The changing geographies of old-age employment in Sweden 1990–2021

Community Engagement and Cognition in a Sample of Older Adults Residing in Costa Rica

Telehealth clinical applications, which allow medical professionals to use telecommunications technologies to provide services to individuals remotely, continue to expand in areas such as low vision rehabilitation, where evaluations are provided to patients who live in rural areas. As with face-to-face low vision rehabilitation, the goal of clinical video telehealth is to help patients cope with a loss of vision, as well as accept and recognize challenges and provide skills to maintain independence and safety, and to prevent depression. Important aspects of implementing clinical video telehealth are increasing access, building capacity, saving time, and decreasing travel costs for patients and providers in several clinical specialties. Reducing barriers to care is achieved through telehealth by enabling patients to avoid traveling long distances when they feel they are unable to drive safely or when they rely on family or friends for transportation. The purpose of this article is to illustrate the development, need, and benefits of establishing a low vision clinical video telehealth clinic, and to increase access to low vision rehabilitation among the aging population with vision loss. Uncorrectable vision loss due to conditions such as macular degeneration and diabetic retinopathy often restricts mobility and travel of older adults (especially by automobile), which is one of the barriers to receiving low vision rehabilitation faced by partially sighted individuals who live in rural areas. Telehealth is defined as the use of electronic communication and information technologies to provide or support long-distance clinical health care, patient and professional health-related education, public health, and health administration (National Advisory Committee on Rural Health and Human Services, 2015). In order to provide better care to veterans with visual impairments, especially those residing in rural or highly rural areas, in 2011 the U.S. Department of Veterans Affairs (VA) Blind Rehabilitation Services began pursuing innovative care delivery strategies. Federal funding was allocated to VA low vision clinics throughout the United States to purchase telehealth equipment, which challenged providers to develop protocols and best practices for low vision clinical video telehealth rehabilitation. This expansion of telehealth services improved access to care and increased patient satisfaction (U.S. Department of Veterans Affairs, 2015). Nonprofit rehabilitation agencies that provide low vision rehabilitation services to older adults within their own communities also have challenges regarding innovative care delivery strategies, especially in rural or highly rural areas. By using this rapidly expanding technology, other public and private sectors can also improve access to care for patients with visual impairments who live in rural areas. Telemedicine continues to advance and has been critical to improving health outcomes in rural regions in the United States. Rural regions are those outside of urban areas that generally have populations smaller than 2,500 (U.S. Department of Health & Human Services, 2015). Residents in rural regions often experience challenges in accessing medical and rehabilitation services because of the vast distances that may separate them from more densely populated regions, where services are typically located. To address the problem of access to health care, VA telehealth service clinics are set up around the United States for cardiology, neurology, psychiatry, and a range of other medical services that patients can access electronically without being physically in the presence of the health professional. Ophthalmology and optometry clinics within several VA hospitals utilize store and forward telehealth technology for virtual encounters by which they capture digital retinal images and then send them electronically to physicians for medical opinions or diagnoses (U. …

Loneliness is a significant public health issue in China, particularly among the older population. This study sought to explore differences in the incidence of loneliness among older adults in urban versus rural regions and to quantify the contribution of relevant influencing factors. This study assessed data from 13,735 older adults derived from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). The chi-squared test was employed to examine the distribution characteristics of relevant indicators among older adults in the two regions. Logistic regression was utilized to explore the factors affecting loneliness in older adults across different areas. Additionally, the Fairlie decomposition analysis method was applied to quantify the four categories of influencing factors—demographic characteristics, sociological characteristics, personal lifestyle, and health status—that contributed to differences in loneliness and to estimate their respective contributions among urban and rural older adults. A total of 26.79% of older adults reported feeling lonely, with a higher proportion of rural older adults (27.77%) experiencing loneliness than their urban counterparts (24.27%). In rural regions, risk factors for loneliness included a body mass index (BMI) of < 18.5 kg/m², being widowed, and other marital statuses, as well as self-reported local income status as “rich.” Conversely, protective factors included being male, having an educational level of 1–6 years or ≥ 7 years, self-reported local income status as “average,” alcohol consumption, engaging in exercise, and self-reported health (SRH) as “good.” In urban areas, risk factors included being widowed or in other marital statuses, as well as self-reported local income status as “rich.” In contrast, protective factors comprised being ≥ 100 years old, engaging in exercise, having sleep durations of 6.0–7.9 h, 8.0–9.9 h, or ≥ 10 h, and self-rated health as “good.” The Fairlie decomposition analysis revealed that 95.38% of the disparity in loneliness symptoms stemmed from observable factors, whereas the remaining 4.62% was attributed to urban–rural differences. Factors such as gender, educational attainment, marital status, living conditions, self-reported local income level, alcohol consumption, physical exercise, sleep length, and SRH played a significant role in explaining the disparities in loneliness symptoms between the two groups. Older adults residing in rural regions exhibited a greater prevalence of loneliness than their counterparts in urban areas. This difference is mainly caused by gender, educational level, marital status, living status, self-reported local income status, drinking, exercise, sleep duration, and SRH. Addressing these influential factors of loneliness would aid in developing targeted and more precise intervention strategies specifically tailored to enhance the mental wellness of high-risk older adults.

Dynamics of rural areas: an assessment of clusters of employment in Sweden

Physical activity and mental well-being play an important role in reducing the risk of various diseases and in promoting independence among older adults. Appropriate physical activity, including yoga and mindfulness practices, can help rectify the loss of independence due to aging and have a positive influence on physical health and functional activities. This study assessed rural–urban differences in yoga and mindfulness practices and their associated factors among middle-aged and older Indian adults. The total sample size considered for the current analysis was 72,250 middle-aged and older adults (aged ≥ 45 years). Bivariate and multivariable logistic regression analyses were used to estimate the prevalence of yoga and mindfulness practices and examine the associations of selected variables with yoga and mindfulness practices among the participants. Further, we used the Fairley decomposition technique to determine the factors contributing to rural–urban differences in the prevalence of yoga and mindfulness practices among middle-aged and older adults. More than 9% of middle-aged and older adults in rural areas and 14% in urban areas reported practicing yoga and mindfulness activities more than once per week. Adults aged ≥ 65 years were more likely to practice yoga and mindfulness activities than those who age 45–54 years were. Those with an education of ten years and above were 2.3 and 2.1 times higher likely to practice yoga in rural (AOR: 2.28; CI: 2.07–2.52) and urban (AOR: 2.13; CI: 1.91–2.37) areas compared to their uneducated peers, respectively. The largest contributors in diminishing the gap in yoga practice among participants were education (44.2%), caste (2.5%), chronic diseases such as hypertension (4.53%), diabetes (1.71%), high cholesterol (3.08%), self-reported pain (5.76%), and difficulties in instrumental activities of daily living (1.22%). The findings suggest that middle-aged and older adults in urban areas practice yoga and mindfulness activities more than their peers in rural areas do. Education level, household characteristics, and health outcomes such as chronic conditions, pain, and functional difficulties explain the observed differences in yoga and mindfulness practices across rural and urban areas. Age-appropriate healthy practices such as yoga and mindfulness should be encouraged to enhance the physical and mental well-being of middle-aged and older adults, especially in rural areas.

The dual demographic changes in massive rural-to-urban labour migration and population ageing have significantly impacted the lives of older adults, who have either been left behind in rural regions or migrated to urban areas. While many extant studies on migration and wellbeing of older adults have focused on either migrating or left-behind older adults, a very limited number of studies have directly compared these two groups. Utilising data from the China Longitudinal Ageing Social Survey, this study examines the impacts of different migration patterns (i.e.migrating older adults, left-behind older adults and non-migrating older adults) on the social networks and mental health of older adults in rural China. Structural equation modelling results showed that older adults who have been left behind reported weaker family ties and poorer mental health than the other older adults. Moreover, weakened family ties increased older adults’ risk of developing mental health problems. Older migrants reported the lowest level of depressive symptoms among the three groups of older adults. However, migration may be associated with poorer mental health among the older migrants due to the shrinking/weakening of family/friendship ties.

It is known that because socialism policies which promote social equality were enforced by Chinese government, the gender gap in wage and employment was little during the planned economy system period in urban China. The gender wage gap became enlarged during the economic transition period. What factors can explain the gender wage gap in the 2000s? As described in Chap. 3, to counter the developing countries and the other economic transition countries in central and eastern Europe, there exists the labor market segmentation between public sector and private sector which is a special labor market structure for China. Does the labor market segmentation by public sector and private sector affect the gender wage gap in China? Chapter 5 focuses on this issue which is not noticed in the previous studies and provides some evidence to answer the question. Some interesting findings are obtained. For example, it is found that the problem of discrimination against female workers in a given ownership sector (public or private sectors) is becoming more serious, and is the main factor which causes the gender wage gap expanding in urban China from 2002 to 2013.

Temperature vulnerability tends to be heterogenous between urban and rural regions, with usually larger risks in the former. However, it is unclear whether this pattern will persist under different climate change scenarios. Climate change combined with population growth, ageing and urbanization is expected to amplify the current temperature-related mortality burden, particularly since these drivers will follow diverse trajectories across urban and rural areas in the future. This study aimed to compare the impact of climate change regarding changes in heat- and cold-related mortality under various warming scenarios across urban/rural districts in Switzerland, while also accounting for changes in population demographics. We first estimated the district-age-specific (<75/>=75years) temperature-mortality association between 1990-2010 in Switzerland using a two-stage time series design with distributed-lag nonlinear models. We then projected heat- and cold-related mortality under 1.5C, 2.0C, 3.0C and 4.0C warming scenarios using downscaled temperature projections under RCP8.5 while accounting for the Shared Socio-economic pathway (SSP5) population development storyline. In Switzerland, heat- and cold-related mortality will increase by 2,420(95%CI:1654;3,884) and 993(82;1883) deaths /year, respectively, under 4.0C warming (vs. 1990-2010). Urban areas are more affected by both heat and cold and this pattern appears to be amplified under warmer scenarios. In particular, per 100 heat-related deaths in rural areas, there will be an increase from 362 to 391 deaths in urban areas, with similar results for cold (from 262 to 286 per 100 deaths in rural areas), indicating a slight increase in vulnerability to climate change in urban regions in the near future. Our preliminary findings suggest that climate change will increase current heat and cold-related mortality in Switzerland, and moreover, urban areas will continuously more be disproportionately affected. Further analyses will aim to account for urbanization projections and disentangle the contribution of the different drivers across urban and rural regions.

BackgroundWhile several studies have reported a “bilingual advantage” in cognition among older adults, others have not. Most studies of bilingualism and cognitive aging are in urban settings among high income countries, limiting the generalizability among bilinguals residing in lower‐and middle‐income countries, such as Mexico. Additionally, the association of bilingualism and cognition among indigenous populations is unknown. In Mexico, there are almost 7 million speakers of indigenous languages, residing primarily in rural areas, and over 15 million people that report speaking English, predominantly in urban settings. To account for sociocultural factors confounding the type of bilingualism (i.e., English‐Spanish, Indigenous‐Spanish), we evaluated whether bilingualism was associated with better cognitive functioning among adults across urban and rural regions in Mexico.MethodAnalyses included participants from the Mexican Health and Aging Study (MHAS) aged 55 and older in urban (N = 1053, 12% Spanish‐English bilinguals) and rural (N = 814, 20% Spanish‐Indigenous bilinguals) areas. Participants reported speaking English and/or an indigenous language in addition to Spanish. Participants completed comprehensive cognitive testing assessing memory, language, executive function, and visuospatial domains. General linear models stratified by region evaluated bilingualism on cognitive domain performance covarying for sociodemographic factors.ResultSociodemographic characteristics differed by region and language group. English‐Spanish bilinguals in urban areas were younger, predominantly men, with higher education, less likely illiterate, and with greater U.S. migration history compared to monolinguals. In rural areas, Indigenous‐Spanish bilinguals were younger, with less education, higher prevalence of illiteracy, and less likely to have U.S. migration history compared to monolinguals. In urban settings, English‐Spanish bilingualism was not associated with performance on any cognitive domain (p&gt;0.05). In rural settings, Indigenous‐Spanish bilingualism was associated with worse performance across all cognitive domains (p&lt;0.01).ConclusionThere was no evidence of a bilingual cognitive advantage among older adults residing in urban and rural regions in Mexico. While indigenous bilinguals demonstrated the lowest cognitive test performance, further work is required to understand the socioeconomic and environmental factors associated with bilingualism among indigenous populations in Mexico. Greater characterization of their bilingualism (i.e., age and context of acquisition, proficiency, frequency of use) across all languages can help elucidate the association between bilingualism and cognitive test performance.

Interface of Law and Psychiatric Problems in the Elderly.

Population ageing and urbanisation requires a more thorough understanding and monitoring of older adult residential mobility trends. Many older adults move to urban areas and previous studies have been carried out on ageing in place in traditional low-rise residential buildings. However, there is little in the literature about the important push and pull factors influencing older adult moves to medium- and high-rise multi-storey residential buildings in urban areas as they age. This case study research considered the housing migration model of push and pull factors used in elderly residential mobility and investigated the older adults' decision-making regarding mobility to age in place in medium- and high-rise multi-storey residential buildings in South East Queensland, Australia. The study revealed how the older adults expressed a desire to age in place in multi-storey residential buildings in urban areas and identified it as an important element of quality of life. Many older adults chose to move house to high density urban areas from low density urban areas between the ages of 65 and 84. The ‘pull’ factor to significantly influence the decisions of movers was a low maintenance property and lifestyle change from a large suburban home whereas the ‘push’ factor was upkeep difficulties of the house related to old age. This study makes empirical contributions to knowledge in ageing residential mobility trends in urban areas and concludes by providing policy recommendations for developing more effective housing, public spaces, transportation, and community activities and services for older adults, including highlighting a number of recommendations for future research.

Greenness-air pollution-physical activity-hypertension association among middle-aged and older adults: Evidence from urban and rural China

BackgroundWith the world’s population aging, more health-conscious older adults are seeking health information to make better-informed health decisions. The rapid growth of the internet has empowered older adults to access web-based health information sources. However, research explicitly exploring older adults’ online health information seeking (OHIS) behavior is still underway.ObjectiveThis systematic scoping review aims to understand older adults’ OHIS and answer four research questions: (1) What types of health information do older adults seek and where do they seek health information on the internet? (2) What are the factors that influence older adults’ OHIS? (3) What are the barriers to older adults’ OHIS? (4) How can we intervene and support older adults’ OHIS?MethodsA comprehensive literature search was performed in November 2020, involving the following academic databases: Web of Science; Cochrane Library database; PubMed; MEDLINE; CINAHL Plus; APA PsycINFO; Library and Information Science Source; Library, Information Science and Technology s; Psychology and Behavioral Sciences Collection; Communication & Mass Media Complete; ABI/INFORM; and ACM Digital Library. The initial search identified 8047 publications through database search strategies. After the removal of duplicates, a data set consisting of 5949 publications was obtained for screening. Among these, 75 articles met the inclusion criteria. Qualitative content analysis was performed to identify themes related to the research questions.ResultsThe results suggest that older adults seek 10 types of health information from 6 types of internet-based information sources and that 2 main categories of influencing factors, individual-related and source-related, impact older adults’ OHIS. Moreover, the results reveal that in their OHIS, older adults confront 3 types of barriers, namely individual, social, and those related to information and communication technologies. Some intervention programs based on educational training workshops have been created to intervene and support older adults’ OHIS.ConclusionsAlthough OHIS has become increasingly common among older adults, the review reveals that older adults’ OHIS behavior is not adequately investigated. The findings suggest that more studies are needed to understand older adults’ OHIS behaviors and better support their medical and health decisions in OHIS. Based on the results, the review proposes multiple objectives for future studies, including (1) more investigations on the OHIS behavior of older adults above 85 years; (2) conducting more longitudinal, action research, and mixed methods studies; (3) elaboration of the mobile context and cross-platform scenario of older adults’ OHIS; (4) facilitating older adults’ OHIS by explicating technology affordance; and (5) promoting and measuring the performance of OHIS interventions for older adults.

A striking feature of many cities in less developed countries (LDCs) is the coexistence of large, well-organized, high-technology firms with the small street vendors who own little but a wooden box to sit on. This apparent dualism in the urban economy has been a concern of students of economic development for many years. Several international agencies, notably the International Labour Organisation (ILO) and the World Bank, have focused attention on this phenomenon. The ILO popularized the terms formal and to describe this dichotomy. To many economists, one consequence of this dualism is labor market segmentation.' Labor market segmentation plays a crucial role in explanations provided for some important issues, such as rural-urban migration, urban poverty, unemployment, underemployment, and growth.2 In this article I examine the hypothesis that labor market segmentation exists in San Jos6, Costa Rica, between the public and private-formal sectors and between the privateformal and informal sectors (defined in the Appendix). I define labor market segmentation as a situation where, because of institutional barriers to occupational mobility between sectors, a worker in the lower sector has less than full access to a job in the upper sector held by an observationally identical worker.3 If there were no barriers, workers in the low wage sector would enter the high wage sector and force the wages in that sector down until wages across sectors were equalized. That is, labor market segmentation implies differences in wages for observationally identical workers. Relying on this inference, most of the empirical literature on labor market segmen-

Falls among older adults are a significant challenge to global healthy aging. Identifying key factors and differences in fall risks, along with developing predictive models, is essential for differentiated and precise interventions in China's urban and rural older populations. The data of 5,876 older adults were obtained from the China Health and Retirement Longitudinal Survey (Waves 2015 and 2018). A total of 87 baseline input variables were considered as candidate features. Predictive models for fall risk over the next 3 years among urban and rural older populations were developed using five machine learning algorithms. Logistic regression analysis was employed to identify key factors influencing falls in these populations. The fall incidence among older adults was 22.4%, with 23.2% in rural areas and 20.9% in urban areas. Common risk factors across both settings include gender, age, fall history, sleep duration, activities of daily living questionnaire scores, memory status, and chair stand test time. In rural areas, additional risks include being unmarried, having diabetes, heart disease, memory-related medication use, and living in houses built 6-20 years ago. For urban, liver disease, arthritis, physical disabilities, depressive symptoms, weak hand strength, poor relations with children, and digestive medication use are significant risk factors while living in a tidy environment is protective. Random Forest models achieved the highest AUC-ROC and sensitivity in both rural (AUC = 0.732, 95% CI: 0.69-0.78; sensitivity = 0.669) and urban (AUC = 0.734, 95% CI: 0.68-0.79; sensitivity = 0.754) areas. Decision curve analysis confirmed the model's clinical utility across a range of threshold probabilities. Key predictors included prior experience of falling, gender, and chair stand test performance in rural areas, while in urban areas, experience of falling, gender, and age were the most influential features. The key factors influencing falls among older people differ between urban and rural areas, and the predictive models effectively identify high-risk populations in both settings. This facilitates targeted prevention and precise interventions, supporting healthy aging in China.