ABSTRACT
Around the world, population ageing has become a defining attribute of the twenty-first century and nowhere is this happening more rapidly than in rural regions. Global rates of rural population ageing (i.e., the increasing proportion of rural residents in older age cohorts) are outpacing that of urban and metropolitan populations (World Health Organization, 2015). Rural populations are generally understood to live in a wide range of smaller, dispersed, under-serviced settlements that lie outside urban and metropolitan regions, often at a great distance (Woods, 2010). As illustrated in the Australian context, for instance, older adults are less likely to live in urban centres, with one-third of older adults living outside of major cities in regional and remote settings (Australian Institute of Health and Welfare, 2017). These trends are also observed across Europe, North America and in countries located in the global South (see Phillips and Feng, Chapter 8; Rishworth and Elliott, Chapter 9; Rosenberg and Wilson, Chapter 5). They are driven by the rural outmigration of younger cohorts for employment and education, the ageing in place of older rural residents and, in some cases, the in-migration of retirees into rural areas, with significant health care system, socio-economic and cultural implications for individuals, households and communities (Keating, 2008). The result is a scenario poignantly described more than a decade ago as a ‘double-jeopardy’ (Joseph and Cloutier-Fisher, 2005), whereby increasing numbers of older rural adults throughout the world, many of whom have age-related health issues, are growing older in increasingly vulnerable rural places, many of which are struggling to provide services and supports, and are often reliant on volunteer and informal networks.
