Quality of life in rural and urban adults 65 years and older: findings from the National Health and Nutrition Examination survey.
OBJECTIVE
The proportion of people over 65 years of age is higher in rural areas than in urban areas, and their numbers are expected to increase in the next decade. This study used Andersen's behavioral model to examine quality of life (QOL) in a nationally representative sample of community-dwelling adults 65 years and older according to geographic location. Specifically, associations between 3 dimensions of QOL (health-related QOL [HQOL], social functioning, and emotional well-being) and needs and health behaviors were examined.


METHODS
The 2005-2006 National Health and Nutrition Examination survey was linked with the 2007 Area Resources File via the National Center for Health Statistics' remote access system. Frequencies and distribution patterns were assessed according to rural, adjacent, and urban locations.


RESULTS
Older adults reported high levels of QOL; however, rural older adults had lower social functioning than their urban counterparts. Older blacks and Hispanics had lower scores than whites on 2 dimensions of QOL. Associations between QOL and needs and health behaviors varied. Although activities of daily living were associated with all 3 dimensions, others were associated with 1 or 2 dimensions.


CONCLUSIONS
The lower scores on social functioning in rural areas suggest that rural older adults may be socially isolated. Older rural adults may need interventions to maintain physical and mental health, strengthen social relationships and support, and increase their participation in the community to promote QOL. In addition, older blacks and Hispanics seem more vulnerable than whites and may need more assistance.
School of Nursing, University of Virginia, Charlottesville, Virginia 22903, USA. baernholdt@virginia.edu
Marianne
M
Baernholdt
Guofen
G
Yan
Ivora
I
Hinton
Karen
K
Rose
Meghan
M
Mattos
D000203:Activities of Daily Living; D000368:Aged; D004522:Educational Status; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data; D009749:Nutrition Surveys / Q000706:statistics & numerical data*; D011788:Quality of Life; D012044:Regression Analysis; D012424:Rural Population / Q000706:statistics & numerical data*; D012917:Social Adjustment; D014481:United States / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data*