Aging in urban and rural areas: Where are the differences? A study of health care utilization by the elderly population of eastern Ontari

This dissertation examines rural and urban aging in conjunction with the components of service delivery and public policy. The dissertation has four goals. The first is to determine whether a significant difference exists between rural and urban supply of services for seniors. The second goal is to uncover differences in the utilization of services by the rural and urban elderly population. The third goal is to reinterpret aging and utilization of services as a gendered process. The fourth goal is to understand the potential role that long-term care reform will have on future service delivery.;These goals are met through an empirical analysis carried out between 1991 and 1992 which integrates data on the supply of health and social services and consumption of services by the elderly population in the census divisions of Frontenac and Lennox and Addington, located in eastern Ontario, Canada. Separate questionnaire surveys were designed and administered to suppliers of health and social services and to a sample of urban and rural elderly persons living independently within the study area.;While a wide range of services exist in rural areas, the nature of service delivery in rural areas is limited by the number and scope of agencies. With respect to urban and rural differences in utilization of services, rural widowed women represented the largest percentage of users. While service availability needs to be understood as part of the explanation for service utilization, the other part is a more complex set of processes intertwined with age, gender, residential history and mobility. As the government of Ontario moves to reform long-term care, this study indicates that the differences between the rural and urban elderly population needs to be at the forefront of policy development.