The proportion of excess deaths occurring in each of the four different types of rural places, relative to deaths in urban places, were calculated for different gender and age groups. Differences in mortality across the urban-rural continuum are mainly driven by people under 45 years, and are particularly due to deaths caused by injury and poisoning, motor vehicle accident MVA and suicide. The proportion of excess deaths relative to urban places for those under 45 years increases with decreasing age. Remote places have the highest excess in mortality for suicide, MVA, injury and poisoning, relative to urban places.
The relative mortality for young girls living in rural compared with urban places is similar to the relative mortality for young rural boys.
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Introduction According to Rioja et al. In the late 19th century, when infectious disease mortality was high, worse sanitary hygiene and over-crowding in cities led to higher mortality rates than in the countryside.
Recent Incidents Highlight Risks of Remote Travel in Death Valley’s Heat
With the epidemiological transition, the more rapid pace of modernization in the cities has led to a faster decline in urban mortality relative to rural places so that now, in some but not all developed nations, mortality rates in rural places for many causes of death are higher than they are in urban places 3,4. The extent of the difference in mortality across the rural-urban continuum varies, in some cases quite markedly, from nation to nation 3,5 and by specific cause of death 3,4,6,7. Increasingly researchers recognize that, even in developed nations where rural and urban mortality is similar 5 , rural areas have higher in some cases much higher morality among children and young adults.
In developed nations such as Canada and Australia where age-adjusted rural mortality tends to be much greater than rural mortality, deaths from unintentional injuries, poisoning, motor vehicle trauma, and suicide, causes of death which are disproportionately high among the young, also tend to be higher in rural places 3,4,8,9. Several studies in recent years have demonstrated a consistent deficit in health status among rural compared with urban Canadians 3,4,6,7, This recent CIHI study utilized a more sophisticated definition of 'rural' than has been used in previous investigations of rural health in Canada In most health studies rural places have been defined crudely on the basis of population size.
However, CIHI investigators in their study used Statistics Canada's Metropolitan Influenced Zone MIZ system to classify rural places into four sub-groups based, not only on population size, but also on their proximity to urban places, and the extent to which rural places are 'influenced' by nearby urban centers. The CIHI analysis, using this more finely graded definition of rural places, demonstrated fairly consistent gradients in health outcomes, including mortality, along both the urban-rural continuum and this more finely subdivided rural continuum.
This new definition of rurality fairly well described in the original CIHI study , was operationalized with administrative data and furthers our understanding of the impact of place on health. The primary purpose of this article is to illustrate the use of an age, gender, and place based re-analysis of data from an existing study 4 in order to more clearly demonstrate the role of these three factors in rural-urban differences in mortality, in order to better develop policy to reduce this gap.
The article is organized as follows.
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The methods section reviews the way 'rural' and 'urban' are defined, and the methods used to gather and analyze data in the original CIHI study. The approach of the present study is outlined, whereby the original study results were re-visited, re-synthesized and presented in such a way that age, gender, and place are integral to the analysis of the mortality gap between urban and rural residents in Canada. The results of the re-analysis are presented in the results section. Because some census district boundaries changed over this period, mortality data from each of these years was fitted to CSD boundaries.
These MIZs characterize rural areas according to population size and proximity and influence exerted by nearby urban areas. The MIZs offer a more sophisticated way of defining 'rural' than is found in typical analyses where rural areas are defined solely in terms of population size or density.
The mortality gap between urban and rural Canadians: a gendered analysis
Statistics Canada's MIZ system estimates the level of influence exerted by nearby urban areas by assessing the proportion of residents in a rural CSD who commute on a regular basis to nearby urban areas. While this is a fairly crude measure of urban 'influence' on a rural CSD, it is a vast improvement when compared with traditional 'size-only' measures of rurality. The suppression of data for CSDs with small populations explains the unavailability of some census data at the CSD level as well. It is clear therefore that sub-populations, particularly those living in very small communities in remote places, were under-ascertained using this sampling framework.
The results section of the original CIHI report and the appendix contained a number of tables with data on mortality rates for major causes of death by MIZ regions, age group, and gender. The original report presented general results with discussion based on each major causes of death. In the present study calculations were performed to determine the proportion of excess deaths occurring in each of the four different types of rural places, relative to deaths in urban places. These calculations were performed for different gender and age groups.
In this way, the age, gender, and rural place-specific characteristics of mortality gradients for major causes of death were highlighted.
This re-analysis provides a new set of insights into the gender and place dimensions of the mortality gap between urban and rural Canadians, and can be used to more effectively to develop prevention policy in rural Canada. Results All-cause mortality by gender and across the urban-rural continuum In all causes of death except cancer age-standardized mortality rates are higher in rural compared with strong MIZs, and male mortality for all causes of death and within each place category is always greater than female mortality Table 2.
Annual mortality rates per in Canada by residence and gender Figure 1 illustrates the presence of a rough gradient in all-cause mortality for both genders moving from strong MIZs through to remote regions. Age-standardized all-cause mortality rates per by place of residence and gender, Canada to MIZ, metropolitan influenced zone.
Full of journals dating back maybe 10 years or so. We camped within sight of the cabin - behind an outcropping of rocks just to the north - and east of striped butte because we wanted to be scared should a light come on inside after dark!! Own or manage this property? Claim your listing for free to respond to reviews, update your profile and much more. All of your saved places can be found here in My Trips.
Deaths & remoteness
Log in to get trip updates and message other travelers. Log in Join Recently viewed Bookings Inbox. Gems of Death Valley remote cabins for Attraction details Owner description: This stone cabin is available for public use and is just beyond the Russell Camp. Reviewed April 1, Gems of Death Valley remote cabins for public use. See what travelers are saying: Reviewed May 23, A night with the burros. Park rangers responded recently to three major incidents in remote areas of the park.
High temperatures, lack of ability to call for help in case of an emergency, and long distances for emergency responders create a sometimes-deadly combination. On Thursday, June 9 park visitors found a deceased motorcyclist on Harry Wade Road, an unpaved road in the extreme southern end of the park. When park rangers arrived, they made no effort to resuscitate him because the state of his body indicated he had been dead for an extended period of time.
Rural & remote health, Deaths & remoteness - Australian Institute of Health and Welfare
The man's motorcycle was parked upright and was still functional. Inyo County is investigating the cause of death. We think of national parks as wonderlands to explore. We don't know what happened to him, but if he had been on Highway or near Badwater. Death Valley National Park holds the world record for hottest official temperature: In spite of this, large numbers ofpeople visit the park in summer, especially in July and August.
Many of these people are from other countries, with limited English skills and little experience traveling in remote areas without cell phone coverage.