Rural residence and mortality in later life: Exploring the role of social integration and social support from a longitudinal perspective

Abstract

Though prior research has attempted to understand the impact of rural residence in early life on later mortality, the role of social integration and social support in explaining the residential mortality gap remains unclear. We first use the inverse probability treatment weighting method to address the potential selection bias in the data and then apply the complementary log–log modelling to a unique person‐wave data drawn from the Americans' Changing Lives study. The results indicate that (a) respondents living in small‐towns (i.e., rural areas) after childhood have a lower risk of death than those living in either suburban areas or central cities, (b) including social integration and social support in the analysis further widens the gaps between small‐town respondents and central city participants, and (c) social integration and social support have opposite effects on mortality. Social integration and social support are important in shaping health, but they cannot explain the rural mortality advantage.

Are There Place-Based Disparities in Mortality Risk? Findings from Two Longitudinal Studies of Aging

“…Likewise, the present research is partially consistent with prior population-level data indicating that there is a rural mortality penalty (Cossman et al, 2010;Cross et al, 2021;James, 2014;Singh & Siahpush, 2014) and further strengthens our ability to draw causal inferences about the impact of rurality on individuals' risk for mortality. Finally, it is worth noting that the present results stand in contrast to prior longitudinal work suggesting that there is a rural mortality advantage (Smith et al, 1995;Yang et al, 2021), which may be due to measurement differences. Residential location was self-reported in Yang et al (2021), whereas standard metropolitan statistical areas (SMSAs) were used in Smith et al (1995).…”

“…Finally, it is worth noting that the present results stand in contrast to prior longitudinal work suggesting that there is a rural mortality advantage (Smith et al, 1995;Yang et al, 2021), which may be due to measurement differences. Residential location was self-reported in Yang et al (2021), whereas standard metropolitan statistical areas (SMSAs) were used in Smith et al (1995).…”

“…In contrast to studies with county-level data, they found that risk of death was highest among those living in central cities, whereas risk was death was lowest for those living in rural areas, though the protective effects of rural areas weakened with increasing age. Additionally, Yang et al (2021) used longitudinal data from the Americans' Changing Lives study and showed that after accounting for age and sex, rural residents have lower risk of death than those living in central cities. The discrepancy in findings regarding rural-urban differences in mortality risk across population-level and individual-level data is peculiar, especially considering that researchers do find longitudinal associations between rurality and individuals' risk for various age-related diseases, such as Alzheimer's Disease (Glauber, 2022).…”

Are there place-based disparities in mortality risk? Findings from two longitudinal studies.

“…In contrast to studies with county-level data, they found that the risk of death was highest among those living in central cities, whereas the risk of death was lowest for those living in rural areas, though the protective effects of rural areas weakened with increasing age. Additionally, Yang et al (2021) used longitudinal data from the Americans’ Changing Lives study (1986–2011) and showed that after accounting for age and sex, rural residents have a lower risk of death than those living in central cities. The discrepancy in findings regarding rural–urban differences in mortality risk across population-level and individual-level data is peculiar, especially considering that researchers do find longitudinal associations between rurality and individuals’ risk for various age-related diseases, such as Alzheimer’s disease (Glauber, 2022).…”

Rural–Urban Differences in Common Mental Disorders, Functional Limitation and Social Support among Adults with Cancer: A Population-Based Study in Spain

“…PSS is also beneficial for the immune system in individuals with cancer, and those individuals with social support live approximately twice as long as those without such support [ 17 ]. A previous study has suggested that rural dwellers experience stronger social support than their urban counterparts [ 18 ].…”