The relationship between access to health care services and relocation for rural older adults: Is the decision to move one of choice or necessity?

Previous research comparing how older adults use health services in urban and rural areas of Canada is inconclusive and sometimes contradictory. Some research found no differences between urban and rural residents; other studies found that people living in rural areas tend to use fewer services than those in urban centres. Diane Allan is comparing health care use and the mobility patterns of urban and rural residents. She is tracking health service records for people 55 and older on Vancouver Island to determine health service use before and after a move, including physician and hospital visits, home support and long-term residential care. Diane is assessing whether the current health care system is able to accommodate people in rural areas who require more specialized and intensive services, and if a lack of services forces people to relocate closer to the health care they require. One challenge is developing an appropriate measure of rural and urban residence. Diane is comparing traditional measures developed by Statistics Canada, with measures based on geographic information systems (GIS) technology, such as distance to a hospital. From a policy perspective this research may help to clarify why some findings report few differences in health service utilization among rural and urban older adults. If only healthy older adults remain living in rural areas while those with poorer health are forced to relocate to more resource rich environments, similar health utilization does not necessarily suggest an adequate health care system. Diane hopes her research will contribute to determining if and why rural older adults move in order to place these utilization patterns into context.