| Abstract: | Although often forgotten among people in affluent nations, malaria represents a leading global health concern in poor, rural countries. Malaria is traditionally thought of as a rural disease, given the close proximity of rural households to mosquito disease vectors. However, more insight is needed to investigate the larger social, economic, and environmental conditions that perhaps interact with rurality to explain why some nations continue to have high levels of prevalence of this preventable and eradicable parasitic infection. We employ structural equation modeling to efficiently test for both direct and indirect effects of rurality. The results demonstrate that rurality works in important indirect ways; although rurality has indirect links to malaria through export agriculture, health spending, and sociohealth resources, careful decomposition of the indirect effects illustrates that the indirect effects through heath spending and sociohealth resources are most important. Overall, the findings suggest that rural vulnerabilities to malaria are not inherent and can be largely addressed by increasing public health provisions among rural populations. |
