title: Urban and rural differences in risk of admission to a care home: a census-based follow-up study.
abstract: Research on admissions to care homes for older people has paid more attention to individual and social characteristics than to geographical factors. This paper considers rural-urban differences in household composition and admission rates.
  
  
  METHODS
  51,619 people aged 65 years or older at the time of the 2001 Census and not living in a care home, drawn from a data linkage study based on c.28% of the Northern Ireland population. Living alone was less common in rural areas; 25% of older people in rural areas lived with children compared to 18% in urban areas. Care home admission was more common in urban (4.7%) and intermediate (4.3%) areas than in rural areas (3.2%). Even after adjusting for age, sex, health and living arrangements, the rate of care home admission in rural areas was still only 75% of that in urban areas. People in rural areas experience better family support by living as part of two or three generation households. Even after accounting for this difference, older rural dwellers are less likely to enter care homes; suggesting that neighbours and relatives in rural areas provide more informal care; or that there may be differential deployment of formal home care services.
authors.affiliation: MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 200 Renfield Street, Glasgow G2 2QB, United Kingdom. Electronic address: Mark.McCann@glasgow.ac.uk.
authors.forename: Mark
authors.initials: M
authors.lastname: McCann
authors.affiliation: Dept. of Social Policy, London School of Economics, Houghton Street, London, WC2A 2AE, United Kingdom.
authors.forename: Emily
authors.initials: E
authors.lastname: Grundy
authors.affiliation: Centre for Public Health, Institute of Clinical Sciences, Royal Hospitals Site, BT12 6BJ, Queen's University Belfast, Belfast, United Kingdom.
authors.forename: Dermot
authors.initials: D
authors.lastname: O'Reilly
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019352:Censuses; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009660:Northern Ireland; D009735:Nursing Homes; D010343:Patient Admission; D012111:Residence Characteristics; D018570:Risk Assessment; D012424:Rural Population; D014505:Urban Population
keywords: Aged; Nursing home; Residence characteristics; Rural population