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Correlates of Rural, Appalachian, and Community Identity in the CITIES Cohort.

ABSTRACT: PURPOSE:To determine correlates of rural, Appalachian, and community identity among a cohort of participants in the Community Initiative Towards Improving Equity and Health Status (CITIES) project. METHODS:Mixed linear and logistic regression effects models were utilized to determine correlates of 3 outcomes: 1) community identity, 2) rural identity, and 3) Appalachian identity among participants in the Ohio CITIES project. FINDINGS:Distinct demographic characteristics were found to be associated with each of the outcomes. For community identity, while no differences were found for rural or urban participants, those who were single or never married (P < .0001) as well as those who graduated from college (P = .0005) reported significantly lower community identity scores than married individuals with less than a college education. Those who resided in an Appalachian county reported higher community identity scores (P = .0009) than non-Appalachian residents. For rural identity, those who did not identify as Christian (P = .018) as well as those who identified as Democrat (P = .027) reported significantly lower rural identity scores than others. Lastly, for Appalachian identity, county-level percentage of families in poverty (P = .06), as well as gender (P = .05), were associated with self-reported Appalachian identity, but these effects were only marginally significant. CONCLUSIONS:Although community, rural, and Appalachian identity may be viewed as similar due to their measure of attachment to a place, results from this study suggest that there are distinct individual and area-level correlates associated with community, rural, and Appalachian identity.

SUBMITTER: Paskett ED

PROVIDER: S-EPMC6436975 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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Correlates of Rural, Appalachian, and Community Identity in the CITIES Cohort.

Paskett Electra D ED Young Gregory S GS Bernardo Brittany M BM Washington Chasity C DeGraffinreid Cecilia C Fisher James L JL Huerta Timothy R TR

The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association 20190304 2

<h4>Purpose</h4>To determine correlates of rural, Appalachian, and community identity among a cohort of participants in the Community Initiative Towards Improving Equity and Health Status (CITIES) project.<h4>Methods</h4>Mixed linear and logistic regression effects models were utilized to determine correlates of 3 outcomes: 1) community identity, 2) rural identity, and 3) Appalachian identity among participants in the Ohio CITIES project.<h4>Findings</h4>Distinct demographic characteristics were ...[more]

PMID: 30830989

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Project description:BackgroundMultimorbidity estimates are expected to increase in India primarily due to the population aging. However, there is a lack of research estimating the burden of multimorbidity in the Indian context using a validated tool. We estimated the prevalence and determinants of multimorbidity amongst the adult population of the rural Uddanam region, Andhra Pradesh.MethodsThis community-based cross-sectional study was conducted as a part of an ongoing research program. Multistage cluster sampling technique was used to select 2419 adult participants from 40 clusters. Multimorbidity was assessed using Multimorbidity Assessment Questionnaire for Primary Care (MAQ-PC) tool, collecting information on 13 chronic diseases. Patient Health Questionnaire (PHQ-12) was used to screen for depression. Multiple logistic regression was conducted to identify the strongest determinants of multimorbidity.ResultsOf the 2419 participants, 2289 completed the MAQ-PC tool. Mean age (standard deviation) of participants was 48.1 (13.1) years. The overall prevalence of multimorbidity was 58.5% (95% CI 56.5-60.6); with 30.7%, 15.6%, and 12.2% reporting two, three, and four chronic conditions, respectively. Acid peptic disease-musculoskeletal disease (44%) and acid peptic disease-musculoskeletal disease-hypertension (14.9%) were the most common dyad and triad. Among metabolic diseases, diabetes-hypertension (28.3%) and diabetes-hypertension-chronic kidney disease (7.6%) were the most common dyad and triad, respectively. Advancing age, female gender, and being obese were the strongest determinates of the presence of multimorbidity. Depression was highly prevalent among the study population, and participants with higher PHQ-12 score had 3.7 (2.5-5.4) greater odds of having multimorbidity.ConclusionsOur findings suggest that six of 10 adults in rural India are affected with multimorbidity. We report a higher prevalence of multimorbidity as compared with other studies conducted in India. We also identified vulnerable groups which would guide policy makers in developing holistic care packages for individuals with multimorbidity.

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Correlates of Rural, Appalachian, and Community Identity in the CITIES Cohort.

Publications

Correlates of Rural, Appalachian, and Community Identity in the CITIES Cohort.

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