title: Is living in a rural area good for your respiratory health? Results from a cross-sectional study in Scotland.
abstract: OBJECTIVE
  We aimed to investigate the epidemiology of self-reported chronic respiratory disease throughout Scotland, and to explore the relationship between quality of life and geographic location in those reporting disease.
  
  
  METHODS
  A cross-sectional study. Self-reported data on age, gender, socioeconomic factors, smoking habits, selected illnesses (major respiratory and atopic diseases, and other major conditions), respiratory symptoms, use of medicines and health services, and quality of life were collected using a postal questionnaire.
  
  
  METHODS
  A total of 4,560 adults registered with 1 of 57 family practices (22 rural and 35 urban) throughout Scotland.
  
  
  RESULTS
  The response rate was 60%. Following adjustment for potential confounders, participants from rural areas reported a significantly lower prevalence of any chest illness (adjusted odds ratio [OR], 0.72; 95% confidence interval [CI], 0.58 to 0.91), asthma (adjusted OR, 0.59; 95% CI, 0.46 to 0.76), and eczema/dermatitis (adjusted OR, 0.67; 95% CI, 0.52 to 0.87). Rural location was less likely than urban location to be associated with the reporting of persistent cough and phlegm and different symptoms (types of breathlessness and wheeze) indicative of asthma. No difference in prevalence was found for other respiratory problems. Participants from rural areas reporting COPD or emphysema, or cough or phlegm symptoms had significantly better quality of life scores than their urban counterparts.
  
  
  CONCLUSIONS
  In this study, living in a rural area was associated with a lower prevalence of asthma but not other chronic respiratory disorders, and a lower prevalence of some respiratory symptoms (including wheeze). Although the prevalence of COPD or emphysema did not differ between rural and urban areas, rural residency appeared to be associated with better health status among subjects with these conditions.
authors.affiliation: Department of General Practice & Primary Care, University of Aberdeen, Foresterhill Health Centre, Westburn Rd, Aberdeen, AB25 2AY, UK. l.iversen@abdn.ac.uk
authors.forename: Lisa
authors.initials: L
authors.lastname: Iversen
authors.forename: Philip C
authors.initials: PC
authors.lastname: Hannaford
authors.forename: David B
authors.initials: DB
authors.lastname: Price
authors.forename: David J
authors.initials: DJ
authors.lastname: Godden
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001249:Asthma / Q000453:epidemiology; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005194:Family Practice; D006801:Humans; D008875:Middle Aged; D015995:Prevalence; D012140:Respiratory Tract Diseases / Q000453:epidemiology*; D012423:Rural Health / Q000592:standards*; D012606:Scotland / Q000453:epidemiology; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D014504:Urban Health; D014505:Urban Population