scholarly journals Area Deprivation Share: A New Measure of Social Need Faced by Hospitals Serving Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 918-918
Author(s):  
Kellia Hansmann ◽  
Amy Kind ◽  
Ryan Powell
Keyword(s):  
Older Adults ◽  
Rural Areas ◽  
Hospital Readmissions ◽  
Small Towns ◽  
Social Needs ◽  
Area Deprivation ◽  
Care Processes ◽  
Black Patients ◽  
The Social ◽  
Medicare Policy

Abstract Medicare’s Hospital Readmissions Reduction Program (HRRP) places disproportionate penalties on hospitals serving populations with complex medical and social needs. Without measures to identify the social need intensity of populations cared for by these hospitals, the HRRP cannot account for these risk factors, leading to burdensome penalties that may inadvertently hinder the ability of such hospitals to care for vulnerable populations. The objective of this study is to characterize the social need intensity of US hospital acute care populations. Using the Area Deprivation Index (ADI), a validated measure that ranks neighborhood socioeconomic disadvantage based on income, employment, housing, and education factors, we determined an “Area Deprivation Share” (ADS) for hospitals with 25 or more discharges using 100% of national Medicare claims data from 2013-2014. Hospital ADS is the proportion of qualifying discharges residing in the most disadvantaged neighborhoods (ADI ≥ 80th percentile) out of all qualifying discharges during the study period. Of 4,603 hospitals, median ADS was 17% (Interquartile Range: 6% - 34%). Hospitals in the highest quintile of ADS (39% to 100%), were more frequently located in small towns or isolated rural areas (52.6%, comparted to 24.2% in lower quintiles) and served a higher percentage of Black patients (19.0%, comparted to 9.7% in lower quintiles). ADS is a potential tool to inform future Medicare policy decisions. Additional research will inform how hospitals target care processes to meet the needs of older adults with complex social needs. Further study can also explore overlapping disadvantage domains of socioeconomic status, race, and rurality.

scholarly journals Meeting the Social Needs of Older Adults in Rural Areas

2020 ◽  
Vol 1 (11) ◽  
pp. e201411
Author(s):  
Carrie Henning-Smith
Keyword(s):  
Older Adults ◽  
Rural Areas ◽  
Social Needs ◽  
The Social

scholarly journals Homeless on Main Street: Using Photovoice to Highlight Older Adults Among the Hidden Homeless

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 728-728
Author(s):  
H Shellae Versey
Keyword(s):  
Older Adults ◽  
Rural Areas ◽  
Meaning Making ◽  
Small Towns ◽  
Photo Elicitation ◽  
Service Agency ◽  
Structured Interviews ◽  
Community Based Interventions ◽  
Community Based ◽  
Formerly Homeless

Abstract Homelessness is a reality for a growing number of Americans living in small towns and rural areas. However, unlike in cities, housing instability may be less visible. Using a photo-elicitation method (i.e., Photovoice), this study explores the meaning of place and obscured visibility to currently and formerly homeless older adults living in a small town in central Connecticut. Participants (N = 27) were recruited from a local service agency, given cameras and asked to photograph areas around town that were meaningful to them. Photographs were developed and followed by in-person, semi-structured interviews with participants in which photos and experiences during the project were discussed. Primary themes included belonging, generativity, social isolation, and place-making as meaning-making. The study culminated in a community photography exhibition in which photographs from the project were displayed in public spaces around town. Implications for community-based interventions to reach homeless groups in rural areas are discussed. Part of a symposium sponsored by the Qualitative Research Interest Group.

scholarly journals Economic component in the field of livestock as a factor of formation of sustainable development in the context of rural areas

2020 ◽  
pp. 91-99
Author(s):  
V. Moskalenko ◽  
V.P. Kolosha
Keyword(s):  
Sustainable Development ◽  
Rural Areas ◽  
Social Situation ◽  
Developed Countries ◽  
Environmental Problems ◽  
Social Needs ◽  
Livestock Sector ◽  
The Social ◽  
Definition Of ◽  
Constituent Elements

The article deals with the problems of the influence of the livestock sector on the formation of sustainable development of rural areas. It is emphasized that currently global problems have formed in the world, namely: differentiation in living standards between developed countries and ‘third world’ countries, significant differentiation of income levels among most countries, environmental pollution, limited and reduced easily accessible natural resources, degradation of agricultural lands. Today, the principles of sustainable development are recognized as strategic directions for the development of the sector by the world’s leading countries. In the process of research, dialectical methods of cognition of processes and phenomena, monographic method (analysis of views on the concept of sustainable development), abstract-logical (theoretical generalizations and formulation of conclusions) were used. The article addresses the problems of the influence of the livestock sector on the formation of sustainable development of rural areas. A brief overview of approaches and principles for the interpretation of the concept of ‘sustainable development’ was conducted. It is noted that the current situation in rural areas is critical in terms of, first of all, social and environmental problems. The livestock sector should become one of the elements of their solution. It is noted that its development allows not only to diversify production, but also to improve the social situation and solve certain environmental problems. The authors give their own definition of rural development as a development that provides an increase in the level and quality of life of rural residents with the provision of their social needs and the ability to pass on the natural biodiversity of the respective areas to future generations. It is emphasized that this definition combines economic, social and environmental development.The key principles of the state policy in development of rural territories on the principles of susta­inable development with allocation of its constituent elements are formulated. Measures for sustainable development of rural areas through the support of the livestock sector as one of the components of agricultural production are proposed. It is noted that intensive production is possible today, provided that the optimal ratio of the structure of land use and the presence of the livestock sector in the structure of production is maintained.

scholarly journals REPRESENTATION OF THE FINANCIAL NEEDS OF RURAL MALAGASY HOUSEHOLDS

2021 ◽  
Vol 9 (11) ◽  
pp. 23-29
Author(s):  
L. S. Razafindrakoto ◽  
S. Ramananarivo ◽  
H. L. Rakotonirainy ◽  
H. F. Ranaivoarisoa ◽  
A.M. S. Rabotovao ◽  
...  
Keyword(s):  
Rural Development ◽  
Rural Areas ◽  
Financial Services ◽  
Rural Households ◽  
Financial Innovation ◽  
Social Needs ◽  
Financing System ◽  
Traditional Practice ◽  
Schwartz Formula ◽  
The Social

Madagascar is committed to implementing local financial services to facilitate rural households' access to these various services and promote rural development. The objective of the study is to understand the realities of the financing system in rural areas and more particularly in the rural commune of Alakamisy Itenina in vohibato district, and this, through the experience of rural households that determine the different financial needs and their financial priority. Using the Schwartz formula, surveys of 81 households were statistically treated. The results show that rural households prioritize social needs by meeting the social obligations dictated by fihavanana. The first place of the social obligations is perceived through the attachment to the traditional practice by the proverb “atero k'alao” which means "one receives by giving". This is how behavioural logic has been observed in localities far from financial services. Changing this behavioral logic turns out to be the best option. Rural households should accept new forms of financial innovation.

scholarly journals Social participation needs of older adults living in a rural regional county municipality: Toward reducing situations of isolation and vulnerability

2020 ◽  
Author(s):  
Melanie Levasseur ◽  
Sonia Routhier ◽  
Irma Clapperton ◽  
Chantal Doré ◽  
Frances Gallagher
Keyword(s):  
Older Adults ◽  
Action Research ◽  
Social Participation ◽  
Rural Areas ◽  
Community Organization ◽  
Health Condition ◽  
Support Network ◽  
Personal Factors ◽  
Convenience Sample ◽  
The Social

Abstract Background: Social participation is restricted for approximately half the older adult population but is critical in fostering community vitality, promoting health, and preventing disabilities. Although targeted through interventions by community organizations, healthcare professionals and municipalities, little is known about the needs of older adults to participate socially, especially in rural areas. This study thus aimed to identify and prioritize the social participation needs of older adults living in a rural regional county municipality.Methods: A participatory action research was conducted in a rural regional county municipality (RCM) in Quebec, Canada, with a convenience sample of 139 stakeholders, including older adults, caregivers, healthcare and community organization managers, healthcare and community organization workers, community partners and key informants.Results: Facilitators and barriers to social participation are related to personal factors (e.g., health, interests, motivation), the social environment (e.g., availability of assistance or volunteers) and the physical environment (e.g., distance to resources, recreational facilities and social partners). Nine older adults’ needs emerged and were prioritized as follows: 1) having access to and being informed about transportation options, 2) being informed about available activities and services, 3) having access to activities, including volunteering opportunities, suited to their interests, schedule, cost, language and health condition, 4) being accompanied to activities, 5) having access to meeting places near home and adapted to their health condition, and 6-9 (no preferred order) being reached when isolated, being personally invited and welcomed to activities, having a social support network, and being valued and recognized. Differences emerged when prioritizing needs of older adults with disabilities (greater need for assistance, accessibility and adapted activities) and older adults living in a rural area (greater need for transportation).Conclusions: To promote active participation in the community, the social participation needs of older women and men living in rural areas must be addressed, especially in regard to transportation, information, adapted activities, assistance and accessibility. The first part of this action research will be followed by community selection and implementation of initiatives designed to ultimately foster their social participation.

scholarly journals Frailty among Older Adults and Its Distribution in England

2021 ◽  
pp. 1-6
Author(s):  
D.R. Sinclair ◽  
A. Maharani ◽  
T. Chandola ◽  
P. Bower ◽  
B. Hanratty ◽  
...  
Keyword(s):  
Older Adults ◽  
Rural Areas ◽  
Coastal Areas ◽  
Service Planning ◽  
Healthy Ageing ◽  
Population Projections ◽  
Background Information ◽  
Area Deprivation ◽  
Health And Social Care ◽  
Using Data

Background: Information on the spatial distribution of the frail population is crucial to inform service planning in health and social care. Objectives: To estimate small-area frailty prevalence among older adults using survey data. To assess whether prevalence differs between urban, rural, coastal and inland areas of England. Design: Using data from the English Longitudinal Study of Ageing (ELSA), ordinal logistic regression was used to predict the probability of frailty, according to age, sex and area deprivation. Probabilities were applied to demographic and economic information in 2020 population projections to estimate the district-level prevalence of frailty. Results: The prevalence of frailty in adults aged 50+ (2020) in England was estimated to be 8.1 [95% CI 7.3-8.8]%. We found substantial geographic variation, with the prevalence of frailty varying by a factor of 4.0 [3.5-4.4] between the most and least frail areas. A higher prevalence of frailty was found for urban than rural areas, and coastal than inland areas. There are widespread geographic inequalities in healthy ageing in England, with older people in urban and coastal areas disproportionately frail relative to those in rural and inland areas. Conclusions: Interventions aimed at reducing inequalities in healthy ageing should be targeted at urban and coastal areas, where the greatest benefit may be achieved.

scholarly journals Social participation needs of older adults living in a rural regional county municipality: toward reducing situations of isolation and vulnerability

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Mélanie Levasseur ◽  
Sonia Routhier ◽  
Irma Clapperton ◽  
Chantal Doré ◽  
Frances Gallagher
Keyword(s):  
Older Adults ◽  
Action Research ◽  
Social Participation ◽  
Rural Areas ◽  
Community Organization ◽  
Health Condition ◽  
Support Network ◽  
Personal Factors ◽  
Convenience Sample ◽  
The Social

Abstract Background Social participation is restricted for approximately half the older adult population but is critical in fostering community vitality, promoting health, and preventing disabilities. Although targeted through interventions by community organizations, healthcare professionals and municipalities, little is known about the needs of older adults to participate socially, especially in rural areas. This study thus aimed to identify and prioritize the social participation needs of older adults living in a rural regional county municipality. Methods A participatory action research was conducted in a rural regional county municipality (RCM) in Quebec, Canada, with a convenience sample of 139 stakeholders, including older adults, caregivers, healthcare and community organization managers, healthcare and community organization workers, community partners and key informants. Results Facilitators and barriers to social participation are related to personal factors (e.g., health, interests, motivation), the social environment (e.g., availability of assistance or volunteers) and the physical environment (e.g., distance to resources, recreational facilities and social partners). Nine older adults’ needs emerged and were prioritized as follows: 1) having access to and being informed about transportation options, 2) being informed about available activities and services, 3) having access to activities, including volunteering opportunities, suited to their interests, schedule, cost, language and health condition, 4) being accompanied to activities, 5) having access to meeting places near home and adapted to their health condition, and 6–9 (no preferred order) being reached when isolated, being personally invited and welcomed to activities, having a social support network, and being valued and recognized. Differences emerged when prioritizing needs of older adults with disabilities (greater need for assistance, accessibility and adapted activities) and older adults living in a rural area (greater need for transportation). Conclusions To promote active participation in the community, the social participation needs of older women and men living in rural areas must be addressed, especially in regard to transportation, information, adapted activities, assistance and accessibility. The first part of this action research will be followed by community selection and implementation of initiatives designed to ultimately foster their social participation.

Experiences of social frailty among rural community-dwelling and assisted-living older adults: a qualitative study

2021 ◽  
pp. 1-21
Author(s):  
Steven Bunt ◽  
Nardi Steverink ◽  
Linden Douma ◽  
Cees van der Schans ◽  
Hans Hobbelen ◽  
...  
Keyword(s):  
Older Adults ◽  
Rural Community ◽  
Assisted Living ◽  
Theoretical Perspective ◽  
Social Resources ◽  
Community Dwelling ◽  
Social Needs ◽  
Ageing In Place ◽  
Rural Villages ◽  
The Social

Abstract Although social frailty has been described from a theoretical perspective, the lived experiences of older adults regarding social frailty are yet unknown. In this paper, we aim to (a) gain more in-depth insights into community-dwelling and assisted-living older adults’ experiences of social frailty and (b) explore the differences in these experiences between these two groups. We conduct a thematic analysis of 38 interviews with community-dwelling and assisted-living older adults in rural villages the Netherlands. We structure our findings along three overarching themes which highlight different aspects of the social frailty experiences of our participants: (a) present resources and activities to fulfil social needs, (b) resources and activities that have been lost, and (c) how they manage and adapt to changes in resources and activities over time. Loneliness is only reported among the community-dwelling participants, while the loss of mobility and participation in (social) activities is experienced most strongly by the assisted-living participants. These findings challenge the widespread policies and practices of ageing in place. We conclude that for some older adults, living in assisted arrangements is preferred over ageing in place, as doing so can prevent social frailty. The key reason for this is that life in assisted living is likely to bring about new social resources and activities, which may serve to fulfil the social needs of older adults.

scholarly journals Social participation needs of older adults living in a rural regional county municipality: Toward reducing situations of isolation and vulnerability

2020 ◽  
Author(s):  
Melanie Levasseur ◽  
Sonia Routhier ◽  
Irma Clapperton ◽  
Chantal Doré ◽  
Frances Gallagher
Keyword(s):  
Older Adults ◽  
Action Research ◽  
Social Participation ◽  
Rural Areas ◽  
Community Organization ◽  
Health Condition ◽  
Support Network ◽  
Personal Factors ◽  
Convenience Sample ◽  
The Social

Abstract Background: Social participation is restricted for approximately half the older adult population but is critical in fostering community vitality, promoting health, and preventing disabilities. Although targeted through interventions by community organizations, healthcare professionals and municipalities, little is known about the needs of older adults to participate socially, especially in rural areas. This study thus aimed to identify and prioritize the social participation needs of older adults living in a rural regional county municipality. Methods: A participatory action research was conducted in a rural regional county municipality (RCM) in Quebec, Canada, with a convenience sample of 139 stakeholders, including older adults, caregivers, healthcare and community organization managers, healthcare and community organization workers, community partners and key informants. Results: Facilitators and barriers to social participation are related to personal factors (e.g., health, interests, motivation), the social environment (e.g., availability of assistance or volunteers) and the physical environment (e.g., distance to resources, recreational facilities and social partners). Nine older adults’ needs emerged and were prioritized as follows: 1) having access to and being informed about transportation options, 2) being informed about available activities and services, 3) having access to activities, including volunteering opportunities, suited to their interests, schedule, cost, language and health condition, 4) being accompanied to activities, 5) having access to meeting places near home and adapted to their health condition, and 6-9 (no preferred order) being reached when isolated, being personally invited and welcomed to activities, having a social support network, and being valued and recognized. Differences emerged when prioritizing needs of older adults with disabilities (greater need for assistance, accessibility and adapted activities) and older adults living in a rural area (greater need for transportation).Conclusions: To promote active participation in the community, the social participation needs of older women and men living in rural areas must be addressed, especially in regard to transportation, information, adapted activities, assistance and accessibility. The first part of this action research will be followed by community selection and implementation of initiatives designed to ultimately foster their social participation.

When your world gets smaller: how older people try to meet their social needs, including the role of social technology

2018 ◽  
Vol 39 (8) ◽  
pp. 1826-1852 ◽  
Author(s):  
TINA TEN BRUGGENCATE ◽  
KATRIEN G. LUIJKX ◽  
JANIENKE STURM
Keyword(s):  
Older Adults ◽  
Social Network ◽  
Older People ◽  
Health Problems ◽  
Community Dwelling ◽  
Social Needs ◽  
Social Technology ◽  
The Social ◽  
The World

ABSTRACTSocial needs are important basic human needs. When social needs are not fulfilled, it can lead to mental and physical health problems. In an ageing society, meeting the social needs of older adults is important to sustain their wellbeing and quality of life. Social technology is used by younger people attempting to fulfil social needs. The aim of this study is to understand the social needs of older people and the role of social technology in fulfilling these needs. Using this information we will uncover opportunities for (technological) interventions. We conducted a qualitative explorative field study by interviewing 19 community-dwelling older adults. The participants were selected by professional care-givers with the help of a list of criteria for people at risk of social isolation or loneliness. Semi-structured interviews were held, using a topic list covering the following topics: social networks, social support, connectedness, neighbourhood, activities and hobbies, as well as use of and experiences with social technology. After thematic analysis, inductive codes were attached to quotations relevant to the research question. The results were described in four sections: (a) social needs and relationships; (b) the influence of life history and personality; (c) possibilities and barriers to meet social needs; and (d) use of and attitude towards social technology. The results indicate that the group of participants is heterogeneous and that their social needs and the way they try to meet these are diverse. The Social Production Functions Theory of Successful Aging (SPF-SA) was found to be a useful basis for interpreting and presenting the data. Social needs such as connectedness, autonomy, affection, behavioural confirmation and status are important for the wellbeing of older people. Although the need for affection is most easy to fulfil for older people, it looks like satisfaction of the need for behavioural confirmation and status are in some cases preferred, especially by the male participants. Resources such as relationships, activities, personal circumstances and social technology can help meet social needs. Where there is a lack of (physical) resources such as health problems, reduced mobility, death of network members, fear of rejection and gossip, and poor financial circumstances, meeting social needs can be more difficult for some older people. Social technology now plays a modest role in the lives of older people and in fulfilling their social needs. Because of its potential and its role in the lives of younger people, social technology can be seen as a promising resource in the satisfaction of social needs. However, since it is yet unknown how and to what extent the use of social network technologies, such as Facebook, can be beneficial for older people, more research in this area is needed. Based on our findings, we conclude that the world of older individuals is getting smaller. The loss of resources,e.g.the loss of one's health and mobility, may make it more difficult for an older person to connect with the world outside, which may result in a smaller social network. We therefore suggest that interventions to support older adults to meet their social needs may focus on two aspects: supporting and improving the world close by and bringing the world outside a little bit closer.

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