Approximately 23% of all seniors in Canada live in rural areas, a pattern that is similar to the overall population since four out of five Canadians lived in urban areas in 2011 (Canada Mortgage and Housing Corporation, 2012). Large-scale studies on the overall prevalence of social isolation in rural areas in Canada are virtually non-existent, and few studies have compared differences between urban and rural areas. Kobayashi et al. (2009) found that as many as 17% of older adults, living primarily in small-town and small-city environments in British Columbia, were socially isolated.
Gender differences were also identified, with rural older men having smaller support networks and lower utilization rates of health and social services compared to rural women, who used more services and received more support from family and friends. The authors conclude that geographic and gender differences require targeted programs to help individuals sustain or enhance social integration.
For seniors living in rural areas with advanced cancer, lack of community support and access to services can lead to isolation and loneliness (Duggleby et al., 2011). Inadequate resources, loss in community and devaluing of rurality have also been linked to loneliness and a negative view of one’s self among rural senior women in Ontario. Ethnicity and gender were additional negative factors, with Aboriginal women pointing to a long history of discrimination and exclusion (Panazzola and Leipert 2013). In focus groups conducted by Hall et al. (2003), the inadequacy or non-existence of transportation services in rural areas was brought up as a source of isolation and loneliness. Keating et al. (2013) also found that loneliness among long-time residents in rural areas of newly affluent communities may have been linked to the fact that they were no longer able to take part in activities and organizations due to financial challenges (see also section on seniors with low income). The link between lack of transportation and isolation in rural areas has been noted elsewhere in the literature (Keefe et al., 2006). (See above for findings on isolation and living in remote areas among caregivers).
The way in which social isolation interacts with mental health may also vary by living environment. While seniors in rural, urban, and small-town environments exhibit similar levels of depressive symptoms (about 11.5% of the senior population), the factors associated with depression vary significantly across different environmental settings.
For seniors in rural areas, living alone, perceiving one’s income as inadequate, and having a functional impairment were associated with depressive symptoms (St. John et al., 2006) in contrast to a different set of factors for urban and small-town seniors.
Despite the limited research on rurality and social isolation among seniors, the literature suggests that social isolation has an impact on the wellbeing of rural seniors that cannot be assimilated to the more general experience. More comparative research is required in this area.