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01.12.2012 | Research article | Ausgabe 1/2012 Open Access

BMC Health Services Research 1/2012

Is the health of people living in rural areas different from those in cities? Evidence from routine data linked with the Scottish Health Survey

Zeitschrift:
BMC Health Services Research > Ausgabe 1/2012
Autoren:
P Teckle, P Hannaford, M Sutton
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1472-6963-12-43) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors' contributions

PT This study was conducted as part of a PhD thesis by PT. PT developed the idea for the study and conducted all aspects of the study under the supervision of PH and MS. PT's PhD was funded by the Chief Scientist Office of the Scottish Executive Department of Health. PH is funded by NHS Grampian. MS was funded by the Chief Scientist Office. All authors were involved in the final review of the manuscript and all authors read and approved the final manuscript.

Abstract

Background

To examine the association between rurality and health in Scotland, after adjusting for differences in individual and practice characteristics.

Methods

Design: Mortality and hospital record data linked to two cross sectional health surveys. Setting: Respondents in the community-based 1995 and 1998 Scottish Health Survey who consented to record-linkage follow-up. Main outcome measures: Hypertension, all-cause premature mortality, total hospital stays and admissions due to coronary heart disease (CHD).

Results

Older age and lower social class were strongly associated with an increased risk of each of the four health outcomes measured. After adjustment for individual and practice characteristics, no consistent pattern of better or poorer health in people living in rural areas was found, compared to primary cities. However, individuals living in remote small towns had a lower risk of a hospital admission for CHD and those in very remote rural had lower mortality, both compared with those living in primary cities.

Conclusion

This study has shown how linked data can be used to explore the possible influence of area of residence on health. We were unable to find a consistent pattern that people living in rural areas have materially different health to that of those living in primary cities. Instead, we found stronger relationships between compositional determinants (age, gender and socio-economic status) and health than contextual factors (including rurality).
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