Rural Age Research Articles

Research on Rural Public Space Reconstruction for the aged from the Perspective of Community Endowment—Taking Jinqiao village in Fengyang as an Example

The emergence of urban-rural dual structure and the increasingly serious problem of rural aging are inevitable results in the process of urbanization. It will play a very important role to improve pension infrastructure to meet the new demand for rural aging. Taking Jinqiao Village, Fengyang County, Anhui Province of P. R. of China as an example, the importance of communication space, cultural space and healthcare space as the main activity areas for the aged has been explored according to their family status, psychological characteristics, residence and behavior habits. The design and analysis of the public pension activity space and facilities of the village are carried out from the angle of “convenience”, “culture” and “security”. The strategy of improving and optimizing the reconstruction of rural pension space is put forward.

Diet Quality and Risk of Parkinson Disease: A Prospective Study and a Meta-Analysis

Abstract Objectives Several dietary components have been shown to be neuroprotective against risk of neurodegeneration. We thus examined the associations between diet quality and risk of Parkinson disease (PD) in a prospective cohort study and a meta-analysis. Methods Included in the cohort study were 3653 participants (1519 men and 2134 women; mean age: 81.5 years) in the Geisinger Rural Aging Study longitudinal cohort in Pennsylvania. Diet quality was assessed using a validated dietary screening tool containing 25 food- and behavior-specific questions in 2009 (baseline). Potential PD cases were identified using electronic health records based on ICD10 code (G20) and PD-related treatments. Incident PD cases were defined as being diagnosed after 1 year of follow-up and receiving PD-related medication treatments. Hazard ratios (HRs) and 95% confidence intervals (CIs) across diet quality tertiles were calculated using cox proportional hazards models after adjusting for age, sex, race, educational level, smoking, oral health, obesity and living arrangement. We further performed a meta-analysis by pooling our study with four published papers on this topic. Random-effects model was utilized to calculate the pooled risk ratios and 95% CIs. Results During a mean of 6.94 years of follow-up, 47 incident PD cases were documented. Having high diet quality at baseline was associated with lower PD risk (p-trend = 0.02). The adjusted HR was 0.39 (95% CI: 0.17–0.89) for the highest vs the lowest diet quality tertiles. The meta-analysis including 140,617 individuals also showed that adherence to a healthy dietary pattern was associated with lower risk of incident PD (pooled risk ratio = 0.64; 95% CI: 0.49–0.83). Conclusions Having high diet quality was associated with lower future risk of PD. Funding Sources United States Department of Agriculture, Agricultural Research Service agreement.

Association between Medicaid expansion status and metastatic disease at diagnosis in patients with melanoma.

7030 Background: The Affordable Care Act (ACA) expanded Medicaid coverage in 2010. It is unknown what impact the ACA expansion has had on a timely diagnosis for patients with melanoma. We hypothesize Medicaid ACA expansion has decreased the odds of being diagnosed with Stage IV melanoma. Methods: The National Cancer Database was queried. Analysis was restricted to patients diagnosed (dx’d) in or after 2010. Stage IV dx was the outcome variable. Predictors were dx’d at an already expanded ACA state (ES) or not (NES). Covariates were age, race, sex, education status, income, rural setting, and Charlson co-morbidity index. Univariate and Multivariate analyses were performed using logistic regression (table). The outcome model was adjusted using a generated Propensity Score as a continuous variable. An interaction term was used to evaluate for effect modification of ES on the association between race and Stage IV. Results: 219,475 patients diagnosed in 2010 or later were included. Median age was 62 years. By Univariate analysis, NES, age > = 65, black race, male sex, lower educational and income level, rural area, and a higher Charlson score were significantly associated with increased odds of being dx’d with Stage IV melanoma (all p < 0.001). By Multivariate Analysis, these associations persisted except for rural area and age. After adjusting for propensity score, ES patients were 9% less likely to be diagnosed with Stage IV melanoma as compared with NES patients (OR = 0.91 p < 0.001; 95% CI 0.867 – 0.959). ACA expansion status was an effect modifier on the association between race and late diagnosis (p = 0.004 for interaction term). For NES patients, black race had 3.26 odds (p < 0.001 95% CI 2.56 – 4.18) of being diagnosed with Stage IV as compared with white patients. The odds dropped to 1.76 (p 0.004; 95% CI 1.20 – 2.57) for ES patients. Conclusions: ES patients were less likely to be diagnosed with Stage IV melanoma as compared to NES patients. Medicaid expansion decreased the likelihood for black patients to be diagnosed with Stage IV as compared with whites. This suggests Medicaid expansion improves access to care and earlier diagnosis of melanoma and decreases racial gaps. [Table: see text]

Stewardship of the rural: Conceptualising the experiences of rural volunteering in later life

The figure of the older volunteer involved with the civil society of rural communities is written onto by the dual demands to age well and productively; to benefit themselves but also to be a good citizen and to contribute to their communities and to wider society. Considering this popular narrative in depth, this paper brings two bodies of literature into useful dialogue. First, we consider the re-emerging interest in the geographies of ageing and, in particular, the role of place and environment in shaping the process of how we experience growing older and the later stage of our lives. Second, we consider that expanding body of work which focuses on the geographies of volunteering, and particularly those studies which account for the shifting landscape of volunteering and the increasing role of voluntary organisations in rural communities. Our entry point into both of these sets of literature is through the emotional and affective experience of both volunteering and rural ageing. The paper draws on case study data gathered in rural Wales to demonstrate how individuals actively strive to maintain their sense of self-identity and continuity of place through the voluntary work they are engaged in. In doing so, the paper makes the argument that ageing in rural places can be understood as a type of stewardship of place wherein the need to preserve continuity of the self in later life becomes intertwined with a desire to support the continuity of place(s). • Older people engage with the rural environment through a diverse a varied set of voluntary practices. • The voluntary contributions many people make to place(s) in later life challenge ideas of dependence in rural ageing. • Rural volunteering can be understood as a process of continuity of identity and contributing to a continuity of place. • Stewardship provides a way of conceptualising how older people engage with the rural environment through voluntary pursuits.

Sexual and reproductive health rights knowledge and reproductive health services utilization among rural reproductive age women in Aleta Wondo District, Sidama zone, Ethiopia: community based cross-sectional study

BackgroundVarious countries in the world have achieved promising progress in promoting, protecting and guaranteeing sexual and reproductive health rights (SRHRs) since the 1994 International Conference on Population and Development (ICPD) in Cairo. However, SRHRs have not been recognized to their maximum potential in Ethiopia, despite the domestication of the international instruments related to their successful implementation. This study was intended to determine the magnitude of SRHRs knowledge, reproductive health services utilization and their independent predictors among rural reproductive-age women in the Aleta Wondo District, Ethiopia.MethodsA community-based cross-sectional study was conducted among 833 rural reproductive-age women from April to May 2019. A systematic random sampling technique was employed to select households, and a structured questionnaire was used to gather the data. EPI INFO version 7 was used to enter the data, and SPSS version 23 was used for data analysis. Logistic regression analysis was employed to assess the association between outcomes and explanatory variables. Odds ratios at 95% CI were also computed and reported.ResultsOf 833 respondents, 43.9% had good knowledge of SRHR, and 37% had used at least one sexual and reproductive health (SRH) service. Variables that had a statistically significant association with SRHR knowledge in multivariable analysis were: had formal education, household with the highest income, having information sources for SRH services, and knowing about SRH services and providing institutions. SRH services utilization was associated with: having information sources for SRH services, had formal education, household with the highest income, and knowing about SRH services and providing institutions.ConclusionIn this study demographic and economic factors, such as education and household monthly income were positively identified as independent predictors for knowledge of SRHR and SRH services utilization. Therefore, responsible government sectors and NGOs should design and implement programs to promote women’s educational status and household economic status to enhance women’s SRHR knowledge and SRH services utilization.

COVID-19 Pandemic and Australia: “The Lucky Country”

Australia has indeed come through the first-wave COVID lightly. The strain on Australian society is more from the secondary effects of adaptation to contain the outbreak than from the outbreak itself. On a societal level, Australia has several factors that have contributed to the comparative mildness of the impacts of the lockdown. Tertiary psychiatric service demands appear to have been well met, although there appears to have been an increase in required support in other areas. The mental health burden of COVID is unlikely to be spread proportionately across the population, with variations based on the rural location, ethnicity, age, and indigenous status. Beyond the acute phase of the pandemic significant challenges loom. One can expect severe economic repercussions, including a spike in unemployment and a concomitant rise in anxiety and depression as other social determinants worsen.

Survival analysis of Rural Clinical School of Western Australia graduates: the long-term work of building a long-term rural medical workforce

BackgroundDeficits in the rural medical workforce is an international issue. In Australia, The Rural Clinical School intervention is effective for initial recruitment of rural doctors. However, the extent of survival is not yet established. This paper summarises rural survival over a 10-year period.MethodsRural Clinical School graduates of Western Australia were surveyed annually, 2006–2015, and post Graduate Years (PGY) 3–12 included. Survival was described as “tours of service”, where a tour was either a period of ≥1 year, or a period of ≥2 weeks, working rurally. A tour ended with a rural work gap of ≥52 weeks. Considering each exit from urban as an event, semi-parametric repeated measures survival models were fitted.ResultsOf 468 graduates, using the ≥2 weeks definition, 239 PGY3–12 graduates spent at least one tour rurally (average 61.1, CI 52.5–69.7 weeks), and a total length of 14,607 weeks. Based on the tour definition of ≥1 year, 120 graduates completed at least one tour (average 1.89, 1.69–2.10 years), and a total of 227 years’ rural work. For both definitions, the number of tours increased from one to four by PGY10/11, giving 17,786 total weeks (342 years) across all PGYs for the ≥2 weeks tour definition, and 256 years total for ≥1 year. Significantly more graduates exited from urban work for the 2007–09 middle cohort compared with 2010–11 (HR 1.876, p = 0.022), but no significant difference between 2002 and 06 and 2010–11. Rural origin, age and gender were not statistically significant.ConclusionsPGY3–12 RCS graduates contributed substantially to the rural workforce: 51% did so by short rotations, while 26% contributed whole years of service. There was an apparent peak in entry and survival for the middle cohort and decline thereafter, likely attributable to lack of advanced/specialist vocational training. These data indicate a real commitment to rural practice by RCS graduates, and the need for rural vocational training as a key element of a successful rural survival strategy.

PRODUCTIVE AND ACTIVE RURAL AGING: TOWARD CRITICAL PERSPECTIVES

Despite global trends in rural population ageing, relatively little attention within research and policy has been directed to understanding what it means for rural people, communities and institutions to be at the forefront of twenty-first century demographic change. To build understanding of rural ageing, this symposium draws together papers from four countries to provide insights in the gaps in rural ageing research – specifically the in context of productive and active rural ageing by examining rural work, retirement and volunteering through the critical perspectives of citizenship, contestation and complexity. Winterton and Warburton will explore how active citizenship trends among rural older adults support or hinder the capacity of rural settings to support health ageing. Colibaba and Skinner will discuss the contestation of rural ageing by examining a volunteer-based rural library and the emergent ‘contested spaces of older voluntarism’ whereby older volunteer negotiate their rights and responsibilities associated with ageing and volunteering in rural communities. Duvvury and Ni Leime will examine the interactions between the twin phenomena of feminisation of agriculture and the feminisation of ageing in the consequent implications for rural women’s work and retirement. Skinner and Joseph offer a critical perspective on voluntarism in ageing rural communities by examining volunteer leadership biographies as another means of understanding the contribution of older rural adults.

CRITICAL SOCIAL GERONTOLOGY AND RURAL AGING

This paper examines the extent to which critical gerontology has raised awareness of the heterogeneity of rural ageing in High Income Countries (HICs) and compare this to our knowledge of the issues that are associated with rural ageing in Low to Middle Income Countries (LMICS). We will draw on Nancy Fraser’s social justice framework to summarize key issues around: (1) Demography (such as globalization, urbanization, counter-urbanization and rural population ageing); (2) Resources (individual material and social resources; community resources such as access to services); (3) Recognition (social status, cultural visibility through social participation and cultural worth through valued social roles); (4) Representation (in social, health and rural development policies; and in private sector and NGO approaches). We argue that an intersectional approach that takes into account location and context (structural/economic/political) alongside other dimensions of oppression and/or privilege can provide a better understanding of the experience of ageing in rural areas.

RETHINKING RURAL GERONTOLOGY THROUGH A DEWEYAN PRAGMATIST PERSPECTIVE

Rural aging as we have conceived of it in the gerontological literature of the past 50 years no longer exists, if it ever did. In this presentation, we contribute toward a reframing of the discourse on rural aging through a critique of established views of rural aging as an ecological, cultural, and phenomenological experience. We argue that each view is limited in its ability to encapsulate the essence of rural living and community. Our critique provides a context for a dynamic perspective on rural aging that embraces the situational uniqueness of each rural environment. We introduce that perspective, based in John Dewey’s philosophy, and grounded in the idea of situationally defined manifestations of place integration within an ever-changing milieu. We conclude with a discussion of key implications, including how this perspective reshapes the roles of researchers and older rural residents in the process of ongoing rural gerontological inquiry.

LIVING IN RURAL CONTEXTS: TOWARD A CRITICAL INTERDISCIPLINARY PERSPECTIVE ON RURAL AGING

Despite a growing focus on rural ageing, international literature in this field remains underdeveloped in critical and interdisciplinary perspectives. Reflecting traditional divisions across geographic, gerontological and health literatures, how we understand experiences of growing older in rural settings can still be characterised by a narrow, applied approach. This has implications for our capacity to disentangle multifaceted lived realities from rural contexts, and macro socio-economic and structural environments. There then remains questions about the ways in which the study of rural ageing needs to develop to direct policy, research and practice agendas to be a more critical reflection of these complexities. This symposium aims to draw together interdisciplinary critical perspectives on ageing and rurality as a means to advance this development. It will consider different theoretical approaches and major cross cutting challenges in relation to rural ageing. Burholt and Scharf will examine how critical gerontology has raised awareness of the heterogeneity of rural ageing across social justice elements of demography, resources, recognition and representation. Keogh and Walsh address these same elements in relation to the empirical intersection of exclusion and change in the production of a new rurality for older people. Cutchin and Rowles present a pragmatist theoretical perspective to encapsulate the essence of rural integration within an ever-changing milieu. Poulin et al. offer a critical approach to rural gerontological health that emphasizes intersectionality in the formation and development of older adult health. Herron and Skinner explore the intersectional construction of dementia and mental health in rural settings for older adults.

INTEREST GROUP SESSION—RURAL AGING: INNOVATIONS THAT SUPPORT RURAL OLDER ADULTS’ HEALTH AND WELL-BEING: MODELS, NETWORKS, CASE STUDIES, REFLECTIONS

Access of rural older people to health and wellness services is limited and becoming progressively more limited as trends toward increasing centralization of Government and private services continue. “Top-down” or urban centric models for rural service delivery often miss context essential to effectiveness and sustainability. In this symposium, each presenter in this multidisciplinary group of researchers presents innovative, community-based interventions that address these challenges using different methodologies and in respect to different needs Maiden (Psychology) compares the utilization of mental health services by rural older adults over time with their need for such services. Through the lens of social gerontology Holley examines networks of support that have intersected successfully to generate local solutions to unmet needs of rural-dwelling older adults. Crowther and Ford within a nursing and care context explore community-based models that draw upon the role of culture to integrate care for rural older adults. Katz, from an adult development perspective, reports on an educational game-intervention developed to reduce cognitive decline which is tailored specifically for older adults in rural areas. Wiese presents evidence from a pilot home-based approach that demonstrates a model for increasing rates of AD detection and treatment in a rural retired farm worker community in Florida. Our discussant, an emerging scholar in the field of rural gerontology, will reflect on the major themes that emerge from these multidisciplinary perspectives, especially the role of intersecting networks in community-based innovations and rural aging.

PREDICTION OF THE NUMBER OF AND CARE COSTS FOR DISABLED OLDER ADULTS FROM 2020 TO 2050 IN URBAN AND RURAL AREAS IN CHINA

Disability for the elderly has become a crucial policy concerns in rapidly aging Asia counties, especially in China. This study aimed to predict the trend of the number of and care costs for disabled older adults from 2020 to 2050 in urban and rural areas in China. Population Administration Decision Information System was used to predict the population of China by urban and rural areas and age group from 2020 to 2050. Monte Carlo simulation and Policy Simulation Model were used to estimate the number and care costs of disabled elderly between urban and rural areas, based on the Chinese latest census data, statistical yearbook, and national survey database. The total disabled population rises rapidly from 43.75 million in 2020 to 91.4 million in 2050, of which 69.7% were urban adults. Compared with the values in 2020, the growth rates of the adults with mild, moderate and severe disabilities were 108%, 104% and 120% in 2050, respectively. The value were 167% and 39% in urban and rural areas, respectively. By 2050, the total care costs increase from 538.0 billion yuan in 2020 to 8530.8 billion yuan, of which 80.2% occurs in urban areas. The predicted results indicate that the numbers and care costs for disabled older adults increase sharply from 2020 to 2050, especially in urban areas of China. It provided a series of evidence for the establishment of the long-term care insurance system in China.

BARRIERS AND SOLUTIONS TO IMPROVE AGE-RELATED SERVICE ACCESS IN UTAH: A QUALITATIVE STUDY

Utah is projected to be in the top 10 states for growth in the aging population, but it is among the most rural. Local and regional contexts guide policy and practice, and these perspectives will inform solutions as more older adults require services in rural and other under-served areas in the coming decades. Guided by Bronfenbrenner’s Process-Person-Context-Time model, this study used a qualitative participatory research orientation involving stakeholders in Utah’s aging service system in order to identify local barriers and solutions to accessing rural aging services. The stakeholders included service providers, caregivers, older adults, state-administrators, and other community members. There were 3 male and 7 female participants ranging in age from 40 to 80. Thematic analysis revealed that communities faced barriers common to rural areas (local service insufficiencies, distance and time concerns, systemic issues such as healthcare and ageism, finances - both personal and programmatic were deemed a recurrent barrier, in addition to transportation issues. However, participants reported assets in rural areas, such as a strong sense of belonging in the community and creative problem solving. Solutions for improving access to age-related services included strategies for making information more available, publicized, and centralized and increasing access to telehealth or internet-delivered services and health information. These barriers and solutions were nested across the levels of context in Bronfenbrenner’s model, with both person, time, and in interactions (processes) having influence, but localized analysis of the barriers is necessary to ensure that the solutions are appropriate in a specific context.

Domestic Exposure to Tobacco Smoke in Children

Background Secondhand smoking (SHS) is one of the important risk factors among non-communicable diseases and is responsible for more than 1% of the total burden of diseases among under five-year-old children. The prevalence of SHS among children has not been investigated both at national and provincial levels in Iran. This study was carried out to address this issue at national and provincial levels. Method: Iran’s Multiple Indicator Demographic and Health Survey (IrMIDHS) in 2010 was a multi-stage stratified cluster-random cross-sectional nationwide study over all provinces with a sample representing general population at district levels of provinces. Analyses were performed on the data of the participants who were <10 years. Data were collected by 240 trained teams over 31 provinces of Iran using standard questionnaires. Two questions about being exposed to smoking through at least one household member and number of exposure days per week were asked of the participants. Univariate and multivariable logistic regression model were utilized to assess the associated factors with SHS among children. Results: Out of a total of 111,825 participants in IrMIDHS, 18,712 of the participants were under 10 years old. About 52.48% (50.82%–52.14%) were male and 61.42% (55.42%–67.11%) resided in urban regions. Crude prevalence of SHS at this age group at national levels was 25.51% (22.48%–28.93%). After age adjustment according to the World Health Organization (WHO) population, the prevalence of secondhand smoking (SHS) at the national level was 25.59% (22.56%–28.89%). There was no significant difference between male and female participants (25.70% versus 25.48% in male and female, respectively). The highest standardized prevalence of SHS was reported from Chaharmahal and Bakhtiari, West Azerbaijan, and Hamadan provinces (44.7%, 43.9%, and 39.1%, respectively). The lowest standardized prevalence belonged to Gilan (12.8%), Golestan (14.7%), and Ilam (14.8%) provinces. Concerning the duration of exposure to SHS, 77.8% of those with history of exposure to smoke reported everyday exposure. In the multivariable model, SHS was positively associated with residence in rural areas (odds ratio = 1.31; 95% confidence interval 1.14–1.51) and age (odds ratio = 1.15; 95% confidence interval 1.03–1.28). Conclusion: SHS was relatively prevalent in 2010 among children <10 years of age in Iran. This rate was very different over the provinces. Although the prevalence of SHS among Iranian kids was found to be lower than its prevalence worldwide, through attention to easily preventable exposure to SHS along with proper legislation and cultural reforms, exposure to SHS could be markedly curbed and reduced.

Effects of land use transitions and rural aging on agricultural production in China’s farming area: A perspective from changing labor employing quantity in the planting industry

Understanding the impact of rural aging on agricultural production is critical for implementing a comprehensive rural vitalization strategy in China. In this paper, the planting structure is converted into and measured by the amount of labor employing quantity in the planting industry with the 2000 and 2010 census data and crop planting area data at the county level. By establishing the elasticity coefficient of rural aging - labor quantity and taking the coupling relation between the rural aging and the change in crop production quantity in the Huang-Huai-Hai region into account, the spatio-temporal pattern of rural aging and the recessive transition of land use is analyzed. The results show that the aging level of the rural population in the Huang-Huai-Hai region has maintained an overall growth rate of 27.03% from 2000 to 2010. During the research period, the labor employing quantity in the planting industry decreased by 14.18% and, was mainly distributed among the western Shandong hilly region, the Taihang and Yanshan mountainous region, and the eastern part of the Huang-Huai-Hai Plain agricultural region. The spatial coupling relationship between the rural aging and the changes in labor employing quantity in the planting industry presented diversified patterns. From 2000–2010, the number of counties with three different coupling modes, namely, rural aging increasing and labor employing quantity decreasing, increasing of rural aging and labor employing quantity, and decreasing of rural aging and labor employing quantity, account for 84.90%, 11.11%, and 3.7%, respectively. To achieve the goal of agricultural development, the authors argue that in the dual context of rural aging and population mobilization, agricultural development must cultivate new professional farmers and improve the level of agricultural modernization in China.

Diet Quality Is Associated With Mortality in Adults Aged 80 Years and Older: A Prospective Study.

Diet quality has been associated with health outcomes and quality of life. However, the association between diet quality and mortality in older people, those aged 80 years and older, is understudied. Therefore, we conducted a prospective study to examine whether better diet quality, assessed by a validated dietary screening tool (DST), was associated with lower mortality in those aged 80 years and older. Our study included 1990 participants (812 men and 1178 women), with a mean age of 84.1 years at baseline (ranging from 80 to 102 years old), from the Geisinger Rural Aging Study longitudinal cohort in Pennsylvania. Baseline descriptive information was obtained in 2009, and the DST was administered via mailed survey. The DST is composed of 25 food- and behavior-specific questions associated with dietary intake that generate a diet quality score ranging from 0 (lowest) to 100 (highest). Death was identified using electronic medical record and the Social Security Death Index data. Hazard ratios (HRs) and 95% confidence intervals (CIs) across three diet quality categories were calculated by using Cox proportional hazards models after adjusting for potential confounders. Over 8 years of follow-up (October 2009-February 2018), 931 deaths were documented. Higher diet quality was associated with lower mortality risk (P-trend = .04). Participants with high diet quality (defined as DST scores >75) had significantly lower risk of mortality compared with those with low diet quality (defined as DST scores <60) after adjusting for potential risk factors (adjusted HR = 0.76; 95% CI = 0.59-0.97). Diet quality, assessed by DST, is significantly associated with risk of mortality in older adults aged 80 years and older in our prospective cohort. Our results indicate that nutrition may have an important role in healthy aging, and more studies are needed to develop appropriate dietary recommendations for older persons. J Am Geriatr Soc 67:2180-2185, 2019.

Rural public libraries as contested spaces of older voluntarism in ageing communities

Abstract Recent efforts to better understand how rural communities are coping with population ageing have highlighted ageing rural volunteers as key issues for ageing in place of rural residents and the sustainability of ageing rural communities. Drawing on a case study of a volunteer-based rural public library in Ontario, Canada, this paper explores this issue from the perspectives of volunteers, library staff and community stakeholders to better understand the experiences of older volunteers and dynamics of older voluntarism, and how they connect to rural community development. Findings from interviews and focus groups reveal how the opportunities and challenges associated with older voluntarism (such as participation and wellbeing vs. burden of care and conflict) can inform our understanding of rural ageing in general and the ‘contested spaces of rural ageing’ in particular. The conceptual and applied implications of researching older voluntarism in ageing rural communities, via social institutions such as libraries, are discussed.

Ease of Use and Usefulness of Medication Reminder Apps among Rural Aging Adults

ABSTRACTOlder adults manage multiple medications for chronic disease and those living in rural areas are impacted by health care disparities due to health provider shortages and fewer pharmacies. The use of downloadable medication reminder apps on smartphones may serve as a strategy for medication self-management of chronic diseases. In this feasibility study, thirteen rural older adult participants downloaded Medisafe® and used the app to manage their daily medications. The community-dwelling aging adults in this pilot perceived the Medisafe® as not difficult to use, useful for medication tracking and providing reminders for the self-management of multiple medications.

Self-rated health among elders in different outmigration areas\u2014a case study of rural Anhui, China

China has been a rapid growing economy in recent decades. Part of its economic development engine comes from internal rural-urban migration. The decades-long rural-urban migration is the result of China’s long-lasting uneven development between its urban and rural areas and its income and resource distribution inequality. Rural Anhui is one of the most affected outmigration regions of China. The absence of young and middle-aged villagers changed its natural villages’ demographics. It broke the self-sufficient rural family structure and their traditional lifestyle with no societal infrastructure to replace family support. Meanwhile, it created aging communities—particularly in relatively poorer villages. This study investigates rural elder villagers’ perception of their physical health in the context of rural-urban migration. It explores the reality of the left-behind rural aging population—their real life challenges and regional disparities reflected in their self-rated health status: those who are living in a relatively poorer region (county) tend to have significantly lower self-rated health (SRH) scores than their counterparts in wealthier areas. Women tend to have lower SRH scores than men, and living alone elders tend to perceive their own physical health to be poorer than others. These findings also show that regional economic condition affect individual lives, women are more vulnerable, and healthy personal interaction is an essential element for wellbeing.