The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2026
The role of residence tenure on rural Medicare beneficiaries' health outcomes.
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Ligus Kaleigh, Bellizzi Keith, Robison Julie
Аннотация
PURPOSE: Rural older adults with chronic disease face greater health care access and quality barriers than non-rural older adults which may result in poorer health-related quality of life (HRQoL). Few studies have explored if rural health disparities are related to geographic mobility, specifically, how long an individual has lived in a particular area. This study explored the relationship between residence tenure (aging-in-place vs. in-migrants), HRQoL and preference for health care decision-making among a nationally representative sample of Medicare beneficiaries living with a chronic disease.
METHODS: Using National Health and Aging Trends (NHATS) data, we examined 1012 older Medicare beneficiaries living with a chronic disease who participated in a supplemental chronic disease self-management (CDSM) module.
FINDINGS: Of the rural residents (n = 218) in the sample, 76% were aging-in-place (n = 166) and 24% were in-migrants (n = 52). Aging-in-place older adults reported lower self-rated health (M = 3.12, p < 0.05) than in-migrants (M = 3.31) and non-rural residents (M = 3.35) and reported higher anxiety (M = 0.99, p < 0.05) than in-migrants (M = 0.54) and non-rural residents (M = 0.73).
CONCLUSIONS: Results showed that rural older adults were not more likely to prefer independent health care decision-making, contrasting some previous studies. Implications of this research point to needed improvements in delivering person-centered care in clinical settings and in Medicare mental health coverage. The role of residence tenure in health outcomes is an important topic for ongoing examination.
METHODS: Using National Health and Aging Trends (NHATS) data, we examined 1012 older Medicare beneficiaries living with a chronic disease who participated in a supplemental chronic disease self-management (CDSM) module.
FINDINGS: Of the rural residents (n = 218) in the sample, 76% were aging-in-place (n = 166) and 24% were in-migrants (n = 52). Aging-in-place older adults reported lower self-rated health (M = 3.12, p < 0.05) than in-migrants (M = 3.31) and non-rural residents (M = 3.35) and reported higher anxiety (M = 0.99, p < 0.05) than in-migrants (M = 0.54) and non-rural residents (M = 0.73).
CONCLUSIONS: Results showed that rural older adults were not more likely to prefer independent health care decision-making, contrasting some previous studies. Implications of this research point to needed improvements in delivering person-centered care in clinical settings and in Medicare mental health coverage. The role of residence tenure in health outcomes is an important topic for ongoing examination.