Access to Services in Rural Areas from the Point of View of Older Population-A Case Study in Finland

Age-inclusive Arctic outdoor spaces: a policy review in four Nordic countries

In the last decade, policy strategies were adopted in response to population ageing in the Nordic countries. Governmental actions have to be evaluated in terms of their efficacy. The objective of this article is to identify and review the policies related to age-inclusive outdoor spaces in the Arctic regions of Nordic countries. Our analysis focuses on central government white papers that address the older adults in Finland, Norway, Sweden, and Iceland. A review of such policy documents provides insights into the predominant understandings of older adults and healthy ageing. Moreover, such analysis may identify "blind spots" in the national policies, especially regarding the sparsely researched northernmost and rural Arctic territories. Our results demonstrate how the older populations in the Nordic Arctic and their access to outdoor spaces are addressed in the policy documents. We found that with few exceptions, the older people of the rural Arctic is strikingly absent in the Nordic national governmental papers. Moreover, access to outdoor spaces is mentioned in general terms, and specific challenges of the rural Arctic context, such as the harsh climate, long winters and geographical distances are not addressed. The noticed omissions might be the result of "urban-rural", "south-north", "indoor-outdoor", and "generalisation" biases.

Health equity in urban and rural settings: implementation of the place standard tool in Spain

The physical, social, and economic characteristics of neighborhoods and municipalities determine the health of their residents, shaping their behaviors and choices regarding health and well-being. Addressing local environmental inequalities requires an intersectoral, participatory, and equity-focused approach. Community participation plays a vital role by providing deeper insights into local contexts, integrating community knowledge and values into processes, and promoting healthier, fairer, and more equitable actions. In recent years, various tools have been developed to assess places and transform them into health-promoting settings. One such tool, the Place Standard Tool (PST), facilitates discussions on Social Determinants of Health grouped into 14 themes, serving as a starting point for local health interventions. In this study, that took place between August 2019 and February 2020, we described the resident's perceptions of two municipalities in the Valencian Community, Spain, using the validated Spanish version of the PST. A mixed-method convergent-parallel design was used to gain a holistic insight into residents' experiences concerning their physical, economic, and social environment. A total of 356 individuals from both municipalities participated in the study through discussion groups, structured interviews, and online survey. Descriptive analysis of the individual questionnaire answers was conducted, and differences between municipalities were explored. Qualitative thematic analysis was conducted on structured interviews and discussion groups. Quantitative and qualitative data were integrated to facilitate their comparison and identify areas of convergence or divergence in the findings. Overall, rural areas received more favorable evaluations compared to urban ones. Public Transport as well as Work and Local Economy were consistently rated the lowest across all groups and contexts, while Identity and Belonging received the highest ratings. In the urban area, additional negative ratings were observed for Traffic and Parking, Housing and Community, and Care and Maintenance. Conversely, Identity and Belonging, Natural Spaces, Streets and Spaces, Social Interaction, and Services emerged as the highest-rated themes overall. In the rural context, positive evaluations were given to Walking or Cycling, Traffic and Parking, Housing and Community, and Influence and Sense of Control. Significant differences (p < 0.01) between urban and rural settings were observed in dimensions related to mobility, spaces, housing, social interaction, and identity and belonging. Our study illustrated the capacity of the PST to identifying aspects within local settings that influence health, revealing both positive and challenging factors. Successful implementation requires appropriate territorial delineation, support from local authorities, and effective management of expectations. Furthermore, the tool facilitated community participation in decision-making about local environments, promoting equity by connecting institutional processes with citizen needs.

Aging in Rural Communities

Purpose of Review

Population aging is occurring worldwide, particularly in developed countries such as the United States (US). However, in the US, the population is aging more rapidly in rural areas than in urban areas. Healthy aging in rural areas presents unique challenges. Understanding and addressing those challenges is essential to ensure healthy aging and promote health equity across the lifespan and all geographies. This review aims to present findings and evaluate recent literature (2019-2022) on rural aging and highlight future directions and opportunities to improve population health in rural communities.

Recent Findings

The review first addresses several methodological considerations in measuring rurality, including the choice of measure used, the composition of each measure, and the limitations and drawbacks of each measure. Next, the review considers important concepts and context when describing what it means to be rural, including social, cultural, economic, and environmental conditions. The review assesses several key epidemiologic studies addressing rural-urban differences in population health among older adults. Health and social services in rural areas are then discussed in the context of healthy aging in rural areas. Racial and ethnic minorities, indigenous peoples, and informal caregivers are considered as special populations in the discussion of rural older adults and healthy aging. Lastly, the review provides evidence to support critical longitudinal, place-based research to promote healthy aging across the rural-urban divide is highlighted.

Summary

Policies, programs, and interventions to reduce rural-urban differences in population health and to promote health equity and healthy aging necessitate a context-specific approach. Considering the cultural context and root causes of rural-urban differences in population health and healthy aging is essential to support the real-world effectiveness of such programs, policies, and interventions.

Sustainable Innovative Mobility Solutions Preferred by Inhabitants of Rural Areas—The Case of Lithuania and Poland

The research problem discussed in the paper covers innovative mobility solutions in rural areas. This study aims to identify the specifics of innovative mobility solutions expected by inhabitants of rural areas based on the example of selected regions in Lithuania and Poland. The research was conducted between 2019 and 2021 in two rural regions: Druskininkai and Birštonas in Lithuania, as well as the Hajnowski district and the area of the Bialowieza Forest in Poland. The quantitative methodology was used, i.e., survey research. The research confirmed the proposed concept and showed relatively many innovative mobility solution proposals in both regions. Another method used in the study was correspondence analysis, which was performed to assess the strength of the correlation between the proposed innovative solutions and the age and education of the respondents. Comparisons were also made with the use of Pearson’s chi-squared test and the Cramér’s V statistical method. Among the options presented, organisational innovation—the synchronisation of timetables of various means of transport—was met with great interest in Poland and Lithuania alike. The introduction of electric bikes was considered the most desirable product innovation. Solutions that require the ability to use a mobile application are accepted, especially by young people and individuals with university-level education. The results of the research include transport solution models that are expected to improve the mobility of residents of rural areas. This comparative approach concerning slightly different rural regions in two neighbouring countries ought to be deemed a new approach.

Older Rural People's Perception of Connectedness through Communication Application: A Qualitative Descriptive Study

Connectedness among older people is essential for healthy communities, especially among rural populations where limited social interaction and associated health effects may be cause for concern. In this qualitative descriptive study, we explored older rural people's perception of connectedness through a communication application. The study assessed 10 participants (mean age = 76.2 years) living in rural Japan who regularly participated in a senior citizens' club. From July 2019 to January 2020, the participants used a social media application developed by our research team to meet the needs of older people. Semi-structured interviews were conducted. Six themes representing older rural people's perception of connectedness were identified: (1) thoughtful consideration for members strengthened even without them meeting face-to-face, (2) encouragement received from familiar members, (3) joy in sharing daily routine with neighbors, (4) courage to advance through face-to-face interaction, (5) willingness to continue club membership, and (6) fear of disrupting club's harmony. Participants who used the application felt compensated for the lack of social interaction opportunities in rural settings and strengthened their existing relationships. This article is protected by copyright. All rights reserved.

Improving Rural Accessibility: A Multilayer Approach

Rural territories are worse equipped than urban ones in terms of accessibility to services and opportunities, due to their scattered development and peripheral character. Increasing cuts to loss-making services in traditional public transport contributed to increased social inequality and marginality, in so doing undermining the livability of rural communities. In this light, improving accessibility is an essential prerequisite for the sustainable development of rural areas. Whereas demand responsive transport solutions are often seen as a panacea in circumstances where traditional services are not viable, their implementation is more challenging than it may seem, due to the potential barriers intrinsically related to the differential socioeconomic, cultural, and institutional features of places. Furthermore, enhancing transport offer is only one side of the multifaceted prism of rural accessibility, and the institution of effective multi-level and multi-sector governance mechanisms is a precondition to approach the mentioned challenges under a more comprehensive perspective. Drawing on the results of the European Territorial Observatory Network (ESPON) Urban-Rural Connectivity in Non-Metropolitan Areas (URRUC) project, the paper sheds light on this issue, exploring the accessibility challenges of rural areas and proposing a multilayer policy approach aimed at supporting decision-makers in improving rural accessibility across Europe.