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Realities for the Rural Elderly

There are many commonly-held beliefs about elderly persons living in rural areas. The National Center for Health Statistics (1993) published a monograph entitled Common Beliefs About the Rural Elderly: What Do National Data Tell Us? The monograph examines data from various sources to support or debunk some of the more commonly held beliefs about the rural elderly. Here are some of their findings:

Population - The commonly held belief is that older residents and children comprise higher proportions of the population in non-metropolitan areas than in metropolitan areas. Data from the 1990 census show this to be true: the elderly comprised about 15% of the non-metropolitan population and only 12% of the metropolitan population. Census data shows that older persons (65 and over) and children (under age 18) were more concentrated in non-metropolitan areas.

Minorities - The common belief is that a smaller proportion of minority elderly live in non-metropolitan areas and that minority populations in non-metropolitan areas are more impoverished than others. This also appears to be true. Nationwide, 92% of non-metropolitan elderly persons are white while 88% of metropolitan elderly are white. Elderly African Americans in non-metropolitan areas are more likely to be poor than those in metropolitan areas-nearly one-half of elderly African Americans in non-metropolitan areas are poor.

Income and Education - The common belief is that non-metropolitan elderly are more impoverished and less educated than their metropolitan counterparts. There is some truth here. A higher proportion of the non-metropolitan elderly are impoverished when compared with the metropolitan elderly-one-half of non- metropolitan elderly are poor, near poor or in low-income families. While non- metropolitan areas had a higher percent of persons who completed less than nine years of school and metropolitan areas had a higher percent of older persons with a college education, approximately one-third of the populations in both settings had a high school diploma as their highest level of educational attainment.

Housing - The commonly held belief is that housing for non-metropolitan elderly is of lower value and in poorer condition than that for the metropolitan elderly. Again, there is some truth in this belief. While non-metropolitan elderly were more likely to own their own homes and to own them without a mortgage, their homes were of lower value and in poorer physical condition than the homes of elderly persons in metropolitan areas.

Social Networks - The common belief is that non-metropolitan elderly benefit from a closely knit community and have a better social support network than elderly persons in metropolitan settings. There is evidence for this belief, but it isn't overwhelming. While the social networks of elderly persons were roughly comparable (more than 85% of both groups had one or more relatives whom they could call for help), a higher percent of non-metropolitan elderly reported having more than three friends whom they could call for help if needed.

Health - The common belief is that most non-metropolitan elderly are healthier and have a more active lifestyle while minority elderly in non-metropolitan areas are sicker than their metropolitan counterparts. Data show that non-metropolitan elderly persons are not healthier nor more active than their urban counterparts, that there is little difference in health behaviors (smoking, drinking, diet, weight control), and that a greater percent assess their health as fair or poor. A higher percent of elderly African Americans in non-metropolitan areas rated their health as fair or poor when compared with their counterparts in metropolitan settings. Elderly women in non-metropolitan areas are more vulnerable to dying from breast cancer because fewer utilize clinical screenings and mammograms.

Long-Term Care - The common belief is that non-metropolitan elderly have a greater need for long term care but utilize services less when compared with metropolitan elderly. The data indicate that there is little difference between metropolitan and non-metropolitan elderly populations when it comes to problems with activities of daily living (ADL's-eating, bathing, transferring from bed to chair), or instrumental activities of daily living (IADL's-tasks for living independently such as shopping and preparing meals). Among older persons reporting at least one limitation in ADL's or IADL's, a lower proportion of non- metropolitan persons reported using home health services.