How ‘age-friendly’ are rural communities and what community characteristics are related to age-friendliness? The case of rural Manitoba, Canada

Abstract

Since the World Health Organization introduced the concept of ‘age-friendly’ communities in 2006, there has been rapidly growing interest in making communities more age-friendly on the part of policy makers world-wide. There is a paucity of research to date, however, that has examined age-friendliness in diverse communities, particularly in rural communities. The main objective of the study reported in this paper was to examine whether age-friendliness varies across community characteristics, such as a population size. The study was based on surveys administered in 56 communities throughout Manitoba, a mid-Western Canadian province, in the context of a needs assessment process for communities that are part of the Age-Friendly Manitoba Initiative. A total of 1,373 individuals completed a survey developed to measure age-friendliness. Domains included the physical environment; housing options; the social environment; opportunities for participation; community supports and health-care services; transportation options; and communication and information. Community characteristics were derived from census data. Multi-level regression analysis indicated that the higher the percentage of residents aged 65 or older, the higher the ratings of age-friendliness overall and, specifically, ratings of the social environment, opportunities for participation, and communication and information. Moreover, small communities located within a census metropolitan area and remote communities in the far north of the province emerged as having the lowest age-friendliness ratings. These findings suggest that communities are generally responsive to the needs of their older residents. That different results were obtained for the various age-friendly domains underscores the importance of considering age-friendliness in a holistic way and measuring it in terms of a range of community features. Our study further highlights the importance of differentiating between degrees of rurality, as different patterns emerged for communities of different sizes and proximity to a larger urban centre.

Key characteristics of age-friendly cities and communities: A review

“…For example, 33% of Canadian older adults live in rural areas (Dandy & Bollman, 2008). In recent years several provinces in Canada have launched age-friendly initiatives in rural areas after discussions with rural communities identified age-friendly features that were similar to those in cities (Menec et al, 2013). Transportation issues were found to be magnified in rural areas, as well as a lack of access to social and healthcare services (Canada, 2006).…”

Measuring the attractiveness of rural communities in accounting for differences of rural primary care workforce supply

“…The US measure of county affluence was also significantly associated with increased doctor supply. While access to other services such as shopping, employment, cultural and other recreational opportunities was not directly measured, it is known that these services are all strongly related to population size 51 . Additionally, while poorer access to schools was not significant within the Australian models, this measure is strongly correlated with population size and shown to be a major reason for dissatisfaction of doctors living in smaller rural areas or not taking up rural practice in the first instance 6,9,26 .…”

Accessing rural health services: Results from a qualitative narrative gerontological study

“…This group of people did not appreciate seeing a different doctor each time they required medical services. Studies undertaken in rural Canada found that the provision of appropriate and consistent primary health‐care services to older communities was influenced by the ability to recruit and retain health professionals including physicians . Difficulties with recruitment and retention lead to the utilisation and reliance on “locum” or casual health professionals, a common feature in the provision of primary health care in rural areas …”

“…Studies undertaken in rural Canada found that the provision of appropriate and consistent primary health-care services to older communities was influenced by the ability to recruit and retain health professionals including physicians. 24 Difficulties with recruitment and retention lead to the utilisation and reliance on "locum" or casual health professionals, a common feature in the provision of primary health care in rural areas. 25 As evident in the narratives, nurses were reported as being central figures in the provision of health services, including being first point of contact when a doctor was not available, as well as providing a diverse range of health services both inside clinics and in community settings (eg house calls by district nurses).…”