Rural ageing in the United States: Trends and contexts

This paper examines rural population ageing in the United States with a particular focus on the contrasting contexts in which older rural residents live. We compare the characteristics of the older population by rural versus urban residence, and explore challenges and opportunities associated with the ageing of rural baby boomers. The United States is a vast territory, and rural areas in the US are diverse regionally, in poverty and income, principal forms of employment, proximity to metropolitan areas, population size, density and composition, the history of change in these parameters, and a number of other factors that affect the ageing process. Hence, the diversity across rural areas is an important consideration in what affects the well being of rural elderly individuals, as well as the community-level impacts of rural ageing. Further, the characteristics of the older rural population help shape community and rural development outcomes for diverse rural communities. We use data from various US Census Bureau sources, and cite other studies to provide a demographic overview of ageing in the rural United States, and to analyze how this situation differs in varying socio-demographic and regional contexts. In the concluding section, we focus on policy implications associated with rural ageing.     

Intergenerational Coresidence and Nearness in Korea and Japan: Unbalanced Aspects of Family Changes

Abstract  This study aims to explain similarity and difference in geographic proximity between elderly parents and their children in Korea and Japan. Using data sets from two nationally representative surveys conducted in Korea and Japan, this study examines the extent to which needs and kinship of elderly parents and regional constraints influence intergenerational coresidence and nearness.
Results highlight a complex feature of intergenerational relationship in Korea and Japan. Advanced economic and health conditions of Korean elderly parents increase the likelihood of living with children. For Japanese elderly parents, however, coresidence with children is significantly likely to occur in response to their disadvantaged economic status. These results suggest that the elderly Korean are more likely than the elderly Japanese to lack not only economic and health resources but also opportunities in obtaining family support in a time of need.
Characteristics of children, however, show a similar trend between the two societies. Both societies maintain a strong son preference for extended family living arrangement. Eldest children in both societies are more likely than their siblings to live with or near elderly parents. However, children of younger cohorts in both societies are significantly more likely than those of older cohorts to maintain a disperse geographic network indicating a significant change in family attitude among different cohorts.
Finally, this study finds a more disperse family network among rural elderly parents than urban elderly parents in both societies reflecting the fact that massive rural-to-urban migration of young population has contributed to geographic segregation of kinship in these societies.     

Old age pension and intergenerational living arrangements: a regression discontinuity design

China launched a pension program for rural residents in 2009, now covering more than 300 million Chinese. This program offers a unique setting for studying the ageing population, given the rapidity of China’s population ageing, traditions of filial piety and co-residence, decreasing number of children, and dearth of formal social security, at a relatively low income level. This paper examines whether receipt of the old-age pension payment equips elderly parents and their adult children to live apart and whether parents substitute children’s time involved in instrumental support to them with service consumption. Employing a regression discontinuity design to a primary longitudinal survey conducted in Guizhou province of China, this paper overcomes challenges in the literature that households eligible for pension payment might be systematically different from ineligible households and that it is difficult to separate the effect of pension from that of age or cohort heterogeneity. Around the pension eligibility age cut-off, results reveal large and significant reduction in intergenerational co-residence of the extended family and increase in service consumption among elderly parents.     

Migrant Interactions With Elderly Parents in Rural Cambodia and Thailand

This paper examines interactions between older adults living in rural areas of Thailand and Cambodia and their adult children. Thai data come from the Survey of the Welfare of the Elderly (N= 3,202 older adults and 17,517 adult children). Cambodia data are from the Survey of the Elderly in Cambodia (N= 777 older adults and 3,751 adult children). Results indicate that older adults in rural areas are not being abandoned, and supportive expressions such as visits and provision of material goods depend on living proximity, characteristics that relate to the needs and dependency of the older adult, and the life circumstances of adult children. These findings support an extension of an altruistic perspective that incorporates notions of vulnerability of older adults.     

Financial Exploitation of Older Adults in Rural Settings: A Family Perspective

Federal agencies responsible for funding protective services to older adults are increasingly concerned with the growing incidence of financial exploitation in rural areas. The Wall Street Journal recently has reported an increasing trend of unemployed adult children migrating from urban centers to smaller rural towns and countrysides to live with their parents since 2008. This current study explores the attitudes of family caregivers regarding management of financial matters for their elderly care recipients. The major findings of the study include that adult children often (1) overestimate their parents' ability to manage their finances; (2) prefer to manage their parents' finances informally, as opposed to using legal options like power of attorney; and (3) tend to think of their parents' assets as “almost theirs.” The study concludes with recommendations on the critical need for information to help families make important decisions about helping elderly parents with their finances. This information would not only promote the use of safeguards against abuse, but could potentially provide caregivers with greater confidence and protection.     

Residential Differences in Filial Responsibility Expectations Among Older Persons1

Abstract This study examines variation in filial responsibility expectations-the extent to which adult children are expected to assist and care for their aging parents-among a sample of 440 older persons. The analysis focuses on the relationship of filial responsibility expectations to residential location and tests the hypothesis that older rural residents have higher expectations for assistance from their children than do older urbanites. Current residential location is found to have little impact on expectations, but older persons who were raised in rural areas, particularly on farms, have significantly higher expectations for filial assistance than do older persons from urban backgrounds. Possible consequences of these patterns for the transmission of expectations from parents to children are discussed.     

Parent child relations among very old parents in Wales and the United States: A test of modernization theory

This study contrasts the structure of parent-child relationships of older parents living in Wales, U.K. with those of older parents living in the United States. Specifically, we examine whether the principal dimensions of intergenerational solidarity and their associations with each other, are invariant across two national cultures. Comparable measures are assessed from the responses of older parents participating in three surveys: Bangor Longitudinal Study of Ageing (N = 139), USC Longitudinal Study of Generations (N = 129) and AARP Study of Intergenerational Linkages (N = 102). Overall, there were fewer differences than expected among the samples. Although proximity and contact with adult children were higher among older parents in the Wales sample, there were no appreciable differences in emotional closeness and receipt of help. However, there was a significantly higher correspondence between proximity and emotional closeness among Welsh parents than among both samples of American parents, suggesting that parents in North Wales forge more intimate ties with local children. Moreover, older Welsh parents were more likely than older parents in the American samples to receive help from children who were both proximate and emotionally close. The results are interpreted in terms of the greater importance that neolocality plays in promoting inter generational integration within more traditional cultures and more rural societies.     

Intergenerational Coresidence Among Small Farmers in Brazilian Amazônia

This article examines intergenerational coresidence among rural farm families near Santarém, Pará, Brazil using survey data collected by the authors on 896 children whose parents live in 175 households on 150 farms. Married adult children, daughters, and the best educated are more likely to live off their parents’ rural property (vs. on the property). Results support arguments that coresidence results from the interests of children rather than the control that parents exert over children. These results have implications for our understanding of intergenerational relations in the developing world and for the future development of similar areas.     

Coresidence and Geographic Proximity of Mothers and Adult Children in Stepfamilies

Children who live with or near a parent provide more care and receive more help from parents than geographically distant children. Stepfamily ties may be weaker than ties between biological kin, but little is known about the geographic proximity of step‐ versus biological kin. The authors used data from the Health and Retirement Study (N = 13,239 mothers and 45,675 biological and stepchildren) to show that stepchildren and stepmothers are less likely to live together, less likely to live nearby, and less likely to move closer than biological children and mothers. When mothers have only stepchildren, they are less likely to have a coresident child or a child nearby than mothers with both step‐ and biological children. Coresidence and geographic proximity are lower in stepfamilies formed after divorce than after widowhood. The findings are consistent with a legacy of conflict and strain and the likely competing needs of biological and stepmothers.     

Middle-Aged and Elderly Finnish Households Considering Moving,Their Preferences,and Potential Downsizing Amidst Changing Life Course and Housing Career

We examine the moving and housing preferences of middle-aged and older in Finland, a country where population composition and movement through the life course are changing. A logistic regression reveals that middle-aged, moderate income residents, renters, those who have lived in their houses only a short time, and residents who are generally dissatisfied are most likely to consider moving. Downsizing appeals to residents with lower incomes who live alone, and who have been in their current houses longer. All potential movers agree on the importance of transportation access and a neighborhood grocery store; however, those preferring to downsize are also interested in house and neighborhood design as well as services that will allow aging in place. Income limitations may create affordability problems for some potential movers.     

Poverty and health: older minority women and the rise of the female-headed household

This analysis uses the 1984 Survey on Aging (SOA) supplement to the National Health Interview Survey (NHIS) to compare the relative impacts of poverty and health on the propensity of unmarried older black, Hispanic, and non-Hispanic white women to live with family. The results reveal that for blacks and Hispanics, economics are more significant than health in determining whether a woman lives with her children. Our findings also show that black unmarried elderly females are more likely than similar non-Hispanic white women to head their households. The literature and our findings suggest that black and Hispanic older women have fewer options in living arrangements than non-Hispanic older women in the event of diminished health.     

Social Capital and Residential Decision Making Among Rural and Nonrural College Graduates

Due to the low demand for highly educated workers in rural areas, high‐achieving rural students have been portrayed as having to pick between staying close to home and facing limited economic opportunities or leaving to pursue higher education and socioeconomic advancement. But what of those who want both—college degree and return to rural living? Comparing the experiences of rural graduates who returned to rural locales with those who out‐migrated and nonrural graduates across one predominantly rural state, this study explores how social capital matters in the residential decision‐making process. Proximity to work and family were the primary factors determining adult residence. Sense of place—but not attachment to a specific community—also mattered, especially for rural graduates. Family, school, and community social capital were more likely to play a role in career development for rural students, as career aspirations during adolescence followed by career‐driven college choices created pathways for rural return. Findings underscore the importance of analyzing rural return from a regional lens, as respondents reframed lifestyle elements researchers tend to portray as mutually exclusive—rural lifestyle, proximity to family, and professional career—as compatible by employing broad and flexible definitions of proximity and place.     

Where are you from? A case of rural residential identification

This study analyzes the way people identify where they live in a rural midwestern area. This geographic area was chosen because it lacks a single name and includes sections of two states. One year of participant observation and intensive interviews with 45 prominent residents provided the data. Respondents gave a variety of answers to the question, “Where are you from?” These answers utilized (1) governmental district; (2) proximity to a place of concentration; (3) proximity to a famous place or person; (4) mailing address; (5) political location; (6) location of telephone exchange. Different residential identifications are evoked by different activities: negotiating with bureaucracies, traveling, financial transacting, giving directions for residence location, and joining local organizations. This study was conducted in the frameworks of “locating activities” (Psathas and Henslin, 1967) and “cognitive perspectives on community” (Moore and Golledge, 1976). The data suggest that residential identification can be problematic, rather than simple, as has been assumed in previous community research. By examining how people identify their residences, we gain insight into the microdynamics of communities.     

The cost of caregiving: wage loss among caregivers of elderly and disabled adults and children with special needs

Sixty-one percent of the adults caring for elderly and disabled family members and 53% of parents of children with special needs are employed. Yet studies examining the experience of employed caregivers of children with special needs and elderly or disabled adult family members have not examined the impact on earnings or the workplace policies that might help reduce the conflicts between work and caregiving. This study begins to fill this gap using data from a nationally representative US survey of American adults. We find that employees who live with a child with a health problem are 48% more likely to have lost wages. Each adult with health issues that an employee is responsible for raises the chances of wage loss by 29%. At the same time, access to paid leave for family health needs reduces the likelihood of wage loss by 30%, and having a supportive supervisor reduces the odds of experiencing wage loss by 37%. Implications for employers and US policy-makers are discussed.     

Mobility Intentions of Rural Elderly and Non-Elderly

Although mobility investigations in urban areas indicate an overwhelming desire of older persons to age in place, such studies in rural areas are scarce. This study of 198 rural residents assesses the differences between elderly and younger respondents for socio-demographic and housing characteristics, as well as housing attitudes. Findings indicate rural elderly prefer to remain in their present home and are significantly different from their younger counterparts in socio-demographic characteristics. Recommendations are made for planned housing and for services to assist aging in place.     

A Typology of Source of Information About the Continuing Care Retirement Community and Older Adults’ Living Arrangement

Abstract

A continuing care retirement community (CCRC) represents a residential alternative for older adults. It offers a variety of social and health care services to meet older adults’ needs and preferences. Using the theory of innovation as a theoretical basis, the overall goal of the study was to use the source of information about the CCRC as a potential predictor of the decision to move. In total, 76 older adults responded to a question about the source of information on the CCRC. Of these, 40 were CCRC residents and 36 were community dwellers, who expressed an interest in the CCRC but decided to remain in their community. Based on their responses, respondents were classified into one of five clusters (e.g., spouse, friends, children, nonhuman sources, mixed human and nonhuman sources). Those classified into the spouse or adult children as sources of information were more likely to live in a CCRC. Results show that information about the CCRC should be conveyed to additional members in the family, such as adult children, as they often take a major role in the decision to relocated. The findings have implications for administrators as they clearly point to potential sources of greater influence on older adults’ decision to relocate.     

Nursing home admissions and long-stay conversions among persons with and without serious mental illness

The appropriateness of nursing homes for individuals with serious mental illness remains a controversial issue in long-term care policy more than a decade since the landmark U.S. Supreme Court Olmstead decision in 1999 , which affirmed the rights of persons with disabilities to live in their communities. Using national nursing home Minimum Data Set assessments from 2005, the authors compared the demographic, clinical, and functional characteristics of persons with and without serious mental illness newly admitted to nursing homes. They found that newly admitted people with serious mental illness were younger and more likely to become long-stay residents than those admitted with other conditions, despite a higher proportion of residents with serious mental illness, including the elderly, classified as low-care status. The most substantial and clinically significant difference for rates of low-care status 90 days after initial admission are for persons younger than 65 with serious mental illness versus those younger than 65 without serious mental illness (33% vs. 8.5%, or 3.9 times greater). There is a notable difference in low-care status between persons aged 65 and older with serious mental illness and those aged 65 and older without serious mental illness (14% vs. 6.6%, or 2.1 times greater). These results suggest that a substantial number of adults with serious mental illness residing in nursing homes may have the functional capacity to live in less restrictive environments.     

Explaining Late Life Urban vs. Rural Health Discrepancies in Beijing

Social characteristics that differ by place of residence are consequential for health. To study implications of this among older adults in rural vs. urban China, this study employs data from the Beijing municipality, a region that has witnessed growth and gaps in development. Life and active life expectancy is assessed using a multistate life table technique that estimates hazard rates and subsequent expected years in various health states. Hazards are estimated for a model that adjusts regional differences for age and sex and for a series of other models including additional covariates. Results indicate urban residents have an advantage. Specific factors show socio-economic status and access to health service account for a large part, social support and health behaviors for little, while disease is a suppressor.     

Medical Utilization and Health Expenditure of the Elderly in Taiwan

The present analysis, based upon data from the 1989 Taiwan Labor Force Survey, includes two parts. First, the determinants of physician visits and hospitalization by the elderly are analyzed according to the behavioral systems approach, and, second, variation in health expenditures among the elderly are examined using the Tobit model with sample selection. Findings show that elderly with good or poor health conditions are less likely to use medical services than the frail elderly and that married elders are less likely than the non-married to use medical care. The higher the educational level, the lower the probability of using formal medical services, and elderly who have health insurance are more likely to use formal health care than those who have no health insurance. The elderly who live with their children are less likely to use formal medical services than those who do not live with their children. Finally, among the elderly who have used formal health care, individual health expenditures are influenced primarily by three factors: health condition, health insurance, and residential location. Implications for Taiwan's relatively newly established national health insurance program (effective April 1, 1995) are discussed based upon the findings of this research.     

The Roles of Relationship With Family and Life Values in the Housing Choices of Elderly Koreans

Housing choice is a significant factor in forecasting the housing market. In an aging population in which the wealth of the elderly is found mostly in housing equity, the housing choices of the elderly are an increasingly important yet underrepresented research theme. In addition to lower income and greater leisure time, the change of family relationships of the elderly are likely to result in significantly different housing choices from those made by younger groups. This article investigates the roles of family relationships and life values in the housing choices (tenure and location) of elderly Koreans. Subjective life satisfaction and propensity for expenditure were found to be significant determinants in the choice of housing tenure, whereas the choice of location is influenced by circumstances, especially their relationship with their children. These findings provide new insight into the Asian housing market, in which the elderly of traditional large families have a children-oriented mindset and maintain a geographic proximity with their children despite a growing trend toward family nuclearization.