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Abstract

Objectives

This study identifies differences in unmet mobility needs among older adults living in rural versus urban areas.

Methods

We used data from Round 9 of the National Health and Aging Trends Study (NHATS), limiting our analyses to respondents who had not moved since baseline (average housing tenure of 27 years; n = 3343). We conducted bivariate and multivariate analyses to detect rural/urban differences in unmet mobility needs, adjusting for socio-demographics, health status, and housing characteristics.

Results

Rural residence was associated with higher odds of any unmet mobility needs for older adults aging in place (adjusted odds ratio: 1.64, 95% confidence interval: 1.10–2.44, p < .05). The relationship between rurality and unmet needs for help with mobility limitations remained significant in fully adjusted models.

Discussion

Rural older adults aging in place have greater unmet needs for help with mobility limitations. This study highlights several important gaps in supporting rural older adults aging in place.

Keywords

rural housing aging in place mobility limitations

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References

Bacsu

Jeffery

Abonyi

Johnson

Novik

Martz

Oosman

(2014). Healthy aging in place: Perceptions of rural older adults. Educational Gerontology, 40(5), 327–337. https://doi.org/10.1080/03601277.2013.802191

Barriers to Affordable Rural Housing . (2018). July 10, 2019, National Rural Housing Coalition website: http://ruralhousingcoalition.org/overcoming-barriers-to-affordable-rural-housing/

Bennett

K. J.

Borders

T. F.

Holmes

G. M.

Kozhimannil

K. B.

Ziller

(2019). What is rural? Challenges and implications of definitions that inadequately encompass rural people and places. Health Affairs (Project Hope), 38(12), 1985–1992. https://doi.org/10.1377/hlthaff.2019.00910

Bureau of Health Workforce . (2021). Designated health professional shortage areas. https://data.hrsa.gov/Default/GenerateHPSAQuarterlyReport

Centers for Disease Control and Prevention . (2020). Chronic disease and Cognitive Decline - a Public health issue. 17, 2022 from Centers for Disease Control and Prevention website: https://www.cdc.gov/aging/publications/chronic-diseases-brief.html#type

Chapman

S. A.

Greiman

Bates

Wagner

L. M.

Lissau

Toivanen-Atilla

Sage

(2022). Personal care Aides: Assessing self-care needs and worker shortages in rural areas. Health Affairs, 41(10), 1403–1412. https://doi.org/10.1377/hlthaff.2022.00483

Chen

Amano

Park

Kim

(2019). Home and community-based services and life satisfaction among homebound and poor older adults. Journal of Gerontological Social Work, 62(7), 708–727. https://doi.org/10.1093/geroni/igy023.1805

Cromartie

(2019). Urban influence codes-documentation. USDA Economic Research Service website: https://www.ers.usda.gov/data-products/urban-influence-codes/documentation.aspx

Cromartie

(2021). Rural aging occurs in different places for very different reasons. November 18, 2022 USDA website: https://www.usda.gov/media/blog/2018/12/20/rural-aging-occurs-different-places-very-different-reasons

10.

Erickson

L. D.

Call

V. R. A.

Brown

R. B.

(2012). SOS-satisfied or stuck, Why older rural residents Stay put: Aging in place or stuck in place in rural Utah. Rural Sociology, 77(3), 408–434. https://doi.org/10.1111/j.1549-0831.2012.00084.x

11.

Friedman

Caldwell

Kennedy

A. R.

Rizzolo

M. C.

(2019). Aging in place: A national analysis of home- and community-based Medicaid services for older adults. Journal of Disability Policy Studies, 29(4), 245–256. https://doi.org/10.1177/1044207318788889

12.

Gorges

R. J.

Sanghavi

Konetzka

R. T.

(2019). A national examination of long-term care setting, outcomes, and disparities among elderly dual eligibles. Health Affairs, 38(7), 1110–1118. https://doi.org/10.1377/hlthaff.2018.05409

13.

Healy

(2019. March 4). Nursing homes are closing across rural America, Scattering residents - the New York times. https://www.nytimes.com/2019/03/04/us/rural-nursing-homes-closure.html

14.

Henning-Smith

Lahr

MacDougall

Mulcahy

(2022). Social cohesion and social engagement among older adults aging in place: Rural/urban differences. https://rhrc.umn.edu/publication/social-cohesion-and-social-engagement-among-older-adults-aging-in-place-rural-urban-differences/

15.

Henning-Smith

Lahr

Tanem

(2021). They’re not leaving their home; this is where they were born, this is where they will die: Key Informant Perspectives from the U.S. Counties with the Greatest Concentration of the Oldest Old. Research on Aging, 44(3–4), 312–322. https://doi.org/10.1177/01640275211032387

16.

Henning-Smith

Moscovice

Kozhimannil

(2019). Differences in social isolation and its relationship to health by rurality. The Journal of rural health, 35(4), 540–549. https://doi.org/10.1111/jrh.12344

17.

Henning-Smith

Mulcahy

Lahr

Tanem

(2021). Preferences for long-term care arrangements among rural and urban older adults. University of Minesota Rural Health Research Center. November 18, 2022: https://rhrc.umn.edu/publication/preferences-for-long-term-care-arrangements-among-rural-and-urban-older-adults/

18.

Henning-Smith

Shippee

Capistrant

(2017). Later-life disability in environmental context: Why living arrangements Matter. The Gerontologist, 58(5), 853–862. https://doi.org/10.1093/geront/gnx019

19.

Henning-Smith

Lahr

(2019). Unmet need for personal care assistance among rural and urban older adults. https://rhrc.umn.edu/publication/unmet-need-for-personal-care-assistance-among-rural-and-urban-older-adults/

20.

Housing Assistance Council . (2008). Housing in rural America. https://www.google.com/search?site=&source=hp&q=rural-urban+housing+quality&oq=rural-urban+housing+quality&gs_l=psy-ab.3...184.4301.0.4462.38.30.2.0.0.0.188.3065.11j16.27.0....0...1.1.64.psy-ab..9.28.2946.0..0j0i131k1j0i22i30k1j33i22i29i30k1j33i160k1j33i2

21.

Kasper

J. D.

Wolff

J. L.

Skehan

(2018). Care arrangements of older adults: What they prefer, what they have, and implications for quality of life. The Gerontologist, 59(5), 845–855. https://doi.org/10.1093/geront/gny127

22.

Kondrat

M. E.

(2013). Person-in-Environment. Encyclopedia of social work. Published online. https://doi.org/10.1093/ACREFORE/9780199975839.013.285

23.

Kozhimannil

K. B.

Henning-Smith

(2021. March 16). Improving health among rural residents in the US. JAMA - Journal of the American Medical Association, 325(11), 1033–1034. https://doi.org/10.1001/jama.2020.26372

24.

La Grow

Yeung

Towers

Alpass

Stephens

(2013). The impact of mobility on quality of life among older persons. Journal of Aging and Health, 25(5), 723–736. https://doi.org/10.1177/0898264313490198

25.

MacDowell

Glasser

Fitts

Nielsen

Hunsaker

(2010). A national view of rural health workforce issues in the USA. [Rural and Remote Health Electronic Resource], 10(3), 1531. [pii]. https://doi.org/10.22605/RRH1531

26.

Musich

Wang

S. S.

Ruiz

Hawkins

Wicker

(2018). The impact of mobility limitations on health outcomes among older adults. Geriatric Nursing, 39(2), 162–169. https://doi.org/10.1016/j.gerinurse.2017.08.002

27.

Park

N. S.

Roff

L. L.

Sun

Parker

M. W.

Klemmack

D. L.

Sawyer

Allman

R. M.

(2010). Transportation difficulty of Black and white rural older adults. Journal of Applied Gerontology, 29(1), 70–88. https://doi.org/10.1177/0733464809335597

28.

Pruchno

(2018. January 18). Aging in context. Gerontologist, 58(1), 1–3. https://doi.org/10.1093/geront/gnx189

29.

Sharma

Bin Abdul Baten

Ullrich

Clinton MacKinney

Mueller

K. J.

(2021). Trends in nursing home closures in nonmetropolitan and metropolitan counties in the United States, 2008-2018. www.banko. http://www.public-health.uiowa.edu/rupri/

30.

Sheafor

B. W.

Horejsi

C. R.

(2007). Techniques and Guidelines for social work Practice. Pearson.

31.

Skinner

M. W.

Winterton

(2018). Interrogating the Contested Spaces of rural aging: Implications for research, policy, and Practice. Gerontologist, 58(1), 15–25. https://doi.org/10.1093/geront/gnx094

32.

Tuttle

Tanem

Lahr

Schroeder

Tuttle

Henning-Smith

(2020). Rural-urban differences among older adults. https://rhrc.umn.edu/wp-content/uploads/2020/08/Rural-Urban-Older-Adults_Chartbook_Final_8.25.20.pdf

33.

United States Federal Reserve . (2020). Changes in U.S. Family finances from 2016 to 2019: Evidence from the survey of consumer finances. Federal Reserve Bulletin, 106(5). https://doi.org/10.17016/bulletin.2020.106

34.

University of North Carolina Cecil G Sheps Center for health services research . (2022). Rural Hospital Closures since January 2005, (p. 183). November 18, 2022 from UNC website: http://www.shepscenter.unc.edu/programs-projects/rural-health/rural-hospital-closures/

35.

Wang

Temkin-Greener

Simning

Konetzka

R. T.

Cai

(2021). Medicaid home- and community-based services and discharge from skilled nursing facilities. Health Services Research2, 56(6), 1156–1167. https://doi.org/10.1111/1475-6773.13690

36.

White

G. B.

(2015, January). Rural America’s silent housing crisis. The Atlantic. https://www.theatlantic.com/business/archive/2015/01/rural-americas-silent-housing-crisis/384885/

Unmet Needs for Help With Mobility Limitations Among Older Adults Aging in Place: The Role of Rurality

Abstract

Objectives

Methods

Results

Discussion

Keywords

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References