%0 Journal Article
%T Is the health of people living in rural areas different from those in cities? Evidence from routine data linked with the Scottish Health Survey
%A P Teckle
%A P Hannaford
%A M Sutton
%J BMC Health Services Research
%D 2012
%I BioMed Central
%R 10.1186/1472-6963-12-43
%X 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).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.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).Rural Scotland comprises 89% of Scotland's landmass, and contains 20% of the population, and 27% of those employed [1]. There is growing interest in the health of people living in rural and remote areas, and in the study of health care services provided to them [2-4]. Urban-rural variations in health outcomes have been studied within Scotland [5-9] and the UK [10,11]. Studies so far have used a variety of health outcomes, including long standing illness [12], mortality [13], cancer [14-16], hypertension and cardiovascular disease [17-20], and respiratory health [5]. The available evidence is derived from specific, one-off projects and the collective evidence is inconclusive [5,16,21-23].
%K Health determinants
%K Rural health
%K Administrative data-linkage
%K Survey methods
%U http://www.biomedcentral.com/1472-6963/12/43