Location Matters: Disparities in the Likelihood of Receiving Services in Late Life

• Published in: International journal of aging & human development Vol. 93; no. 1; pp. 653 - 672
• Main Authors: Weaver, Raven H., Roberto, Karen A.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.07.2021; Baywood Publishing Co., Inc
• Subjects: Aging; Food; Home health care; Older people; Rural areas; Rural urban differences; Social services delivery; social services; geographic-based disparities; barriers to receiving services; aging in place; long-term care
• ISSN: 0091-4150; 1541-3535
• DOI: 10.1177/0091415020948205

Moving beyond typical dichotomous rural–urban categorizations, this study examines older adults’ likelihood of receiving home- and community-based services. Data from 1608 individuals aged 60+ who requested assistance from Area Agencies on Aging in Virginia in 2014–2015 were analyzed; 88% of individuals received at least one service. Receiving services was associated with geographic-based factors. Individuals living in completely rural areas were significantly less likely to receive any service compared to individuals in mostly rural (OR = 2.46, p = .003) and mostly urban (OR = 1.97, p = .024) areas. There were subtle but significant geographic-based differences in the likelihood of receiving specific services including food/meal, fresh food, information and referral, in-home care, utilities support, and transportation. Findings provide nuanced insights about geographic-based disparities in the receipt of services and suggest the need for new and modified service delivery strategies that maximize older adults’ ability to live.