Rural-urban differences in health and health behaviour:: A baseline description of a community health-promotion programme for the elderly

Study objective: To ( 1) describe the setting and design of the Good Ageing in Lahti Region ( GOAL) programme; ( 2) by using the baseline results of the GOAL cohort study, to examine whether living in urban, semi-urban, or rural communities is related to risk factors for chronic diseases and functional disability in ageing individuals. Design: The baseline data of a cohort study of ageing individuals living in three community types ( urban, semi-urban, rural). Data were collected by two questionnaires and laboratory assessments. Setting: Fourteen municipalities in the Lahti region (Paijat-Hame County) in Finland. Participants: A regionally and locally stratified random sample of men and women born in 1946-50, 1936-40, and 1926-30. A total of 4,272 were invited and 2,815 (66%) participated. Main results: Elevated serum cholesterol, obesity, disability, sedentary lifestyle (< 2 times/week walking), and high fat intake were more prevalent in rural vs. urban and semiurban communities. After adjustment for sex, age, education, obesity, diet, physical activity, smoking, and alcohol use, rural communities remained the only community type with increased (p < 0.05) probability for high BMI (OR 1.33) and high waist circumference (OR 1.43). Conclusions: The unfavourable health and lifestyle profile, together with an old population, makes health promotion for elderly citizens a special challenge for rural communities such as those in Paijat-Hame County, Finland. Most, if not all, of the differences in health between the three community types were explained by educational background, physical activity, and smoking.