Urban-Rural Disparities in Life Satisfaction Among Older Koreans: Determinants and Healthcare Policy Implications

This study examines how social and geographical factors shape life satisfaction among older adults in South Korea, which became a super-aged society in 2024. As Korea moves toward implementing a nationwide integrated eldercare system by 2026, understanding the contextual determinants of wellbeing among older populations is critical for effective policy design.

We use nationally representative survey data and apply a two-stage instrumental variable regression approach to address potential endogeneity in estimating the effects of key predictors on life satisfaction.

Subjective health and social connectedness are positively associated with life satisfaction. Physical activity shows context-specific effects, with notable differences between urban and rural areas. Surprisingly, greater accessibility to government services is linked to lower levels of physical activity, indicating a possible unintended consequence of well-intentioned policy measures. Gender differences are also evident: in urban areas, women report higher life satisfaction than men, whereas in rural areas, men report higher satisfaction than women.

These findings highlight the need for aging policies that are context-sensitive and socially inclusive. Policymakers should consider regional and gender-specific dynamics when designing programs to improve life satisfaction among older adults in a rapidly aging society.