Changes in Life Satisfaction and Health for Rural And Non-rural Older Adults in the United States

Drawing from a human development framework, this paper uses the 2014 and 2016 waves of the longitudinal Health and Retirement Study (HRS) with contextual data from the American Community Survey (ACS) and classification scales of the Economic Research Service of the U.S. Department of Agriculture to examine whether county-level rural and non-rural status is associated with changes in life satisfaction and perceived decrease in health among U.S. residents aged 65 and older. Controlling for individual declines in function (cognition, gross motor function and/or fine motor function), other individual characteristics, and additional county-level characteristics, we find that functional decline has a relationship to perceived health change and life satisfaction, but that the most substantial community and individual level characteristics are related to health not life satisfaction. Aside from the walkability of the county, no other county characteristics were predictive of change in life satisfaction. We calculate that the average predicted probability that someone experienced a decrease in health was highest (0.32) among older adults who experienced functional decline and who live in a rural county. This offers useful context for communities, and we discuss the implications for these findings as they relate to understanding how functional decline may be experienced differently for older adults across different types of places and what this may mean about the experience of disability.