Mental health literacy and help-seeking behaviour among Egyptian undergraduates: a cross-sectional national study.

BACKGROUND: Mental health literacy (MHL) and help-seeking behaviors are pivotal in managing mental well-being, especially among Egyptian undergraduates. Despite the importance and prevalent psychological distress in this group, limited research has addressed MHL and associated behaviors in Egypt. This study aimed to assess the levels of MHL and help-seeking behavior among Egyptian university students. METHODS: A cross-sectional study was conducted across ten Egyptian universities during the academic year 2022-2023. A convenience sample of 1740 students was obtained through online questionnaires distributed via social media platforms. The survey comprised demographic characteristics, the Mental Health Literacy Scale (MHLS), and the General Help Seeking Behavior Questionnaire (GHSPQ). RESULTS: Among 1740 Egyptian undergraduates, medical students scored higher in recognizing disorders (p < 0.05), while non-medical students excelled in attitudes (p < 0.05). A strong correlation was observed between attitudes toward mental illness and total mental health literacy (coefficients of 0.664 and 0.657). Univariate analysis indicated a significant association with professional help-seeking (OR = 1.023). Females, individuals aged 21 or above, and non-medical students were more likely to seek mental health information (OR = 1.42, 1.82, 1.55 respectively). Help-seeking behavior for emotional problems was more inclined towards intimate partners, whereas suicidal thoughts prompted seeking professional help. CONCLUSION: The findings advocate for comprehensive mental health education, particularly in rural areas, and emphasis on the role of personal relationships in mental well-being. Implementing these insights could foster improved mental health outcomes and reduce related stigma in Egypt.

Different impacts of physical activity on health in urban and rural older adults.

OBJECTIVE: This study aimed to explore the impact of physical activity on health among older adults in urban and rural areas in Taiwan. METHODS: This study employed a cross-sectional design and data were analyzed from 2015 to 2019 from the Hualien County Health Bureau. Participants were divided into urban (n = 4780) and rural groups (n = 4983), and logistic regression models were employed to examine how physical activity relates to their health condition in urban and rural older adults. RESULTS: Results indicated lower physical activity levels and higher unhealthy behavior rate in rural older adults compared to their urban counterparts. Rural older adults had higher rates of cardiovascular diseases and diabetes but lower rates of mental illness. Physical activity demonstrated greater physical health benefits for urban older adults than rural older people. Conversely, rural individuals who engaged in physical activity 150 min/week exhibited greater mental health benefits than their urban counterparts. CONCLUSIONS: Physical activity offers significant mental health benefits for both urban and rural older adults; however, notable improvements in physical health among urban older adults was found. If in the presence of unhealthy behaviors, regular physical activity may not effectively prevent chronic diseases. It is crucial to promote physical activity and healthy behaviors in rural areas.

Urban-rural differences in the prevalence of having a family dentist and their association with income inequality among Japanese individuals: a cross-sectional study.

BACKGROUND: Few reported studies evaluate the status of those who have a family dentist (FD) by regional differences and the socioeconomic factors associated with this status. This study aimed to assess the prevalence of having an FD among Japanese individuals across three samples of municipality type: urban, intermediate, and rural areas, and determine the factors associated with having an FD. METHODS: This was a cross-sectional study involving a web-based survey. In total, 2,429 participants (comprising men and women aged 20-69 years) were randomly selected from among the registrants of a web research company: 811 urban residents, 812 intermediate residents, and 806 rural residents. In each area, we categorized the participants into those who had an FD (FD group) and those who did not (non-FD group). A multivariate modified Poisson regression analysis was used to determine the factors associated with the FD group as compared to the non-FD group. RESULTS: The proportion of the FD group was lowest in rural areas (42.3%), followed by intermediate (48.6%) and urban areas (49.7%). The regression analysis revealed a statistically significant tendency between associated factors in the two groups; that is, the higher the household income, the more likely that the family belonged to the FD group (prevalence ratio (95%CI), JPY 4-6 million: 1.43 (1.00-2.03), JPY ≥ 8 million: 1.72 (1.21-2.44)). CONCLUSIONS: Rural areas have the lowest proportion of people with an FD among the three areas, and income inequality is associated with having an FD. Thus, when planning policies to encourage individuals to have an FD to manage their oral health, it is necessary to consider regional differences.

Explaining the urban-rural gradient in later fertility in Europe.

Demographic research shows that, in Europe, fertility takes place later and is lower in cities than in rural areas. One might expect fertility to be delayed in urban areas because of longer periods in education and enhanced career opportunities. We, therefore, examine how prevalent later fertility (35+ and 40+) is along the urban-rural axis, and whether differences can be explained by economic, cultural and compositional factors. We estimate multilevel random coefficient models, employing aggregated Eurostat data of 1328 Nomenclature des unités territoriales statistiques (NUTS) 3 and 270 NUTS 2 regions from 28 European countries. The urban-rural gradient in later fertility considerably diminishes once factors describing the economic environment, family and gender norms as well as population composition are accounted for. The higher prevalence of later fertility in cities is particularly associated with higher female education, greater wealth and a higher share of employment in high-technology sectors.

Changes of Grocery Shopping Frequencies and Associations with Food Deserts during the COVID-19 Pandemic in the United States.

The COVID-19 pandemic has dramatically altered people's lives in multiple aspects, including grocery shopping behaviors. Yet, the changing trend of grocery shopping frequencies during the COVID-19 and its associations with food deserts remain unclear. We aimed to (1) examine variations of grocery shopping frequencies at county level in the USA during the COVID-19 pandemic from March 2020 to December 2021; (2) investigate associations between grocery shopping frequencies and food deserts during the COVID-19 pandemic; and (3) explore heterogeneity in grocery shopping frequencies-food desert associations across urban and rural areas. The county-level grocery shopping frequencies were derived from a grocery pattern dataset obtained from SafeGraph. We divided the 22-month period into 5 stages and employed the growth curve modeling to estimate the trajectories of grocery shopping frequencies and the associations between grocery shopping frequencies and food deserts in each stage, separately. Results revealed that grocery shopping frequencies experienced a "W-shaped" pattern from March 2020 to December 2021. Counties with the least percent of food deserts had slower decrease in grocery shopping frequencies at the initial stage and recovered more rapidly at later stages. Counties with the highest percent of food deserts were subject to deprivation amplification as a result of the pandemic. We also found differences existed in the grocery shopping frequencies-food desert associations between metropolitan counties and rural counties. Our findings suggest the impacts of COVID-19 on grocery shopping frequencies varied across different time periods, shedding light on designing different strategies to reduce the risk of contagion while shopping inside of grocery stores. Further, our findings highlight an urgent need to help people living in food deserts (especially in rural counties) to procure healthy foods safely during health emergencies like COVID-19 pandemic which disrupt mobility and social behaviors.

Urban-rural difference in the lagged effects of PM2.5 and PM10 on COPD mortality in Chongqing, China.

BACKGROUND: It is true that Chronic obstructive pulmonary disease (COPD) will increase social burden, especially in developing countries. Urban-rural differences in the lagged effects of PM2.5 and PM10 on COPD mortality remain unclear, in Chongqing, China. METHODS: In this study, a distributed lag non-linear model (DLNMs) was established to describe the urban-rural differences in the lagged effects of PM2.5, PM10 and COPD mortality in Chongqing, using 312,917 deaths between 2015 and 2020. RESULTS: According to the DLNMs results, COPD mortality in Chongqing increases with increasing PM2.5 and PM10 concentrations, and the relative risk (RR) of the overall 7-day cumulative effect is higher in rural areas than in urban areas. High values of RR in urban areas occurred at the beginning of exposure (Lag 0 ~ Lag 1). High values of RR in rural areas occur mainly during Lag 1 to Lag 2 and Lag 6 to Lag 7. CONCLUSION: Exposure to PM2.5 and PM10 is associated with an increased risk of COPD mortality in Chongqing, China. COPD mortality in urban areas has a high risk of increase in the initial phase of PM2.5 and PM10 exposure. There is a stronger lagging effect at high concentrations of PM2.5 and PM10 exposure in rural areas, which may further exacerbate inequalities in levels of health and urbanization.

The home language environment in rural China: variations across family characteristics.

BACKGROUND: A rich language environment is an important element of a nurturing home environment. Despite their proven importance, vocabulary and conversation have been shown to vary widely across households-even within the same socio-economic class. One significant gap in the existing literature is its nearly exclusive geographic focus on Western and developed settings, with little attention given to poorer communities in lower/middle income countries. The purpose of this study was to empirically illustrate the characteristics of the home language environment in the low SES, non-Western cultural setting of rural China. METHODS: Using Language Environment Analysis (LENA) automated language-analysis system, this study measured the home language environment of 38 children aged 20-27 months in Northwest rural China. Our primary measures of the home language environment were Adult Word Count (AWC), Conversational Turn Count (CTC) and Child Vocalization Count (CVC). Multivariate linear regression models were used to examine the association between home language environment and family/child characteristics, and language skills (Measured by MacArthur-Bates Communicative Developmental Inventory score). RESULTS: In this paper, by comparison, we found that the home language environment of our rural sample fell far behind that of urban households. We also identify significant, positive correlations between language skills and both AWC and CTC. Our analysis finds no significant correlations between home language environment and family/child characteristics. CONCLUSION: In this paper, we present the first ever findings using the LENA system to measure the home language environment of young children from poor rural communities in China. We found that the home language environment of lower-SES household was significantly worse than high-SES households, and demonstrated the importance of the home language environment to language skills, pointing to a need for more high-quality studies of the home language environment in rural China to better understand possible mechanisms behind low levels of parent-child language engagement and ways to improve the home language environment.

Urban-rural differences in perceived environmental opportunities for physical activity: a 2002-2017 time-trend analysis in Europe.

Urban-rural disparities in resources, services and facilities not only impact daily living conditions but also contribute to inequalities in physical activity, which may be associated with variations in basic public resources between urban and rural areas. This study aims to examine the evolution of perceived opportunities for physical activity in European urban and rural environments from 2002 to 2017 and their association with an active lifestyle. Data from four waves (2002, 2005, 2013 and 2017) of cross-sectional Eurobarometer surveys were collected (n = 101 373), and multilevel binomial logistic regressions were conducted. Firstly, the time trend of perceived opportunities for physical activity between urban and rural environments was explored, and secondly, the effect of urban-rural perceived opportunities on achieving an active lifestyle over the years was estimated. The findings revealed that individuals residing in rural settings encountered less opportunities to be physically active. Conversely, urban settings experienced an increase in perceived opportunities. The significance of health promotion through perceived physical activity opportunities lies in the increased likelihood of being physically active, regardless of place of residence or individual socioeconomic factors [in the area: odds ratio (OR) = 1.40, 95% confidence interval (CI) = 1.34-1.47; provided by local sport clubs: OR = 1.29, 95% CI = 1.23-1.35]. Modifying environmental aspects, such as enhancing the quantity, quality and accessibility of physical activity opportunities in both rural and urban areas, may lead to improved physical activity and health promotion, particularly among individuals who are more physically inactive.

Urban-rural differences in outcomes and management of vertebral fractures: A real-world observational study.

BACKGROUND: A fracture liaison services (FLSs) and its modified services reduce refractures and mortality and can be cost-effective. Limited studies have addressed whether urban-rural differences exist in vertebral fracture outcomes and management. Therefore, the aims of the study were to investigate any urban-rural differences in refracture, mortality, prescription pattern, and associated factors of vertebral fractures after receiving assistance from an FLSs. METHODS: Baseline characteristics and osteoporosis medication prescription patterns of participants were collected. After 1-year follow-up, mortality, refracture rate, and osteoporosis medication switching and adherence were evaluated. Multivariate logistic regressions were performed to identify baseline correlates on one-year mortality. RESULTS: There was higher mortality rate in the rural group but no urban-rural difference in the 1-year refracture rate after implementation of FLSs and medication management services (MMSs). The types of osteoporosis medications prescribed for both groups were similar, but participants in the rural group were less likely to change their osteoporosis medications during the 1-year follow-up timeframe and with lower adherence rate. The likelihood of being older and having chronic kidney disease, osteoarthritis, and neurological disease was higher in the rural group. CONCLUSION: Our multicomponent services have similar effectiveness in osteoporosis treatment between urban and rural areas. The overall adherence rate was lower in the rural group with higher mortality but no difference in the refracture rate in one year.

Difference in bypass for inpatient care and its determinants between rural and urban residents in China.

BACKGROUND: Bypass for inpatient care is an event of excessive demand. Though primary care facilities provide inpatient care in China, local residents may choose more distant higher-level hospital for inpatient care services. Given the differences in accessibility of hospitals and socioeconomic development between urban and rural areas, this study aims to estimate the rate of bypass for inpatient care and explore the factors predictive of bypass among rural and urban residents in China. METHODS: The rates of bypass for inpatient care were estimated using data from 1352 hospitalized patients, obtained from the 2018 Sixth National Health Service Survey of Hubei, China. Bypass for inpatient care was identified if the patient was hospitalized in a hospital for a certain disease that should be treated at primary care facilities in accordance with government requirement. Anderson's Behavioral Model of Health Services Use was used as a theoretical framework for determining the factors of bypass. Logistic regression was used to identify the relationship between bypass for inpatient care and predisposing, enabling, and need characteristics for urban and rural residents. RESULTS: The rate of bypass for inpatient care was 73.8%. This rate for inpatient care (91.3%) in cities is higher than that in rural areas (56.2%). Age were associated with bypass for both rural (OR, 0.982; 95% CI, 0.969-0.995) and urban (OR, 0.947; 95% CI, 0.919-0.976) patients. The patients whose closest healthcare facility was hospitals were more likely to have bypass behavior in rural (OR, 26.091; 95% CI, 7.867-86.537) and urban (OR, 8.323; 95% CI, 2.936-23.591) areas than those living closest to township/community health centers. Signing a family doctor was not helpful for retaining patients at primary care facility. Among rural patients, those with circulatory (OR, 2.378; 95% CI, 1.328-4.258), digestive (OR, 2.317; 95% CI, 1.280-4.192), or skin and bone (OR, 1.758; 95% CI, 1.088-2.840) system diseases were more likely to show bypass behavior than those with respiratory diseases. CONCLUSIONS: Bypass for inpatient care is sizable, and urban residents have a higher bypass rate for inpatient care than rural residents in China. More actionable measures in strengthening and leading patients to primary care are needed. Gradual establishment of a referral system is recommended. Inpatient care for circulatory, digestive, or skin and bone system diseases may be prioritized to be improved at primary care facilities in rural China.

Urban-rural differences in financial toxicity and its effect on cancer survivors' health-related quality of life and emotional status: a latent class analysis.

OBJECTIVE: This study aimed to investigate the urban-rural differences in associations between financial toxicity (FT), physical health-related quality of life (HRQoL), negative emotional status, and the effect of patients' socioeconomic status and clinical and cost-related characteristics on the levels of FT in a sample of Chinese cancer survivors. METHODS: Data were obtained from a cross-sectional survey conducted by the oncology department at two tertiary level hospitals in China. The COmprehensive Score for financial Toxicity, Euroqol five-level instrument (EQ-5D), and Depression Anxiety Stress Scale - 21 (DASS-21) were used to measure patients' FT, physical HRQoL, and negative emotional status. A latent class analysis was used to identify patient subgroups with distinct symptom experiences based on self-reported data on symptom occurrence using the EQ-5D and DASS-21. RESULTS: Four distinct latent classes were identified: all low (47.6%); high physical and low psych (18.6%); low physical and high psych (17.1%); and all high (17.1%). Rural patients younger than 50 years showed a statistically significantly higher FT than urban patients. Rural patients who were male, highly educated, insured, first hospitalization, new cases, received surgery or immunotherapy, and had low cancer-related costs in all low classes showed a higher FT than urban patients. CONCLUSIONS: Rural patients with cancer suffered from higher FT than their urban counterparts, and the negative impact of psychological distress on FT was higher than that of physical HRQoL.

Do Community Social Capital and Built Environment Associate With Homebound in Older Adults? The JAGES Niigata Study.

BACKGROUND: Homebound status is one of the most important risk factors associated with functional decline and long-term care in older adults. Studies show that neighborhood built environment and community social capital may be related to homebound status. This study aimed to clarify the association between homebound status for community-dwelling older adults and community environment-including social capital and neighborhood built environment-in rural and urban areas. METHODS: We surveyed people aged 65 years and older residing in three municipalities of Niigata Prefecture, Japan, who were not certified as requiring long-term care. The dependent variable was homebound status; explanatory variables were community-level social capital and neighborhood built environment. Covariates were age, sex, household, marital status, socioeconomic status, instrumental activities of daily living, the Geriatric Depression Scale-15, self-rated health, number of diseases under care, and individual social capital. The association between community social capital or neighborhood built environment and homebound status, stratified by rural/urban areas, was investigated using multilevel logistic regression analysis. RESULTS: Among older adults (n = 18,099), the homebound status prevalence rate was 6.9% in rural areas and 4.2% in urban areas. The multilevel analysis showed that, in rural areas, fewer older adults were homebound in communities with higher civic participation and with suitable parks or pavements for walking and exercising. However, no significant association was found between community social capital or neighborhood built environment and homebound status for urban older adults. CONCLUSION: Community social capital and neighborhood built environment were significantly associated with homebound status in older adults in rural areas.

Urban-Rural Differences in Health Care Utilization for Inflammatory Bowel Disease in the USA, 2017.

BACKGROUND: Urban-rural differences in IBD-specific health care utilization at the national level have not been examined in the USA. AIMS: We compared urban and rural rates of IBD-related office visits and IBD-specific (Crohn's disease (CD) or ulcerative colitis (UC)) hospitalizations and emergency department (ED) visits. METHODS: From multiple national data sources, we compared national rates using Z test and compared estimates of patient and hospital characteristics and hospitalization outcomes between urban and rural areas using Chi-square and t tests. RESULTS: In 2015 and 2016, digestive disease-related office visit rates, per 100 adults, were 3.1 times higher in urban than in rural areas (8.7 vs 2.8, P < 0.001). In 2017, age-adjusted rates per 100,000 adults were significantly higher in rural than urban areas for CD-specific hospitalizations (26.3 vs 23.6, P = 0.03) and ED visits (49.3 vs 39.5, P = 0.002). Compared with their urban counterparts, rural adults hospitalized for CD or UC in 2017 were more likely to be older and non-Hispanic white, have lower household income, Medicare coverage, and an elective admission, and were discharged from hospitals that were large, non-federal government owned, and in the Midwest or South. There were no significant urban-rural differences in length of stay and 30-day readmission rate. CONCLUSIONS: While IBD or digestive disease-related office visit rates were lower in rural compared to urban areas, CD-specific hospitalization and ED visit rates were higher. Strategies that improve office-based care among rural patients with IBD may help to avoid more costly forms of health care use.

Decomposing urban-rural differences in multimorbidity among older adults in India: a study based on LASI data.

BACKGROUND: Multimorbidity is defined as the co-occurrence of two or more than two diseases in the same person. With rising longevity, multimorbidity has become a prominent concern among the older population. Evidence from both developed and developing countries shows that older people are at much higher risk of multimorbidity; however, urban-rural differential remained scarce. Therefore, this study examines urban-rural differential in multimorbidity among older adults by decomposing the risk factors of multimorbidity and identifying the covariates that contributed to the change in multimorbidity. METHODS: The study utilized information from 31,464 older adults (rural-20,725 and urban-10,739) aged 60 years and above from the recent release cross-sectional data of the Longitudinal Ageing Study in India (LASI). Descriptive, bivariate, and multivariate decomposition analysis techniques were used. RESULTS: Overall, significant urban-rural differences were found in the prevalence of multimorbidity among older adults (difference: 16.3; p < 0.001). The multivariate decomposition analysis revealed that about 51% of the overall differences (urban-rural) in the prevalence of multimorbidity among older adults was due to compositional characteristics (endowments). In contrast, the remaining 49% was due to the difference in the effect of characteristics (Coefficient). Moreover, obese/overweight and high-risk waist circumference were found to narrow the difference in the prevalence of multimorbidity among older adults between urban and rural areas by 8% and 9.1%, respectively. Work status and education were found to reduce the urban-rural gap in the prevalence of multimorbidity among older adults by 8% and 6%, respectively. CONCLUSIONS: There is a need to substantially increase the public sector investment in healthcare to address the multimorbidity among older adults, more so in urban areas, without compromising the needs of older adults in rural areas.

Urban-rural differences in China's crude death rate changes.

BACKGROUND: From 1982 to 2010, the country's crude death rate (CDR) dropped sharply, fluctuated, and finally slightly declined. There is a big difference in CDR between urban and rural areas. From 1982 to 1990, the CDR in the country and the countryside declined, and the CDR in cities and towns rose. After 1990, the CDR in cities gradually decreased, the CDR in towns first fell and then rose, and the CDR in the countryside steadily increased. The CDR is affected by changes in the age-specific death rate (ASDR) and age structure. METHODS: This paper decomposes CDR changes into the influence of declines in ASDR and the impact of age structure changes based on 1982, 1990, 2000, and 2010 census data. RESULTS: The decline in ASDR reduces the CDR, and the aging population increases the CDR (including cities, towns, and the countryside). At the same time, decomposing the difference between the countryside and cities (or the countryside and towns) CDRs found that after 1990, the influence of ASDR differences and age structure differences increased with time. Our results revealed a more significant effect of ASDR differences. The combined effect of two factors (ASDR and age structure) makes the 0, 1-14, 15-64 age groups reduce the CDR, and the 65+ age group increases the CDR. In addition, the 0-year-old group has a not negligible impact on the changes in CDR, although it accounts for a small proportion of the total population. CONCLUSIONS: The influence of ASDR and age structure differs over time (1982 to 1990, 1990 to 2000, and 2000 to 2010) and across regions (cities, towns, the countryside). Considering the slow decline in ASDR and the accelerated aging population, we can infer that the CDR in 2020 will stabilize or even rise slightly instead of dropping significantly (compared with the CDR in 2010). This study provides a basis for the formulation of relevant public health policies.

One year into the pandemic: the impacts of social vulnerability on COVID-19 outcomes and urban-rural differences in the conterminous United States.

This paper first explores spatial distributions and patterns of COVID-19 case rates (cases/100,000 people) and mortality rates (deaths/100,000 people) and their disparities between urban and rural counties in the contiguous US. A county-level social vulnerability index was created using principal component analysis. Social vulnerability components were regressed against both county case and mortality rates. Results suggest that hotspots of case and mortality rates are clustered in Midwest and Upper-Midwest US. We found substantial disparities in case and mortality rates between urban and rural counties. County social vulnerability was positively correlated with both case and mortality rates suggesting counties with higher social vulnerability had higher case and mortality rates. Relationships between social vulnerability components and case and mortality rates vary across the conterminous US. Additionally, counties with increased racial and ethnic minorities, higher percentages of minors, and lower median household income are associated with higher COVID-19 case and mortality rates.

Urban-rural differences in factors affecting mortality and causes of death among older adults.

This study examined the differences in factors affecting mortality between urban and rural areas in Taiwan. A retrospective study design was adopted by using the older adult health examination data during 2013-2019 from Hualien, Taiwan. The overall mortality risk in rural areas was significantly higher than urban areas. However, there was no significant difference in the mortality risk between the urban and rural older adults with unhealthy behaviors. Betel nut chewing was a significant risk factor of mortality among the rural older adults, while alcohol consumption was a protective factor; smoking, hepatitis C, and mental illness were significant risk factors among the urban older adults. The rural older adults had a higher rate of death from heart disease and lower rate of death from sepsis than the urban older adults. This study highlights the importance of individualized health promotion strategies for urban and rural areas for reducing mortality from disease.

The influence of socioeconomic status on menarcheal age among Chinese school-age girls in Tianjin, China.

The association between socioeconomic status and the onset age of menarche is still not conclusive. This cross-sectional study was conducted among primary and middle school girls aged 7 to 16 years old in Tianjin, China, to explore the distribution of menarcheal age and its association with socioeconomic status. A self-designed structured questionnaire was completed by students and their parents to collect information on socioeconomic status (i.e., family income, parental education level, living residence), menarcheal status, and covariates (weight status of girls and their parents, sleeping hours per day, physical activity). Information on menarcheal status included whether or not menarche had occurred (Yes/No) and the exact age at menarche. Linear regression analysis was used to explore the association between socioeconomic status and menarcheal age before and after covariate adjustment. Among 1485 eligible girls with complete information, 445 had experienced menarche, with an overall menarche rate of 30%. The mean age at menarche was 12.9 years (95% confidence interval 12.8-13.0). Urban girls experienced menarche earlier than rural girls did (12.1 years vs. 13.5 years). Univariate analysis showed that urban residence and higher parental education were associated with earlier onset of menarche. After covariate adjustment, the significance still existed. However, after adjusting further for residence, the significant association with the parental education disappeared. Only urban residence was still significantly associated, even after further adjustment for parental education and family income, with adjusted regression coefficients (95% confidence interval) of - 1.087 (- 1.340,-0.834), indicating that the onset age of menarche among urban girls was 1.087 years (0.834, 1.340) younger than that among rural girls. Family income was not related to the onset age of menarche in any analyses.Conclusion: Urban-rural differences played a more important role in the early onset of menarche than socioeconomic differences between families. What is Known: • The age at menarche varies by race and country, but the global trend is towards earlier onset as a result of changes in nutrition, family structure, socioeconomic status, and physical condition. What is New: • Urban girls experienced menarche earlier than rural girls, but this urban-rural difference could not be explained by family income, parental education, weight status of the participants and their parents, participants' physical exercise and sleeping hours. • Higher parental education was associated with earlier onset of menarche, but this association disappeared after adjustment for living residence.

[Poisoning inquiries from Berlin and Brandenburg from 1999-2018: an urban-rural comparison]. / Vergiftungsanfragen aus Berlin und Brandenburg 1999­2018: Ein Stadt-Land-Vergleich.

BACKGROUND AND OBJECTIVE: Since 1963, the poison control center in Berlin has been the central helpline for the Berlin and Brandenburg population on the subject of poisoning. Furthermore, the institution performs a vital function in the field of poisoning prevention. The aim of this paper is to describe the development of the volume of consultations and their content from 1999 to 2018. Differences in the urban and rural origin of the callers as well as in the private or professional background of the inquiries are considered. The results will serve to improve prevention work. METHODS: The case data of the poison control center (1999-2018) were evaluated and analyzed using descriptive statistical methods. Correlations between the categories "origin of call" (urban or rural area), "background" (private or professional), and "noxious agent" were analyzed using the Pearson's chi-squared test. RESULTS: The annual volume of consultations tended to increase. In particular, the increases are mainly related to inquiries regarding exposures of adults and seniors. The most frequent topics were poisoning with medications and products used in daily life. Inquiries about illegal drugs increased the most (average annual growth rate 6.3%). Inquiring persons with a private background can be helped directly in most cases (86.8%), so medical treatment is rarely recommended. Private persons call more frequently from urban areas, while calls from medical staff predominate in rural areas. Calls about pesticides, mushrooms, animals, and plants were more common in rural areas. Calls about food, foreign bodies, stimulants (alcoholic, caffeinated, and nicotine-containing foods/consumables), or illegal drugs, on the other hand, were received more frequently from urban areas.

Urban-Rural Differences in Bone Mineral Density and its Association with Reproductive and Menstrual Factors Among Older Women.

PURPOSE: This study aimed to compare the bone mineral density (BMD) of older women living in rural and urban areas, and evaluate the potential factors affecting the risk of osteoporosis. METHODS: We recruited 574 women aged 65 years or older from rural areas and 496 from urban areas in Shanghai, China. The BMD values of the lumbar vertebrae and total left hip were measured by a dual energy X-ray absorptiometry densitometer. We also recorded information about education level, family income, medications, reproductive and menstrual history, diet, smoking, and alcohol consumption. RESULTS: Women in urban areas had significantly higher BMD in their lumbar spine, and there was a dramatic increase in the proportion of women with osteoporosis in rural areas. The age at menarche was significantly higher among women living in rural areas, and there were more years from menarche to menopause among urban women. Rural women had significantly higher numbers of both pregnancies and parity, and a significantly lower age at first parity. In multiple linear regression analyses, years from menarche to menopause was independently related to high lumbar spine BMD, while age at menarche and parity was independently related to low lumbar spine BMD. CONCLUSION: More older women in rural areas had osteoporosis. Later menarche, less years from menarche to menopause and higher parity might partially contribute to decreased BMD among women in rural areas. More attention should be paid to women in rural areas to prevent bone loss and further bone and health impairment.