Healthy Aging in Rural Communities: Challenges and Opportunities

Healthy aging in rural communities comes with unique challenges and opportunities. This section describes challenges that affect healthy aging and the many opportunities to support healthy aging in rural communities.

Challenges to Rural Healthy Aging

Social Isolation: Social connectedness is important for mental health and well-being. In rural areas, lower population density means older adults may live farther from friends and family, leading to social isolation. Lack of regular social interactions can pose health risks for older adults, such as anxiety and depression, as well as physical risks such as hypertension and heart disease.

Access to Services: Rural communities are home to a higher proportion of older residents, but have fewer services than metro core communities, including healthcare, housing, transportation civic engagement, nutrition services, and social services. Several other challenges include a lack of health insurance and a lack of access to linguistically appropriate services and accommodations for communication needs.

Access to Transportation: Rural communities are car-centric, with more than 90% of trips taken by car. For older adults who do not or cannot drive, there are fewer transportation options such as public transportation. Adding to this challenge, rural residents travel longer distances and spend more time traveling to reach healthcare and other services.

Housing Affordability: Due to smaller community size, rural older adults have fewer housing options than those who live in urban areas. Additionally, rural older adults who rent housing are more likely to experience problems with housing affordability than those who own their homes. Housing affordability may make it difficult for rural older adults to stay in their community as they age.

Healthcare Workforce Shortages: In rural communities, healthcare workforce shortages impact older adults. Many rural communities have been impacted by rural hospital closures due to staffing shortages, low patient volume, low reimbursement, and other challenges. This means that older adults may have to travel further for inpatient care. Small and nonmetro counties have fewer geriatricians and direct care workers such as home health aides and nurses per capita.

Health Behaviors: Rural residents are more likely to engage in unhealthy behaviors that impact healthy aging. Smoking is more prevalent in rural areas, and for older adults, smoking is known to accelerate other age-related conditions, such as dementia, and reduce life expectancy and quality of life.

Built Environment: Rural older adults are less likely than their urban counterparts to engage in physical activity. In rural areas, physical activity may be challenging due to fewer sidewalks and parks, and having to travel longer distances to reach recreation centers.

Food Insecurity: Eating a healthy diet can be more difficult for older rural adults. Older adults may experience food insecurity or live in food deserts, and are at a higher risk for malnutrition. To learn more about food insecurity in rural areas, see the Rural Hunger and Access to Healthy Food topic guide.

Opportunities for Rural Healthy Aging

Strong Community Ties: Rural communities are often close-knit with strong social connections. Kinship relationships and intergenerational households bring opportunities for social connection and caregiving. Family, friends, and neighbors can provide support for older adults. Everyday interactions with people in service positions, such as bank tellers, mail carriers, and grocery store clerks play an important role in healthy aging, as these individuals are well-positioned to notice potential declines in an older adult's health and well-being.

Community Engagement: Older adults' civic engagement through churches, recreation groups, and other organizations in the community is the backbone of many rural communities. Through volunteering, for example, older adults can use their wisdom and skills to help their communities thrive. Participation in community activities may help older adults feel valued, appreciated, and connected to others, contributing positively to mental health. Community spaces, such as libraries or churches, can be adapted for older adults to engage in social activities.

Natural Assets: Rural communities have natural assets, such as lakes, ponds, forests, and grasslands. Nature and green space have been positively linked to older adults' physical and mental health, providing visual stimulation, pleasure, and relieving stress as well as serving as space for physical activity and spontaneous or organized social interactions.