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Rising rural body-mass index is the main driver of the global obesity epidemic in adults
Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities
1
,
2
. This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity
3
–
6
. Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017—and more than 80% in some low- and middle-income regions—was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing—and in some countries reversal—of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.
Contrary to the view that urbanization is a major driver of the global rise in obesity, the global increase in body-mass index is shown to be mostly due to increases in the body-mass indexes of rural populations.
Journal Article
Prevalence and determinants of undernutrition among under-five children residing in urban slums and rural area, Maharashtra, India: a community-based cross-sectional study
Background
Undernutrition among under five children in India is a major public health problem. Despite India’s growth in the economy, the child mortality rate due to undernutrition is still high in both urban and rural areas. Studies that focus on urban slums are scarce. Hence the present study was carried out to assess the prevalence and determinants of undernutrition in children under five in Maharashtra, India.
Methods
A community-based cross-sectional study was conducted in 16 randomly selected clusters in two districts of Maharashtra state, India. Data were collected through house to house survey by interviewing mothers of under five children. Total 2929 mothers and their 3671 under five children were covered. Multivariate logistic regression analysis was carried out to identify the determinants of child nutritional status seperately in urban and rural areas.
Results
The mean age of the children was 2.38 years (±SD 1.36) and mean age of mothers was 24.25 years (± SD 6.37). Overall prevalence of stunting among children under five was 45.9%, wasting was 17.1 and 35.4% children were underweight. Prevalence of wasting, stunting and underweight were more seen in an urban slum than a rural area. In the rural areas exclusive breast feeding (
p
< 0.001) and acute diarrhea (
p
= 0.001) were associated with wasting, children with birth order 2 or less than 2 were associated with stunting and exclusive breast feeding (
p
< 0.05) and low maternal education were associated with underweight. Whereas in the urban slums exclusive breast feeding (
p
< 0.05) was associated with wasting, sex of the child (
p
< 0.05) and type of family (
p
< 0.05) were associated with stunting,and low income of the family (
p
< 0.05) was associated with underweight.
Conclusions
Factors like sex of the child, birth order,exclusive breast feeding,economic status of the family, type of family,acute diarrhea and maternal education have influence on nutritional status of the child. Improvement of maternal education will improve the nutritional status of the child. Strategies are needed to improve the economic status of the community.
Trial registration
Trial registration number:
CTRI/2017/12/010881
; Registration date:14/12/2017. Retrospectively registered.
Journal Article
Low-Cost Internet-of-Things Water-Quality Monitoring System for Rural Areas
Water is a vital source for life and natural environments. This is the reason why water sources should be constantly monitored in order to detect any pollutants that might jeopardize the quality of water. This paper presents a low-cost internet-of-things system that is capable of measuring and reporting the quality of different water sources. It comprises the following components: Arduino UNO board, Bluetooth module BT04, temperature sensor DS18B20, pH sensor—SEN0161, TDS sensor—SEN0244, turbidity sensor—SKU SEN0189. The system will be controlled and managed from a mobile application, which will monitor the actual status of water sources. We propose to monitor and evaluate the quality of water from five different water sources in a rural settlement. The results show that most of the water sources we have monitored are proper for consumption, with a single exception where the TDS values are not within proper limits, as they outperform the maximum accepted value of 500 ppm.
Journal Article
The Impact of the Land Cover Dynamics on Surface Urban Heat Island Variations in Semi-Arid Cities: A Case Study in Ahmedabad City, India, Using Multi-Sensor/Source Data
This study examines the behavior of land surface temperature (LST) and surface urban heat island (SUHI) from MODIS data over Ahmedabad city, Gujarat state (India), from 2003 to 2018. Summer and winter LST patterns were analyzed, both daytime and nighttime. Ahmedabad, one of the fastest growing metropolitan cities in India, is characterized by a semi-arid climate. The investigation focuses on the SUHI variations due to warming or cooling trends of both urban and rural areas, providing quantitative interpretations by means of multi-sensor/source data. Land cover maps, normalized differential vegetation index, surface albedo, evapotranspiration, urban population, and groundwater level were analyzed across the years to assess their impact on SUHI variations. Moreover, a field campaign was carried out in summer 2018 to measure LST in several rural and urban sites. During summer daytime, the rural zone exhibits a higher average LST than the urban area, resulting in a mean negative SUHI, typical of arid cities, while a slight positive SUHI (mean intensity of 0.4 °C) during winter daytime is present. An evident positive SUHI is found only during summer (1.8 °C) and winter nighttime (3.2 °C). The negative SUHI intensity is due to the low vegetation presence in the rural area, dominated by croplands turning into bare land surfaces during the pre-monsoon summer season. Higher LST values in the rural area than in the urban area are also confirmed by the field campaign, with an average difference of about 5 °C. Therefore, the impact of the rural LST in biasing the SUHI is evident, and a careful biophysical interpretation is needed. For instance, within the urban area, the yearly intensity of the summer daytime SUHI is not correlated with the evapotranspiration, while the correspondent summer daytime LST exhibits a significant negative correlation (−0.73) with evapotranspiration. Furthermore, despite the city growth across the years, the urban area does not generally reveal a temporal increase of the magnitude of the heat island but an enlargement of its spatial footprint.
Journal Article
Comparison of Depressive Symptoms and Its Influencing Factors among the Elderly in Urban and Rural Areas: Evidence from the China Health and Retirement Longitudinal Study (CHARLS)
Depression amongst the elderly population is a worldwide public health problem, especially in China. Affected by the urban–rural dual structure, depressive symptoms of the elderly in urban and rural areas are significantly different. In order to compare depressive symptoms and its influencing factors among the elderly in urban and rural areas, we used the data from the fourth wave of the China Health and Retirement Longitudinal Study (CHARLS). A total of 7690 participants at age 60 or older were included in this study. The results showed that there was a significant difference in the prevalence estimate of depression between urban and rural elderly (χ2 = 10.9.76, p < 0.001). The prevalence of depression among rural elderly was significantly higher than that of urban elderly (OR-unadjusted = 1.88, 95% CI: 1.67 to 2.12). After adjusting for gender, age, marital status, education level, minorities, religious belief, self-reported health, duration of sleep, life satisfaction, chronic disease, social activities and having income or not, the prevalence of depression in rural elderly is 1.52 times (OR = 1.52, 95% CI: 1.32 to 1.76) than that of urban elderly. Gender, education level, self-reported health, duration of sleep, chronic diseases were associated with depression in both urban and rural areas. In addition, social activities were connected with depression in urban areas, while minorities, marital status and having income or not were influencing factors of depression among the rural elderly. The interaction analysis showed that the interaction between marital status, social activities and urban and rural sources was statistically significant (divorced: coefficient was 1.567, p < 0.05; social activities: coefficient was 0.340, p < 0.05), while gender, education level, minorities, self-reported health, duration of sleep, life satisfaction, chronic disease, social activities having income or not and urban and rural sources have no interaction (p > 0.05). Thus, it is necessary to propose targeted and precise intervention strategies to prevent depression after accurately identifying the factors’ effects.
Journal Article
What Can We Expect for the Development of Rural Areas in Europe?—Trends of the Last Decade and Their Opportunities for Rural Regeneration
Rural areas in Europe have been undergoing structural change for years, resulting in strong functional differentiation and fragmentation into prosperous and structurally weak areas. Rural areas are as diverse as the challenges they face. Not only various megatrends but also social, economic, technological, ecological, and political trends influence and shape the development of rural areas. In order to understand the problems and causes of the current development of rural areas, this paper provides a differentiated trend analysis for rural areas at the European level. A content analysis of more than 70 EU-funded project reports on rural areas and rural development is carried out. The aim is to identify trends and their drivers over the last decade and to summarize opportunities and challenges for successful rural regeneration. These external and overarching trends, particularly in the context of a sustainable transition, renewable energies, the emergence of new technologies and growing awareness of environmental impacts, offer rural areas more opportunities than ever before. The interplay between external incentives (e.g., European Union policies) and endogenous regional development (e.g., local actors) is crucial for the successful exploitation of these opportunities for rural regeneration.
Journal Article
Challenges facing the management of wastewater treatment systems in Chinese rural areas
The water environment in Chinese rural areas has seriously deteriorated to the extent that the development of rural areas is now under threat. To deal with this issue, the Chinese government has been promoting wastewater treatment systems (WTS) in rural areas since 2005. However, some of these wastewater treatment plants have shut down after just a few years. Thus, even though the number of newly built plants in rural areas has been rapidly increasing, the failure of these plants can impede the development of an efficient wastewater treatment in Chinese rural areas. This paper investigates the challenges faced by the management of the constructed wastewater treatment plants in Chinese rural areas using the case study method. Two cases, of Zhejiang and Hainan provinces, were analysed separately; the operation was successful in the former province and a failure in the latter one. The study demonstrates that the WTS in rural areas are faced with diverse implementation challenges, ranging from unsustainable financial sources for operation and maintenance cost to inappropriate governance structure, potential risks due to the local leadership rotation system of the government, limited participation by farmers in the management and technical complexity.
Journal Article
Can Digital Inclusive Finance Narrow the Chinese Urban–Rural Income Gap? The Perspective of the Regional Urban–Rural Income Structure
This paper empirically studies the impact of digital inclusive finance on the income structure of urban and rural residents in eastern, central, and western China. The results show that, first, digital inclusive finance is beneficial to narrowing the urban–rural per capita disposable income gap that has a disequilibrium effect among regions. Second, narrowing the wage income, property income, and transfer income gaps is beneficial but has little effect on the net operating income gap between urban and rural residents. Third, narrowing the wage income, property income, and transfer income gaps reduces the total income gap, and the wage income gap has the strongest intermediary force. In the end, the paper puts forward corresponding countermeasures for the development of digital inclusive finance to narrow each of these income gaps in different regions of China.
Journal Article
Urbanisation and asthma in low-income and middle-income countries: a systematic review of the urban–rural differences in asthma prevalence
BackgroundUrbanisation has been associated with temporal and geographical differences in asthma prevalence in low-income and middle-income countries (LMICs). However, little is known of the mechanisms by which urbanisation and asthma are associated, perhaps explained by the methodological approaches used to assess the urbanisation-asthma relationship.ObjectiveThis review evaluated how epidemiological studies have assessed the relationship between asthma and urbanisation in LMICs, and explored urban/rural differences in asthma prevalence.MethodsAsthma studies comparing urban/rural areas, comparing cities and examining intraurban variation were assessed for eligibility. Included publications were evaluated for methodological quality and pooled OR were calculated to indicate the risk of asthma in urban over rural areas.ResultsSeventy articles were included in our analysis. Sixty-three compared asthma prevalence between urban and rural areas, five compared asthma prevalence between cities and two examined intraurban variation in asthma prevalence. Urban residence was associated with a higher prevalence of asthma, regardless of asthma definition: current-wheeze OR:1.46 (95% CI:1.22 to 1.74), doctor diagnosis OR:1.89 (95% CI:1.47 to 2.41), wheeze-ever OR:1.44 (95% CI:1.15 to 1.81), self-reported asthma OR:1.77 (95% CI:1.33 to 2.35), asthma questionnaire OR:1.52 (95% CI:1.06 to 2.16) and exercise challenge OR:1.96 (95% CI:1.32 to 2.91).ConclusionsMost evidence for the relationship between urbanisation and asthma in LMICs comes from studies comparing urban and rural areas. These studies tend to show a greater prevalence of asthma in urban compared to rural populations. However, these studies have been unable to identify which specific characteristics of the urbanisation process may be responsible. An approach to understand how different dimensions of urbanisation, using contextual household and individual indicators, is needed for a better understanding of how urbanisation affects asthma.PROSPERO registration numberCRD42017064470.
Journal Article