Social exclusion and well-being among older adults in rural and urban areas.
BACKGROUND
Social exclusion (SE) is a process that limits participation in society across life domains, and is associated with poor quality of life. Neighbourhood exclusion has been identified as particularly important for older adults. This paper examines the association between SE and well-being in older adults from urban and rural areas, focusing on neighbourhood exclusion.


METHODS
Using a cross-sectional survey design with a stratified sampling frame, participants (aged 65+) from rural (n = 628) and urban (n = 627) areas of Barnsley, United Kingdom, completed a questionnaire containing indicators of five SE domains: civic activity, material resources, social relationships, services and neighbourhood. Sequential multiple regression models were developed for 1) total sample; 2) rural areas; and 3) urban areas, with well-being regressed on SE indicators after controlling for self-reported health.


RESULTS
SE indicators explained 13.4% of the variance in well-being in the total sample (of which neighbourhood exclusion explained 1.2%); corresponding figures for the rural model were 13.8% (3.8%) and for the urban model 18.0% (1.7%); the addition of neighbourhood exclusion significantly improved all three models. Five SE indicators were significant in the rural model, compared with seven in the urban model, with four common to both.


DISCUSSION
Neighbourhood exclusion explained more variance in well-being in rural than urban areas, whereas exclusion from services explained more variance in urban than rural areas. Area characteristics and the role of neighbourhood should be considered in policy initiatives to reduce SE and promote well-being.
['Dahlberg|Lena|L|', 'McKee|Kevin J|KJ|']
D000368:Aged D000369:Aged, 80 and over D003430:Cross-Sectional Studies D005260:Female D006801:Humans D008297:Male D012929:Psychological Distance D011788:Quality of Life D012424:Rural Population D012934:Social Isolation D006113:United Kingdom D014505:Urban Population
Social exclusion Well-being Rural Urban Quality of life Neighbourhood Community Life satisfaction Older people