Living in rural area: A protective factor for a negative experience of the lockdown and the COVID-19 crisis in the oldest old population?

Rural-urban differences in the perceived impact of COVID-19 on mental health by European women

PURPOSE

Many studies have documented an adverse impact of the pandemic on women´s mental health. This cross-sectional study aims to explore associations between women's perceived impact of lockdowns and curfews on their mental health and their residential location, along with other contextual and individual factors.

METHODS

Using data from the Flash Eurobarometer 2712 "Women in times of COVID-19", conducted between January 25 and February 3, 2022, across the 27 Member States of the European Union (n = 23,671), this study applied bivariate tests and stratified models based on respondent location (rural areas, small or medium-sized towns and urban areas). The exploration sought predictors influencing the perceived mental health impact, encompassing five individual characteristics (age, disability, employment status, educational attainment, and household type), perceptions of violence against women, and country of residence. The dependent variable was assessed subjectively, measured on a scale from 1 (minor negative impact) to 5 (major negative impact).

RESULTS

Women living in urban areas generally reported a higher perceived negative impact on mental health compared to women in rural areas or in small/medium-sized towns. Age and disability were significantly linked to perceiving a negative impact on mental health. Similar adjusted odds ratios for age were observed across rural areas (aOR 0.97, 95% CI = 0.97-0.98), small or medium-sized towns (aOR 0.98, 95% CI = 0.97-0.98), and urban areas (aOR 0.97, 95% CI = 0.97-0.98). In terms of disability, the odds were higher in rural areas (aOR 1.44, 95% CI = 1.20-1.73) than in urban ones (aOR 1.36, 95% CI = 1.15-1.62). Among women residing in urban areas, those in childless couples were less likely to perceive a negative impact on mental health (aOR 0.89, 95% CI = 0.80-0.99) compared to women in couples with children. Respondents perceiving increased violence against women due to COVID-19 were more likely to perceive a negative impact on mental health, with higher odds ratios in rural areas (aOR 1.56, 95% CI = 1.40-1.74) compared to urban areas (aOR 1.29, 95% CI = 1.17-1.41). Differences across countries were also found.

CONCLUSION

The perceived impact of lockdowns and curfews on mental health exhibited variance between urban and rural areas. These disparities were influenced by individual characteristics such as age, disability, or household type, as well as the effects of COVID-19 on violence against women and contextual variables like country of residence.

COVID-19 Imposed Closure of Rural Co-Housing and Loneliness in Older Adults Living Alone: Longitudinal Evidence From South Korea

This study aimed to examine the impact of COVID-19 on loneliness among rural older women in senior cohousing in Korea. Using a natural experimental study design, we investigated how the pandemic-induced closure of cohousing affected the former residents' loneliness. The sample comprised 84 cohousing residents and 51 individuals in conventional homes. The dependent variable is loneliness, and the independent variables include housing transition, social contact, and support from neighbors and friends. Our findings from fixed effect regression models showed former cohousing residents were less likely to experience loneliness when they had more contact with their friends and neighbors, while negative relationships exacerbated feelings of loneliness. Sharing meals and participating in activities with friends and neighbors in cohousing helped the residents develop effective coping strategies. Senior cohousing in rural areas has the potential to strengthen social ties and protect the most vulnerable subgroup of older adults from social isolation and loneliness.

Physical Activity and Social Interaction among Rural Older Adults in Saskatchewan during COVID-19

Physical activity and social interaction among rural older adults are important, particularly during the COVID-19 pandemic when restrictions on physical gatherings were placed. The purpose of this qualitative study was to gain a deeper understanding of rural older adults' experience with physical activity and social interaction during the COVID-19 pandemic. An interpretative phenomenological approach was used to explore the experience of 10 older adults, 67-82 years of age, from rural communities throughout Saskatchewan. Findings revealed that many rural older adults acknowledged the health benefits of physical and social activities and experienced loneliness when COVID-19 restrictions were placed, even when living with a partner. For some, the restrictions placed on physical and social activity provided a welcome break from daily responsibilities. Rural communities, often at a disadvantage, were also perceived by participants as being protected against COVID-19. The resilience demonstrated among rural participants to persevere and adapt to their changing environment during the pandemic was evident in the findings.

Social isolation and loneliness among older adults living in rural areas during the COVID-19 pandemic: a scoping review

BACKGROUND

The causes and consequences of social isolation and loneliness of older people living in rural contexts during the COVID-19 pandemic were systematically reviewed to describe patterns, causes and consequences.

METHODS

Using the Arksey and O'Malley (2005) scoping review method, searches were conducted between March and December 2022, 1013 articles were screened and 29 were identified for data extraction.

RESULTS

Findings were summarized using thematic analysis separated into four major themes: prevalence of social isolation and loneliness; rural-only research; comparative urban-rural research; and technological and other interventions. Core factors for each of these themes describe the experiences of older people during the COVID-19 pandemic and related lockdowns. We observed that there are interrelationships and some contradictory findings among the themes.

CONCLUSIONS

Social isolation and loneliness are associated with a wide variety of health problems and challenges, highlighting the need for further research. This scoping review systematically identified several important insights into existing knowledge from the experiences of older people living in rural areas during the COVID-19 pandemic, while pointing to pressing knowledge and policy gaps that can be addressed in future research.

Understanding the Effects of COVID-19 on Child Maltreatment Reporting Among Rural Versus Urban Communities in the United States

The onset of the coronavirus disease 2019 (COVID-19) pandemic impacted child protective services (CPS) reporting systems in the United States. It may have also led to widened gaps between rural and urban communities in child maltreatment (CM) report rates due to decreased interaction between children and mandated reporters especially in urban jurisdictions. Using data from the National Child Abuse and Neglect Data System, this study tests the hypothesis that during the onset of the COVID-19 pandemic, the decrease in CM reports made to CPS in urban counties was more pronounced than in rural counties. Reports of CM received by CPS offices between January 6, 2020 and June 28, 2020 were aggregated to per-county-per-week-per-10,000 children maltreatment report rates. We used changepoint analyses to analyze the inter- and intra-region incidence rate ratios among rural and urban counties. Moreover, we used multilevel random effects models to generate regression coefficients for the associations between rates of children with a maltreatment report, COVID-19 occurrence, rural-urban designation, and maltreatment risk factors. During the study period, rates of children with a maltreatment report among urban counties decreased more dramatically when compared with rural counties. Our findings persisted even with the inclusion of control variables associated with maltreatment risk factors. Social distancing restrictions may have had the unintended consequence of decreasing the visibility of at-risk children in urban counties more so than in rural counties. Considering geography is critical to continue to protect children during the COVID-19 pandemic and as we prepare for future disasters.

Coping strategies and household stress/violence in remote Alaska: a longitudinal view across the COVID-19 pandemic

The COVID-19 pandemic has introduced novel stressors. Remote/rural communities have experienced additional difficulties, while also potentially benefitting from unique sources of resilience against such stressors. However, very little research has been conducted in remote/rural communities regarding coping and stress/violence. This study examines coping strategies and household stress/violence in remote Alaska communities across the pandemic through three online survey waves (November 2020-September 2021) (total n = 1,020). Across all waves, personal care was reported most frequently followed by social activities, religious activities, and traditional/subsistence activities. Substance use combined (alcohol, nicotine, marijuana) and seeking counselling were less frequently reported, with significant differences across gender and age categories. Less than 10% of individuals reported physical violence towards children and/or other adults within the household. Overall, these findings indicate that individuals are primarily relying on positive coping strategies to contend with additional stress brought into their lives by the COVID-19 pandemic.

Behavioral Patterns of Supply and Demand Sides of Health Services for the Elderly in Sustainable Digital Transformation: A Mixed Methods Study

The aging transformation of digital health services faces issues of how to distinguish influencing factors, redesign services, and effectively promote measures and policies. In this study, in-depth interviews were conducted, and grounded theory applied to open coding, main axis coding, and selective coding to form concepts and categories. Trajectory equifinality modeling clarified the evolution logic of digital transformation. Based on the theory of service ecology, a digital health service aging model was constructed from the “macro–medium–micro” stages and includes governance, service, and technology transformation paths. The macro stage relies on organizational elements to promote the institutionalization of management and guide the transformation of governance for value realization, including the construction of three categories: mechanism, indemnification, and decision-making. The meso stage relies on service elements to promote service design and realize service transformation that is suitable for aging design, including the construction of three categories: organization, resources, and processes. The micro stage relies on technical elements to practice experiencing humanization, including the construction of three categories: target, methods, and evaluation. These results deepen the understanding of the main behaviors and roles of macro-organizational, meso-service, and micro-technical elements in digital transformation practice and have positive significance for health administrative agencies to implement action strategies.

Mental health and well-being in times of COVID-19: A mixed-methods study of the role of neighborhood parks, outdoor spaces, and nature among US older adults

The role of parks and nature to support well-being during the COVID-19 pandemic is uncertain. To examine this topic, we used mixed-methods data collected in April-May 2020 from US adults aged ≥55 in the COVID-19 Coping Study. We quantitatively evaluated the associations between number of neighborhood parks and depression, anxiety, and loneliness; and conducted qualitative thematic analysis of participants' outdoor experiences. Among urban residents, depression and anxiety were inversely associated with the number of neighborhood parks. Thematic analysis identified diverse engagement in greenspaces that boosted physical, mental, and social well-being. The therapeutic potential of outdoor and greenspaces should be considered for interventions during future epidemics.

Online Emotional Support Accompany Group Intervention and Emotional Change of the Public During the COVID-19 Pandemic: A Multi-Period Data Analysis From China

COVID-19 has made it difficult to adopt traditional face-to-face psychological intervention under this situation because of the blocked down and social distancing, which brings big psychological crisis to the public among the global. To explore the emotional change of the public in China at the outburst of the pandemic at different phases, to establish an online working platform and create a new model of an online intervention to hold public emotions under pandemic, and test its effectiveness, so to give advisement for government emergency management system. We established an online organization to work for this program ad innovated a model of online group counseling with online emotional support accompany group (OESAG) right after the outburst of a pandemic. We analyzed 53 OESAGs from February 10 to April 9, including 555 application forms, 253 feedback from members, and 139 feedback from group leaders by using NVivo and SPSS to explore the evolution and characteristics of public emotion during COVID-19 and the effectiveness of OESAG. Our results showed that the emotional changes of members ranged from shock to depression to positive. The public's emotions swiftly changed from stress, anxiety, and isolation, to the hope of returning to work or finding a job during the pandemic with the help of OESAG. OESAG has effectively regulated the negative emotions of members by conducting psychological crisis intervention to provide members a space to communicate with each other, especially the female and frontline staff. Policy makers can set up an online systematic psychological crisis intervention system as soon as possible to make up for the lack of psychological assistance in the emergency management system.

Living in rural area: A protective factor for a negative experience of the lockdown and the COVID-19 crisis in the oldest old population?

OBJECTIVES

Some factors influence the experience of the COVID-19 pandemic (health, loneliness, digital access...), but what about the living area? The objective was to compare between rural and urban areas, the psychological and social experiences of the older individuals with regard to the COVID-19 crisis during the first French lockdown.

METHODS

The sample included participants of three existing population-based cohorts on aging. Telephone interviews conducted by psychologists focused on the lockdown period. Data collected included living environment, professional assistance, social support, contacts with relatives, difficulties encountered, health, and knowledge and representations of the epidemic. The negative experience was defined by the presence of at least two of the following items: high anxiety symptomatology, depressive symptoms, worries or difficulties during the lockdown and insufficient social support.

RESULTS

The sample included 467 participants, aged on average 87.5 years (5.2), 58.9% were female and 47.1% lived in rural areas. Persons living in rural area had better social support, greater family presence, a less frequent feeling of imprisonment (OR = 0.60, 95 CI% = 0.36-0.99), 95% had a garden (vs. 56%), fewer depressive symptoms and lower anxiety scores, but also tended to lower comply with the health measures. Finally, they had an almost twofold lower risk of having a negative experience of the lockdown compared to their urban counterparts (OR = 0.55, 95% CI = 0.33-0.92, p = 0.0223).

CONCLUSIONS

The oldest old living in rural area experienced the first lockdown better than the urbans. Living conditions, with access to nature, a greater social support and family presence, could have contributed to these findings.