The Changing Rural Older Adult Population, Characteristics Of Rural Older Adults, Health And Home- And Community-based Service Use Among Rural Older Adults
Description of the life circumstances of older people living in remote or rural areas is complicated by different definitions of rural residence and by the lack of variability within residential categories. The U.S. Bureau of the Census, for example, classifies residence based solely on the size of the population living in a predetermined geographical area. An ‘‘urbanized area’’ refers to one or more places plus the surrounding territory or fringe that include at least fifty thousand people. Urban residents are people living in either an urbanized area or outside an urbanized area in a place (e.g., township) with at least twenty-five hundred total residents. All other residents are considered rural. Rural residents are subdivided further into ‘‘farm’’ and ‘‘nonfarm’’ designations. According to the Census Bureau, about 24 percent of people aged sixty-five and over lived in rural areas in 1990, approximately the same proportion as the general population living in rural areas. About 16 percent of people aged sixty-five and over were rural farm residents in 1990, compared to only 1.5 percent of the total population (McLaughlin and Jensen).
Because the definition of rural residence used by the U.S. Office of Management and Budget (OMB) includes other criteria, such as commuting patterns and business activity, the Census and OMB sometimes classify residence differently. Different definitions and simplistic dichotomous categories frustrate efforts to learn more about the lives of rural elderly persons because researchers often rely upon data gathered by government agencies. Indeed, the terms ‘‘rural’’ and ‘‘nonmetropolitan’’ will be used here inter-changeably, depending upon the data source cited. Rural elderly residents include those living in a remote county on a Wyoming ranch forty-five miles from the nearest small town, as well as those living on the outskirts of a large city. Similarly, the nonmetropolitan category includes remote counties as well as those with populations over 100,000 people. These definitions also matter because they influence national and state funding allocations. Further, the tax base contained within the geographic boundaries of these areas affects local millage rates and the potential to provide needed health and human services. Whether counties are nonmetropolitan or communities have fewer than 2,500 people would also make little difference if these counties or communities were alike. It is known, however, that counties differ according to indicators such as premature mortality (Mansfield, Wilson, Kobrinski, and Mitchell) and small communities differ according to poverty (Weinberg) and health services delivery and availability. Such differences affect the lives of elders with regard to availability and access to needed health and other services, opportunities for paid employment, or involvement in volunteer or leisure activities.
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