What Community Characteristics Help or Hinder Rural Communities in Becoming Age-Friendly? Perspectives From a Canadian Prairie Province

Abstract

Age-friendly initiatives are increasingly promoted as a policy solution to healthy aging, The primary objective of this article was to examine older adults’ and key stakeholders’ perceptions of the factors that either help or hinder a community from becoming age-friendly in the context of rural Manitoba, a Canadian prairie province. Twenty-four older adults and 17 key informants completed a qualitative interview. The findings show that contextual factors including size, location, demographic composition, ability to secure investments, and leadership influence rural communities’ ability to become age-friendly. Government must consider the challenges these communities face in becoming more age-friendly and develop strategies to support communities.

Keywords

qualitative analysis age-friendliness rural communities

Highlights:

Age-friendliness is increasingly promoted as a policy solution to healthy aging.

Size, location, demographic makeup, and leadership influence age-friendliness.

Contextual factors influence the ability of rural communities to become age-friendly.

If Canada is to move from a system focused predominantly on health care to one more oriented to improved health status, promoting policies and programs that make a critical contribution to the health and wellness of Canadians is imperative (Chenier, 2002). Promoting the improved health and well-being of the Canadian population has become an increasingly worthy goal given that Canada is undergoing an unprecedented demographic shift that brings healthy aging to the forefront of the social policy agenda (Public Health Agency of Canada, 2011). As a response to population aging, The World Health Organization (WHO) is engaging cities worldwide to become more “age-friendly” (World Health Organization, 2007), with an age-friendly city defined as one in which policies, services, and structures in the physical and social environment support and enable active aging. In Canada, the Public Health Agency of Canada (PHAC) proposed that becoming age-friendly is an effective policy approach to responding to the challenges and opportunities associated with population aging (Butler-Jones, 2010) and several provincial governments have launched age-friendly initiatives.

Despite the growing interest in the notion of age-friendliness as a policy solution to healthy aging, there has been no research to date that has explored what characteristics impact communities’ ability to become more age-friendly. Thus the purpose of the present study was to examine older adults’ and key stakeholders’ perceptions of what community characteristics either help or hinder a community from becoming age-friendly. We examine this question in the context of rural Manitoba, a Canadian prairie province, where the provincial government launched the Age-Friendly Manitoba Initiative in 2008 as a way to encourage the promotion of age-friendly environments throughout Manitoba.

There are several reasons why a focus on rural communities is important and rural Manitoba provides an appropriate setting to conduct our research. First, rural communities in Manitoba and Canada as a whole have been characterized by significant social and economic changes since the end of the Second World War, including a decline in populations and increased mobility among rural residents with consumer tastes and shopping preferences becoming more oriented towards the larger and often more distant centers (Stadel, 1996). However, a large proportion of older adults still live in rural or remote areas with an estimated 33% of older adults aged 65 or older in Canada residing in predominantly rural regions (census divisions where more than 50% of the population lives in a rural community) in 2006 (Dandy & Bollman, 2008).

Second, many communities throughout the province of Manitoba have joined the Age-Friendly Manitoba Initiative in an attempt to become more age-friendly. These communities vary from one another on the basis of a number of characteristics, including their population size and distance from larger and better serviced centers, thereby providing an opportunity to examine the implementation of an age-friendly initiative in diverse contexts.

Finally, this study represents a significant advance on previous related work on age-friendly communities, which has predominantly focused on identifying specific features of an age-friendly community (Federal, Provincial, Territorial Ministers Responsible for Seniors, 2007; Novek & Menec, 2013) but not the characteristics that are related to whether a community can become more age-friendly. Gaining an understanding of these characteristics is not only important because it may assist communities in becoming more age-friendly but can also help governments in other jurisdictions with the implementation of age-friendly, or similar initiatives.

Background

The Concept of Age-Friendliness

Although there is no universally accepted definition of what constitutes an “age-friendly” community, the WHO’s (2007) definition has been gaining increasing attention in recent years. According to the WHO, eight domains need to be considered in terms of making cities more age-friendly: outdoor spaces and buildings; transportation; housing; respect and social inclusion; social participation; civic participation and employment; communication and information; and community supports and health services (WHO, 2007). Within each of these domains, focus groups conducted in 33 cities around the world identified numerous specific features as being important in older adults’ lives, such as well-maintained sidewalks, accessible buildings, programs that promote social engagement, to name just a few (WHO, 2007).

In Canada, the concept of age-friendliness has been expanded to rural and remote communities in recognition of the fact that older people constitute a high percentage of the population in rural and remote regions. Moreover, older adults living in rural communities face unique social and environmental challenges that differ from those in urban areas. As such, the Federal, Provincial, Territorial (F/P/T) Ministers Responsible for Seniors initiated a project to determine (via focus groups) what features make rural and remote communities age-friendly, focusing again on the eight domains identified by the WHO (F/P/T Ministers Responsible for Seniors, 2007). Much is known, therefore, about what features make both cities as well as rural and remote communities age-friendly.

Lui, Everingham, Warburton, Cuthill, and Bartlett (2009) have noted that the discussion related to the development of age-friendly communities has been encouraged by a number of developments in recent years. First, there has been a wide adoption of aging-in-place as a policy goal that supports individuals’ remaining at the same place or residence as they age (Graff & Wiseman, 1978; Hanson & Emlet, 2006). One of the best ways to promote the aging-in-place of residents in a community would be to become age-friendly. All residents of a community, regardless of their length of residency in that community, can benefit from the provision of age-friendly features that provide supports to residents. Second, environmental gerontology suggests that adaptation to age-related changes depends on the fit between the individual and the environment (Lawton & Nahemow, 1973). Thus, by becoming age-friendly, communities can work toward meeting the needs of older residents (Alley, Liebig, Pynoos, Banerjee, & Choi, 2007; Lehning, Scharlach, & Del Santo, 2009). Third, influential organizations like the WHO have been promoting the concept.

The Concept of Place

“Place,” defined as “location” by geographers, has acquired a particular connotation as a context for human action that is rich in human significance and meaning (Norton, 2009). In the present study we are interested in age-friendly rural communities as physical places with significance and meaning to older adults. Studying the character of places themselves and why particular places evoke a sense of awe and attachment reflects a shift away from studying humans toward a concern for the qualities or attributes of places that move the individual (Wilkie, 2003). Perspectives on place have also attempted to factor in the larger cultural milieu involving both natural and cultural landscapes as places of meaning adding layers of depth into the cognitive world of sensing a place (Roberson & Wilkie, 2010). We would argue that understanding the meaning that people assign to locations, particularly their perceptions of a community’s age-friendliness, is crucial.

We must also note that age-friendliness fits into the literature on the linkages between aging-in-place and place integration. Place integration refers to the short-term elimination of conflicts in place (i.e., a lack of appropriate housing options) and the creation of new meanings and values for individuals through individual and social action (Cutchin, 2001). These conflicts in place ultimately threaten the older person’s attachments with place. Thus the problem for older people in place is to develop the ability to integrate and reintegrate in a meaningful way. The utility of the place integration perspective in the study of aging-in-place and migration decision making has been addressed by Cutchin (2001) and Spina (2009). We argue that becoming an age-friendly community would assist aging individuals in integrating or reintegrating with place in the face of continuously evolving challenges.

Rural Aging

As is the case for most countries, Canada’s population is aging. According to the Census of Canada, older adults accounted for 14.8% of the population in 2011, up from 13.7% in 2006 (Statistics Canada, 2012) and 13.0% in 2001 (Statistics Canada, 2007). Rural populations in Canada are aging at a faster rate than urban ones (Dandy & Bollman, 2008). This is due to several reasons: (a) “aging in place,” that is, individuals remaining in the same community as they age; (b) in-migration of older adults; and (c) out-migration of younger persons, which increases the concentration of older adults in a given area (Dandy & Bollman, 2008).

Apart from permanent in- and out-migration, some older adults are changing their place of residence for at least part of the year. The change many involve a local move within the community or region, or a permanent or seasonal migration to a new geographical region. The aging of the Canadian population implies that the spatial mobility of older people will be a growing force shaping Canadian society. As the Canadian population ages, a larger proportion of the population will be concerned with retirement issues. Retirement often prompts a desire to change home, and in many cases the appeal of a simplified life in a smaller rural or semirural community may become the focus of future plans (Brown & Glasgow, 2008; Walters, 2000).

As people age, they not only require more housing options but also transportation, shopping facilities, and other day-to-day services. In small rural communities, a lack of many of these services creates serious problems for local governments in meeting the needs of older people (Hodge & Gordon, 2008; Rogers, 1989). A substantial body of work has focused on services for older adults in rural areas. For example, research has addressed mobility constraints impeding rural seniors’ access to regionalized services (Ryser & Halseth, 2012), challenges to the provision of health care services (Forbes & Edge, 2009; Hanlon & Halseth, 2005), the views concerning factors that affect the mental health of older adults and how well these factors were addressed in rural and midsize urban communities (Mcgee, Tuokko, MacCourt, & Donnelly, 2004), as well as determinants of health service used by Canadians 55 or older across a range of urban and rural areas of residence (McDonald & Conde, 2010).

Besides health care services, a wide range of other features are important for older adults, including affordable housing options, outdoor spaces that promote a healthy lifestyle (e.g., walking paths, feeling safe); general services (e.g., grocery store); activities (e.g., recreation activities, exercise programs); and keeping seniors engaged in the community, including intergenerational activities (F/P/T Ministers Responsible for Seniors, 2007).

For rural communities, being able to provide services and opportunities for older adults can be essential. In other words, the retention of older adults in, and attraction of older adults to communities, can be used to a community’s advantage in promoting population growth, community sustainability, and regional competitiveness (Jauhiainen, 2009). In this respect, Halseth (2003) found that fringe development along the southeastern Vancouver Island was the result of the age-specific service needs of retirees, the dominant in-migration group. Thus making a community age-friendly may become a community development strategy to both help retain older adults in a rural community (i.e., minimize out-migration) and also help to attract older adults to a community (i.e., foster in-migration).

Context of the Present Study

According to the 2011 Census of Canada, the province of Manitoba registered a population of 1.2 million individuals, 55% of whom were concentrated into one urban centre, Winnipeg, located in the south of the province. Winnipeg is the only place in the province classified by Statistics Canada as a “Census Metropolitan Area” (CMA) with a population of at least 100,000 people. All other places are classified by Statistics Canada as either “Census Agglomerations” (3 locations having populations of between 10,000 and 100,000 people); “Other Urban Areas” (places with populations between 1,000 and 10,000 people); and “Rural Areas” (locations with populations of less than 1,000 people). Thus the majority of communities in Manitoba are small towns or villages that contain a sizable number of the province’s 65+ population.

In February 2008, the Manitoba government launched the Age-Friendly Manitoba Initiative. Led by the Seniors and Healthy Aging Secretariat, the section within the provincial government responsible for issues pertaining to older adults, the Age-Friendly Manitoba Initiative is designed to “support seniors in leading active, socially engaged, independent lives that contribute to healthy aging” (Seniors and Healthy Aging Secretariat, 2012). The Initiative reflects a commitment by the province of Manitoba to support both older adults and the communities in which they live. Since 2008, municipalities throughout the province have been formally invited by government to join the Initiative and become more age-friendly. To date, 86 municipalities have joined the Initiative with the intent of becoming an age-friendly community. Most of the participating communities are small towns and villages. These towns and villages serve as the geographic scale of our work.

Method

Participants

To address our research objective, older adults recruited from three rural Manitoba communities that are part of the Age-Friendly Manitoba Initiative, and key informants were invited to participate in a qualitative interview. In particular, the project included 41 participants: 24 older adults and 17 key informants (representatives of local, municipal, regional, and provincial levels of government and representatives of nongovernmental associations). Ethical approval to conduct all components of the field survey was granted by the University of Manitoba’s Psychology/Sociology Research Ethics Board (PSREB) Protocol No. P2011:026.

An age baseline of 55 years of age was utilized in the present study as the lower age limit for older adult participants because this age baseline is used by many community and age-based organizations. Forty-two percent of our older adult sample was male versus 58% female. A small majority of respondents were 65 to 74 years of age, while three respondents were 85+.

Key informants were defined as individuals who (a) were knowledgeable on issues addressed in this study and (b) can impact the design and promote programs and policies that support the Age-Friendly Manitoba Initiative by helping communities become age-friendly. Our key informants were almost evenly distributed between representatives of the local, municipal, and provincial levels of government, with one representative at the regional level.

Participant Recruitment

Convenience and snowball sampling were utilized in the present study. Older adults were recruited via community organizations and senior resource coordinators who were contacted regarding the need for participants in the three rural communities. Advertisements about the nature and purpose of the research project, and the need for participants, were posted on notice boards at senior centers in these communities. Advertising was also conducted through local media/advertising sources and a public presentation. Furthermore, participants were asked to speak about the study to other older adults in their community in an attempt to recruit additional participants for the study. Key informants were identified by compiling a list of individuals whom we knew were involved in the Age-Friendly Manitoba Initiative at either the community level or provincial level. We also identified key informants with nongovernmental associations who had an interest in the initiative. These key informants were then approached, introduced to the purpose of the study, and asked to participate in the study.

Discussion Topics

An age-friendly community provides supports and opportunities for older adults as a way to enhance participation, health, and, ultimately, quality of life (WHO, 2007). Thus older adults and key informants were asked questions surrounding the attraction, retention, and participation of older adults in communities. They were not provided with a definition of age-friendly; rather, they were asked broad-based questions regarding the age-friendliness of their communities. However, as noted above, key informants were recruited on the basis of their involvement in the Age-Friendly Manitoba Initiative and were thus familiar with the concept.

Key informants were further specifically asked about the extent that they felt attracting and retaining older adults should and could be part of a community’s economic development strategy; the costs of not having programs and services for older adults in communities; and the extent that Manitoba communities and associated stakeholders should invest in becoming more age-friendly. Aside from a few structured questions, primarily semistructured and unstructured questions were utilized. This method provided qualitative depth by allowing interviewees to talk about the subject in terms of their own “frame of reference” both with and without many probes by the interviewer (May, 2001).

Analyses

Interviews were conducted over the telephone and lasted approximately 30 to 45 min. Interviews were tape-recorded and later transcribed for analysis using NVivo, a qualitative data software program. Once we transcribed our interviews, each question was coded. Coding involved identifying the key topics identified by respondents in relation to each question. Each question was then subsumed within a larger theme, or broad idea. This method of analysis allowed a comparison of the qualitative responses of older adults with one another and between older adults and key informants. To ensure rigor, our coding process occurred an additional two times to ensure that all of the relevant topics and broader themes had been identified. In addition, relevant direct quotations provided by older adults and key informants were recorded to provide qualitative evidence of relevant issues discussed throughout the interview process.

Results

Five dominant community characteristics emerged from the data analysis that help or hinder rural communities in becoming age-friendly: (a) community size; (b) the proximity of a community to other communities; (c) the demographic composition of a community; (d) securing investment; and (e) leadership and advocacy.

Community Size

The ability of communities to become age-friendly may be shaped by the size of the community. Both older adults and key informants recognized that smaller communities face barriers in becoming age-friendly because they cannot afford to offer the same range of opportunities for older adults as larger communities can. For some older adults, the small town atmosphere of these communities was a factor in attracting them to the community even though they recognized the downsides of living in such an environment. As one older adult put it,

Because we’re in a small town, you tend to kind of feel a little isolated at times, and go into the city for a movie, or go into the city for entertainment and sports—Manitoba Moose [hockey team]type of thing . . . It’s a trade-off. I mean, we recognize that, living in Winnipeg, sure there’s lots more to do but you weigh the plusses and minuses. (Older Adult)

Older adults and key informants also recognized that the limited range of goods and services in small towns can make it difficult to retain and attract older adults to communities. For example, one key informant recognized that the retention of older adults in communities may be very difficult due to a lack of services:

. . . the problem is that some of the smaller rural communities just don’t have facilities like hospitals or even pharmacies or restaurants to provide a meal service so, in the very small communities it’s difficult to keep people. (Key Informant)

Recognizing the challenges of small communities face in providing a range of services for older adults, respondents suggested that partnerships across communities might be the solution. As one key informant stated,

I mean there’s a lot of small communities in Manitoba and everybody’s not going to get a hospital, and everybody’s not going to have a care home, but maybe if it’s done on a regional basis, one community maybe has one thing and one has another and, maybe you won’t be able to stay in the community you were born in your whole life but you only have to go 50k down the road to go to the care home when you’re older instead of having to go 300k to Winnipeg or Brandon. (Key Informant)

The Proximity of a Community Relative to Other Communities

The location of communities relative to a larger urban center was also important. Being close to an urban, service-rich center meant that a rural community did not need to provide all services. Indeed, the close proximity of some communities to Winnipeg was an important characteristic in attracting some older adults to move or consider moving to their current communities. These communities were attractive because they combined small-town living with the convenience of being located near a large urban center that can provide a greater variety of shopping and entertainment opportunities as well as a large pool of services that become increasingly important in later life. For example, one older participant stated,

The good thing about it is where we’re located. If you want to go to the city, you can go into Winnipeg within 40 minutes or you can go to Winkler (city) within half an hour. Our hospital is about 20 minutes away, Boundary Trails (located between Winkler and the nearby town of Morden), we have one here but if you need the big one, and you need specialists you can go to Boundary Trails. And we’re not very far from Portage, we’re 40 minutes from there so it’s really centralized and you can go whatever direction you want to go if you need to use those facilities. (Older Adult)

Key informants also commented on the advantages of being close to larger centers for health services, which become particularly important for older adults as well as proximity to family:

If somebody has some medical issues, yes, we have a hospital right away. But if there’s an emergency, we’re also within a very short drive, within an hour’s drive, of major hospitals, which a lot of more remote communities can’t necessarily provide either. A lot of them choose to retire out here but yet have, very easily, access to the city and the city services. (Key Informant)

Key informants further saw the potential of communities close to a larger urban center using that to their advantage in attracting older adults to the community, as exemplified by the following quote:

Maybe communities close to Winnipeg need to focus on that more as a potential place for people to move to, so they can be closer to their children and grandchildren, but yet not live in the city. (Key Informant)

Thus, given that many small rural communities will be challenged to provide the full range of services for older adults, a community in close proximity to a large urban center may be able to afford to be less age-friendly, yet older adults’ needs can still be met.

The Demographic Composition of a Community

The demographic makeup of a community can tell us something about the services needed and the nature of healthy aging policies that might be offered. In our interviews with key informants, we found that the planning priorities of communities (i.e., housing, transportation options) are influenced by the demographic makeup of communities and recent trends in population change. For example, one key informant commented on how the notion of age-friendliness fits well with the existing focus on older adults in their community:

When we were first designated as an age-friendly community and went to the different seminars and things, I thought “well this isn’t really new to our community” because they’ve been doing a lot of this already, which was fortunate, because that seems to be the focus of our town council, because they know that seniors are an asset and we don’t seem to be able to attract the young people as much. So if this is going to be a retirement town, so be it. (Key Informant)

In contrast, other communities that may have a greater focus on younger individuals may not be as concerned with the needs of older adults in their community or the attraction of older adults to their community, as illustrated by the following quote:

Part of the reason why they’re not really as focused on attracting older residents is because we have such a strong immigration program here. We have hundreds and hundreds of families that move into this area every year. So that’s 800, 1000, 1200 people that are now moving here every single year from other countries. So we’ve already got a stream for population growth. So there isn’t the need for us to look at attracting seniors. (Key Informant)

Nevertheless, key informants also recognized the need for a balanced community development strategy that focuses both on the retention of younger and older generations. As one participant put it,

A community development strategy needs to be integrated with the whole retention of our younger generation at the same time, because communities that lose the young people will eventually die. (Key Informant)

Securing Investment

Our results further indicate that the ability of communities to become age-friendly is impacted upon by the ability to secure funding, which in turn is dependent on factors such as communities’ demographic composition and existing infrastructure, along with growth trends. For example, housing is essential for the safety and well-being of individuals, with the design, location, and choice of housing being important considerations for residents in a community. One of our key informants indicated that communities that had a high percentage of low income seniors, as well as available housing units that could be renovated and would subsequently be in demand by residents, were favored for investments in an attempt to retain older adults in communities. In the context of housing, the relative location of communities in relation to other communities is also important:

If we’re looking at developing a new project, one of the things they’ve been doing is really looking at the growth trends in the area, the other options that are available in the immediate areas. And, if there’s a very small community and they want to build a 10 unit seniors housing project but in 10ks down the road there’s a lot of options for seniors then we would take that into account. It’s not to say that they wouldn’t necessarily get funding, there are a lot of different factors that are considered, but we certainly do look at the economic sustainability of the community. And if you build a project you want to have at least 35 to 50 years where you can say that it’s going to be occupied and used, because it’s a big investment for the province so it’s a lot of factors to consider. (Key Informant)

At the provincial level, communities with a high percentage 65+, low income, and available housing units that could be renovated were viewed as communities that would be targeted for investment into renovating housing units in an attempt to retain older adults in communities:

We looked at, you know, percentage of seniors in these areas and the age of some of our tenants and thought that this would be some of the locations that we had some vacant units that could be renovated for them and also that there would be a demand for these units if they had been developed in this way. And we worked with the regional health authorities to identify certain cities or communities that would benefit from this. (Key Informant)

Leadership and Advocacy

The ability of a community to become age-friendly is also impacted by municipal and provincial governments and their ability and willingness to provide sustained support to the Age-Friendly Manitoba Initiative. Our interviews indicated that the success of making communities more age-friendly depends on having strong leadership (from local, municipal, and provincial governments) to promote the initiative as well as provide funding.

With regard to the advocacy and the need for sustained funding of age-friendly communities by the province, one key informant noted,

In the past it was fine to have the Age Friendly Initiative begin with a kick start of money from provincial level. But then, when that money goes away, then municipalities are now left with the province saying oh you’re age friendly, but now the money’s gone. And the municipality has a new expense in their budget line. (Key Informant)

In addition, strong leadership at the local level is critical. As one key informant stated,

I say the biggest challenge that has been faced in regards to age friendly here is not a lack of interest or desire. But the moment that it was made very plain and clear that we were like a token committee, that we really didn’t have any authority and we really had no say and now we had no budget. There was no longer any interest around that table. It, the whole thing just deflated and it has struggled, and struggled, and struggled ever since. (Key Informant)

Similarly, another key informant commented on the importance of competent leadership.

The excitement’s there and it’s increased the excitement but a community needs good leadership and if a community doesn’t have leadership then it goes stagnant. And some of these communities in which we are working with are not as their leadership (council or business community) is debatable. We’re already recognizing the locations where there’s a lack of drive. (Key Informant)

In order for the initiative to be effective, it was recognized that a number of key stakeholders would have to be part of the process:

They should be utilizing the resources that they have from utilizing both the, for example, for us, the seniors resource council, utilizing youth, utilizing economic development personnel, recreation, the municipal representatives, both town and RM [Rural Municipality], they should be utilizing everybody that they can to come together to be involved to come up with great ideas and bring your community forward and have a great strategy. Everybody should be involved. (Key Informant)

Moreover, providing an appropriate range of services and programs for older adults occurs within structural constraints and competing priorities. As one key informant indicated, one challenge is to get the initiative identified as a priority within communities:

I don’t think the challenge on the age-friendly stuff is to get the ear of government or their attention, it’s just a matter of how do you prioritize that with immediate health care needs and justice issues and infrastructure issues. (Key Informant)

Discussion

That communities should become more age-friendly is being promoted by international (WHO, 2007), national (Public Health Agency of Canada, 2007, 2011), and provincial (Seniors and Healthy Aging Secretariat, 2012) governments and agencies. Although there has been a growing body of literature addressing the development of age-friendly communities, the question of what characteristics help or hinder communities in becoming age-friendly has to date not been addressed. The present study was designed to explore these issues in the context of rural communities that are part of the Age-Friendly Manitoba Initiative. Our research is particularly relevant given the increased attention to policy solutions to healthy aging.

The present findings indicate that characteristics vary across communities with pronounced differences between smaller sized communities relative to larger communities. These findings indicate that although communities may want to be responsive to the needs of older adults, the size of a community may prevent it from providing a fully supportive environment. With regard to place characteristics, we also found that those communities in closer proximity to larger centers can afford to be less age-friendly, as individuals can access services in those centers. Communities in close proximity to larger centers can utilize this to their strategic advantage to attract and retain older adults in the community which, in part, supports the aging-in-place of older adults in their communities (Graff & Wiseman, 1978; Hanson & Emlet, 2006).

Our findings also indicate that the demographic composition of a community impacts the ability of a community to become age-friendly. In other words, communities with a large percentage of younger individuals may not consider services and opportunities for older adults a priority. This finding parallels conclusions made by Blank (2005) in the context of how poverty and policies to alleviate poverty are shaped by local characteristics. Blank concluded that places with large poor older populations are likely to be in greater need of health services, whereas poor places with a high birthrate are more likely to benefit from good schools and good health care programs aimed at children and pregnant mothers (Blank, 2005). In our case, places with large older adult populations are in greater need of and would therefore tend to put more emphasis on becoming age-friendly.

The collective impact of community characteristics ultimately relates to whether communities can secure investments to become age-friendly. In the province of Manitoba, hierarchies of settlements based on trends in recent population growth and their economic and social characteristics have been defined (Stadel, 1996). Tiers range from centers that have experienced considerable growth and exhibit stronger and more diversified economies and offer an extensive range of services to those communities that have experienced population losses or in which population change is stagnant and that have limited diversity in services and economic activity and do not function as regional service centers of any significance. It has been suggested that communities higher in the hierarchy are more likely to receive funding (Carter, 2011). In turn, it may be easier for communities higher in the hierarchy to secure funds to become more age-friendly.

Our findings further suggest that the relationship between community characteristics and the ability of communities to become age-friendly is tempered by the leadership at the municipal, regional, and provincial levels of government and their abilities, advocacy efforts, and willingness to support the initiative. Buy-in from leaders is particularly important as providing an appropriate range of services and programs for seniors occurs within structural constraints of funding. As Menec, Means, Keating, Parkhurst, and Eales (2011) point out, age-friendliness is just one of a number of competing economic, environmental, and social issues confronting federal, provincial, and municipal governments.

Strong leadership can overcome the potential challenges of geography and demography by finding creative ways of securing funding. For example, one village in Manitoba has developed new housing that was privately funded by local business owners who recognized that having housing was key to attracting and retaining residents. The town has since seen property values increase, population growth, and increased commercial development. Similarly, another village tackled its housing shortage by establishing a local development corporation made up of a group of local investors to oversee the construction of new homes in the community.

More broadly, becoming age-friendly can encourage community development and regional competitiveness through the development of age-specific services for older adults (Bourne, Bunce, Taylor, & Luka, 2003; Halseth, 2003; Jauhiainen, 2009). Developing communities in this way can create positive meanings and values for older adults, increasing their “sense of place” or attachments and emotional ties to a place (Relph, 1976). A heightened “sense of place” among older adults in an age-friendly community can promote a sustainable community by discouraging the out-migration of residents and encouraging the successful place integration of person and place (Spina, 2009).

In sum, the present research has expanded our knowledge of age-friendliness by highlighting what characteristics impact the extent to which rural communities are able to support an aging resident population. In particular, we highlight the impact of these characteristics on the successful implementation of a healthy aging policy targeted to addressing the needs of older adults at this geographic scale. Thus policies should explicitly provide tangible solutions to overcoming these challenges in rural communities. In addition, the differences between rural and urban areas must be acknowledged. Rural communities face unique social and environmental challenges that can have an impact on health and healthy aging and challenge aging-in-place, such as limited transportation, housing options, and limited health services (F/P/T/ Ministers Responsible for Seniors, 2007).

A limitation of the study is that the experiences of older adults and views of key informants were solicited at one point in time. A longitudinal study design incorporating multiple interviews over time would provide a sense of how changes in communities (e.g., changes in population concentrations or demographic composition of the community) affect their ability to become age-friendly. For instance, a community that becomes a retirement destination is likely to shift its priorities to addressing the needs of older adults.

A methodological limitation of this study was the utilization of snowball and convenience sampling, as it precludes the targeting of specific older adult subgroups (most notably, those subject to poorer health and social/spatial isolation). Moreover, our study was limited to three communities in Manitoba, a prairie province. Whether the findings are transferable to other localities needs further investigation.

Implications

Concentrations of older persons in rural areas present both challenges and opportunities for smaller communities. Our findings highlight that not all communities can easily become age-friendly; some are simply too small to provide a full range of services and opportunities for older adults and may have difficulty attracting the funds to become more age-friendly, and some may have a demographic composition that makes older adults a lesser priority. As governments, in our case the Manitoba government, launch age-friendly initiatives, they would be well advised to consider the challenges these communities face and develop strategies to support communities. For example, communities that are at a disadvantage may be targeted for specific funding opportunities.

Governments should also consider the scale at which an age-friendly community is implemented—at a community versus a regional level. The present findings indicate that although some communities may be at a disadvantage to becoming more age-friendly, sharing resources (e.g., administrative staff, health care services, care homes) and developing partnerships across communities might be a solution to overcoming barriers to successfully becoming age-friendly. Becoming, jointly, as age-friendly as possible through regional planning and clustering age-friendly infrastructure and services could also help small communities become sustainable, as it creates efficiencies within communities, in addition to the sharing of costs and the leveraging of additional resources. Our findings parallel those of Ryser and Halseth (2012) who concluded that to overcome mobility constraints impeding rural seniors’ access to regionalized services in northern British Columbia, a greater coordination across municipal governmental agencies and jurisdictions is needed. They also argued that more supportive policies and resources must be in place to facilitate a comprehensive regional transportation strategy.

However, sharing resources and developing partnerships may not be possible for all communities, particularly those in more remote locations where large distances can prohibit communities within a given geographical radius to function as a single age-friendly region. The challenges that communities face in becoming age-friendly is reflected in related literature such as those facing health care service provision (Hanlon & Halseth, 2005) and staffing and funding of home care programs to ensure effective health care services (Forbes & Edge, 2009). Such communities may need, and be targeted for, additional government support. Local initiatives can also be successful.

Local governments play a key role in making communities more age-friendly and older adults need to be considered an important segment within the community in order for age-friendly initiatives to take root. As participants in this study noted, there needs to be a balanced community development approach that recognizes the importance of both young and old. Media campaigns raising awareness of issues pertaining to older adults or, more generally, raising awareness of the social and economic contributions made to communities by older adults would thus be beneficial. An increased awareness would also impact the way older adults look at places as places continue to evolve and transform. An age-friendly community that supports older adults will be one that retains older adults in, and attracts older adults to a community. It would promote a shared sense of place among older adults (Roberson & Wilkie, 2010), encouraging older adults to age in place, consistent with the objectives of an age-friendly community.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Social Sciences and Humanities Research Council of Canada (SSHRC) [Grant No. 833-2007-1013]. V. Menec holds a Canada Research Chair in Healthy Aging.

Author Biographies

John Spina received his doctorate in geography from the University of Manitoba in 2009 and he completed his post-doctoral fellowship there in 2012. His research focuses on age-friendly communities, community economic development, and retirement communities.

Verena H. Menec is a Professor in the Department of Community Health Sciences, Faculty of Medicine and the Director of the Centre on Aging at the University of Manitoba. Her main research interests lie in the areas of healthy aging, determinants of healthy aging, age-friendly communities, and health care utilization among older adults, particularly at the end of life.

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