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Rural life hardly healthier

乡村生活并不更健康

It’s tempting to conclude that suburbs rule as it seems theic notions that country life is healthy and idyllic, and city life toxic and schizophrenic, are both wrong. And right. According to experts, the health perils of country and city life are different, but probably a wash when it comes to the question of whether rural or urban living is healthier.

人们很容易得出这样的结论：郊区统治着一切——乡村生活是健康的、田园诗般的，城市生活是有毒的、精神分裂症的——这些经典观念都是错误的。没错。根据专家的说法，乡村和城市生活对健康的危害是不同的，但当涉及到农村还是城市生活更健康的问题时，这可能是一种洗白。

There’s certainly little validity to the proposition that country life, replete with all that fresh air, is a guarantor of good health, says Raymond Pong, a senior research fellow at the Centre for Rural and Northern Health Research, and a professor in the School of Rural and Northern Health at Laurentian University in Sudbury, Ontario.

安大略省萨德伯里市劳伦斯大学农村与北方卫生学院教授、农村与北方健康研究中心高级研究员雷蒙德·庞说，充满新鲜空气的乡村生活是健康的保证，这一说法肯定没有什么根据。

“It’s not that the whole of the rural population is in jeopardy, but generally speaking, the more remote, the more northern, the smaller the community, the poorer the health status,” says Pong, principal investigator on a Canadian Institute for Health Information study which found that people living in rural Canada have higher mortality rates and shorter life expectancies than those in urban regions. It also found that life expectancy in 2001 for men born in remote, rural areas was 74 years compared to 76.8 years in urban Canada. The difference was statistically negligible in woman, with life expectancies ranging from 81.3 to 81.5 years.

加拿大卫生信息研究所的一项研究的首席研究员庞说：“并不是说整个农村人口都处于危险之中，但总的来说，越偏远、越北部、社区越小，健康状况就越差。”研究还发现，2001年出生在偏远农村地区的男性预期寿命为74岁，而加拿大城市的预期寿命为76.8岁。女性的差异在统计学上可以忽略不计，预期寿命在81.3至81.5岁之间。

Obesity, smoking and less physical activity contributes to a higher incidence of chronic diseases like diabetes and cardiovascular disease among country dwellers, who also suffered more deaths from motor vehicle collisions and occupational hazards such as injuries and poisoning, the study found.

研究发现，肥胖、吸烟和体育活动减少导致农村居民患糖尿病和心血管疾病等慢性疾病的几率更高，他们还因机动车碰撞以及受伤和中毒等职业危害而死亡。

But the news wasn’t all bad for rural residents. They have lower cancer death rates, experience less stress, suffer less respiratory disease and report a greater “sense of community belonging,” it added.

但这个消息对农村居民来说并不全是坏事。报告补充道，他们的癌症死亡率较低，压力较小，患呼吸道疾病较少，且报告表明他们有更大的“社区归属感”。

Pong says that rural Canadians also face a health challenge in terms of access to health services in comparison with their city counterparts. Their remoteness often requires them to travel longer distances to obtain care, which leads to a higher rate of traffic collisions. There’s also the fact that they often hold more dangerous jobs in the farming, mining, fishing and logging industries, he adds.

庞说，与城市同行相比，加拿大农村地区在获得医疗服务方面也面临着健康挑战。他们地处偏远，往往需要走更长的路才能得到医疗保障，这导致了更高的交通事故率。他补充道，还有一个事实是，他们经常在农业、采矿、渔业和伐木行业从事更危险的工作。

The disparity in access to health services is typical of rural and urban environments throughout the world, according to a World Health Organization study. “Even in countries where the majority of the population lives in rural areas, the resources are concentrated in the cities. All countries have difficulties with transport, communication, services and resources, and they all face the challenge of shortages of health-care providers in rural and remote areas,” it states.

根据世界卫生组织的一项研究，在获得医疗服务方面的差异在世界各地的农村和城市环境中是典型的。报告指出：“即使在大多数人口居住在农村地区的国家，资源也集中在城市。所有国家都在交通、通信、服务和资源方面存在困难，它们都面临着农村和偏远地区医疗保健提供者短缺的挑战。”

But if country living isn’t all that it’s cracked up to be, health-wise, it isn’t as if city living constitutes any manner of Shangri-La, as studies have repeatedly shown that city-dwellers suffer a high incidence of mental health problems, including depression, psychosis and schizophrenia, as well as a greater incidence of drug and alcohol dependence.

但是，如果从健康角度来看，乡村生活并不是人们所说的那样，那么城市生活就不构成香格里拉的任何形式，因为研究一再表明，城市居民的心理健康问题发生率很高，包括抑郁症、精神病和精神分裂症，药物和酒精依赖的发生率也更高。

It’s not clear, though, what aspect of city life is responsible for that higher incidence of mental health problems, says Jens Pruessner, associate professor of psychiatry, neurology and neurosurgery at McGill University in Montréal, Quebec.

魁北克蒙特利尔麦吉尔大学精神病学、神经病学和神经外科副教授延斯·普鲁斯纳表示，目前尚不清楚城市生活的哪些方面导致了心理健康问题的高发。

“It could be the noise, the traffic. … There might be a greater social pressure in the city compared to the rural environment because of the greater number of people you are exposed to,” says Pruessner, coauthor of a study which surmised that there might be differences in the way in which the brains of urban dwellers and rural residents process social stress, which could contribute to more schizophrenia and mood or anxiety disorders among city dwellers.

一项研究的合著者普鲁斯纳说：“可能是噪音、交通……与农村环境相比，城市可能会有更大的社会压力，因为你接触的人更多。”该研究推测，城市居民和农村居民的大脑处理社会压力的方式可能存在差异，这可能会导致城市居民出现更多的精神分裂症和情绪或焦虑障碍。

But there may be other factors at play in the lower incidence of mental health problems among rural Canadians, says Judith Kulig, professor of health sciences at the University of Lethbridge in Alberta. A strong sense of community belonging and “connection to the landscape” can contribute to positive health among rural Canadians, she says. “When people live in a physical environment that they feel an attachment to and that gives them not just a sense of belonging, but a sense of peacefulness, that actually assists with lack of stress.”

但阿尔伯塔省莱思布里奇大学健康科学教授朱迪斯·库利格表示，在加拿大农村地区，心理健康问题发生率较低的原因可能还有其他因素。她说，强烈的社区归属感和“与自然的关联”有助于加拿大农村地区的积极健康。“当人们生活在一个他们感到依恋的物理环境中，这不仅给了他们归属感，而且给了他们平静感，这实际上有助于减少压力。”

As well, greater social cohesion in rural areas also means that country dwellers can more readily rely on friends and neighbours for help in the event of injury or illness, Kulig adds. “There are many, many stories of farmers who have some kind of accident or something and aren’t able to finish their harvest, and their neighbours come out and finish their harvest for them.”

此外，库利格补充道，农村地区更大的社会凝聚力也意味着农村居民在受伤或生病时可以更容易地依靠朋友和邻居的帮助。“有很多很多农民的故事，他们发生了某种事故或其他什么，无法完成收成，他们的邻居出来帮他们完成收成。”

But others say no safe conclusions can be drawn about the respective health merits of country or city life.

但也有人表示，对于乡村或城市生活各自的健康价值，无法得出确定的结论。

There are some cities, or pockets of some cities, and some rural areas, or pockets of some rural areas, that are healthier to live in than others, says Judith Guernsey, associate professor of community health and epidemiology in the Faculty of Medicine at Dalhousie University in Halifax, Nova Scotia.

新斯科舍省哈利法克斯市达尔豪斯大学医学院社区卫生和流行病学副教授朱迪斯·根西说，有些城市、一些城市的一部分、一些农村地区或一些农村地区的一部分比其他城市更健康。

Not all rural communities are plagued with poor health and difficulties accessing services, Guernsey says. “Some rural communities are absolutely beautiful, pristine and healthy and very well-resourced, whereas other rural and remote locations are completely challenged, impoverished.”

根西说，并非所有农村社区都受到健康状况不佳和难以获得服务的困扰。“一些农村社区绝对美丽、原始、健康，资源非常充足，而其他农村和偏远地区则完全面临挑战，一贫如洗。”

But city life is no less variable, she adds, citing a study that found an 11-year difference in life expectancy between two areas of Montréal. “Some urban communities are thriving. You go to the downtown core and they’re thriving areas, but there are other urban settings that are very challenged,” she says. “From a research perspective, we really have to look at the local context … to understand why some people are healthier than others.”

但她补充道，城市生活的变化也不小，她引用了一项研究，该研究发现蒙特利尔两个地区的预期寿命相差11岁。她说：“一些城市社区正在蓬勃发展。你去市中心，他们是蓬勃发展的地区，但还有其他城市环境面临着巨大挑战。”。“从研究的角度来看，我们真的必须看看当地的情况……才能理解为什么有些人比其他人更健康。”

【Source】www.ncbi.nlm.nih.gov

【Translated by】Spark Liao (廖怀宝)

【Illustration】From Bing