Environmental Characteristics Associated with Older Adults’ Social Participation: The Contribution of Sociodemography and Transportation in Metropolitan, Urban, and Rural Areas

Although social participation fosters older adults’ health, little is known about which environmental characteristics are related to greater participation in social activities. The Canadian Community Health Survey (n = 2737), a transportation survey, and multiple secondary data sources were used to identify the environmental characteristics associated with older Quebecers’ social participation according to living area. Greater social participation was associated with: (1) a higher concentration of older adults (IRR = 2.172 (95% CI 1.600, 2.948); p < 0.001), more kilometers traveled by paratransit (IRR = 1.714 (95% CI 1.286, 2.285); p < 0.01), a lack of medical clinics (IRR = 0.730 (95% CI 0.574, 0.930); p = 0.01), and more funded home adaptations (IRR = 1.170 (95% CI 1.036, 1.320); p = 0.01) in large metropolitan areas; (2) larger paratransit fleets (IRR = 1.368 (95% CI 1.044, 1.791); p = 0.02) and a lower density of road intersections (IRR = 0.862 (95% CI 0.756, 0.982); p = 0.03) in regular metropolitan areas; (3) less social deprivation (IRR = 1.162 (95% CI 1.025, 1.318); p = 0.02) in urban areas; and (4) a higher concentration of older populations (IRR = 2.386 (95% CI 1.817, 3.133); p < 0.001) in rural areas. According to these findings, social participation interventions should target the local environment—for example, by providing more social interaction opportunities for older adults living in younger neighborhoods and by improving access to public transportation, especially paratransit.

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Caractéristiques environnementales favorisant la participation sociale: une enquête auprès d’aînés québécois

Canadian Journal on Aging / La Revue canadienne du vieillissement ◽

10.1017/s0714980819000138 ◽

2019 ◽

Vol 39 (1) ◽

pp. 1-11 ◽

Cited By ~ 1

Author(s):

Daniel Naud ◽

Mélanie Hamel ◽

Mélyna Caron ◽

Virginie Cardin ◽

Marie-Hélène D. Roux ◽

...

Keyword(s):

Social Media ◽

Social Participation ◽

Public Transportation ◽

Rural Areas ◽

Urban Areas ◽

User Friendliness ◽

Environmental Characteristics ◽

Local Residents ◽

The City ◽

Participation Sociale

ABSTRACTWe document and compare the environmental characteristics potentially associated with social participation of older Quebecers, according to the level of rurality. A survey was carried out among older Quebecers aged 65 and over recruited by different senior groups and through social media. The Questionnaire their potential for social participation, developed from a systematic literature review, was completed by respondents. According to the 515 older participants, 71.5 years old on average, environmental characteristics linked to social participation, as well as user-friendliness of the city and neighborhood, are more favorably perceived in metropolitan and urban areas than rural areas. However, access to public transportation and the welcoming and openness of local residents are more appreciated by rural respondents. These results support the presence of inequalities in social participation according to level of rurality and offer some leads for action.

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Frailty Status and Transport Disadvantage: Comparison of Older Adults’ Travel Behaviours between Metropolitan, Suburban, and Rural Areas of Japan

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17176367 ◽

2020 ◽

Vol 17 (17) ◽

pp. 6367

Author(s):

Takumi Abe ◽

Akihiko Kitamura ◽

Satoshi Seino ◽

Yuri Yokoyama ◽

Hidenori Amano ◽

...

Keyword(s):

Older Adults ◽

Logistic Regression ◽

Regression Analysis ◽

Logistic Regression Analysis ◽

Metropolitan Area ◽

Public Transportation ◽

Rural Areas ◽

Metropolitan Areas ◽

Frailty Status ◽

Transport Disadvantage

This study examined differences in older adults’ travel behaviours by frailty status in metropolitan, suburban, and rural areas of Japan. Data were collected from 9104 older adults (73.5 ± 5.7 years; 51% women; 19% frail) living in metropolitan (n = 5032), suburban (n = 2853), and rural areas (n = 1219) of Japan. Participants reported if they walked, cycled, drove a car, rode a car as a passenger, and used public transportation (PT) once per week or more. A standardised questionnaire was used to assess frailty status. We conducted logistic regression analysis to calculate the odds ratios of using each travel mode by frailty status stratified by locality. Relative to non-frail participants, frail participants were less likely to walk and drive a car in all three areas. Frail participants had significantly higher odds of being a car passenger in the suburban (OR = 1.73 (95% CI: 1.32, 2.25)) and rural areas (OR = 1.61 (1.10, 2.35)) but not in the metropolitan area (OR = 1.08 (0.87, 1.33)). This study found that frail older adults living in suburban and rural areas tended to rely more on cars driven by someone else, suggesting that transport disadvantage is more pronounced in suburban and rural areas than in metropolitan areas.

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The Nordic @geing Online project: Co-creating a social application together with older adults

European Journal of Public Health ◽

10.1093/eurpub/ckz185.297 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

J Nordmyr ◽

A K Forsman

Keyword(s):

Older Adults ◽

Health Promotion ◽

Social Participation ◽

Rural Areas ◽

New Technologies ◽

Psychosocial Health ◽

Design Approach ◽

Online Services ◽

Online Application ◽

Development Fund

Abstract Background Online resources present various possibilities for health promotion, also in the growing older adult population. Tailored online services aiming to support social participation among users could potentially promote older adults’ psychosocial health. In the @geing Online project an online application is developed, focusing on access to meaningful social activities among older adults in rural areas in Finland and Sweden. The innovation project (2017-2020) is funded by the Interreg Botnia-Atlantica programme (European Regional Development Fund). Methods A collaborative, user-centred design approach is applied when developing the online application, allowing older potential users and personnel groups from the social and health care sector to evaluate application features in a step-wise process. The inclusion of personnel groups allows for the exploration of the feasibility of introducing the tool in home care services and similar relevant contexts from an organizational perspective. Further, the inclusion of regional IT-companies presents opportunities for them to develop their competence regarding eHealth tools and older adults as a target group. Results An advanced prototype of the application and its core features is presented. Promising approaches and outcomes regarding the co-creation methods applied to ensure the involvement of stakeholders in the development process are elaborated upon. Challenging issues related to the project theme, such as stereotypical and negative views of older adults’ competences and motivation related to application use are also discussed. Conclusions The project highlights possibilities - but also challenges - when co-creating a social application together with older adults, some of whom have no experience in internet use. The gathered project outcomes will provide lessons on the potential of new technologies for delivering health promotion initiatives among older adults. Key messages Tailored online services aiming to support social participation among users provide possibilities for promoting psychosocial health in the growing population of older adults. Application development utilizing a user-centered design approach can be implemented even if the end-users are not familiar with the internet or application use.

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Rural–Urban Differences in the Factors Affecting Depressive Symptoms among Older Adults of Two Regions in Myanmar

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18062818 ◽

2021 ◽

Vol 18 (6) ◽

pp. 2818

Author(s):

Yuri Sasaki ◽

Yugo Shobugawa ◽

Ikuma Nozaki ◽

Daisuke Takagi ◽

Yuiko Nagamine ◽

...

Keyword(s):

Older Adults ◽

Middle School ◽

Depressive Symptoms ◽

Rural Areas ◽

Urban Areas ◽

Depression Scale ◽

Wealth Index ◽

School Level ◽

Cross Sectional ◽

Middle School Level

The aim of the study was to investigate rural–urban differences in depressive symptoms in terms of the risk factors among older adults of two regions in Myanmar to provide appropriate intervention for depression depending on local characteristics. This cross-sectional study, conducted between September and December, 2018, used a multistage sampling method to recruit participants from the two regions, for face-to-face interviews. Depressive symptoms were assessed using the 15-item version of the Geriatric Depression Scale (GDS). Depressive symptoms were positively associated with living in rural areas (B = 0.42; 95% confidence interval (CI): 0.12,0.72), female (B = 0.55; 95% CI: 0.31,0.79), illness during the preceding year (B = 0.68; 95% CI: 0.45,0.91) and non-Buddhist religion (B = 0.57; 95% CI: 0.001,1.15) and protectively associated with education to middle school level or higher (B = −0.61; 95% CI: −0.94, −0.28) and the frequency of visits to religious facilities (B = −0.20; 95% CI: −0.30, −0.10). In women in urban areas, depressive symptoms were positively associated with illness during the preceding year (B = 0.78; 95% CI: 0.36, 1.20) and protectively associated with education to middle school level or higher (B = −0.67; 95% CI: −1.23, −0.11), middle or high wealth index (B = −0.92; 95% CI: −1.59, −0.25) and the frequency of visits to religious facilities (B = −0.20; 95% CI: −0.38, −0.03). In men in rural areas, illness during the preceding year was positively associated with depressive symptoms (B = 0.87; 95% CI: 0.33, 1.42). In women in rural areas, depressive symptoms were positively associated with illness during the preceding year (B = 0.83; 95% CI: 0.36, 1.30) and protectively associated with primary education (B = −0.62; 95% CI: −1.12, −0.12) and the frequency of visits to religious facilities (B = −0.44; 95% CI: −0.68, −0.21). Religion and wealth could have different levels of association with depression between older adults in the urban and rural areas and men and women. Interventions for depression in older adults should consider regional and gender differences in the roles of religion and wealth in Myanmar.

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The Rural-Urban Continuum of Polarization: Understanding the Geography of the 2018 Midterms

The Forum ◽

10.1515/for-2020-2102 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Kenneth M. Johnson ◽

Dante J. Scala

Keyword(s):

Rural Areas ◽

Urban Areas ◽

Metropolitan Areas ◽

Political Attitudes ◽

The United States ◽

Rural America ◽

Rural Regions ◽

Urban America ◽

Urban And Rural Areas ◽

The Continuum

Abstract This study of the 2018 congressional midterms demonstrates how voting patterns and political attitudes vary across a spectrum of urban and rural areas in the United States. Rural America is no more a monolith than is urban America. The rural-urban gradient is better represented by a continuum than a dichotomy. This is evident in the voting results in 2018, just as it was in 2016. We found that the political tipping point lies beyond major metropolitan areas, in the suburban counties of smaller metropolitan areas. Democrats enjoyed even greater success in densely populated urban areas in 2018 than in 2016. Residents of these urban areas display distinctive and consistent social and political attitudes across a range of scales. At the other end of the continuum in remote rural areas, Republican candidates continued to command voter support despite the challenging national political environment. Voters in these rural regions expressed social and political attitudes diametrically opposed to their counterparts in large urban cores.

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Decomposing Urban-rural Differences in Multimorbidity Among Older Adults in India: A Study Based on Lasi Data

10.21203/rs.3.rs-701569/v1 ◽

2021 ◽

Author(s):

Shekhar Chauhan ◽

Shobhit Srivast ◽

Pradeep Kumar ◽

Ratna Patel

Keyword(s):

Older Adults ◽

Rural Areas ◽

Urban Areas ◽

Decomposition Analysis ◽

The Public ◽

Analysis Techniques ◽

Ageing Study ◽

Urban Rural ◽

The Difference ◽

Urban And Rural Areas

Abstract Background: Multimorbidity is defined as the co-occurrence of two or more than two diseases in the same person. With rising longevity, multimorbidity has become a prominent concern among the older population. Evidence from both developed and developing countries shows that older people are at much higher risk of multimorbidity, however, urban-rural differential remained scarce. Therefore, this study examines urban-rural differential in multimorbidity among older adults by decomposing the risk factors of multimorbidity and identifying the covariates that contributed to the change in multimorbidity.Methods: The study utilized information from 31,464 older adults (rural-20,725 and urban-10,739) aged 60 years and above from the recent release of the Longitudinal Ageing Study in India (LASI) wave 1 data. Descriptive, bivariate, and multivariate decomposition analysis techniques were used.Results: Overall, significant urban-rural differences were found in the prevalence of multimorbidity among older adults (difference: 16.3; p<0.001). Moreover, obese/overweight and high-risk waist circumference were found to narrow the difference in the prevalence of multimorbidity among older adults between urban and rural areas by 8% and 9.1%, respectively.Conclusion: There is a need to substantially increase the public sector investment in healthcare to address the multimorbidity among older adults, more so in urban areas, without compromising the needs of older adults in rural areas.

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Comparison of The Risk Factors For Falls Among Older Adults Between Urban and Rural Areas of Shantou City, China

10.21203/rs.3.rs-72830/v1 ◽

2020 ◽

Author(s):

Xiaodong Chen ◽

Zeting Lin ◽

Ran Gao ◽

Yijian Yang ◽

Liping Li

Keyword(s):

Risk Factors ◽

Older Adults ◽

Fall Prevention ◽

Rural Areas ◽

Urban Areas ◽

Multivariable Analysis ◽

Living Environment ◽

Balance Function ◽

Urban And Rural Areas ◽

Risk Factors For Falls

Abstract Background: To investigate the prevalence of falls and risk factors among older adults in urban and rural areas and to facilitate the design of fall prevention interventions.Methods: We used cluster random sampling to investigate the sociodemographic information, living habits, medical history, and falls among 649 older adult participants. Univariable and multivariable logistic regression was used to examine fall risk factors in urban and rural areas.Results: The fall rate and rate of injury from falls among older adults in urban areas were 27.3% and 18.6%, respectively, which were higher than those in rural areas (17.0% and 12.2%; P<0.05). Multivariable analysis showed that the risk factors for falls among urban older adults included a high school or below education level (OR=3.737, 95% CI: 1.503~9.291); diabetes medicine use (OR=4.518, 95% CI: 1.228~16.626); incontinence (OR=8.792, 95% CI: 1.894~40.824); lack of fall prevention education (OR = 11.907, 95% CI: 1.321～107.354); and reduced balance function (OR = 3.901, 95% CI: 1.894~7.815). The risk factors among rural older adults included a previous nonfarming occupation (OR=2.496, 95% CI: 1.416~4.398); incontinence (OR =11.396, 95% CI: 1.901~68.327); poor living environment (OR=3.457, 95% CI: 1.488~8.033); and reduced balance function (OR =4.260, 95% CI: 2.361~7.688).Discussion: The rate of falls among older adults in urban areas is higher than that in rural areas of Shantou City. Fall prevention in urban areas should target older adults with low education and modify the diabetes medication use. Interventions should focus on improving the home environment of older adults in rural areas.

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Factors associated with elevated consumption of alcohol in older adults—comparison between China and Norway: the CLHLS and the HUNT Study

BMJ Open ◽

10.1136/bmjopen-2018-028646 ◽

2019 ◽

Vol 9 (8) ◽

pp. e028646 ◽

Cited By ~ 4

Author(s):

Juan Li ◽

Bei Wu ◽

Kjerstin Tevik ◽

Steinar Krokstad ◽

AS Helvik

Keyword(s):

Public Health ◽

Older Adults ◽

Alcohol Consumption ◽

Rural Areas ◽

Secondary Data ◽

Primary Objective ◽

Health Study ◽

Cross Sectional ◽

Chinese Sample ◽

Factors Associated

ObjectivesThe primary objective was to investigate the prevalence and factors associated with elevated alcohol consumption among older adults 65 years and above in China and Norway. The secondary objective was to compare the prevalence and factors in the two countries.DesignA secondary data analysis was conducted using two large cross-sectional studies (Chinese Longitudinal Healthy Longevity Survey data in 2008–2009 and Nord-Trøndelag Health Study data in 2006–2008).ParticipantsA total of 3223 (weighted) Chinese older adults and 6210 Norwegian older adults who responded drinking alcohol were included in the analysis.Outcome measuresThe dependent variable was elevated alcohol consumption, which was calculated as a ratio of those with elevated drinking among current drinkers. Multivariable logistic regression was used to test the dependent variable.ResultsThe prevalence of elevated alcohol consumption among current drinkers for the Chinese and Norwegian samples were 78.3% (weighted) and 5.1%, respectively. Being male was related to a higher likelihood of elevated alcohol consumption in both Chinese and Norwegian samples (OR=2.729, 95% CI 2.124 to 3.506, OR=2.638, 95% CI 1.942 to 3.585). Being older, with higher levels of education and a living spouse or partner were less likely to have elevated drinking in the Chinese sample (OR=0.497, 95% CI 0.312 to 0.794, OR=0.411, 95% CI 0.260 to 0.649, OR=0.533, 95% CI 0.417 to 0.682, respectively). Among Norwegian older adults, a higher level of education was related to higher likelihood of elevated drinking (OR=1.503, 95% CI 1.092 to 2.069, OR=3.020, 95% CI 2.185 to 4.175). Living in rural areas and higher life satisfaction were related to lower likelihood of elevated drinking in the Norwegian sample (OR=0.739, 95% CI 0.554 to 0.984, OR=0.844, 95% CI 0.729 to 0.977, respectively).ConclusionsThe elevated alcohol consumption patterns were strikingly different between China and Norway in regards to prevalence and socioeconomic distribution. To develop and implement culturally appropriate public health policies regarding alcohol in the future, public health policy makers and professionals need to be aware of the cultural differences and consider the demographic, social and economic characteristics of their intended population.

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Socioeconomic status and survival among older adults with dementia and depression

The British Journal of Psychiatry ◽

10.1192/bjp.bp.113.134734 ◽

2014 ◽

Vol 204 (6) ◽

pp. 436-440 ◽

Cited By ~ 16

Author(s):

Ruoling Chen ◽

Zhi Hu ◽

Li Wei ◽

Kenneth Wilson

Keyword(s):

Older Adults ◽

Socioeconomic Status ◽

Low Socioeconomic Status ◽

Rural Areas ◽

Urban Areas ◽

Computer Assisted ◽

Late Life Depression ◽

People With Dementia ◽

Risk Of Mortality ◽

The Impact

BackgroundPeople from lower socioeconomic groups have a higher risk of mortality. The impact of low socioeconomic status on survival among older adults with dementia and depression remains unclear.AimsTo investigate the association between socioeconomic status and mortality in people with dementia and late-life depression in China.MethodUsing Geriatric Mental Status – Automated Geriatric Examination for Computer Assisted Taxonomy (GMS-AGECAT) we interviewed 2978 people aged ⩾60 years in Anhui, China. We characterised baseline socioeconomic status and risk factors and diagnosed 223 people with dementia and 128 with depression. All-cause mortality was followed up over 5.6 years.ResultsIndividuals with dementia living in rural areas had a three times greater risk of mortality (multivariate adjusted hazard ratio (HR) = 2.96, 95% CI 1.45–6.04) than those in urban areas, and for those with depression the HR was 4.15 (95% CI 1.59–10.83). There were similar mortality rates when comparing people with dementia with lowv.high levels of education, occupation and income, but individuals with depression with lowv.high levels had non-significant increases in mortality of 11%, 50% and 55% respectively.ConclusionsOlder adults with dementia and depression living in rural China had a significantly higher risk of mortality than urban counterparts. Interventions should be implemented in rural areas to tackle survival inequality in dementia and depression.

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Association between Personal Social Capital and Loneliness among Widowed Older People

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17165799 ◽

2020 ◽

Vol 17 (16) ◽

pp. 5799 ◽

Cited By ~ 2

Author(s):

Dongdong Jiang ◽

Yitan Hou ◽

Jinwei Hao ◽

Jiayi Zhou ◽

Junfeng Jiang ◽

...

Keyword(s):

Older Adults ◽

Social Capital ◽

Older People ◽

Rural Areas ◽

Urban Areas ◽

Short Form ◽

Linear Regression Models ◽

Bridging Social Capital ◽

Related Quality ◽

Health Related

To explore the association between the personal social capital and loneliness among the widowed older adults in China. Data from 1497 widowed older adults were extracted from China’s Health-Related Quality of Life Survey for Older Adults 2018. The Chinese version of the Personal Social Capital Scale (PSCS-16) was used to evaluate the participants’ status of bonding and bridging social capital (BOC and BRC). Loneliness was assessed by the short-form UCLA Loneliness Scale (ULS-8). Multiple linear regression models were established to examine the relationship between social capital and loneliness. The BOC and BRC of rural widowed older people were significantly lower than those of widowed older people in urban areas, while loneliness of rural widowed older people was higher than that of widowed older people in urban areas. The result of the final model showed that loneliness of rural participants was significantly associated with both BOC (B = 0.141, p = 0.001) and BRC (B = −0.116, p = 0.003). The loneliness of the urban widowed sample had no association with both BOC and BRC (p > 0.05). These findings suggested that more social support and compassionate care should be provided to enrich the personal social capital and thus to reduce loneliness of widowed older adults, especially those in rural areas.

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