Examining the relationship between communities' 'age-friendliness' and life satisfaction and self-perceived health in rural Manitoba, Canada

Introduction: Population aging is a worldwide phenomenon. As a response, the World Health Organization (WHO) introduced the concept of 'age-friendliness' in 2006. Age-friendliness is defined in terms of a range of domains, such as housing, opportunities for participation, and transportation. Communities that accommodate the needs of older adults in these domains will, it is thought, promote healthy, active aging. The purpose of the present study was to examine communities' age-friendliness and its relationship to health-related outcomes in a rural context. Methods: The study included 29 communities located in Manitoba, a mid-Western Canadian province, that are part of the Province of Manitoba's Age-Friendly Manitoba Initiative. As part of a needs assessment process in these communities, 593 individuals, including seniors and younger adults, completed an Age-Friendly Survey. The survey was designed to measure a variety of features in seven domains (the physical environment, housing options, the social environment, opportunities for participation, community supports and healthcare services, transportation options, and communication and information), as well as containing measures of life satisfaction and self-perceived health. Community characteristics were derived from census data. Moreover, communities were categorized on a rural-urban continuum. Results: Multi-level regressions indicated that an overall Age-Friendly Index was positively related to both life satisfaction (b=0.019, p<0.0001) and self-perceived health (b=0.013, p<0.01). When examining more specifically each of the seven age-friendly domains, all but housing was positively related to life satisfaction. Results were not as consistent for self-perceived health, with significant relationships emerging only for the physical environment, social environment, opportunities for participation, and transportation options. A subsequent analysis for seniors versus younger participants, respectively, indicated that significant relationships between age-friendly domains and life satisfaction and self-perceived health were restricted primarily to seniors. None of the community characteristics were related to life satisfaction and self-perceived health, nor was degree of rurality. Conclusions: The concept of age-friendliness has been garnering considerable attention from policy-makers as a way to promote healthy aging. For example, in Canada, several provinces have launched age-friendly initiatives. Although causality cannot be inferred from the present, cross-sectional study, the findings are encouraging as they show that age-friendliness is associated with enhanced life satisfaction and self-perceived health in a rural context. The study further supports the notion that a wide range of domains within the community environment are important in older adults' lives and need to be considered. Public policy initiatives, such as the Province of Manitoba's Age-Friendly Initiative, may thus be one approach to enhancing healthy aging in rural settings.