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Conditions facilitating aging in place in rural communities: The case of smart senior towns in Iowa [1]

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Date: 2023-01-01

By 2030, about 20% of the overall American population is expected to be aged 65 or older (Glasgow and Brown 2012, p. 442). The rural population is aging more rapidly than its urban counterpart. In 2012–2016, the share of people aged 65 years, or more was 17.5% in rural areas, compared to 13.8% in urban places (Smith and Trevelyan 2019, p. 2). Rural counties account for 85% of those most aged, with shares of residents aged 65+ reaching 20% or beyond (Cromartie 2018, p. 5). Different population trends contribute to rural aging depending on a demographic region. A significant number of rural counties have been aging predominantly due to attracting retirees for their amenities and recreation possibilities. These are in the Upper Great Lakes, the Appalachians and Ozarks, the Texas hill country, and across the Rocky Mountain West. Other aged rural counties are characterized by a persistent population loss due to out-migration, especially of young adults, pushed out by the lack of opportunities related to restructuring of agriculture and industry. These are located mostly in the Northern Great Plains and Corn Belt, with a smaller concentration in the Midwest and along Appalachia (Cromartie 2018; Glasgow and Brown 2012). Iowa belongs to the latter category. Its rural population constitutes a substantial portion of the state, i.e., about one fourth in case of rural counties and almost a half when combined with those in counties with a small city. Rural Iowa is significantly affected by demographic aging. In 2012–2016, the share of the state's population aged 65 or more in rural areas amounted to 41.1%, whereas the average percentage for the entire country was 22.9% (Smith and Trevelyan 2019, p. 5). Older adults in Iowa's rural communities are ‘aging in place’ and represent an increasing part of the rural population (Liu and Besser 2003). Since the beginning of the 20th century, transformations in the physical and social infrastructure of America, particularly in farming, but also in local manufacturing, have been provoking the loss of population in rural areas in Iowa, as well as in the rest of the country (Peters 2013). This combined with demographic aging leads to new pressing challenges—how to preserve a good quality of life in aging and shrinking rural communities. The Iowa Small Towns Project data, a unique longitudinal study on the quality of life in small rural towns, indicate that some rural communities may deal better with these challenges than others (Peters et al., 2018; Peters 2019). However, these studies were not focused on the older adults’ sub-population and did not include comparisons across age groups. Therefore, the insights provided by our analysis are unique, and may be relevant not only for rural Iowa, but also other regions of similar socio-demographic characteristics, especially within Great Plains and Midwest areas (Liu and Besser 2003). Despite structural differences in terms of, for example, financing service provision, lessons from Iowa will be also valuable for other countries facing demographic changes in rural areas.

We conceptualize ‘smart senior’ towns as local communities being good places for older adults to live, i.e., where their needs are addressed in a way that is satisfactory for them, and which allow them for aging in place. This means the opportunity for older people to live in their own home and community safely, independently, and comfortably (WHO 2015). It contributes to the well-being of older adults, provides a sense of biographical continuity, and allows avoiding costs of moving (Bigonesse and Chaudhurry 2020; Forsyth and Molinsky 2021; Pani-Harreman et al., 2021). Our approach is in line with the most recent trends in the literature encompassing a growing recognition of neighborhood/community influence, the importance of access to services and amenities, as well as older adults' empowerment and social inclusion as crucial for aging in place (Bigonesse and Chaudhurry 2020). We see aging in place as a policy issue that requires comprehensive planning adapted to specific needs, conditions and resources of a given community (Warner et al., 2017). Drawing from this literature, we argue that several domains need to be included in our analysis. First, we focus on local services as important factors of aging in place. Previous research showed also that satisfaction with these is a solid indicator of overall community quality of life (Boncinelli et al., 2015; Potter et al., 2012). We include both residents' opinions about crucial services, and their use of services in town. The former refer to jobs, medical services, public schools, housing, local government services (e.g., utilities), as well as child and senior services. The latter addresses the issue to what extent various types of services are actually used in town in terms of people's daily needs. In line with conceptualizing aging in place as a policy issue, we also include the perceptions of local leadership. Secondly, we include the place dimension in terms of community perceptions, social relationships, and place attachment. Aging in place refers to social connections (family and friends), security and a sense of identity (Pani-Harreman et al., 2021; Stedman 2002). Attachment to place combines social, environmental, emotional, and psychological meanings of place that develop over time (Butcher and Breheny 2016). Finally, we include the dimension of social capital, civic engagement, and socialization in town. These refer to local participation and social inclusion important for aging in place. There is strong evidence that social capital is an important factor contributing to the quality of life in local communities dealing with change, as well as community resiliency (Aldrich and Meyer 2015). The research by Brown et al. (2019) shows that rural communities can maintain a good quality of life among older residents thanks to building cooperation between relevant local institutions as well as partnerships with external organizations that facilitate aging-related service provision. Importantly, people's community engagement and participation in decision-making is crucial for both age-friendly and intergenerational planning (Warner and Zhang 2019; Warner et al., 2017). For building social capital and social connections between people, the importance of so-called ‘third places’ is emphasized. These include churches, libraries, local shops, etc., which provide opportunities for people to meet and contribute to social cohesion in the community (Zhang and Warner 2021).

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[1] Url: https://www.sciencedirect.com/science/article/abs/pii/S0743016723000050?via%3Dihubhttps://www.sciencedirect.com/science/article/pii/S0743016723000050?via%3Dihubhttps://www.sciencedirect.com/science/article/pii/S0743016723000050?via%3Dihubhttps://www.sciencedirect.com/science/article/pii/S0743016723000050?via%3Dihubhttps://www.sciencedirect.com/science/article/pii/S0743016723000050?via%3Dihubhttps://www.sciencedirect.com/science/article/pii/S0743016723000050?via%3Dihubhttps://www.sciencedirect.com/science/article/pii/S0743016723000050?via%3Dihub

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