ArticleBMJ open2014
A small-area analysis of inequalities in chronic disease prevalence across urban and non-urban communities in the Province of Nova Scotia, Canada, 2007-2011.
Article in BMJ open, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Neighbourhood characteristics related to mental health service use among adults with diabetes: a population-based cohort study in New Brunswick, Canada.BMC research notes · 2022Observational
- Gendering Neighbourhood Marginalization Metrics in Mental Health Services Research: A Cross-Sectional Exploration of a Rural and Small Urban Population.International journal of environmental research and public health · 2021Article
- Mapping chronic disease prevalence based on medication use and socio-demographic variables: an application of LASSO on administrative data sources in healthcare in the Netherlands.BMC public health · 2021Article
- Urban-regional patterns of food purchasing behaviour: a cross-sectional analysis of the 2015-2016 Australian Household Expenditure Survey.European journal of clinical nutrition · 2021Article
- Cardiovascular mortality and risk behaviours by degree of urbanization before, during and after the economic crisis in Spain.BMC public health · 2019Article
- Article
- Misclassification errors from postal code-based geocoding to assign census geography in Nova Scotia, Canada.Canadian journal of public health = Revue canadienne de sante publique · 2016Article
- Small-area spatio-temporal analyses of bladder and kidney cancer risk in Nova Scotia, Canada.BMC public health · 2016Article
- Do the classification of areas and distance matter to the assessment results of achieving the treatment targets among type 2 diabetes patients?International journal of health geographics · 2015Article
- Impact of socio-economic status on hospital length of stay following injury: a multicenter cohort study.BMC health services research · 2015Article
- Article
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Authors and funding
3 authors.
Funding
Abstract
backgroundSmall-area studies of health inequalities often have an urban focus, and may be limited in their translatability to non-urban settings. Using small-area units representing communities, this study assessed the influence of living in different settlement types (urban, town and rural) on the prevalence of four chronic diseases (heart disease, cancer, diabetes and stroke) and compared the degrees of associations with individual-level and community-level factors among the settlement types.
methodsThe associations between community-level and individual-level characteristics and prevalence of the chronic diseases were assessed using logistic regression (multilevel and non-multilevel) models. Individual-level data were extracted from the Canadian Community Health Survey (2007-2011). Indices of material deprivation and social isolation and the settlement type classification were created using the Canadian Census.
resultsRespondents living in towns were 21% more likely to report one of the diseases than respondents living in urban communities even after accounting for individual-level and community-level characteristics. Having dependent children appeared to have protective effects in towns, especially for males (OR: 0.49 (95% CI 0.27 to 0.90)). Unemployment had a strong association for all types of communities, but being unemployed appeared to be particularly damaging to health of males in urban communities (OR: 2.48 (95% CI 1.43 to 4.30)).
conclusionsThe study showed that those living in non-urban settings, particularly towns, experience extra challenges in maintaining health above and beyond the socioeconomic condition and social isolation of the communities, and individual demographic, behavioural and socioeconomic attributes. Our findings also suggest that health inequality studies based on urban-only settings may underestimate the risks by some factors. Ways to devise meaningful small-area units comparable in all settlement types are necessary to help plan effective provision of chronic disease-related health services and programmes on a regional scale.
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