developing pollution mitigation strategies from both production and consumption sides could help with reducing pollution-related mortality and associated urban–rural inequality. [ABSTRACT FROM AUTHOR]

Measurements collected from ground monitoring stations have gained popularity as a valuable data source for calibrating numerical models and correcting model errors through data assimilation. Both model calibration and assimilation are driven by the penalty quantified by simulation-minus-observations. However, the penal forces are challenged by the existence of a spatial scale disparity between model simulations and observations. The Chemical Transport Models (CTMs) allow the division of the atmosphere into grid cells, yet their spatial resolution may not align with the limited range of in-situ measurements, particularly for short-lived air pollutants. Within a broad grid pattern, air pollutant concentrations can exhibit significant heterogeneity due to their rapid generation and dissipation. Ground observations with traditional methods (including nearest search and grid mean) are less representative when compared to model simulations. This study develops a new land-use-based representative (LUBR) observational operator to generate spatially representative gridded observation for model calibration and evaluation. It incorporates high-resolution urban-rural land use data to address intra-grid variability. The LUBR operator is validated to consistently provide insights that align with satellite OMI measurements. It is an effective solution to accurately quantify these spatial scale mismatches and further resolve them via assimilation. Model calibrations with 2015-2017 NO2 measurement in China demonstrates biases and errors differed substantially when the LUBR and other operator are used, respectively. The results highlight the importance of considering fine-scale urban-rural differences when comparing models and observations, especially for short-lived pollutants like NO2. [ABSTRACT FROM AUTHOR]

Background: COVID-19 has reportedly resulted in disparities in the use of telemedicine due to several socioeconomic factors. While telemedicine was developed to overcome geographical distance, under COVID-19 telemedicine conversely might have deepened the urban-rural telemedicine divide. Especially in Japan, the authority has virtually regulated distant telemedicine use, which favored telemedicine providers who are located in close proximity to patients. This study aimed to quantify the urban-rural disparity in access to telemedicine and investigate heterogeneity between devices (phone and video visits). Methods: We used two nationally comprehensive data sources in Japan. One was a municipality-level telemedicine provider database. Municipality-provider-level analysis intended to measure the uneven distribution of telemedicine providers compared to usual health care providers as well as the difference among clinical departments. The second source was prefecture-level telemedicine utilization data. Prefecture-utilization-level analysis aimed to quantify how the use of telemedicine converged in urban areas. We investigated the heterogeneity between types of devices and time periods. To measure inequality, this study used the Lorenz Curve and Gini coefficients. Ethical review was not required. Results: The data included 16,927 providers (14,111 clinics and 2,816 hospitals) and 88,952 first visits throughout Japan. The main findings were the geographically converged distribution of telemedicine providers compared with overall providers who were not limited to telemedicine and, possibly as a result of it, the geographically unequal utilization of telemedicine compared with in-person visits. Furthermore, video visits were more unequally utilized than phone visits, let alone in-person visits. The disparity was not resolved over time, which implied a systematic cause. Conclusion: Using comprehensive nationwide data, this study revealed geographical inequality relating to access to telemedicine under the COVID-19 special deregulation in Japan. While telemedicine initially aimed to provide access to care for people in rural areas, several factors, including the digital divide, COVID-19, and the Japanese policy, paradoxically could have caused this disparity. [ABSTRACT FROM AUTHOR]