Impact of health and transportation on accessing healthcare in older adults living in rural regions

Introduction: Living in rural areas pose challenges to accessing healthcare, often requiring individuals to travel to major cities. This study examined the impact of health and transportation among older adults using no healthcare services, family doctor services, and medical specialist services, and compared to those living in rural and small population centers. Methods: Between 2020 and 2021, a survey was disseminated to 244 older adults (Mean age = 72.2 years ± 5.3 years, 50.2% male) living in rural (n = 139) and small communities (n = 105) of Saskatchewan, Canada. Results: In total, 135 participants did not use healthcare services (i.e., family doctor or medical specialist); 55 used family doctor services, and 54 used medical specialist services; 10.6% reported cancelling medical appointments due to the lack or cost of transportation. Living in a rural community was a significant predictor of using family doctors. Additionally, living in a rural environment, not perceiving health as excellent or good, receiving rides from others, and traveling to larger centers for medical care were significant predictors of using medical specialists. Living in a senior’s complex and having diabetes were significantly associated with poorer health. Receiving rides from friends, family, or volunteer driving programs was the most available transportation option in rural vs small population centers. Conclusions: Accessing healthcare is influenced by both health and transportation for older adults living in rural versus small communities. The lack of available and affordable transportation, coupled with the distance and occurrence of medical appointments, impacts healthcare access or cancelling medical appointments

A public health approach to mobilizing community partners for injury prevention: A scoping review.

ObjectivesReducing injuries in adults requires work with diverse stakeholders across many sectors and at multiple levels. At the local level, public health professionals need to effectively bring together, facilitate, and support community partners to initiate evidence-based efforts. However, there has been no formal review of the literature to inform how these professionals can best create action among community partners to address injuries in adults. Thus, this scoping review aims to identify theories, models or frameworks that are applicable to a community-based approach to injury prevention.MethodsSearches of scientific and less formal literature identified 13,756 relevant items published in the English language between 2000 and 2016 in North America, Europe and Australia. After screening and review, 10 publications were included that (1) identified a theory, framework or model related to mobilizing partners; and (2) referred to community-based adult injury prevention.ResultsFindings show that use of theories, frameworks and models in community-based injury prevention programs is rare and often undocumented. One theory and various conceptual models and frameworks exist for mobilizing partners to jointly prevent injuries; however, there are few evaluations of the processes to create community action.ConclusionsSuccessful community-based injury prevention must build on what is already understood about creating partnership action. Evaluating local public health professional injury prevention practice based on available theories, models and frameworks will identify successes and challenges to inform process improvements. We propose a logic model to more specifically guide and evaluate how public health can work locally with community partners