Health and Healthcare Among the Rural Aging

  • Lois Wright Morton
  • Chih-Yuan Weng
Part of the Understanding Population Trends and Processes book series (UPTA, volume 7)


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.


Food Insecurity Collective Efficacy Medicare Part Household Food Insecurity Farm Operator 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Anderson, S. A. (1990). Core indicators of nutritional state for difficult-to-sample populations. The Journal of Nutrition, 120(11 Suppl.), 1555–1600.Google Scholar
  2. Berkman, L. F., Glass, T., Brissette, I., & Seeman, T. E. (2000). From social integration to health: Durkheim in the new millennium. Social Science & Medicine, 51(6), 843–857. doi: 10.1016/s0277-9536(00)00065-4.CrossRefGoogle Scholar
  3. Bickel, G., Nord, M., Price, C., Hamilton, W., & Cook, J. (2000). Guide to measuring household food security. Measuring food security in the United States: Reports of the federal interagency food security measurement project, No. 6 (Rev. March 2000 ed.). Alexandria: Office of Analysis, Nutrition, and Evaluation, Food and Nutrition Service, U.S. Department of Agriculture.Google Scholar
  4. Bishop, B. (2009). Tracing rural America’s ‘mortality penalty’. Accessed 26 Oct 2009.
  5. Bodenheimer, T., Chen, E., & Bennett, H. D. (2009). Confronting the growing burden of chronic disease: Can the U.S. health care workforce do the job? Health Affairs, 28(1), 64–74. doi: 10.1377/hlthaff.28.1.64.CrossRefGoogle Scholar
  6. Borders, T., Rohrer, J., & Cardarelli, K. (2006). Gender-specific disparities in obesity. Journal of Community Health, 31(1), 57–68. doi: 10.1007/s10900-005-8189-8.CrossRefGoogle Scholar
  7. Center for Rural Affairs. (2009). Health care policy and rural America. Accessed 1 Sep 2009.
  8. Centers for Disease Control and Prevention. (2010a). 2009 H1N1 flu in the news—Questions and answers: Morbid obesity as a risk factor for hospitalization and death due to 2009 H1N1. Accessed 16 Oct 2011.
  9. Centers for Disease Control and Prevention. (2010b). Chronic diseases and health promotion. Accessed 16 Oct 2011.
  10. Centers for Disease Control and Prevention. (2011). Healthy weight—It’s not a diet, it’s a lifestyle! About BMI for adults. Accessed 16 Oct 2011.
  11. Cohen, D. A., Finch, B. K., Bower, A., & Sastry, N. (2006). Collective efficacy and obesity: The potential influence of social factors on health. Social Science & Medicine, 62(3), 769–778. doi: 10.1016/j.socscimed.2005.06.033.CrossRefGoogle Scholar
  12. Cosby, A. G., Neaves, T. T., Cossman, R. E., Cossman, J. S., James, W. L., Feierabend, N., et al. (2008). Preliminary evidence for an emerging nonmetropolitan mortality penalty in the United States. American Journal of Public Health, 98(8), 1470–1472. doi: 10.2105/ajph.2007.123778.CrossRefGoogle Scholar
  13. Cvitkovich, Y., & Wister, A. (2001). The importance of transportation and prioritization of environmental needs to sustain well-being among older adults. Environment and Behavior, 33(6), 809–829. doi: 10.1177/00139160121973250.CrossRefGoogle Scholar
  14. Danaei, G., Rimm, E. B., Oza, S., Kulkarni, S. C., Murray, C. J. L., & Ezzati, M. (2010). The promise of prevention: The effects of four preventable risk factors on national life expectancy and life expectancy disparities by race and county in the United States. PLoS Medicine, 7(3), e1000248. doi: 10.1371/journal.pmed.1000248.CrossRefGoogle Scholar
  15. Economic Research Service. (2003). Measuring rurality: New definitions in 2003. Accessed 24 Aug 2009.
  16. Economic Research Service. (2010). Farm household economics and well-being: Glossary. Accessed 16 Oct 2011.
  17. Glasgow, N. (2000). Transportation transitions and social integration of nonmetropolitan older persons. In K. Pillemer, P. Moen, E. Wethington, & N. Glasgow (Eds.), Social integration in the second half of life (pp. 108–131). Baltimore: The Johns Hopkins University Press.Google Scholar
  18. Glasgow, N. (2004). Healthy aging in rural America. In N. Glasgow, L. W. Morton, & N. E. Johnson (Eds.), Critical issues in rural health (pp. 271–281). Ames: Blackwell Publishing.Google Scholar
  19. Glasgow, N., & Arguillas, M.-J. (2008). Social integration and health of older in-migrants to rural retirement destinations. In D. L. Brown & N. Glasgow (Eds.), Rural retirement migration (pp. 117–140). Dordrecht: Springer.CrossRefGoogle Scholar
  20. Hartman, M., Martin, A., Nuccio, O., Catlin, A., & National Health Expenditure Accounts Team. (2010). Health spending growth at a historic low in 2008. Health Affairs, 29(1), 147–155. doi: 10.1377/hlthaff.2009.0839.CrossRefGoogle Scholar
  21. Jackson, J. E., Doescher, M. P., Jerant, A. F., & Hart, L. G. (2005). A national study of obesity prevalence and trends by type of rural county. The Journal of Rural Health, 21(2), 140–148. doi: 10.1111/j.1748-0361.2005.tb00074.x.CrossRefGoogle Scholar
  22. Jones, C. A., Parker, T. S., Ahearn, M., Mishra, A. K., & Variyam, J. N. (2009). Health status and health care access of farm and rural populations (Economic Information Bulletin No. 57). Washington, DC: Economic Research Service, United States Department of Agriculture.Google Scholar
  23. Marshall, T. A., Stumbo, P. J., Warren, J. J., & Xie, X.-J. (2001). Inadequate nutrient intakes are common and are associated with low diet variety in rural, community-dwelling elderly. The Journal of Nutrition, 131(8), 2192–2196.Google Scholar
  24. Meyer, S. (2005). Fatal occupational injuries to older workers in farming, 1995–2002. Monthly Labor Review, 128(10), 38–48.Google Scholar
  25. Morland, K., Wing, S., & Roux, A. D. (2002). The contextual effect of the local food environment on residents’ diets: The atherosclerosis risk in communities study. American Journal of Public Health, 92(11), 1761–1768. doi: 10.2105/ajph.92.11.1761.CrossRefGoogle Scholar
  26. Morton, L. W. (2003). Rural health policy. In D. L. Brown & L. E. Swanson (Eds.), Challenges for rural America in the twenty-first century (pp. 290–302). University Park: Pennsylvania State University Press.Google Scholar
  27. Morton, L. W., Bitto, E. A., Oakland, M. J., & Sand, M. (2004a). Rural food access patterns: Elderly open-country and in-town residents (SP 236). Ames: Iowa State University Extension.Google Scholar
  28. Morton, L. W., Glasgow, N., & Johnson, N. E. (2004b). Reaching the goal: Less disparity, better rural health. In N. Glasgow, L. W. Morton, & N. E. Johnson (Eds.), Critical issues in rural health (pp. 283–291). Ames: Blackwell Publishing.Google Scholar
  29. Morton, L. W., Oakland, M. J., Flakoll, P., Greder, K., Garasky, S., & Li, T. (2004c). Food in my community: A case study of Palo Alto county (Sociology Technical Report No. 1006). Ames: Department of Sociology, Iowa State University.Google Scholar
  30. Murray, C. J. L., Kulkarni, S. C., Michaud, C., Tomijima, N., Bulzacchelli, M. T., Iandiorio, T. J., et al. (2006). Eight Americas: Investigating mortality disparities across races, counties, and race-counties in the United States. PLoS Medicine, 3(9), e260. doi: 10.1371/journal.pmed.0030260.CrossRefGoogle Scholar
  31. National Center for Health Statistics. (2009). Health, United States, 2008, with chartbook. Hyattsville: National Center for Health Statistics.Google Scholar
  32. Ng, T., Harrington, C., & Kitchener, M. (2010). Medicare and medicaid In long-term care. Health Affairs, 29(1), 22–28. doi: 10.1377/hlthaff.2009.0494.CrossRefGoogle Scholar
  33. Patterson, P. D., Moore, C. G., Probst, J. C., & Shinogle, J. A. (2004). Obesity and physical inactivity in rural America. The Journal of Rural Health, 20(2), 151–159. doi: 10.1111/j.1748-0361.2004.tb00022.x.CrossRefGoogle Scholar
  34. Silverstein, N. M., & Wu, B. (1997). Snapshot in the lives of community-residing elders 85 and older: Their lifestyles, contributions, and concerns. Boston: Gerontology Institute and Center, University of Massachusetts at Boston.Google Scholar
  35. Thorpe, K. E., Florence, C. S., Howard, D. H., & Joski, P. (2004). Trends: The impact of obesity on rising medical spending. Health Affairs, 23, w4-480–486, doi: 10.1377/hlthaff.w4.480.
  36. Truffer, C. J., Keehan, S., Smith, S., Cylus, J., Sisko, A., Poisal, J. A., et al. (2010). Health spending projections through 2019: The recession’s impact continues. Health Affairs, 29(3), 522–529. doi: 10.1377/hlthaff.2009.1074.CrossRefGoogle Scholar
  37. U.S. Environmental Protection Agency. (2009). Ag 101: Demographics. Accessed 16 Oct 2011.
  38. U.S. Government Accountability Office. (2008). The nation’s long-term fiscal outlook, April 2008 Update: Health care cost growth and demographic trends drive the long-term fiscal challenge (GAO-08-783R). Washington, DC: U.S. Government Accountability Office.Google Scholar
  39. Wikipedia. (2010). Patient protection and affordable care act. Accessed 16 Oct 2010.
  40. Wooden, J., & Oakland, M. J. (2003). Food insufficiency among older Americans. Hunger and Environmental Nutrition Newsletter. American Dietetic Association.Google Scholar
  41. Xu, K. T. (2003). Financial disparities in prescription drug use between elderly and nonelderly Americans. Health Affairs, 22(5), 210–221. doi: 10.1377/hlthaff.22.5.210.CrossRefGoogle Scholar
  42. Ziller, E. C., Coburn, A. F., Loux, S. L., Hoffman, C., & McBride, T. D. (2003). Health insurance coverage in rural America: Chartbook. Portland, Maine and Washington, DC : Institute for Health Policy, Muskie School of Public Service, University of Southern Maine, with The Kaiser Commission on Medicaid and the Uninsured.Google Scholar

Copyright information

© Springer Science+Business Media Dordrecht. 2013

Authors and Affiliations

  1. 1.Department of SociologyIowa State UniversityAmesUSA
  2. 2.Department of SociologyFu Jen Catholic UniversityNew TaipeiTaiwan (R.O.C.), Taiwan

Personalised recommendations