1991年天津市高血压抽样调查报告

按照全国高血压抽样调查统一标准、方法,对天津市城乡居民20555人进行了高血压流行病学调查,校正应答率88.15%.结果:①确诊高血压标化患病率为10.73%,城乡标化率分别为11.35%和10.07%,市区高于农村,患病率骤升年龄在45～岁组.②性别标化率,男10.35%,女11.06%,女性略高.③与1959年、1979年调查数据比较,患病率一直呈上升趋势.同时对高血压有关危险因素进行了探讨.     

北京市高血压流行病学调查分析

北京市高血压患病率在国内属高发区之一,本研究调查了北京地区所有区县45558人高血压患病率,结果:①临界、确诊、和合并(临界+确诊)高血压标化患病率分别为9.26%,10.46%,19.72%.②高血压患病率于35岁以后明显增加,45岁以前患病率男性高于女性,45岁以后女性患病率上升加快,至55岁以后超过男性.③城市临界、确诊、合并高血压患病率分别为8.92%,8.97%,17.82%,农村分别为11.72%,9.56%、21.28%,农村明显高于城市,.④不同职业合并高血压患病率有明显差异,工人、农民较高,19.66%,19.56%,科技人员最低14.99%,⑤教育水平、卫生知识水平与高血压患病率及血压水平呈负相关.     

河北省成年居民高血压患病及分布特征

目的了解河北省居民高血压的患病及分布情况。方法采用多阶段分层随机抽样,通过问卷调查和体检等探讨河北省4200名18～69岁居民高血压患病及分布特征、高血压知晓率、治疗率和控制率。结果样本人群高血压患病率为39.6%(标化率30.7%),其中男性为42.3%(标化率32.7%),女性为37.7%(标化率29.1%)。男女性患病水平随着年龄的增长而升高。农村居民高血压患病率(40.4%)高于城市(37.6%)。血压正常高值患病率为38.8%,其中男性为41.2%,女性为37.1%。无论城市还是农村,不同体质指数人群的高血压患病率差别均有统计学意义。高血压患者知晓率、治疗率和控制率分别为27.8%,24.8%,5.2%。结论河北省居民高血压患病率较高,应作为河北省慢性病防治重点。     

广西城乡居民高血压流行特征及防治效果分析

目的 了解广西城乡居民高血压的流行特点及防治效果,为制定高血压预防策略和防治措施提供科学依据.方法 采用多阶段分层随机整群抽样的方法,对符合研究条件的3 360名15～69岁城乡居民进行问卷调查和现场测量血压.结果 广西城乡居民高血压患病率为18.21%,标化率13.54%,其中城市、农村、男性、女性标化患病率分别为17.94%、10.45%、15.63%和11.62%.高血压患病率城市高于农村(X2=46.907,P＜0.01)、男性高于女性(X2=12.943,P＜0.01),患病率从25岁开始随着年龄的增加旱现明显的上升趋势;广西居民中正常血压在人群中所占的比例仅为43.19%,血压正常高值比例较高,为38.60%;广西居民高血压知晓率、治疗率和控制率分别为38.52%、30.16%、14.26%,城市明显高于农村.结论 广西城乡居民高血压患病率处于全国较高流行水平,高血压防治现状不容乐观,应积极采取防治措施,控制高血压的发生和流行.     

济南市历城区城乡居民代谢综合征流行病学研究

目的了解历城区城乡居民代谢综合征(MS)流行现状及与慢性疾病的病因联系。方法根据济南市历城区2005年居民疾病负担调查资料,在参加调查的居民中选取血糖、血脂、血压及体检资料完整的15岁及以上的调查对象2136人,其中男性为892人,女性为1244人。MS诊断标准采用2005年国际糖尿病联盟标准。将本次调查是否确诊为MS作为暴露和非暴露因素,进行病例-对照分析。结果济南市历城区城乡15岁及以上居民MS患病率为15.11%,标化患病率为10.83%;15～44岁组男性高于女性,45岁以后女性高于男性;MS患病率随着年龄增长而升高(χ2=64.21,P<0.01);城市高于农村(χ2=7.76,P<0.01)。病例-对照研究结果表明,患MS者较正常者患冠心病、脑卒中、骨关节病、糖尿病、高血压的危险性增加,OR值分别为2.04,2.29,1.47,14.44,4.90。结论济南市历城区城乡居民MS流行较为严重,且与慢性疾病有密切的病因联系,已成为严重危害居民健康的重要的公共卫生问题。     

济南市城乡社区老年人群原发性高血压现况调查

目的 调查济南市城乡社区老年人群原发性高血压现况.方法 选择济南市城乡2626例年龄≥60岁的老年人群进行血压测量和各生化指标测定,并调查其病史、危险因素、治疗和用药情况.结果 城市男性居民高血压患病率、治疗率分别64.1%,61.5%,均高于农村(分别为56.9%,38.3%),差别有统计学意义(P<0.05);控制率分别为15.4%,10.2%.差别无统计学意义(P>0.05);城市女性治疗率高于农村,分别为60.8%,43.1%,差别有统计学意义(P<0.05).随着年龄增长,高血压患病率呈增加趋势(P<0.05),单纯收缩期高血压患病率亦呈明显增加趋势(P<0.05).单纯收缩期高血压占全部高血压患者的56.5%.老年高血压人群合并≥1个心血管疾病危险因素的比例为85.0%,明显高于血压正常人群(46.4%),差别有统计学意义(X2=443.461,P<0.001).城乡社区高血压患者主要服用利尿剂、钙离子拮抗剂和复方制剂进行降压治疗.结论 高血压为济南城乡老年人群常见的心血管疾病,单纯收缩期高血压是主要类型,其治疗率、控制率较低.患者合并其他心脑血管疾病危险因素的比例较高,同时存在用药不合理现象.     

广西城乡居民代谢综合征流行病学特征分析

目的了解广西城乡居民MS患病及其流行病学特征,为制订防治MS对策提供依据。方法采取多阶段随机抽样方法,分别抽取广西4个城市和4个农村共计2 991名15岁及以上城乡居民进行调查,内容包括基本情况问卷调查,对调查对象进行健康体检和实验室生化指标检测。结果代谢综合征(MS)病例100人,城乡居民总体粗患病率为3.3%,标化率为2.1%,其中城市居民MS患病率为5.0%,标化率为3.1%,农村MS患病率为1.8%,标化率0.8%,城市居民患病率显著高于农村(P<0.01);城乡居民均随着年龄增长MS患病率呈上升趋势,其中男性从35岁开始上升,女性从45岁开始上升;35~44岁农村男性MS患病率4.6%,与城市同年龄组男性患病率几乎一致,而且高于农村45岁以上中老年男性居民MS患病率3.3%;城市男女MS患病无明显差异,而农村男性MS患病率显著高于女性(P<0.01);汉族女性居民MS患病率4.4%,显著高于壮族等少数民族1.1%(P<0.01)。结论根据城乡15岁及以上居民MS标化率估计,广西有66.49万MS病人,其中城市32.46万,农村34.03万,MS防治和农村男性青壮年MS高发问题应当引起重视。     

常熟市农村居民对高血压患病的知晓和治疗情况

目的:了解常熟市农村居民高血压患病率、知晓率、治疗率和控制率的变化情况.方法 采用多阶段分层整群抽样的方法,分别于1999和2010年调查35周岁以上农村居民22 423和4 634人,自行设计调查表调查一般情况、高血压患病情况、治疗情况,同时进行血压测量.结果 ①2次调查高血压粗患病率分别为37.58％和36.75％,差异无统计学意义,标化患病率分别为35.04％和26.92％,2010年调查标化患病率明显下降.②男性调查粗患病率下降(x2=9.37,P＜0.01),女性调查粗患病率差异无统计学意义,2次调查男性粗患病率、标化患病率均高于女性.2次调查显示,随着年龄的上升,各年龄组高血压患病率均上升,差异且有统计学意义.男女比较,1999年调查70岁～年龄组以前患病率男性高于女性,70岁～年龄组以后男女患病率差异无统计学意义;2010年调查60岁～年龄组以前患病率男性高于女性,60岁～年龄组以后男女患病率差异无统计学意义;50岁～及以前年龄组,1999年调查患病率显著高于2010年调查患病率;60岁～及以上年龄组,2次调查患病率差异不大.③高血压知晓率、治疗率、控制率、治疗者控制率2010年均高于1999年;高血压知晓率、治疗率1999年调查女性高于男性,而2010年调查男女差异无统计学意义;高血压控制率、治疗者控制率1999年调查女性高于男性,而2010年调查为男性高于女性.结论 2010年调查与1999年调查结果相比,常熟市农村居民高血压患病率得到控制,但随着人口老龄化,老年人口高血压患病率有增高趋势;高血压知晓率、治疗率、控制率、治疗者控制率均有所提高,但控制率、治疗者控制率仍较低.     

寿光市农村居民高血压患病及其影响因素调查

目的了解寿光市农村居民高血压的流行病学特征及其影响因素。方法于2011年按照随机抽样的原则,对寿光市三个镇(街道)9个村共计916名18~69岁的常住人口进行了调查。采取面对面问卷调查的方法,并做体格测量、24小时膳食回顾调查和生化检测。采用SPSS17.0统计软件进行数据分析。结果农村居民高血压标化患病率为23.75%,男性患标化患病率为23.91%,女性标化患病率为22.97%;随着年龄的增长高血压患病率逐渐增高,50岁以前男性患病率高于女性,50岁以后女性患病率高于男性;logistic回归分析结果显示,年龄、文化程度、BMI、FPG、TC、每日人均食盐摄入量、每日人均油摄入量为本次调查高血压的主要影响因素。结论寿光市农村居民高血压患病率较高,应加强健康教育,倡导平衡膳食与健康生活方式,提高居民自我保健意识和能力,降低高血压的患病情况。     

徐州市居民高血压患病率、知晓率、治疗率及控制情况调查

目的了解徐州市居民高血压患病率、知晓率、治疗率和控制状况。方法于2008年6月～2008年12月,采用多阶段分层随机抽样方法,选择具有代表性的样本,共调查20～75岁常住人口17500人,采用统一调查表进行一般情况、高血压患病情况、治疗情况调查及血压测量。结果徐州市人群高血压患病率为20.87%,标化患病率为16.39%;患病率与年龄呈正相关（r=0.36）,随着年龄的增长而升高（P=0.000）。城市、农村患病率分别为28.77%和17.22%,标化患病率分别为21.06%和14.14%,城市高于农村（P=0.000）。男女性别患病率分别为20.73%和20.99%,标化患病率分别为17.06%和15.08%,差别无统计学意义（P=0.676）。调查人群中52.93%为血压正常高值,城市53.08%,农村52.86%,差异无统计学意义（P=0.785）;男性59.97%,女性46.96%,男性高于女性（P=0.000）;其中25～34岁组正常高值比例最高为59.43%。在高血压患者中,42.19%知道自己患有高血压,34.12%的患者服用降压药,9.27%的患者得到控制。结论徐州市高血压患病率低于全国2002年平均水平,血压正常高值人群比例较高,高危人群年轻化;高血压知晓率、治疗率和控制率较全国滞后,徐州市急需开展及完善高血压社区综合防治工作。     

Further increases in rural suicide in young Australian adults: secular trends, 1979-2003

This study investigates changes in Australian urban-rural suicide differentials over time in the context of overall declines in (male) suicide in the late 1990s, and determines the extent to which differences in socio-economic status (SES) account for observed urban-rural trends. Suicide data were stratified for the period 1979-2003 by metropolitan, rural and remote areas and examined across five quinquennia, centred on each Australian census from 1981 to 2001. Suicide rates (per 100,000) were adjusted for confounding by sex, age, country-of-birth and the mediating effects of area SES, using Poisson regression models. Male suicide rates in metropolitan, rural and remote areas diverged significantly over time, especially in young males (15-24 years). Young male suicide rates increased significantly in metropolitan, rural and remote areas over 1979-1998, and in the most recent period (1999-2003) increased further in remote areas from 38.8 (per 100,000) to 47.9 (23% increase). In contrast suicide rates in rural areas decreased from a peak of 27.5 to 19.8 (28% decrease), and in metropolitan areas from a peak of 22.1 to 16.8 (24% decrease). Similar divergence in the 1999-2003 quinquennium, though of a lesser magnitude, was also evident for males aged 25-34 years. Female suicide rates in the earlier part of the period were significantly lower in rural and remote areas than in metropolitan areas, particularly for those aged 25-34 years, then increased in rural and remote areas to converge with female suicide rates in metropolitan areas. Adjusting for SES in addition to age and country-of-birth reduced urban-rural suicide differentials in both males and females, consistent with SES being an intermediary between rural residence and suicide. Nevertheless, urban-rural differences remained statistically significant. These results show that the largest urban-rural male suicide differentials for the 25-year study period occurred in the most recent period (1999-2003), in the context of decreasing male suicide rates overall.     

中国20岁及以上人群高胆固醇血症及胆固醇边缘升高流行病学研究

目的研究中国20岁及以上人群高胆固醇（TC）血症患病率和血浆总TC边缘升高的分布特征。方法采用整群抽样方法，在全国六类地区对抽取到的48299名20岁及以上调查对象进行空腹血浆总TC的检测。结果在一定的年龄范围内，高TC血症患病率和TC边缘升高率均有随年龄增长而升高的趋势，但大部分地区在60～岁组之后出现下降趋势。城市高TC血症患病率由20～岁组1．36％升高到70岁组12．53％；农村由20～岁组0．98％升高到60～岁组的5．15％。城市和农村人群70岁组的TC边缘升高率分别比20～岁组升高了4．4倍和4．2倍。各年龄组的高TC血症患病率和TC边缘升高率均城市高于农村，一类农村均高于二、三、四类农村；二者50岁以前男性均高于女性，50岁之后女性明显高于男性。结论在一定的年龄范围内高TC血症患病率和TC边缘升高率均有随年龄增长而升高的趋势；二者随地区经济水平增高而增高，并有明显的性别差异。     

中国内地居民2000-2009年被动吸烟率Meta分析

目的 运用Meta分析综合评价中国内地居民2000-2009年被动吸烟率,并分析其在性别、城/乡及不同经济发展水平地区、场所等因素间的差别.方法 检索万方数据库、维普信息资源系统、中国期刊全文数据库、中国生物医学文献数据库及PubMed数据库,收集所有关于居民吸烟的调查研究,再从中筛选出有关被动吸烟的研究报告.各资料间进行异质性检验,以确定采用固定模型或随机模型进行合并分析,采用秩相关检验法进行发表偏倚的评估.结果 共入选相关文献19篇,累计不吸烟人数为195 349人,被动吸烟人数为70 781人,总被动吸烟率为47.04%(95%CI:38.88%～55.27%).将被动吸烟率按照性别、城/乡、研究年份、研究地区和被动吸烟场所进行分层分析,男、女性被动吸烟率分别为44.80%(95%CI:34.07%～55.79%)和49.09%(95%C:39.62%～58.59%),P＜0.05;城市、农村地区合并的被动吸烟率分别为46.10%(95%CI:28.88%～63.82%)和47.55%(95%CI:17.85%～78.25%),P＜0.05;研究年份在2000-2004年被动吸烟率合并为47.59%(95%CI:38.31%～56.95%),2005-2009年为46.90%(95%CI:33.19%～60.87%),P＜0.05;东、西部地区居民被动吸烟率分别为41.38%(28.88%～54.47%)和74.38%(95%CI:59.08%～87.10%),P＜0.05;家庭、工作场所、公共场所被动吸烟率分别为73.03%(95%CI: 60.41%～84.00%)、14.72%(95%CI:8.83%～21.82%)和25.90%(95%CI:5.65%～54.24%),P＜0.05.结论 合并的被动吸烟率女性高于男性,农村地区高于城市,研究年份为2005-2009年的被动吸烟率低于2000-2004年,西部地区居民被动吸烟率高于东部地区,家庭内被动吸烟率高于工作场所和公共场所.

Abstract：

Objective To analyze the prevalence of passive smoking among inland residents in China from 2000 to 2009 and to analyze the differences between sex, urban/rural geographic distribution, different levels of economic development etc.. Methods Electronic search strategy was carried out, using WanFang database, China Journal Full-text database, VIP database, CBM and PubMed database to collect data on smoking, and passive smoking status, among residents in China.Fixed effects model or random effects model was employed according to statistical tests for homogeneity. Publication bias was assessed by rank correlation test. All statistical analysis was conducted with R 2.8.0. Results Nineteen studies were selected with a total of 195 349 non-smokers and 70 781 passive smokers involved. The overall prevalence of passive smoking was 47.04%(95%CI: 38.88%-55.27%). The prevalence of passive smoking was stratified by factors as sex, urban/rural, year and areas of the study, and areas where passive smoking was studied. The pooled prevalence rates of passive smoking were as follows: 44.80% (95%CI: 34.07%-55.79%) and 49.09%(95%CI:39.62%-58.59%) ,P＜0.05 for male and female;46.10%(95%CI:28.88%-63.82%),47.55%(95% CI: 17.85%-78.25% ), P＜0.05 for urban and rural, respectively. The pooled prevalence rates of passive smoking were 47.59% (95% CI: 38.31%-56.95% ) in the study year of 2000-2004 and 46.90% (95%CI: 33.19%-60.87% ) in 2005-2009 (P＜0.05). The pooled prevalence rates of passive smoking for eastern and western areas were 41.38%(28.88%-54.47%) and 74.38%(95%CI: 59.08% -87.10% ) (P＜0.05), and 73.03% (95%CI: 60.41% - 84.00% ), 14.72% (95%CI: 8.83%-21.82% )and 25.90% (95% CI: 5.65% - 54.24% ) for family, workplace and public place, respectively (P＜0.05). Conclusion The pooled prevalence of passive smoking was higher in females than males, in rural than in urban and in the western area than in the eastern areas. The prevalence of passive smoking in the study year of 2005-2009 was lower than of 2000-2004. The pooled passive smoking rate in the family was higher than in the workplace or in public.     

2002年与2007年烟台市幼儿身体形态体质测试指标的比较

目的:烟台市3~6岁幼儿身体形态的发育情况。方法:2007年5~8月对烟台市城乡861名3~6岁幼儿进行了身体形态(身高、体重、胸围)的测定,把2007年的体质监测的数据与2002年进行比较研究。结果:烟台市3~6岁幼儿的身高城乡差异不大。2002年与2007年的同龄幼儿相比呈上升趋势,但无统计学意义(P>0.05)。城镇幼儿体重平均增长1.8kg,乡村幼儿平均增长1.3 kg,城镇幼儿体重增长明显高于乡村幼儿(P<0.01)。3~6岁幼儿身体充实度有所提高,生长发育良好。结论:烟台市3~6岁幼儿在身体形态方面,如身高、体重和胸围都呈上升趋势,身体生长发育匀称度有较大的改善。经济发展水平、消费水平和饮食结构是城乡幼儿生长发育存在差异的主要原因。     

武汉地区6～17岁儿童青少年身高、体重及体质指数的分析

目的:研究武汉地区6～17岁儿童青少年身高、体重及体质指数的分布特征。方法:采用整群系统抽样的方法抽取武汉市区及周边农村中小学学生共4 153名,测量身高体重并计算体质指数,分析一般身体形态生长各项指标的年龄性别分布特点,通过两样本t检验分析各年龄组身体形态生长各项指标的性别和城乡差异。结果:武汉地区6～17岁儿童青少年生长发育符合一般规律,身体形态各项指标均值随年龄的增长而增长,城乡和性别之间差异性显著(P<0.05)。女生相对于男生,城市学生相对于农村学生,青春期有提前和缩短的趋势。结论:基于不同年龄组学生身高、体重和体质指数男女及城乡差异,教育工作者应把重点放在青春期和农村。     

Ischaemic heart disease mortality among men in Norway: reversal of urban-rural difference between 1966 and 1989.

OBJECTIVE--This study aimed to examine regional urban-rural differences in mortality from ischaemic heart disease, including sudden death of unknown cause (IHD/SUD) in Norway from 1966-89, for men and women aged 30-69 years. DESIGN--Analysis was based on vital statistics. Regional mortality rates were obtained by aggregating the 443 municipalities in Norway into urban, rural, and intermediate municipalities. SETTINGS AND SUBJECTS--Norway. RESULTS--In 1966-70 the age adjusted IHD/SUD mortality in the age group 30-69 years was higher in urban than in rural areas; for men by 31% (95% CI 27%, 36%) and for women by 28% (95% CI 19%, 36%). In 1986-89 the IHD/SUD mortality for men showed a reversed urban-rural gradient: it was 8% (95% CI 2%, 13%) higher in rural than in urban areas. The mortality rates for women were equal for both these aggregates. For men the results indicate that IHD/SUD mortality peaked first in urban municipalities and then, but at a lower level, in rural areas. For women there was a substantial decline in IHD/SUD mortality between 1966 and 1989, but an actual peak could not be demonstrated in any of the three aggregates during the period. The decline in IHD/SUD mortality among women was steepest in urban municipalities and least noticeable in rural municipalities, but the decline tapered off towards the end of the study period. CONCLUSION--The results confirm a phase-shifted peak in IHD/SUD mortality, which began in towns and ended in rural areas, and provides clues to the main underlying factors in the IHD epidemic at the population level.     

北京市社区老年人群日常活动能力状况及城乡比较

目的 探讨北京市社区老年人群日常活动能力（ADL）状况及主要影响因素,并对城乡老年人群的差异进行比较。方法 2010－2014年在北京市海淀区万寿路地区和密云县巨各庄镇对社区≥60岁的老年人群进行两阶段分层整群随机抽样。结果 共纳入4 499名（其中男性1 815名,女性2 684名）社区老年人,年龄60～95（70.3±6.7）岁。相对于城市老年人,农村老年人文化程度较低（小学及以下85.2%）、吸烟（22.8%）、饮酒（43.1%）比例较高。共有87.9%的老年人生活完全自理,ADL受损（含不同程度功能障碍）情况农村（12.4%）高于城市（11.8%）,差异有统计学意义（P=0.039）。不同年龄组比较,ADL受损随年龄增加而显著增加（P<0.05）。多因素分析结果显示,除了城乡差异（P=0.031）,年龄（P=0.013）、文化程度（P=0.015）、体育锻炼（P=0.001）、患有脑卒中（P<0.001）等均是影响ADL受损的重要因素。结论 北京市社区老年人群ADL受损率相对较低,农村高于城市,年龄、文化程度、体育锻炼、患有脑卒中等均与ADL受损有关。     

Nutrient intake of adult women in Jilin Province, China, with special reference to urban-rural differences in nutrition in the Chinese continent

OBJECTIVES: The objectives of this study were to investigate possible urban-rural differences in food intakes in Jilin province and in continental China as a whole, and to examine possible implications for nutritional status of urban and rural populations. DESIGN: Cross-sectional study. SETTING: Communities. SUBJECTS: In total, 499 adult women in six urban sites and four rural sites, 10 sites in total, including two sites in Jilin province. METHODS: A pair of surveys were conducted in September, 1999, in the provincial capital of Changchun and a farming village in Dehui county, both in Jilin province, in northeast China. Each of 50 adult women per survey site provided a 24 h duplicate food sample and a blood sample, and had an interview on health history including anthropometry and blood pressure measurement. Nutrient intakes were estimated from the food duplicates, using national food composition tables. Results from the two sites were supplemented with data from eight sites where surveys had been conducted following the same protocol, and the pooled material were subjected to analyses for possible urban-rural differences. RESULTS: The Jilin participants consumed daily, on average, about 1600 kcal energy, 44 g protein, and 60 g lipid with a lipid energy ratio (i.e. the ratio of lipid over total nutrients in terms of energy) of 33%. When nutrient intakes were compared between the urban (i.e. Changchun) and rural (Dehui) groups, urban women consumed more energy, protein (especially animal protein) and lipid than rural women. Similar examination of data from six urban and four rural sites, including the present two, showed that adult women in urban areas eat more animal protein and animal fat than their counterparts in villages, and suggested that the observation on urban rural difference in Jilin province can be extrapolated to a nationwide scale. CONCLUSIONS: Urban rural differences in nutrient intakes still persist in 1999 not only in Jilin but in other provinces, typically in the terms of intakes of animal-based foods.     

Residential mobility within England and urban-rural inequalities in mortality

This study is situated within the international literature on geographic health inequalities between urban and rural areas. Using data from the Office for National Statistics Longitudinal Study (ONS LS), this paper assesses the role of residential mobility within England between 1981 and 2001 in explaining geographic inequalities in all-cause mortality between urban and rural Local Authority Districts at the end of the period (deaths occurring between 2001 and 2005). First, the pattern of directly age-standardised death rates (2001-2005) in urban and rural areas of residence in 2001 is examined and compared with the pattern that would have been seen if the observed death/survival of individuals had occurred in their original place of residence in 1981, or in 1991. Secondly, logistic regression is applied to examine whether individuals' residential mobility between urban and rural areas predict the risk of mortality, adjusting for people's socio-demographic characteristics. Findings show that, for this sample, residential mobility 1981-2001 accounts for about 30% of the urban-rural inequalities in mortality observed at the end of the period. LS members who were residentially mobile between urban and rural areas were relatively healthier than long-term urban residents, with better mortality outcomes among rural in-migrants. In age-stratified analysis, LS members of working age (20-64 years) moving out of rural areas, and LS members of retirement age (65 years and older) moving into rural areas, were shown to be healthier. Processes of selective migration in and out of rural areas in England are complex and may partly explain urban-rural health inequalities. In terms of varying mortality risk, findings also highlight the possible marginalisation and disadvantage of sub-groups of the rural population.     

Substance Abuse by Youth and Young Adults in Rural America

ABSTRACT:  Purpose: Addressing substance abuse in rural America requires extending our understanding beyond urban-rural comparisons to how substance abuse varies across rural communities of different sizes. We address this gap by examining substance abuse prevalence across 4 geographic levels, focusing on youth (age 12-17 years) and young adults (age 18-25 years). Methods: The analysis is based on 3 years (2002-2004) of pooled data from the National Survey on Drug Use and Health. We measure rurality using a four-tier consolidation of the 2003 Rural-Urban Continuum Codes: urban, rural-adjacent, rural-large, and rural-small and medium. Findings: Rural youth have higher alcohol use and methamphetamine use than urban youth and the more rural the area, the higher the use. Rural young adults living in rural-large areas have higher rates of substance abuse than their urban peers; those living in the most rural areas have nearly twice the rate of methamphetamine use as urban young adults. Rural youth are more likely than urban youth to have engaged in the high-risk behavior of driving under the influence of alcohol or other illicit drugs. Conclusions: Higher prevalence rates, coupled with high-risk behavior, place rural youth and young adults at risk of continued substance use and problems associated with this use. Rural community infrastructure should be enhanced to support substance abuse prevention and intervention for these populations.