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Social Determinants of Health for Older Women in Canada: Does Rural–Urban Residency Matter?

Published online by Cambridge University Press:  26 April 2010

Deanna Wanless ,
Barbara A. Mitchell  and
Andrew V. Wister
Deanna Wanless*
Affiliation:
Alberta Centre on Aging, University of Alberta
Barbara A. Mitchell
Affiliation:
Departments of Sociology/Anthropology & Gerontology, Simon Fraser University
Andrew V. Wister
Affiliation:
Department of Gerontology, Simon Fraser University
*
*Correspondence concerning this article should be addressed to / La correspondance concernant cet article doit être adressées à: Deanna Wanless, M.A.Research Coordinator Alberta Centre on Aging University of Alberta 305 Campus Tower Edmonton, AB T6K 1K8 ([email protected])
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Abstract

This study provided an exploratory analysis of key social determinants of health for older Canadian women, with a focus on differences between rural and urban residency, given that socio-economic status (SES) and social capital have been shown to differ by rural–urban residence. Secondary analysis was conducted using the 2000/2001 Canadian Community Health Survey. A comparative logistic regression analysis revealed, unexpectedly, that SES and social capital variables were more strongly associated with the health status of urban older women than for the health status of their rural counterparts. Associations between health status measures and household income, food insecurity, and community belonging were largely not supported among rural women, but were for their urban counterparts. Findings are discussed concerning applications of the social-determinants-of-health model for explaining health patterns among older urban and rural women. Cost of living, access to health services, and dimensions of rural culture are discussed as potential explanations.

Résumé

Cette étude a fourni une analyse exploratoire des principaux déterminants sociaux de la santé des femmes âgées canadiennes, en se concentrant sur les différences entre la résidence dans régions rurals et urbaines, étant donné que le statut socio-économique (SES) et le capital social ont été démontrés diffèrent selon la résidence rurale-urbaine. Une analyse secondaire a été effectuée en utilisant l’Enquête de la santé communautaire canadienne, 2000/2001. Une analyse comparative de régression logistique a inopinément révélé que les variables de statut socio-économique et capital social étaient plus fortement associés à la santé des femmes plus âgées urbaines qu’avec leurs homologues rurales. Les associations entre les mesures de revenu de ménage et l’état de santé, de l’insécurité alimentaire et d’appartenance au communauté n’ont pas été pris en charge, pour la plupart, parmi les femmes rurales, mais ont été pris en charge pour leurs homologues urbains. Les conclusions concernant les applications du modèle social-déterminants-de-santé sont discutées pour expliquer les motifs de santé parmi les femmes âgées urbaines et rurales.

Keywords

vieillissementprincipaux déterminants sociaux de la santérural-eurbain-efemmescapital socialagingsocial determinants of healthruralurbanwomensocial capital
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 29 , Issue 2 , June 2010 , pp. 233 - 247
Copyright
Copyright © Canadian Association on Gerontology 2010

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References

Allan, D., & Cloutier-Fisher, D. (2006). Health service utilization among older adults in British Columbia: Making sense of geography. Canadian Journal on Aging, 25(2), 219–232.CrossRefGoogle ScholarPubMed
Baum, F.E., & Ziersch, A.M. (2003). Social capital. Journal of Epidemiology and Community Health, 57, 320–323.CrossRefGoogle ScholarPubMed
Belanger, A., Martel, L., Berthelot, J., & Wilkins, R. (2002). Gender differences in disability-free life expectancy for selected risk factors and chronic conditions. Journal of Women and Aging, 14(1–2), 61–83.CrossRefGoogle ScholarPubMed
Berkman, L.F., & Kawachi, I. (Eds.). (2000). Social epidemiology. New York: Oxford University Press.CrossRefGoogle Scholar
Bolig, E.E., Borkowski, J., & Brandenberger, J. (1999). Poverty and health across the life span. In Whitman, T.L., Merluzzi, T.V., & White, R.D. (Eds.), Life span perspectives on health and illness (pp. 67–84). Mahwah, NJ: Lawrence Erlbaum.Google Scholar
Bowen, G.L., Richman, J.M., & Bowen, N.K. (2000). Families in the context of communities across time. In Price, S., McKenry, P., & Murphy, M.J. (Eds.), Families across time: A life course perspective (pp. 117–128). Los Angeles: Roxbury.Google Scholar
Buckley, N.J., Denton, F.T., Robb, A.L., & Spencer, B.G. (2003). Socioeconomic influence on the health of older people: Estimates based on two longitudinal surveys. Hamilton, Ontario, Canada: QSEP Research Institute.Google Scholar
Cairney, J. (2000). Socio-economic status and self-rated health among older Canadians. Canadian Journal on Aging, 19, 456–478.CrossRefGoogle Scholar
Chappell, N.L. (1998). Maintaining and enhancing independence and well-being in old age. In National Forum on Health (Ed.), Determinants of health: Adults and seniors (pp. 89–141). Saint-Foy, QC: Editiens MultiMondes.Google Scholar
Clark, D., & Dellasega, C. (1998). Unmet health care needs: Comparison of rural and urban senior center attendees. Journal of Gerontological Nursing, 21(2), 24–33.CrossRefGoogle Scholar
Coleman, J.S. (1988). Social capital in the creation of human capital. American Journal of Sociology, 94, S95–S120.CrossRefGoogle Scholar
Davis, R., & Magilvy, J. (2000). Quiet pride: The experience of chronic illness by rural older adults. Journal of Nursing Scholarship, 32(4), 385–390.CrossRefGoogle ScholarPubMed
Denton, M., Prus, S., & Walters, V. (2004). Gender differences in health: A Canadian study of the psychosocial, structural and behavioural determinants of health. Social Science & Medicine, 58, 2585–2600.CrossRefGoogle ScholarPubMed
Forbes, D., Morgan, D., & Janzen, B. (2006). Rural and urban Canadians with dementia: Use of health care services. Canadian Journal on Aging, 25(3), 321–330.CrossRefGoogle Scholar
Gerritsen, J.C., Wolffensperger, E.W., & Van Den Heuvel, W.J.A. (1990). Rural-urban differences in the utilization of care by the elderly. Journal of Cross Cultural Gerontology, 5, 131–147.CrossRefGoogle ScholarPubMed
Gillanders, W.R., Buss, T.F., & Hofstetter, C.R. (1996). Urban/rural elderly health status differences: The dichotomy re-examined. Journal of Aging and Social Policy, 8(4), 7–24.CrossRefGoogle Scholar
Goins, R.T., Hays, J.C., Landerman, L.R., & Hobbs, G. (2001). Access to health care and self-rated health among community-dwelling older adults. Journal of Applied Gerontology, 20, 307–321.CrossRefGoogle Scholar
Grundy, E., & Slogett, A. (2003). Health inequalities in the older population: The role of personal capital, social resources and socio-economic circumstances. Social Science and Medicine, 56, 935–947.CrossRefGoogle ScholarPubMed
Havens, B., Hall, M., Sylvestre, G., & Jivan, T. (2004). Social isolation and loneliness: Differences between older rural and urban Manitobans. Canadian Journal on Aging, 23, 129–140.CrossRefGoogle ScholarPubMed
Hirdes, J.P., & Forbes, W.F. (1993). Factors associated with the maintenance of good self-rated health. Journal of Aging and Health, 5, 101–122.CrossRefGoogle Scholar
Joseph, A.E., & Martin Matthews, A. (1994). Growing old in aging communities. In Marshall, V. & McPherson, B. (Eds.), Aging: Canadian perspectives (pp. 20–35). Peterborough, Ontario, Canada: Broadview Press.Google Scholar
Kawachi, I. (2000). Income inequality and health. In Berkman, L.F. & Kawachi, I. (Eds.), Social epidemiology (pp. 76–94). New York: Oxford University Press.CrossRefGoogle Scholar
Keating, N. (1991). Aging in rural Canada. Toronto, Ontario, Canada: Butterworths Canada.Google Scholar
Keating, N. (Ed.). (2008). Rural ageing: A good place to grow old? London: Policy Press.Google Scholar
Keating, N., & Phillips, J.E. (2008). A critical human ecology perspective on rural ageing. In Keating, N. (Ed.), Rural ageing: A good place to grow old? (pp. 1–10). London: Policy Press.Google Scholar
Kersting, R.C. (2001). Impact of social support, diversity and poverty on nursing home utilization in a nationally representative sample of older Americans. Social Work in Health Care, 33(2), 67–87.CrossRefGoogle Scholar
McCulloch, B.J. (1998). Introduction. In McCulloch, B.J. (Ed.), Old, female and rural (pp. 1–5). Binghamton, NY: Haworth Press.Google ScholarPubMed
Marmot, M. (2004). The status syndrome: How social standing affects our health and longevity. New York: Times Books.CrossRefGoogle Scholar
McMunn, A., Breeze, E., Goodman, A., Nazroo, J., & Oldfield, Z. (2006). Social support and social cohesion. In Marmot, M. & Wilkinson, R.G. (Eds.), Social determinants of health (2nd ed., pp. 148–171). New York: Oxford University Press.Google Scholar
McPherson, B., & Wister, A. (2008). Aging as a social process: Canadian perspectives. Don Mills, Ontario, Canada: Oxford University Press.Google Scholar
Mitura, V., & Bollman, R.D. (2003). The health of rural Canadians: A rural-urban comparison of health indicators. Rural and Small Town Canada Analysis Bulletin, 4(6), 1–23.Google Scholar
Newhouse, J.K. (1995). Rural and urban patterns: An exploration of how older adults use in-home care. New York: Garland Publishing.Google Scholar
Nord, M. (2000). Does it cost to live in rural areas? Evidence from new data on food security and hunger. Rural Sociology, 65(1), 104–125.CrossRefGoogle Scholar
O’Rand, A., & Hamil-Luker, J. (2005). Process of cumulative adversity: Childhood disadvantage and increased risk of heart attach across the life course. Journals of Gerontology: Psychological Sciences and Social Sciences, 60B, 117–124.CrossRefGoogle Scholar
Pearson Scott, J., & Roberto, K.A. (1985). Use of informal and formal support networks by rural elderly poor. The Gerontologist, 25, 624–630.CrossRefGoogle Scholar
Pearson Scott, J., & Roberto, K.A. (1987). Informal supports of older adults: A rural urban comparison. Family Relations, 36, 444–449.CrossRefGoogle Scholar
Pederson, A., & Raphael, D. (2006). Gender, race and health inequalities. In Raphael, D., Bryant, T., & Rioux, M. (Eds.), Staying alive: Critical perspectives on health, illness, and health care (pp. 159–191). Toronto, Ontario, Canada: Canadian Scholars Press.Google Scholar
Pong, R., DesMeules, M., & Lagace, C. (2009). Rural-urban disparities in health: How does Canada fare and how does Canada compare with Australia. Australian Journal of Rural Health, 17, 58–64.CrossRefGoogle ScholarPubMed
Public Health Agency of Canada. (2002). The social determinants of health: An overview of the implications for policy and the role of the health sector. Ottawa, Ontario, Canada: Public Health Agency of Canada. Retrieved August 30, 2009, from http://www.phac-aspc.gc.ca/ph-sp/oi-ar/pdf/01_overview_e.pdfGoogle Scholar
Public Health Agency of Canada. (2006). Determinants of health. Ottawa, Ontario, Canada: Public Health Agency of Canada. Retrieved November 22, 2007, from http://www.phac-aspc.gc.ca/media/nr-rp/2006/2006_06bk2-eng.phpGoogle Scholar
Rabiner, D., Konrad, T., DeFriese, G., Kincade, J., Berbard, S., Woomert, A., et al. . (1997). Metropolitan versus nonmetropolitan differences in functional status and self-care practices: Findings from a national sample of community-dwelling older adults. Journal of Rural Health, 13(1), 14–28.CrossRefGoogle ScholarPubMed
Raphael, D. (2004). Introduction to the social determinants of health. In Raphael, D. (Ed.), Social determinants of health: Canadian perspectives (pp. 1–18). Toronto, Ontario, Canada: Canadian Scholars Press.Google Scholar
Raphael, D. (2006). Social determinants of health: An overview of concepts and issues. In Raphael, D., Bryant, T., & Rioux, M. (Eds.), Staying alive: Critical perspectives on health, illness, and health care (pp. 115–138). Toronto, Ontario, Canada: Canadian Scholars Press.Google Scholar
Robertson, A., Brunner, E., & Sheiham, A. (2006). Food is a political issue. In Marmot, M. & Wilkinson, R.G. (Eds.), Social determinants of health (2nd ed., pp. 172–195). New York: Oxford University Press.Google Scholar
Rogers, A. (1999). Factors associated with depression and low life satisfaction in the low-income, frail elderly. Journal of Gerontological Social Work, 31, 167–194.CrossRefGoogle Scholar
Rosenberg, M.W., & Wilson, K. (2000). Gender, poverty and location: How much difference do they make in the geography of health inequalities? Social Science & Medicine, 51, 275–287.CrossRefGoogle ScholarPubMed
Shapiro, E., & Roos, L.L. (1984). Using health care: Rural/urban differences among the Manitoba elderly. The Gerontologist, 24, 270–274.CrossRefGoogle ScholarPubMed
Shields, M. (2008). Community belonging and self-perceived health. Health Reports, 19(2), 1–10.Google ScholarPubMed
Shenk, D. (1998). Subjective realities of rural older women’s lives: A case study. In McCulloch, B.J. (Ed.), Old, female and rural (pp. 7–24). Binghamton, NY: Haworth Press.Google Scholar
St. John, P.D., Havens, B., van Ineveld, C.H.M., & Finlayson, M. (2002). Rural-urban differences in health status of elderly Manitobans. Canadian Journal of Rural Medicine, 7(2), 89–93.Google Scholar
Stansfeld, S.A. (2006). Social support and social cohesion. In Marmot, M. & Wilkinson, R.G. (Eds.), Social determinants of health (2nd ed., pp. 148–171). New York: Oxford University Press.Google Scholar
Statistics Canada. (2001). Geographic units: Urban area (UA). Data dictionary: 2001 census. Ottawa, Ontario, Canada: Statistics Canada. Retrieved July 11, 2008, from http://www12.statcan.ca/english/census01/Products/Reference/dict/geo049.htmGoogle Scholar
Statistics Canada. (2004a). Canadian community health survey. Ottawa, Ontario, Canada: Statistics Canada. Retrieved July 11, 2008, from http://statcan.ca/english/sdds/3226.htmGoogle Scholar
Statistics Canada. (2004b). Statistical area classification: Highlight tables, 2001 counts, for Canada, provinces and territories. Ottawa, Ontario, Canada: Statistics Canada. Retrieved July 11, 2008, from http://www12.statcan.ca/english/census01/products/highlight/SACGoogle Scholar
Strain, L.A., & Chappell, N.L. (1983). Rural-urban differences among adult day care participants in Manitoba. Canadian Journal on Aging, 2, 197–209.CrossRefGoogle Scholar
Veninga, J. (2006). Social capital and healthy aging. Health Policy Research Bulletin, 12, 21–24.Google Scholar
Wanless, D. (2005). Health differentials among elderly women: A rural-urban analysis (Master’s Thesis, Simon Fraser University, 2005). Masters Abstracts International, 44, 5.Google Scholar
Wilkinson, R., & Marmot, M. (Eds.). (2003). Social determinants of health: The solid facts (2nd ed.). Copenhagen, Denmark: World Health Organization.Google Scholar