Rural and urban differences in perceptions, behaviors, and health care disruptions during the COVID‐19 pandemic

Greteman, Breanna; Garcia-Auguste, Crystal J; Gryzlak, Brian M.; Kahl, Amanda R; Lutgendorf, Susan K.; Chrischilles, Elizabeth A.; Charlton, Mary E.

doi:10.1111/jrh.12667

Cited by 17 publications

(10 citation statements)

References 58 publications

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“… 43 Meanwhile, a US study reported that the proportion of people with increased body weight during the COVID-19 outbreak was higher in urban areas than in rural areas. 44 Further studies are required to clarify the differences in the effects of COVID-19 on obesity and obesity-related comorbidities between rural and urban areas.…”

Section: Discussionmentioning

confidence: 99%

Changes in the Prevalences of Obesity, Abdominal Obesity, and Non-Alcoholic Fatty Liver Disease among Korean Children during the COVID-19 Outbreak

et al. 2023

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Purpose We aimed to investigate the prevalences of obesity, abdominal obesity, and non-alcoholic fatty liver disease (NAFLD) among children and adolescents during the coronavirus disease 2019 (COVID-19) outbreak. Materials and Methods This population-based study investigated the prevalences of obesity, abdominal obesity, and NAFLD among 1428 children and adolescents between 2018–2019 and 2020. We assessed the prevalences of obesity, abdominal obesity, and NAFLD according to body mass index, age, sex, and residential district. Logistic regression analyses were performed to determine the relationships among obesity, abdominal obesity, and NAFLD. Results In the obese group, the prevalence of abdominal obesity increased from 75.55% to 92.68%, and that of NAFLD increased from 40.68% to 57.82%. In age-specific analysis, the prevalence of abdominal obesity increased from 8.25% to 14.11% among participants aged 10–12 years and from 11.70% to 19.88% among children aged 13–15 years. In residential district-specific analysis, the prevalence of both abdominal obesity and NAFLD increased from 6.96% to 15.74% in rural areas. In logistic regression analysis, the odds ratio of abdominal obesity for NAFLD was 11.82. Conclusion Our results demonstrated that the prevalences of abdominal obesity and NAFLD increased among obese Korean children and adolescents and in rural areas during the COVID-19 outbreak. Additionally, the prevalence of abdominal obesity increased among young children. These findings suggest the importance of closely monitoring abdominal obesity and NAFLD among children during COVID-19, focusing particularly on obese young children and individuals in rural areas.

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Section: Discussionmentioning

confidence: 99%

Changes in the Prevalences of Obesity, Abdominal Obesity, and Non-Alcoholic Fatty Liver Disease among Korean Children during the COVID-19 Outbreak

et al. 2023

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“…Additionally, our findings may reflect urban and rural population differences in the perception and/or enforcement of COVID‐19 policies such as lockdown and social distancing policies (Jiang et al, 2022). Evidence suggests that rural populations were less likely to perceive COVID‐19 to be a serious threat, and as such less likely to remain motivated to adhere to lockdown and social distancing policies than their urban counterparts (Greteman et al, 2022).…”

Section: Discussionmentioning

confidence: 99%

Changes in reported levels of depression and anxiety among rural and urban populations during the COVID‐19 pandemic

Danek

Taylor

Hilts

2023

Mental Health Science

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The COVID‐19 pandemic has affected nearly everyone, however experiences and perceptions of COVID have been different across rural and urban areas in the United States, including effects on mental health. The purpose of the current study is to examine changes in levels of reported anxiety and depression within rural and urban populations before and during the COVID‐19 pandemic in the United States. Using the National Health Interview Survey (NHIS), we used a repeated cross‐sectional study design including adults (age 18 or older) who were sampled in 2019 and 2020. We examined the relationship between worsening mental health outcomes (depression and anxiety) and rurality, controlling for individual's demographic and health‐related measures. Individuals living in an urban area were more likely to report worsening anxiety (28.8% vs. 23.0% p < 0.001) and use of mental health services (10.4% vs. 8.1% p = 0.054) in the previous 12 months than their rural counterparts. No significant differences were detected in the likelihood of reporting worsening depression, when comparing those living in rural versus urban areas. We found that individuals living in urban areas were more likely to report worsening anxiety than those living in rural areas during the COVID‐19 pandemic. Urban areas were affected earlier and more severely as early epicenters of the COVID‐19 pandemic in the United States, which may have contributed to worsening anxiety among these populations as compared to rural populations. Additionally, our findings may reflect urban and rural population differences in the perception and/or enforcement of COVID‐19 policies such as lockdown and social distancing policies.

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“…First, in order to maintain comparability to the (unweighted) cancer patient sample, we did not weight our general population sample for this analysis. As a result, our general population sample over-represents rural residents [29]. Additionally, the 26% response of our cancer patient survey increases risk for nonresponse bias.…”

Section: Discussionmentioning

confidence: 99%

“…Methods and measures pertaining to the general population survey have been described in detail elsewhere [29]. Briefly, in August 2020, we mailed the general population survey to a random sample of 10,009 Iowans from the 2018 Iowa voter registration file.…”

Section: Methodsmentioning

confidence: 99%

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Comparing COVID-19 Response Behaviors between a Cancer Patient Sample and a Population-Based Cancer-Free Sample in a Rural Midwestern State

Greteman,

Garcia-Auguste,

Kahl

et al. 2023

Oncology

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Introduction The COVID-19 pandemic caused an increase in fear, anxiety, and depressive symptoms globally. For populations at increased risk for adverse outcomes due to illness, such as cancer patients, these worries may have been exacerbated. Understanding how the pandemic impacted cancer patients will inform better preparation for future events that cause disturbances to cancer care delivery. Methods This study analyzed data from two surveys to determine whether cancer patients’ responses differed from a cancer-free population-based sample in terms of concerns, preventive behaviors, and thoughts on their healthcare provider’s communication regarding COVID-19, in a U.S. midwestern state. In August 2020, a survey was sent to 10,009 Iowans aged 18 and older, randomly selected from the 2018 Iowa voter registration file. In September 2020, a survey was emailed to 2,954 cancer patients aged 18 and older who opted into the University of Iowa Holden Comprehensive Cancer Center’s Patients Enhancing Research Collaborations at Holden program. Previously validated and pre-tested Likert-type and multiple-choice items assessed concern regarding COVID-19, social distancing perception and behaviors, and demographic characteristics of respondents. We used chi-square tests and logistic regression to examine differences between the cancer patient and general population survey responses. Results We included 3,622 responses from the general population survey, and 780 responses from the cancer patient survey in this analysis. Cancer patient survey respondents were more frequently older, lived in urban areas, had Medicare insurance coverage, had a college degree or higher, and were married. Cancer patients were more likely to report engaging in social distancing behaviors and greater concern regarding the pandemic. Conclusion This study suggests differences in the impact of the COVID-19 pandemic on cancer patients compared to cancer-free members of the general population. These results indicate the need for consideration of cancer patients’ physical and mental health during large-scale disruptions to cancer care.

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Rural and urban differences in perceptions, behaviors, and health care disruptions during the COVID‐19 pandemic

Cited by 17 publications

References 58 publications

Changes in the Prevalences of Obesity, Abdominal Obesity, and Non-Alcoholic Fatty Liver Disease among Korean Children during the COVID-19 Outbreak

Changes in the Prevalences of Obesity, Abdominal Obesity, and Non-Alcoholic Fatty Liver Disease among Korean Children during the COVID-19 Outbreak

Changes in reported levels of depression and anxiety among rural and urban populations during the COVID‐19 pandemic

Comparing COVID-19 Response Behaviors between a Cancer Patient Sample and a Population-Based Cancer-Free Sample in a Rural Midwestern State

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