Skip to main content

Urban-Rural Health Disparities at Older Ages

  • Living reference work entry
  • First Online:
Encyclopedia of Gerontology and Population Aging

Synonyms

Rurality; Urbanicity; Urban-rural disparities

Definition (of Entry Term)

“Rural” refers to places and communities of low human population density characteristic of areas outside of large metropolitan areas. “Urban” refers to places and communities of higher population density, generally those areas in cities and surrounding areas. Rural older adults are a population group that experiences notable differences in health outcomes compared to their urban counterparts. Urban-rural health disparities reflect the dichotomy of urban living versus rural living and the impact those have on economics, health, and other aspects of life.

Overview

Where someone lives is critical to determine their health and quality of life in numerous ways. Evidence that one’s place of residence plays a critical role in determining health status comes from research both in the USA and in other countries across the globe. There has been an increasing interest in assessing place-based characteristics or...

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

References

  • Bethea TN, Lopez RP, Cozier YC, White LF, McClean MD (2012) The relationship between rural status, individual characteristics, and self-rated health in the behavioral risk factor surveillance system. J Rural Health 28(4):327–338

    Article  Google Scholar 

  • Bolin JN, Bellamy GR, Ferdinand AO, Vuong AM, Kash BA, Schulze A, Helduser JW (2015) Rural healthy people 2020: new decade, same challenges. J Rural Health 31(3):326–333

    Article  Google Scholar 

  • Braveman PA, Egerter SA, Woolf SH, Marks JS (2011) When do we know enough to recommend action on the social determinants of health? Am J Prev Med 40(1):S58–S66

    Article  Google Scholar 

  • Cohen SA (2009) A review of demographic and infrastructural factors and potential solutions to the physician and nursing shortage predicted to impact the growing US elderly population. J Public Health Manag Pract 15(4):352–362

    Article  Google Scholar 

  • Cohen SA, Kelley L, Bell AE (2015) Spatiotemporal discordance in five common measures of rurality for US counties and applications for health disparities research in older adults. Front Public Health 3:267

    Article  Google Scholar 

  • Cohen SA, Cook SK, Sando TA, Sabik NJ (2018) What aspects of rural life contribute to rural-urban health disparities in older adults? Evidence from a national survey. J Rural Health 34(3):293–303

    Article  Google Scholar 

  • Douthit N, Kiv S, Dwolatzky T, Biswas S (2015) Exposing some important barriers to health care access in the rural USA. Public Health 129(6):611–620

    Article  Google Scholar 

  • Durazo E, Jones M, Wallace S, Van Arsdale J, Aydin M, Stewart C (2011) The health status and unique health challenges of rural older adults in California [Internet]. LA: UCLA Center for health policy research

    Google Scholar 

  • Dye CJ, Willoughby DF, Battisto DG (2010) Advice from rural elders: what it takes to age in place. Educ Gerontol 37(1):74–93

    Article  Google Scholar 

  • Eberhardt MS, Pamuk ER (2004) The importance of place of residence: examining health in rural and nonrural areas. Am J Public Health 94(10):1682–1686

    Article  Google Scholar 

  • Gaber A, Galarneau C, Feine JS, Emami E (2018) Rural-urban disparity in oral health-related quality of life. Community Dent Oral Epidemiol 46(2):132–142

    Article  Google Scholar 

  • Glasgow N, Brown DL (2012) Rural ageing in the United States: trends and contexts. J Rural Stud 28(4):422–431

    Article  Google Scholar 

  • Goodfellow A, Ulloa JG, Dowling PT, Talamantes E, Chheda S, Bone C, Moreno G (2016) Predictors of primary care physician practice location in underserved urban and rural areas in the United States: a systematic literature review. Acad Med: J Assoc Am Med Coll 91(9):1313

    Article  Google Scholar 

  • Hale NL, Bennett KJ, Probst JC (2010) Diabetes care and outcomes: disparities across rural America. J Community Health 35(4):365–374

    Article  Google Scholar 

  • Harlan LC, Bernstein AB, Kessler LG (1991) Cervical cancer screening: who is not screened and why? Am J Public Health 81(7):885–890

    Article  Google Scholar 

  • Hart LG, Larson EH, Lishner DM (2005) Rural definitions for health policy and research. Am J Public Health 95(7):1149–1155

    Article  Google Scholar 

  • Kelly BJ, Lewin TJ, Stain HJ, Coleman C, Fitzgerald M, Perkins D, Vaughan J, Beard JR (2011) Determinants of mental health and well-being within rural and remote communities. Soc Psychiatry Psychiatr Epidemiol 46(12):1331–1342

    Article  Google Scholar 

  • Koziol NA, Arthur AM, Hawley LR, Bovaird JA, Bash KL, McCormick C, Welch GW (2015) Identifying, analyzing, and communicating rural: a quantitative perspective. J Res Rural Educ 30(4):n4

    Google Scholar 

  • Kumar V, Acanfora M (2001) Health status of the rural elderly. J Rural Health 17(4):328–331

    Article  Google Scholar 

  • Larson S, Correa-de-Araujo R (2006) Preventive health examinations: a comparison along the rural–urban continuum. Womens Health Issues 16(2):80–88

    Article  Google Scholar 

  • Liu N, Zeng L, Li Z, Wang J (2013) Health-related quality of life and long-term care needs among elderly individuals living alone: a cross-sectional study in rural areas of Shaanxi Province, China. BMC Public Health 13(1):313

    Article  Google Scholar 

  • Maniecka-Bryla I, Pikala M, Bryla M (2012) Health inequalities among rural and urban inhabitants of Łódź province, Poland. Ann Agric Environ Med 19(4):723

    Google Scholar 

  • McLafferty S, Wang F (2009) Rural reversal? Rural-urban disparities in late-stage cancer risk in Illinois. Cancer 115(12):2755–2764

    Article  Google Scholar 

  • Naumova EN, Parisi SM, Castronovo D, Pandita M, Wenger J, Minihan P (2009) Pneumonia and influenza hospitalizations in elderly people with dementia. J Am Geriatr Soc 57(12):2192–2199

    Article  Google Scholar 

  • Paúl C, Fonseca AM, Martín I, Amado J (2003) Psychosocial profile of rural and urban elders in Portugal. Eur Psychol 8(3):160–167

    Article  Google Scholar 

  • Petterson SM, Phillips Jr RL, Bazemore AW, Koinis GT (2013) Unequal distribution of the US primary care workforce. Am Fam Physician 87(11). https://www.aafp.org/afp/2013/0601/od1.pdf

  • Probst JC, Moore CG, Glover SH, Samuels ME (2004) Person and place: the compounding effects of race/ethnicity and rurality on health. Am J Public Health 94(10):1695–1703

    Article  Google Scholar 

  • Rosenthal TC, Fox C (2000) Access to health care for the rural elderly. JAMA 284(16):2034–2036

    Article  Google Scholar 

  • Smith KB, Humphreys JS, Wilson MG (2008) Addressing the health disadvantage of rural populations: how does epidemiological evidence inform rural health policies and research? Aust J Rural Health 16(2):56–66

    Article  Google Scholar 

  • Tsai TC, Joynt KE, Wild RC, Orav EJ, Jha AK (2015) Medicare’s bundled payment initiative: most hospitals are focused on a few high-volume conditions. Health Aff 34(3):371–380

    Article  Google Scholar 

  • U.S. Census Bureau, Decennial Census of Population and Housing (2010) Website: https://www.census.gov/programs-surveys/decennial-census/data/datasets.2010.html. Accessed August 13, 2019.

  • U.S. Census Bureau, American Community Survey (2016) Downloaded on January 25, 2019. http://www.census.gov/acs/www/

  • Vargas CM, Yellowitz JA, Hayes KL (2003) Oral health status of older rural adults in the United States. J Am Dent Assoc 134(4):479–486

    Article  Google Scholar 

  • Waldorf B (2007) What is rural and what is urban in Indiana. Purdue Center for Regional Development Report, 4:1–20. https://www.pcrd.purdue.edu/files/media/What-is-Rural-and-What-is-Urban-in-Indiana.pdf

  • Waldorf BS, Che SE (2010) Spatial models of health outcomes and health behaviors: the role of health care accessibility and availability. In: Progress in spatial analysis. Springer, Berlin, pp 339–362

    Chapter  Google Scholar 

  • Wang H, Qiu F, Boilesen E, Nayar P, Lander L, Watkins K, Watanabe-Galloway S (2016) Rural-urban differences in costs of end-of-life care for elderly cancer patients in the United States. J Rural Health 32(4):353–362

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Steven A. Cohen .

Editor information

Editors and Affiliations

Section Editor information

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Cohen, S.A., Greaney, M.L. (2019). Urban-Rural Health Disparities at Older Ages. In: Gu, D., Dupre, M. (eds) Encyclopedia of Gerontology and Population Aging. Springer, Cham. https://doi.org/10.1007/978-3-319-69892-2_516-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-69892-2_516-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-69892-2

  • Online ISBN: 978-3-319-69892-2

  • eBook Packages: Springer Reference Biomedicine and Life SciencesReference Module Biomedical and Life Sciences

Publish with us

Policies and ethics