Research design

Definitions of “urban” and “rural”


Health assessment scales

Results regarding differences in elderly health between urban and rural areas

Mainous A. et al., 1995

To examine and compare functional health status between rural and urban adults.

Correlation research with multiple regression analysis.

ž Rural: Town of < 2500 people based on respondents’ self report of living in Kentucky, USA. (Rural area is also recognized as a part of the non-metropolitan statistical area (MSA)).

ž Urban: Town of ≥ 2500 people in the MSA and non-MSA of Kentucky, USA.

ž 662 residents (age ≥18 years): 406 urban and 256 rural residents.

ž Elderly people aged ≥ 65 years among the 662 participants: 47 in MSA and 79 in non-MSA.

ž 20-item Short-Form Health Survey (SF-20). Six health concepts: a) physical functioning; b) role functioning; c) social functioning; d) general mental health; e) general health perceptions; and f) pain.

ž MSA residents aged ≥ 65 years had significantly better functioning on five health status measures compared to non-MSA residents: Physical (p = 0.0009), Role (= 0.01), Social (p = 0.02), Mental Health (p = 0.01), and Health Perception (p = 0.007).

Wang H. et al., 2004

To examine relationships among age, social class, perceived health, self-care, and well-being in urban and rural elderly women and to validate and compare two models using these two groups.

Correlation research with path analysis.

ž No clear description (except for names of the locations: Urban area/Kaohsiung City in southern Taiwan; Rural area/Pintung County in southern Taiwan.

ž 351 elderly women (age ≥65 years); 159 in urban areas and 192 in rural areas.

ž Four instruments: Social Class Scale, Perceived Health Scale (PHS), Chinese version of the Exercise of Self-Care Agency Scale (ESCAS), and Positive Affect Scale (PAS).

ž Age was negatively associated with self-care in rural elderly women.

ž Social class was positively associated with perceived health and self-care in urban areas.

ž Social class was positively associated with self-care and well-being in rural areas.

ž Perceived health was positively associated with self-care and well-being in urban and rural areas.

ž Self-care was positively associated with well-being in urban and rural areas.

ž The two models fit the data well.

Chiu H. et al., 2005

To examine associations between depression, chronic medical conditions, and functional disability among older Taiwanese, and rural/urban differences.

Correlation research with multiple logistic regression analysis.

ž Urban: Kaohsiung City, one of the metropolitan areas in Taiwan.

ž Rural: San-Lin town, has typical characteristics of a rural area in Taiwan (i.e., residents mainly employed in farming work, relatively low education levels, and higher proportion of elderly).

ž 1005 elderly people (age ≥65 years); 678 in urban areas and 327 in rural areas.

ž Depressive symptoms: The Chinese-version Geriatric Depression Scale (GDS)

ž Sociodemographic characteristics: Age, Ethnicity, Gender, Education, Marital Status, and Urban or Rural Residence

ž Chronic Medical Conditions: ‘Have you ever been told by a doctor, nurse, therapist or medical assistant that you had (specific chronic condition)?

ž Functional disability: Self-reporting capacity in ADL activities, including physical activities of daily living (PADL) and instrumental activities of daily living (IADL).

ž Depressive symptoms showed significant differences between urban and rural populations.

ž Depression was significantly associated with age, female gender, having no spouse, living in an urban area, lower education, and living alone (p < 0.001).

ž In the urban sample model, the existence of chronic disease and inability to perform PADL and IADL were consistently found to be predictors of depressive disorders. Living alone (odds ratio [OR] = 2.14) was associated with a higher risk of depression, while higher education level (OR=0.34) was associated with a lower risk.

ž In the rural model, widowhood and PADL/IADL disability were significantly associated with a higher risk of depressive disorders.

ž In the urban sample model, one socioeconomic factor (living alone); two chronic medical conditions (cardiovascular disease and hip fracture); and limitations in toileting, shopping, housework, and handling finances were found to be predictors of depressive disorders. Hip fracture (OR = 3.55) was associated with the highest risk of depression, followed by toileting (OR = 3.10) and shopping independence (OR = 2.91).