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conditions that can contribute to poor health outcomes. Ultimately, the “urban health advantage” masks disparities between poorer and wealthier urban areas. 425 571. In most countries health workers are already disproportionately concentrated in urban areas, 426 although not necessarily serving the urban poor. 427 To avoid neglect of rural areas, innovations are needed to ensure that urban investments also benefit rural areas, for instance through health worker rotations, new uses of mobile technologies and other rural-urban health system linkages. 428 These innovations also need to move outside the traditional boundaries of the health system, to develop transport, resource and financial linkages between rural and urban areas that facilitate connections and reduce inequality across the spatial divide. A major challenge for the coming decades is the creation and evaluation of such innovative health system structures, responding to urban growth in a way that also encourages investments in rural care. 572. States should promote development that will foster and facilitate linkages between urban and rural areas, in recognition of their economic, social and environmental interdependence, including the development and equitable distribution of satellite and nodal centres of excellence in health, education, __________________ 425
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