Meals on Wheels
Encyclopedia
Meals on Wheels are programs that deliver meals to individuals at home who are unable to purchase or prepare their own meals. The name is often used generically to refer to home-delivered meals programs, not all of which are actually named "Meals on Wheels". Because they are housebound, many of the recipients are the elderly, and many of the volunteers are also elderly but able-bodied and able to drive wheeled vehicles, usually a van.

History

Meals on Wheels originated in Great Britain
Great Britain
Great Britain or Britain is an island situated to the northwest of Continental Europe. It is the ninth largest island in the world, and the largest European island, as well as the largest of the British Isles...

 during the Blitz
The Blitz
The Blitz was the sustained strategic bombing of Britain by Nazi Germany between 7 September 1940 and 10 May 1941, during the Second World War. The city of London was bombed by the Luftwaffe for 76 consecutive nights and many towns and cities across the country followed...

, when many people lost their homes and therefore the ability to cook their own food. The Women's Volunteer Service for Civil Defence, (WVS, later WRVS
WRVS
The WRVS is a voluntary organisation concerned with helping people in need throughout England, Scotland and Wales....

), provided food for these people. The name "Meals on Wheels" derived from the WVS's related activity of bringing meals to servicemen. The concept of delivering meals to those unable to prepare their own evolved into the modern programmes that deliver mostly to the housebound elderly for free or with donations.

Great Britain (1947)

The first home delivery of a meal on wheels following World War II
World War II
World War II, or the Second World War , was a global conflict lasting from 1939 to 1945, involving most of the world's nations—including all of the great powers—eventually forming two opposing military alliances: the Allies and the Axis...

 was made by the WVS
WRVS
The WRVS is a voluntary organisation concerned with helping people in need throughout England, Scotland and Wales....

 in Hemel Hempstead
Hemel Hempstead
Hemel Hempstead is a town in Hertfordshire in the East of England, to the north west of London and part of the Greater London Urban Area. The population at the 2001 Census was 81,143 ....

, Hertfordshire
Hertfordshire
Hertfordshire is a ceremonial and non-metropolitan county in the East region of England. The county town is Hertford.The county is one of the Home Counties and lies inland, bordered by Greater London , Buckinghamshire , Bedfordshire , Cambridgeshire and...

, England
England
England is a country that is part of the United Kingdom. It shares land borders with Scotland to the north and Wales to the west; the Irish Sea is to the north west, the Celtic Sea to the south west, with the North Sea to the east and the English Channel to the south separating it from continental...

 in 1947. Many early services used old prams to transport the meals, using straw bales, and even old felt hats, to keep the meals warm in transit.

This type of service requires many volunteers with an adequate knowledge of basic cooking to prepare the meals by a set time each day. The majority of local authorities have now moved away from freshly cooked food delivery, and towards the supply of frozen pre-cooked reheatable meals.

Australia (1952)

In Australia, Meals on Wheels started in 1952 in South Melbourne
South Melbourne, Victoria
South Melbourne is an inner city suburb in Melbourne, Victoria, Australia, 2 km south from Melbourne's central business district. Its Local Government Area are the Cities of Port Phillip and Melbourne...

. The meals were delivered by a lady on a tricycle
Tricycle
A tricycle is a three-wheeled vehicle. While tricycles are often associated with the small three-wheeled vehicles used by pre-school-age children, they are also used by adults for a variety of purposes. In the United States and Canada, adult-sized tricycles are used primarily by older persons for...

. When it became too much for her to cope with, the Red Cross took over.

Doris Taylor founded Meals on Wheels in South Australia
South Australia
South Australia is a state of Australia in the southern central part of the country. It covers some of the most arid parts of the continent; with a total land area of , it is the fourth largest of Australia's six states and two territories.South Australia shares borders with all of the mainland...

 in 1953, and in 1954 the first meal was served from the Port Adelaide
Port Adelaide
Port Adelaide is a suburb of Adelaide lying about 14 kilometres northwest of the City of Adelaide. It lies within the City of Port Adelaide Enfield and is the main port for the city of Adelaide...

 kitchen. The first meals were delivered to eight elderly Port Adelaide residents on 9 August 1954.

In New South Wales
New South Wales
New South Wales is a state of :Australia, located in the east of the country. It is bordered by Queensland, Victoria and South Australia to the north, south and west respectively. To the east, the state is bordered by the Tasman Sea, which forms part of the Pacific Ocean. New South Wales...

, Meals on Wheels was started in March 1957 by the Sydney City Council. In the first week, 150 meals were served for inner city dwellers; these were cooked in the Town Hall kitchen.

Organised on a regional basis, in Australia Meals on Wheels is a well established, active and thriving group of organisations; the interested reader can easily find more information on the web. The history of a small sample of some of the organisations includes: New South Wales, Queensland, South Australia, and Victoria.

United States (1954)

Pennsylvania
The first home-delivered meal program in the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...

 began in Philadelphia, Pennsylvania
Philadelphia, Pennsylvania
Philadelphia is the largest city in the Commonwealth of Pennsylvania and the county seat of Philadelphia County, with which it is coterminous. The city is located in the Northeastern United States along the Delaware and Schuylkill rivers. It is the fifth-most-populous city in the United States,...

, in January 1954. At the request of the Philadelphia Health & Welfare Council, and funded by a grant from the Henrietta Tower Wurtz Foundation, Margaret Toy, a social worker in Philadelphia's Lighthouse Community Center, pioneered a program to provide nourishment that met the dietary needs of homebound seniors and other "shut-ins" in the area who otherwise would have to go hungry. As is the case today, many participants were people who did not require hospitalization, but who simply needed a helping hand in order to maintain their independence. Most of the volunteers were high school students, who were dubbed "Platter Angels." The "Platter Angels" would prepare, package, and deliver food to the elderly and disabled through their community. The daily delivery consisted of one nutritionally balanced hot meal to eat at lunch time, and a dinner consisting of a cold sandwich and milk along with varying side dishes.

Ohio
Columbus, Ohio
Columbus, Ohio
Columbus is the capital of and the largest city in the U.S. state of Ohio. The broader metropolitan area encompasses several counties and is the third largest in Ohio behind those of Cleveland and Cincinnati. Columbus is the third largest city in the American Midwest, and the fifteenth largest city...

, was the second city in the U.S. to establish a community based meals program. Building on the model set forth in Philadelphia, a federation of women's clubs went through the town to inform themselves of possible participants for a meal service. In Columbus, all of the meals were prepared by local restaurants and delivered by taxi cabs during the week. On weekends, high school students filled the posts.

New York
The city of Rochester, New York
Rochester, New York
Rochester is a city in Monroe County, New York, south of Lake Ontario in the United States. Known as The World's Image Centre, it was also once known as The Flour City, and more recently as The Flower City...

, began its home-delivered meal program in 1958. It was originally a pilot project initiated by the New York Department of Health and administered by the Visiting Nurse Service. The Bureau of Chronic Diseases and Geriatrics of the New York Department of Health underwrote the costs.

National
As cities nationwide eventually followed with similar programs, the Meals On Wheels Association of America (MOWAA) was established.

California
Also in the late 1950s, a group of concerned women in San Diego, California
San Diego, California
San Diego is the eighth-largest city in the United States and second-largest city in California. The city is located on the coast of the Pacific Ocean in Southern California, immediately adjacent to the Mexican border. The birthplace of California, San Diego is known for its mild year-round...

 recognized that isolated seniors were in need of regular meals and human contact. So, what was to become Meals-on-Wheels Greater San Diego, Inc. was born in 1960, and has served area seniors for 50 years. When the national association, Meals on Wheels Association of America (MOWAA), sought guidance with the parameters to be used in the evaluation process for locally-run agencies, Meals-on-Wheels Greater San Diego was used as a model to help define the benchmark for successful operations, and "set the standard" for approval. The mission of Meals-on-Wheels Greater San Diego, Inc. is to support the independence and well-being of seniors. A private, not-for-profit corporation, Meals-on-Wheels San Diego strives to keep seniors independent in their own homes by delivering meals to those who are unable to adequately meet their own nutritional needs. Often, the availability of this service enables seniors to avoid seeking institutional alternatives. From modest beginnings, Meals-on-Wheels has grown into one of the largest senior service programs in Southern California. Meals-on-Wheels is currently the only organization in the area home-delivering two meals a day, for seven days a week (including holidays), and providing modified diets to seniors, age 60 and older, throughout San Diego County. In 2009, agency-wide, 82 staff members supported over 2,200 volunteers who donated their time to home-deliver 450,000 meals to approximately 2,000 seniors throughout San Diego County. Debbie Case is the CEO and President of Meals-on-Wheels Greater San Diego.

Another California Meals On Wheels program is Meals On Wheels West (MOWW), which has been delivering services to home-bound individuals in their homes since April of 1974. The agency has since grown from an organization that served 8 clients in one city to one that provides meals and companionship to 396 individuals in 6 of Los Angeles County’s coastal communities by 2010. In 2010 alone, over 3,000 volunteers delivered more than 86,000 meals. Begun as a program of the Westside Ecumenical Conference, MOWW attained its own non-profit status in 1994. The CEO since 1987, RoseMary Regalbuto’s, first challenge upon arrival at MOWW was to eliminate the waiting list by increasing the number of routes and clients served. Since then, no eligible clients have been made to wait for services. When Mrs. Regalbuto took the helm, MOWW was only serving Santa Monica. Due to her leadership, the agency now serves Santa Monica, Topanga, Pacific Palisades, Malibu, and parts of Marina Del Rey. In 2010, 93% of MOWW clients stated that MOWW was a major factor in their ability to remain in their own homes. 88% of clients reported that the daily contact with Meals On Wheels West volunteers was important to them, and 50% stated the volunteers were the only visitors during the day. 70% of volunteers stay with the organization for more than 5 years, which allows for significant lasting connections with clients.

Canada (1965)

Calgary
Calgary
Calgary is a city in the Province of Alberta, Canada. It is located in the south of the province, in an area of foothills and prairie, approximately east of the front ranges of the Canadian Rockies...

: Meals on Wheels was formed in response to a plea from the Hospital Chaplaincy Committee of the Calgary Presbytery of the United Church. In 1965, a study was undertaken by the Presbyterian United Church Women into the needs of the elderly living alone and those being discharged from hospitals with no help available during their convalescence. On November 30, 1965 the Calgary Church Women's Community Care was incorporated and in 1976 the name was officially changed to "Calgary Meals on Wheels". In addition to the United Church, the Anglican, Baptist, Catholic and Presbyterian Churches supported the movement while interested volunteers and service clubs answered the call for help and proved to be the backbone of the fledgling organization. The United Way
United Way of Canada
United Way of Canada is the national organization for the 117 autonomous, volunteer-based United Ways across Canada. United Way campaigns raise money for local groups that address community issues and problems, and the national organization provides leadership, services and coordination to the...

 and the City of Calgary have also played a vital role in the success of this community service. On November 15, 1965 the first meal service started serving eight clients. By 1982 the number of clients had increased to in excess of 380 per day, requiring a move to a larger centre. In 2005, Calgary Meals on Wheels celebrated its 40th Anniversary, (having never missed a meal delivery in its 40 year history), and delivered to some 1900 clients, plus services to several unique programmes. The organization is governed by a Board of Directors, all of whom are volunteers. A pool of some 750 volunteers donate just under 75,000 hours of time a year to deliver meals five days a week within Calgary city limits.

Halifax: Meals on Wheels began in Nova Scotia
Nova Scotia
Nova Scotia is one of Canada's three Maritime provinces and is the most populous province in Atlantic Canada. The name of the province is Latin for "New Scotland," but "Nova Scotia" is the recognized, English-language name of the province. The provincial capital is Halifax. Nova Scotia is the...

 in 1969, with three volunteers delivering six meals in Halifax.

Vancouver
Vancouver
Vancouver is a coastal seaport city on the mainland of British Columbia, Canada. It is the hub of Greater Vancouver, which, with over 2.3 million residents, is the third most populous metropolitan area in the country,...

: Since 1967, the Health and Home Care Society of BC has operated the Meals on Wheels program in Vancouver and Richmond
Richmond, British Columbia
Richmond is a coastal city, incorporated in the Canadian province of British Columbia. Part of Metro Vancouver, its neighbouring communities are Vancouver and Burnaby to the north, New Westminster to the east, and Delta to the south, while the Strait of Georgia forms its western border...

.

Winnipeg
Winnipeg
Winnipeg is the capital and largest city of Manitoba, Canada, and is the primary municipality of the Winnipeg Capital Region, with more than half of Manitoba's population. It is located near the longitudinal centre of North America, at the confluence of the Red and Assiniboine Rivers .The name...

: Meals on Wheels was originally created as a side project of The Home Welfare Association. A 1961 study recommended the establishment of a Meals on Wheels delivery service for people who were unable to prepare meals for themselves, such as the elderly and infirm. A three year pilot project was started and they delivered the first meals on June 30, 1965. In 1981 the Home Welfare Association chapter was officially closed when the name was changed to Meals on Wheels of Winnipeg, Inc.

Edmonton
Edmonton
Edmonton is the capital of the Canadian province of Alberta and is the province's second-largest city. Edmonton is located on the North Saskatchewan River and is the centre of the Edmonton Capital Region, which is surrounded by the central region of the province.The city and its census...

: The first meals were delivered on April 21, 1969 for a fee of $0.65 each. There was one route on the south side with a total of three meals. Today, over 140,000 meals are prepared for clients each year. Edmonton Meals on Wheels not only prepares hot and frozen meals, but also provides grocery delivery, nutrition workshops and lunch time catering.
http://www.mealsonwheelsedmonton.org

Modern programs

Today, Meals on Wheels programs generally operate at the county level or smaller. Programs vary widely in their size, service provided, organisation and funding.

There are active Meals on Wheels programs in Australia
Australia
Australia , officially the Commonwealth of Australia, is a country in the Southern Hemisphere comprising the mainland of the Australian continent, the island of Tasmania, and numerous smaller islands in the Indian and Pacific Oceans. It is the world's sixth-largest country by total area...

, Canada
Canada
Canada is a North American country consisting of ten provinces and three territories. Located in the northern part of the continent, it extends from the Atlantic Ocean in the east to the Pacific Ocean in the west, and northward into the Arctic Ocean...

, the United Kingdom
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...

 and the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...

. The National Association of Care Catering are a great source of information on UK Meals on Wheels services. The Meals On Wheels Association of America (MOWAA) is a national association for senior nutrition programs headquartered in Alexandria, Virginia, but each program operates independently.

Most Meals on Wheels programs deliver meals hot and ready-to-eat, but some deliver cold meals in containers ready to microwave. Others supply deep-frozen meals. Some warm-meal programs provide an additional frozen meal during the days prior to a weekend or holiday (when there would be no delivery). Depending on the program, meals may be delivered by paid drivers or by volunteers. In addition to providing nutrition to sustain the health of a client, a meal delivery by a Meals on Wheels driver or volunteer also serves as a safety check and a source of companionship for the client.

Most clients of Meals on Wheels programs are elderly, but others who are unable to shop or cook for themselves (as well as their pets) are generally eligible for assistance. In the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...

, programs receiving federal funding may not serve people less than 60 years old. US Federally funded programs may only request voluntary contributions from clients, while other programs often charge a moderate fee for service. Regardless of their sources of funding, eligibility for most programs is determined solely by medical need, with financial need and actual ability to pay not making a difference either way.

United Kingdom

In the county of Suffolk, the program is referred to as "Community Meals". "Meals on Wheels" services are provided for those who have been assessed to have difficulty cooking for themselves. Community Meals services can comprise daily hot meals, chilled meals or a weekly or fortnightly delivery of frozen meals. Traditional hot deliveries are cooked in a central kitchen then transported to the service user.

Support to the elderly is also provided by WRVS
WRVS
The WRVS is a voluntary organisation concerned with helping people in need throughout England, Scotland and Wales....

 (formerly named Women’s Royal Voluntary Service).

National Association of Care Catering Community Meals Week is a national event aiming to increase visibility of Community Meals Services. In October 2008, Camilla, The Duchess of Cornwall
Camilla, The Duchess of Cornwall
Camilla, Duchess of Cornwall is the second wife of Charles, Prince of Wales, and is the current holder of the titles of Princess of Wales, Duchess of Cornwall, Duchess of Rothesay and Countess of Chester...

 assisted in Meals on Wheels Week activities.

Increasingly in the UK, commercial (rather than voluntary or government) organisations are being incorporated into the provision of meals. For example, some Local Authorities have stopped providing hot meals, and are instead delivering frozen pre-cooked meals. Other variations include using Apetito
Apetito
apetito is a European frozen food company which started in post-war Germany. They currently serve markets in Germany, the Netherlands, the United Kingdom, Canada and France and employ over 6,000 people...

, who operate a "Chefmobil" service which regenerates meals en route, Apetito subsidiary Wiltshire Farm Foods
Wiltshire Farm Foods
Wiltshire Farm Foods is a frozen meals delivery company that specialises in delivering frozen ready meals to customers' homes throughout the United Kingdom. The majority of the business is operated on a local or regional basis by some sixty franchisees. Uniformed drivers in liveried refrigerated...

, which operates a Meals on Wheels alternative service for those who do not meet assessment criteria, and Oakhouse Foods
Oakhouse Foods
Oakhouse Foods is a home meals service founded in 1994 that delivers frozen meals and desserts throughout the UK.-Company information:A home meals service delivering frozen meals and desserts throughout the UK and offering a diverse menu with over 300 dishes...

, who offer a similar service.

Canada

Halifax Meals on Wheels in Nova Scotia currently operate 68 programmes across the province; more than 600 volunteers serve an estimated 3400 meals a week. In Halifax, the service is partially funded by the municipality. The United Way also provides funding, depending on how much the programmes need. Organizations such as nursing homes and hospitals provide many of the meals; others come from restaurants and private homes. The programme isn't just for the elderly; people of any age who live alone often call when they're recovering after a recent hospital stay and are unable to cook for themselves. Other users of Meals on Wheels are people with disabilities such as multiple sclerosis who use the programme to help them through a rough time when cooking becomes too difficult. In 1996, 56.7% of clients in Halifax used the service for less than three months.

There are dozens of independent meals on wheels in Montreal
Montreal
Montreal is a city in Canada. It is the largest city in the province of Quebec, the second-largest city in Canada and the seventh largest in North America...

, one of the largest and most innovative is the unique intergenerational Santropol Roulant
Santropol Roulant
Santropol Roulant is an award-winning community organization based in the Plateau neighbourhood of Montreal, Quebec, Canada. The organization uses food as a vehicle to break isolation and build bridges between individuals and generations. Unlike most meals on wheels organizations, Santropol...

, an organization operated mainly by young volunteers in central Montreal neighbourhoods. Deliveries are done on foot, by bicycle and by hybrid car in some outlying routes.

A Vancouver
Vancouver
Vancouver is a coastal seaport city on the mainland of British Columbia, Canada. It is the hub of Greater Vancouver, which, with over 2.3 million residents, is the third most populous metropolitan area in the country,...

 organization that specializes in providing meals on wheels service to people living with HIV/AIDS is A Loving Spoonful
A Loving Spoonful
A Loving Spoonful is a Vancouver, British Columbia-based charitable organization that provides free meals to people living with HIV/AIDS in the Metro Vancouver area....

.

United States

The Meals on Wheels Association of America (MOWAA) is headquartered in Alexandria, Virginia
Alexandria, Virginia
Alexandria is an independent city in the Commonwealth of Virginia. As of 2009, the city had a total population of 139,966. Located along the Western bank of the Potomac River, Alexandria is approximately six miles south of downtown Washington, D.C.Like the rest of northern Virginia, as well as...

 and headed by President and CEO Enid Borden
Enid Borden
Enid Borden is the President and CEO of the Meals On Wheels Association of America , headquartered in Alexandria, Virginia. She is also a member of the board of the MOWAA Foundation....

. MOWAA is the oldest and largest organization in the United States representing those who provide meal services to seniors in need, specifically those at risk of or experiencing hunger. MOWAA is a non-profit organization
Non-profit organization
Nonprofit organization is neither a legal nor technical definition but generally refers to an organization that uses surplus revenues to achieve its goals, rather than distributing them as profit or dividends...

 working toward the social, physical, nutritional, and economic betterment of vulnerable Americans by providing the tools and information its programs need to make a difference in the lives of others.

Citymeals-on-Wheels
Citymeals-on-Wheels
Citymeals-on-Wheels is Meals on Wheels-type nonprofit organization in New York City that raises private funds to ensure no homebound elderly New Yorker goes without food or human company.- History :...

 serves the New York City area. In 2008, Citymeals delivered over 2.1 million nutritious meals to 17,713 frail aged in every borough of New York City. In addition, over 1,500 volunteers collectively spent 62,000 hours visiting and delivering meals to New York’s frail aged. Gael Greene and James Beard founded Citymeals-on-Wheels in 1981 after reading a newspaper article about homebound elderly New Yorkers with nothing to eat on weekends and holidays. They rallied their friends in the restaurant community, raising private funds as a supplement to the government-funded weekday meal delivery program. Twenty five years ago their first efforts brought a Christmas meal to 6,000 frail aged.

In 2007, the MOWAA Foundation commissioned a study on hunger (see next section). In 2009, MOWAA partnered with The Mission Continues, an organization which addresses the needs of veteran
Veteran
A veteran is a person who has had long service or experience in a particular occupation or field; " A veteran of ..."...

s who have served the United States.

Specialty Meals on Wheels programs, such as "Kosher Meals on Wheels", also exist to service niche clientele.

MOWAAF study on hunger

The Meals On Wheels Association of America Foundation (MOWAAF), recognizing that hunger
Hunger
Hunger is the most commonly used term to describe the social condition of people who frequently experience the physical sensation of desiring food.-Malnutrition, famine, starvation:...

 is a serious threat facing millions of seniors in the United States, determined that understanding of the problem is a critical first step to developing remedies. In 2007, MOWAAF, underwritten by the Harrah's Foundation, commissioned a research study entitled The Causes, Consequences and Future of Senior Hunger in America. The report was released at a hearing of the U.S. Senate Special Committee on Aging in March 2008 in Washington, D.C.
Washington, D.C.
Washington, D.C., formally the District of Columbia and commonly referred to as Washington, "the District", or simply D.C., is the capital of the United States. On July 16, 1790, the United States Congress approved the creation of a permanent national capital as permitted by the U.S. Constitution....



The study found that in the United States, over 5 million seniors, (11.4% of all seniors), experience some form of food insecurity (i.e., were marginally food insecure). Of these, about 2.5 million are at-risk of hunger, and about 750,000 suffer from hunger due to financial constraints. Some groups of seniors are more likely to be at-risk of hunger. Relative to their representation in the overall senior population, those with limited incomes, under age 70, African-Americans, Hispanics, never-married individuals, renters, and persons living in the Southern United States
Southern United States
The Southern United States—commonly referred to as the American South, Dixie, or simply the South—constitutes a large distinctive area in the southeastern and south-central United States...

 are all more likely to be at-risk of hunger. While certain groups of seniors are at greater-risk of hunger, hunger cuts across the income spectrum. For example, over 50% of all seniors who are at-risk of hunger have incomes above the poverty threshold
Poverty threshold
The poverty threshold, or poverty line, is the minimum level of income deemed necessary to achieve an adequate standard of living in a given country...

. Likewise, it is present in all demographic groups. For example, over two-thirds of seniors at-risk of hunger are caucasian
Caucasian race
The term Caucasian race has been used to denote the general physical type of some or all of the populations of Europe, North Africa, the Horn of Africa, Western Asia , Central Asia and South Asia...

. There are marked differences in the risk of hunger across family structure, especially for those seniors living alone, or those living with a grandchild. Those living alone are twice as likely to experience hunger compared to married seniors. One in five senior households with a grandchild (but no adult child) present is at-risk of hunger, compared to about one in twenty households without a grandchild present. Seniors living in non-metropolitan area
Metropolitan area
The term metropolitan area refers to a region consisting of a densely populated urban core and its less-populated surrounding territories, sharing industry, infrastructure, and housing. A metropolitan area usually encompasses multiple jurisdictions and municipalities: neighborhoods, townships,...

s are as likely to experience food insecurity as those living in metropolitan areas, suggesting that food insecurity cuts across the urban
Urban area
An urban area is characterized by higher population density and vast human features in comparison to areas surrounding it. Urban areas may be cities, towns or conurbations, but the term is not commonly extended to rural settlements such as villages and hamlets.Urban areas are created and further...

-rural
Rural
Rural areas or the country or countryside are areas that are not urbanized, though when large areas are described, country towns and smaller cities will be included. They have a low population density, and typically much of the land is devoted to agriculture...

continuum.
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