Cooperativism and Population Aging: A Substantive Approach Based on Karl Polanyi

Research examining the life situations of the general population of very old adults has increased during the past decade (e.g., Manton, 1986; Rosenwaike, 1985). Very old adults, for example, are found to have longer recovery time from acute health conditions; to have increased limitations of activities, length of hospitalization, institutionalization, and need for assistance; and more limitations in activities of daily living than other older adults (Rosenwaike, 1985). Relatively little research, however, has examined the characteristics and needs of adults surviving to very old age in rural areas. Information on the very old is important because of their distinct vulnerability to inadequate health and related care, especially in rural under-served areas. Approximately 25% of adults 65 years of age or older, or over 7.6 million persons, reside in rural areas (U.S. Bureau of the Census, 1992). In addition, 25% of elders 85 years of age and older live in rural areas (U.S. Bureau of the Census, 1992). Nationally, it is estimated that between 1980 and 2030, the number of adults in this very old age group will triple and by 2050 the number will have increased sevenfold (U.S. Senate Special Committee on Aging, 1991). Although the majority of very old adults will continue to reside in urban locations, a substantial number will be located in rural areas. Additionally, many of these very old rural elders, and the families caring for them, can be expected to have inadequate resources for the maintenance of their well-being. AGING IN RURAL CONTEXT For the purposes of this review, issues related to aging in rural areas have been divided into two major sections. First, information is provided regarding environmental and individual characteristics of very old persons aging in a rural context. Second, information pertinent to the prediction of very old age survival in rural areas is presented. Characteristics of Very Old Persons Elders in rural areas have been described as disadvantaged, both in terms of community and individual resources, when compared with older adults residing in metropolitan areas (e.g., Coward, 1987; Glasgow, 1988; Glasgow, Holden, McLaughlin, & Rowles, 1993; Lee & Lassey, 1980; McLaughlin & Jensen, 1993). Several community-level characteristics, including small community size, population dispersion, geographic isolation, limited public sector resources, and the concentration of economic resources in a small number of business and industry sectors, have contributed to economic hardships and inadequate social and supportive resources available for elders in rural areas (Glasgow, 1993). Glasgow (1993) noted two ways these limitations affected well-being: (a) by reducing the effective social and economic responses possible from the public sector, including adequate access to proximate health care, public transportation, and formal social services; and b) by frequently limiting older adults' access to helpers within their informal network. The life situations of older adults in rural areas have been further affected by individual-level social and economic changes during the last decade. For example, older adults residing in rural areas have become more diverse. This increased diversity has complicated the creation of viable service models. Rowles and Johansson (1993) described four types of rural elderly residents in terms of their community integration: (a) lifelong community residents who have maintained large kinship and informal networks; (b) lifelong community residents whose informal support resources have been reduced as family members have moved from the area; (c) return migrant elders who, because of their limited recent history in the area, have minimal access to informal support networks; and (d) retirees who have moved from urban areas with little or no previous social history in the area and, as a result, have limited informal social support. An individual-level economic change affecting many older rural adults is the increasing number of very old rural adults living in poverty. …

Migration, population aging, and income inequality in China

Technology generation in Latin American manufacturing industries: Jorge M. Katz, ed., (Macmillan Press, London, 1987) pp. xi + 549, £30

When the demographic transition started in the 1970s in Thailand, internal migration of this country also manifested a turning point. Newly reclaimable vacant land almost vanished in the 1980s, although surplus populations in rural areas were being absorbed by other rural areas with lower population densities until the 1970s. This study analyzed population and internal migration changes in Thailand from 1980 to 2030. Analysis of populations by age group in urban areas (central region and Bangkok metropolis) and rural areas (northeast region and Surin province) indicated that decreased growth of younger populations in urban areas caused a marked increase in migration of young generations as the labor force moved from rural to urban areas, especially after the 1990s. Statistics of the inter-regional migration census from the northeast to central regions also indicated that this population flow began to increase around the year 1990. The present trends of population aging and various socioeconomic situations in rural and urban areas in Thailand will result in acceleration of population aging in rural areas through deprivation of rural young populations by urban areas.

This paper underlines that ageing in rural areas is a very complex and multilevel interdependent process which is based on networks—the later is being created by interrelations among a mentally constructed (individual perception of person aged 65+), the formalized (involvement of different relevant stakeholders) and the material (rural areas) environments. We argue that these networks are crucial for the creation of age-friendly rural areas. However, the networks—their establishment, the functioning, the form—are less frequent in research on ageing in rural areas. Therefore, we focus on the hidden geographies of these networks: where are the networks placed, who is included, what kind of relationships is performed, how they are addressing the actual needs and expectations of ageing populations in rural areas. For the further analysis of the significance of these networks, a wide longitudinal research is needed. The hidden needs and expectations, hidden information, hidden knowledge, hidden skills, hidden networks of actors are all creating the contemporary landscape of ageing that is not a win–win situation for ageing in rural areas. We would like to underline that ageing in rural areas becomes friendlier when these networks become visible and operational—since this would open up the field for the creation of new job opportunities in rural areas, also for the fine-tuning of existing and the future development of essential social and economic infrastructure, which is relevant for age-friendly rural communities. Re-organization of public care for elderly on national as well as on the local level is expected, new forms of health and social services need to be developed aiming at more efficiency and financial sustainability.

Population aging is occurring worldwide, particularly in developed countries such as the United States (US). However, in the US, the population is aging more rapidly in rural areas than in urban areas. Healthy aging in rural areas presents unique challenges. Understanding and addressing those challenges is essential to ensure healthy aging and promote health equity across the lifespan and all geographies. This review aims to present findings and evaluate recent literature (2019-2022) on rural aging and highlight future directions and opportunities to improve population health in rural communities. The review first addresses several methodological considerations in measuring rurality, including the choice of measure used, the composition of each measure, and the limitations and drawbacks of each measure. Next, the review considers important concepts and context when describing what it means to be rural, including social, cultural, economic, and environmental conditions. The review assesses several key epidemiologic studies addressing rural-urban differences in population health among older adults. Health and social services in rural areas are then discussed in the context of healthy aging in rural areas. Racial and ethnic minorities, indigenous peoples, and informal caregivers are considered as special populations in the discussion of rural older adults and healthy aging. Lastly, the review provides evidence to support critical longitudinal, place-based research to promote healthy aging across the rural-urban divide is highlighted. Policies, programs, and interventions to reduce rural-urban differences in population health and to promote health equity and healthy aging necessitate a context-specific approach. Considering the cultural context and root causes of rural-urban differences in population health and healthy aging is essential to support the real-world effectiveness of such programs, policies, and interventions.

Aging is a complex multifaceted policy problem that is compounded by a growing and potentially frail elderly population. Existing policy approaches are embedded in a medical conception of aging and modernist forms of political economy. The multifaceted nature of aging as a policy problem challenges this approach, and in rural areas many aspects of the problem are magnified. If aging is approached in cultural terms, a deeper understanding of aging can be developed, and the dimensions of the problem exposed, and it is shown that collaborative approaches may offer a way forward. The new public governance offers a way of incorporating collaborative approaches into public decision-making to address complex problems. The chapter concludes by making some policy recommendations as to how the problems highlighted can be addressed within the framework of the new public governance.

(1) Background: Population aging has been accelerating in China since the 1990s, and the number of people over 65 reached 190 million in 2020. However, the spatial distribution of the aged is not homogeneous; in rural areas, the aged population accounted for 17.72% of the total population, whereas in urban areas, it accounted for 11.11%, which is 6.61 p.p. less. Therefore, this study aims to examine the spatial heterogeneity and influencing factors of population aging in rural China from 2000 to 2020. (2) Methods: First, Getis-Ord Gi* was used to analyze the spatial clustering of the aged population in rural China. Then, standard deviational ellipse was used to characterize the temporal trend of the spatial clustering of population aging in rural China. Finally, potential influencing factors that could have contributed to the spatial-temporal patterns were analyzed using a novel spatial statistical package "Geographical Detector". (3) Results: (a). Aging in rural populations increased and occurred throughout China from 2000 to 2020. (b). The spatial patterns of aging in China are roughly divided by the Hu Line, which is the population density boundary of China. (c). The mean center of the aged population tended to orient around a northeast-to-southwest major axis over the past 20 years, contrary to the internal migration pattern that flows from north to south. (d). The population age structure, longevity rate, and fertility rate were the predominant factors of aging in rural areas. (4) Conclusions: As the aged population is rapidly increasing in rural areas in China in a spatially heterogeneous fashion, governments and private sectors need to collaborate to alleviate the problem.

Access to clean and efficient cooking fuel is crucial for promoting good health, safeguarding the environment, and driving economic growth. Despite efforts to promote the adoption of cleaner alternatives, traditional solid fuels such as charcoal and firewood remain prevalent in Ghana. In this study, we utilized a statistical mechanical model as a framework to explore the statistical relationship between socio-economic factors such as educational attainment, wealth status, place of residence, and cooking fuel choices. We analysed data from the Ghana Malaria Indicator Survey (GMIS) conducted in 2019, involving a total of 2,942 women of reproductive age. The findings revealed that 13.77% of participants preferred using LPG fuels for cooking, while 86.23% preferred non-LPG fuels for their cooking needs. The data indicated that among LPG users, 96.54% are educated women of reproductive age, and 3.46% are non-educated women of reproductive age. Among these, 95.31% are non-poor, and 4.69% are poor. Additionally, 21.73% reside in rural areas, while 78.27% live in urban areas. The data also showed that among non-LPG fuel users, 68.70% are educated women of reproductive age, and 31.30% are non-educated women of reproductive age. Among this group, 16.04% are non-poor, and 83.96% are poor. Furthermore, 67.24% reside in rural areas, and 32.76% live in urban areas. Our findings showed that in the absence of social interaction, a woman's wealth status has a relationship to her choice of fuel for cooking. Additionally, women of reproductive age in rural areas with some education demonstrated a significant private incentive (40.12%) to use LPG, implying a positive correlation between education and the use of LPG for cooking. However, when social interactions are considered, factors such as education, wealth status, and place of residence have significant relationships with a woman's decision about fuel choice. The interaction strength among women of reproductive age in urban areas with some education shows a negative estimate (-4.06%), suggesting that there is no significant imitative effect. The study further suggests that urban women of reproductive age who are poor exert a greater influence on their urban counterparts who are not poor when social interaction is incorporated. Women of reproductive age in rural areas with some form of education exert a greater influence on women of reproductive age in rural areas with no form of education. We recommend that the government of Ghana and its stakeholders focus on leveraging the influence of urban poor women and educated rural women through community-led programs and educational campaigns. Financial support mechanisms like microfinance and subsidies, alongside reliable LPG infrastructure, can make access easier for these target groups. Tailored communication strategies, peer-to-peer learning, and collaboration with local institutions are crucial for spreading awareness and encouraging the adoption of LPG.

Aging in rural areas is challenging and has very specific characteristics in the way these elderly people live their old age, from the perspectives of cognition, functionality and life purpose. There is a lack of information and data in the literature on how people age in rural areas around the world. The aim of this study was to identify and describe how people age in rural areas, focusing on the following domains: cognition, physical function/functionality and life purpose. We included cross-sectional studies published up to April 2023 found in six databases: PubMed, LILACS, PsycINFO, Scopus, SciELO and Web of Science. The Rayyan software was used for the first selection of studies and the Observational Study Quality Evaluation was used to assess methodological quality and risk of bias. For the primary analysis, the titles and abstracts available in the search engine were analyzed using the following MeSH descriptors: "physical functioning"; "cognition"; "cognitive function"; "life purpose"; 'personal satisfaction'; 'subjective well-being'; "aged"; "elderly"; "old"; "rural aging"; "rural population"; "communities, rural"; "distribution, rural spatial"; "medium communities"; "rural settlement"; "small community". In the secondary selection, the selected articles were fully read by two independent reviewers and confirmed by a third reviewer when necessary. From 22 studies methodologically evaluated it was seen that rural aging in the world is female and mostly in elderly women farmers; mental evaluation together with activities of daily living and instrumental activities were the most evaluated; the studies did not mention the evaluation of life purpose. The world ages very differently in rural areas, and the way we age is directly linked to where this process takes place. Cognition, followed by functionality, are the most researched outcomes in cross-sectional studies with this population and the assessment of life purpose has not been investigated to date.

Background and ObjectivesCaregiving for people with dementia is especially challenging in rural areas of the United States, where services and support are often limited. This study explores how contextual factors—environmental conditions, resource availability, and family and social dynamics—intersect to shape experiences of rural family caregivers.Research Design and MethodsThis secondary analysis uses qualitative data from a nationwide randomized controlled trial of an online workshop for rural family caregivers. Semi-structured interviews with 55 participants explored how living in a rural, farming, or small town area influenced their caregiving experiences. Narrative analyses were conducted to identify themes.ResultsThree themes emerged: navigating rural tranquility and environmental challenges, caregiving in resource-limited settings, and variable support from family, friends, and neighbors. Caregivers described the dual impact of their environment—while rural tranquility and perceived safety were valued, they were offset by the need for constant vigilance and the physical demands of land maintenance when caring for a person with dementia. Caregivers also reported challenges accessing specialized care, citing limited availability and inadequate dementia-specific communication from providers that impeded access to information and resources. As a result, many managed care independently to fill critical gaps. While family support was essential for some, it was not always available. Despite familiar surroundings, many caregivers felt isolated, as friends or neighbors remained distant observers rather than hands-on helpers.Discussion and ImplicationsThese findings highlight the complex realities of rural dementia caregiving, where environmental conditions, resource limitations, and social factors intersect to shape caregiver experiences. Aging in rural areas offers comfort but burdens caregivers significantly. Addressing gaps in service accessibility, improving provider communication, and strengthening informal support networks are critical steps toward reducing caregiver burden and enhancing well-being for caregivers and people with dementia.

Background: India, in the associated epidemiological transition, is facing a double burden of communicable and non-communicable diseases. Old age is not a disease in itself, but the elderly are vulnerable to long term diseases of insidious onset like hypertension. Due to deficit of regular screening and unawareness about complications of long term high blood pressure in old age in rural area the large number of population remain undiagnosed so they might suffer from the long term complications of hypertension. The main objectives of the study were to determine prevalence of hypertension among old age population and to study the factors affecting the hypertension. Methods: It was a cross sectional study conducted in rural area of Vadodara district, Gujarat, India from October 2012 to March 2013. The study participants were old age group population with age more than or equal to 60 completed years. A sample size of 600 was obtained using hypothesis testing method. Using simple random sampling, 6 talukas were selected and from each, 4 villages were chosen. From each village, 25 study participants were included by house to house survey. Results: Prevalence of hypertension was 42.7%, significantly higher in age group more than 80 years (61%) and females (48%). Hypertension was significantly associated with current alcohol and tobacco consumption. Education, living arrangements, marital status and working status were significantly affecting hypertension. Conclusions: Specific screening programmes are needed for early detection and control to avoid further complications. Geriatric health care should be integrated in the general health system up to primary health care level.

With the continuous deepening of China's aging population, the high prevalence of chronic diseases, high disability rate and significant medical expenses among older adults have brought huge burdens to individuals, families and the entire social development. Compared with urban areas, the aging population in rural areas is severe and the population's health status is worse. Therefore, how to scientifically address the issue of population aging in rural areas and minimize the negative effects of aging has become a focus of common concern in all sectors of society. As an important non-medical health intervention, exercise has been proven effective by scientific research and is also a common experience of developed countries in actively responding to the issue of population aging. However, the traditional one-way government supply model of rural public products has led to inefficient or ineffective supply of public sports services for a long time, making it difficult to meet the growing personalized needs of rural older adults. Therefore, a comprehensive understanding of the actual demands of rural older adults for public sports services, clarifying their demand types, structural characteristics and influencing factors, is the prerequisite for achieving an effective supply of public sports services for rural older adults and promoting their regular participation in sports. To comprehensively understand the demand situation for public sports services for rural older adults, a sociological survey was conducted on the demand characteristics, influencing factors and satisfaction of public sports services for rural older adults aged 50 and above living in townships, corresponding towns and villages in the eastern, central and western regions of China. The research methods included a literature review, questionnaire survey, interview survey and statistical analysis. Rural older adults have the most urgent demand for establishing sports fitness organizations, improving sports exercise guidance services and strengthening the construction of elderly sports systems; the demand for public sports services among rural older adults is influenced by multiple factors such as demographic characteristics, health status, individual lifestyle and sports exercise cognition level; the overall utilization rate of public sports services for rural older adults is low, and their satisfaction is at a medium level. To meet the public sports service demands of rural older adults, in the future, it is still necessary to enhance the demand subject consciousness of rural older adults, clarify the subjective demand picture of rural older adults, and improve the quality of public sports services for rural older adults.

Contraceptive use is one of the essential influential factors to the birth rate of Indonesia. This article aims to identify the profile of contraceptive use in rural and urban areas based on the socio-economic and demographic characteristics as well as the influential factors. This study conducted a further analysis of Performance Monitoring and Accountability 2020 (PMA2020) survey in 2015, by applying univariate, bivariate, and multivariate analysis. Th e results of the analysis show a similar average number of children for both rural and urban areas; this situation is in accordance with the program of National Population and Family Planning ( BKKBN). In addition, the educational and economic status of women in union of childbearing age in rural areas has improved along with the increasing number of women graduated from senior high school as well as the improvement of their wealth. However, many women in rural and urban areas never have been visited by family planning officers as well as do not have health insurance, such as BPJS. The finding of the study also shows that the higher the economic status of women in rural areas, the higher their chances to use contraception. Conversely, the higher the economic status of women in urban areas, the lower their participation in family planning program. Therefore, specific, intensive and equal interventions to IEC and advocacy programs are needed for both rural and urban areas .

Introduction: Population aging is a global phenomenon that is becoming increasingly evident in Brazil and the state of Amazonas. Understanding this process in different geographic and sociocultural contexts, such as rural areas, is essential to support public health actions aimed at the elderly population. Objective: To analyze the association between functional capacity, depressive symptoms, and quality of life in older elderly individuals living in the rural area of Manaus, AM. Methods: Cross-sectional, population-based study with a quantitative approach involving 91 elderly individuals aged 80 years or older. The following instruments were applied: Katz Scale (ABVD), Lawton and Brody Scale (IADL), Geriatric Depression Scale (EDG-15), and EUROHIS-QOL. Data were analyzed using descriptive statistics and linear regression. Results: The mean age was 85.6 years, and most participants were male (49/ 53.8%), brown (65/ 71.4%), and widowed (40/ 44%). There was a predominance of independence in BADL, with greater female dependence in IADL. Depressive symptoms were present in 29.6% of the elderly people (n=27). There was a significant association between IADL and quality of life, indicating that greater dependence is related to a worse perception of quality of life. No association was identified between functional capacity and depressive symptoms. Conclusion: Limitation in instrumental activities is associated with reduced quality of life of older elderly individuals in rural areas. The lack of association with depressive symptoms suggests the influence of contextual aspects. The findings reinforce the importance of public policies that promote functional autonomy and social support in old age in rural areas.