Town or country

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Country living may be clean and green but it can also be a challenge for the elderly and the chronically ill

If research suggesting that people who live close to major roads could have a higher risk of dementia has prompted thoughts of clean, traffic-free countryside living, then you are probably not alone.

But what is the reality? Is a rural existence better for our health?

Like the causes of dementia itself, it is not a straightforward question and there are no clear-cut answers.

On the face of it, fleeing to the countryside seems like a good idea.

Less than a quarter of the UK population lives there for a start.

The air is cleaner, there is less traffic and air pollution – which increases the risk of stroke, lung cancer, heart disease and respiratory diseases – is not an issue.

There is also more opportunity to get out and exercise in all that open space – remember those long dog walks you have been fantasising about – and enjoy being surrounded by greenery.

Longer life

According to David Newby, British Heart Foundation professor of cardiology at the University of Edinburgh, when it comes to air pollution, “being in the country is better for you”.

That is because living away from busy roads reduces the risk of damage to the lungs and heart from fine particles and gases emitted by traffic.

While buses, high-rise buildings and stop-go traffic are known to increase the risk of exposure to pollution, Prof Newby says you do not have to move far to reduce the health risk.

“The closer you are to a major road the worse it is, but moving to the middle of Hyde Park could be sufficient,” he said.

Roy Harrison, professor of environmental health at the University of Birmingham, says it is “significantly healthier” to live in the countryside.

He says research shows that air pollution is responsible for an average loss of life expectancy of six months across the UK and most of that is driven by urban populations.

“More remote rural areas have half the concentration of pollution of urban areas.”

And a government report, which found that health outcomes are more favourable in rural areas than urban areas, seems to back up these findings.

Complicated picture

Life expectancy is higher, the infant mortality rate is lower and potential years of life lost from common causes of premature death are also lower in rural areas, it says.

But this does not tell the whole story – there are wide variations within rural and urban areas because of deprivation.

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Science Photo Library

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Traffic and air pollution are just some of the downsides to living in urban areas

Someone who lives in a rural village is expected to live longer than someone living in a town in a rural area and someone living in a deprived urban area is less likely to live as long as someone brought up in a leafy city suburb.

According to an Office for National Statistics report from 2010, which tried to take deprivation into account, overall life expectancy was higher in rural areas, but the very highest life expectancies were found in the wealthiest urban areas.

Green and pleasant?

It is easy to romanticise the countryside and see it as a green, rural idyll which is quiet and stress-free.

But even if that was true (ever listened to The Archers?), it can bring its own issues.

With an older population on average living in rural areas, loneliness and isolation can become a problem as people age.

For the elderly and unwell without a car or public transport, and distanced from GP surgeries, hospitals and local amenities, country living can become a serious challenge.

Even younger working people, attracted by the promise of more indoor and outdoor space, can find themselves spending hours commuting every day.

They may also end up spending more time in a car in order to get around, thereby creating more pollution and doing less exercise.

Personal choice

Prof Andy Jones, professor of public health at University of East Anglia, says research shows that urban residents do walk more than rural residents – to the shops and to work, for example – “but these don’t translate to health benefits”.

“In urban areas there is lots more going on, but more deprived people don’t have access to the opportunities.”

In the end where you live is a personal choice based on a number of different factors including jobs, financial means, health and lifestyle, says Prof Jones.

“If you’re living in a place where you are isolated and don’t have the finances to support yourself, it doesn’t matter where you live.

“You can be just as isolated in a city centre as in a rural setting.”

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