Abstract
Rural quality of life and the experience of aging are directly related to health and well-being. Longer life spans are generally thought to be desirable; however, the increasing prevalence of chronic diseases, disability and limitation of activities associated with aging pose difficult challenges for those living in rural places. Diseases of the heart, cancer and stroke are leading causes of death in the United States (US). Of great concern is the growing prevalence in the US population of those who are overweight, obese and have the chronic disease diabetes. Among the near-elderly, those aged 50–69, medical care spending for the severely obese (those with BMI at 35 or higher) is 60 % higher than those of normal weight (Thorpe et al. J Rural Health 20(2):151–159, 2004). The health and well-being of those who choose to age in place in rural America are influenced by personal characteristics (poverty, marital status, living alone) and decisions (physical exercise and diet) as well as access to quality food systems, social support, transportation and medical care.
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- 1.
Asians; northland low-income rural whites; Middle America; low-income whites in Appalachia and the Mississippi Valley; western native Americans; black Middle America; low-income southern rural blacks; and high-risk urban blacks (Murray et al. 2006).
- 2.
The farm operator is the person who runs the farm, making the day-to-day management decisions. The operator could be an owner, hired manager, cash tenant, share tenant, and/or a partner. If land is rented or worked on shares, the tenant or renter is the operator. In the recent Census of Agriculture and in the Agricultural Resource Management Survey (ARMS), information is collected for up to three operators per farm. In the case of multiple operators, the respondent for the farm identifies who the principal farm operator is during the data collection process (Economic Research Service 2010).
- 3.
BMI (Body Mass Index) is an estimate of body fat, based on height and weight. The CDC define BMI from 25.0–29.9 as overweight and 30.0 and above as obese (Centers for Disease Control and Prevention 2011). A BMI of 40 or above is considered morbid or severe obesity. In 2009, 28% of the US population older than 20 were considered obese and 5% morbidly obese (Centers for Disease Control and Prevention 2010a).
- 4.
America 1 are Asians living in counties in which Pacific Islanders make up less than 40% of the total Asian population; America 2 are whites in the northern plains and Dakotas with 1990 county-level per capita income below $11,775 (national median for whites) and population density less than 100 persons/km2; America 3 are all other whites not included in Americas 2 and 4, Asians not in America 1, and Native Americans not in America 5; America 4 are whites in Appalachia and the Mississippi Valley with 1990 county-level per capita income below $11,775; America 5 are native American populations in the mountain and plains areas, predominantly on or near reservations; America 6 are all other black populations living in counties not included in Americas 7 and 8; America 7 are blacks living in counties in the Mississippi Valley and the Deep South with population density below 100 persons/km2, 1990 county-level per capita income below $7,500 (national median for blacks) and total population size above 1,000 persons (to avoid small numbers); and America 8 are urban populations of more than 150,000 blacks living in counties with cumulative probability of homicide death between 15 and 74 years of age greater than 1.0% (Murray et al. 2006).
- 5.
Economic Research Service Urban Influence Categories 2003: (1) In large metro area of 1+ million residents; (2) In small metro area of less than one million residents; (3) Micropolitan adjacent to large metro; (4) Non-core adjacent to large metro; (5) Micropolitan adjacent to small metro; (6) Non-core adjacent to small metro with own town; (7) Non-core adjacent to small metro no own town; (8) Micropolitan not adjacent to a metro area; (9) Non-core adjacent to micro with own town; (10) Non-core adjacent to micro with no own town; (11) Non-core not adjacent to metro or micro with own town; (12) Non-core not adjacent to metro or micro with no own town (Economic Research Service 2003).
- 6.
More information available at http://www.medicare.gov.
- 7.
More information available at http://www.medicare.gov.
- 8.
Measures of household food insecurity are based on the following definition of food security: “Access by all people at all times to enough food for an active, healthy life, which includes at a minimum: (a) the ready availability of nutritionally adequate and safe foods, and (b) the assured ability to acquire acceptable foods in socially acceptable ways (e.g., without resorting to emergency food supplies, scavenging, stealing or other coping strategies)” (Anderson 1990, p. 1598). Hunger is the extreme range of severity of food insecurity. USDA researchers have developed two instruments (18- and 6-item core food security modules) for documenting prevalence of household food insecurity and household food insecurity with hunger in the United States (Bickel et al. 2000).
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Morton, L.W., Weng, CY. (2013). Health and Healthcare Among the Rural Aging. In: Glasgow, N., Berry, E. (eds) Rural Aging in 21st Century America. Understanding Population Trends and Processes, vol 7. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-5567-3_10
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