Considerations for small urban/rural communities

Background

Ontario’s population is aging faster in the many rural and small urban communities across the province. One third of Canada’s population over the age of 65 live in rural and remote communities.^{footnote 1[1]}Rural communities are in an era of transition and may already be challenged by unsustainability and precariousness.^{footnote 2[2]}In implementing Age-friendly Community (AFC) initiatives, rural communities may be confronted by limits in their funding base, demographic composition, the distances involved to access services and events, gaps in infrastructure, reduced access to planning and policy expertise and fewer potential partnerships.^{footnote 3[3]}By supporting older people to age in place through more inclusive participation, AFC initiatives can contribute to the resilience and sustainability of rural communities.

There are many definitions of “rural”, most of which are based on either population density or geography/spatiality.^{footnote 4[4]} Different definitions result in different numbers of “rural” people who may also have diverse characteristics.^{footnote 5[5]}The choice of definition should match the scale of geography of the question or issue, which may be at the local, community, or regional level.

For the purpose of this addendum, a population-based definition of rurality from Statistics Canada is used that accounts for proximity to urban areas is “Metropolitan-Influenced Zone” MIZ, which distinguishes between urban and four kinds of rural areas based on population size and adjacency to metropolitan areas. “Rural and small town” is that part of the population that lives outside the commuting zone of large urban centres with a population of 100,000 or more, and with a population density of lower than 400 people per square kilometer.^{footnote 4[4]}

A rapid scoping review was conducted to identify key findings and gaps in knowledge relevant to the implementation of AFC initiatives in rural Ontario communities. The Ontario Age-Friendly Communities Outreach Program also conducted a multi- phase consultation process that included a review of the factors that impact small urban/rural communities in Ontario and the unique ways in which communities engage and support older adults who live in these communities. In 2017, interviews were conducted with AFC leads in 53 Ontario communities. Key findings from those interviews were further validated at a series of 5 regional roundtables with a total of 120 participants from 65 different communities. Findings were further refined via online surveys completed by 83 AFC community leads (Fall 2017 – Spring 2018), as well as during a breakout session at the provincial AFC Symposium in March 2018, and a provincewide survey of 68 Ontario communities (Fall 2018).

Factors that impact older adults living in small urban/rural communities in Ontario

Based on the scoping review and above outlined consultation process, the following factors were identified as being impactful on aging in small urban/rural Ontario: geography; shifting demographics; a strong sense of community; limited infrastructure, resources, and services; and communication.

Geography

The literature identifies level of remoteness, low population density and large geographic distances as factors that can impact the wellness of rural older adults.^{footnote 6[6]footnote 7[7]}In Ontario, consultations with AFC leads in small urban/rural communities highlighted that geography and distance present challenges for community engagement. The impact of geography and related issues varies within regions. There may also be historical and cultural barriers between communities within a region.

Shifting demographics: a rapidly aging population

Ontario’s population is aging rapidly, and this trend is even more pronounced in the province’s rural areas and small towns because of migration by younger people to urban areas in search of education and employment.^{footnote 8[8]}A senior dependency ratio is the number of older people (65 years and above) per 100 persons of working age (between the ages of 25 and 64). Using 2011 Census data, researchers made 5-year age cohort projections out to 2036 for 159 Ontario municipalities with a population over 10,000 and found that all municipalities are predicted to have 100% increases in senior dependency ratios by 2036.^{footnote 9[9]}

It is expected that there will be a much smaller proportion of working-age adults to support older people at home, therefore the impact of which will be greater in rural and small urban communities that are already challenged by distance, isolation, and lack of services. AFC leads from small urban/rural communities echoed these concerns by sharing that there may be a breakdown of the extended family as limited employment options push younger members to move away.

Assets and capacities: a strong sense of community

Strong local leadership plays a particularly important role in the development of local AFCs.^{footnote 10[10]} In small communities, there is a perception that people can work together more easily because networks are already in place.^{footnote 11[11]} Active involvement by older people in rural and remote communities is often identified as an asset in the literature for AFC development.^{footnote 11[11]} Also, access to local leaders and existing partnerships may be easier than in larger urban communities.^{footnote 8[8]}

In the Ontario AFC consultations, rural AFC leads emphasized a strong sense of community as an asset to their work stating that the rural way is to help each other. It is important to identify and engage people who are connectors in the community. Rural communities often find creative ways to address local issues and volunteering is an important part of the sense of community. However, a strong sense of community is not always present for newcomers in rural communities. New retirees may feel disconnected and often have different expectations than longstanding local residents. Additionally, within municipalities that span over a large geographic area, there is usually a diversity of smaller villages that have their own unique sense of community on a smaller scale.

Limited infrastructure, resources, and services

Older adults in rural communities face unique barriers to staying in their homes and staying engaged in their communities. For instance, the barriers that were identified include the following: lack of choice in housing and transportation options, limited availability of health and social services, and the need to travel out for many health services.^{footnote 7[7]footnote 12[12]} Providing health and social services is more expensive in rural areas than in urban centres because of the increased time required for travel to deliver services to dispersed populations, high levels of need, and difficulty in recruiting and retaining qualified staff.^{footnote 4[4]}

Many rural areas and small towns have undergone economic decline.^{footnote 13[13]footnote 14[14]} This in turn can reduce social inclusion, participation, and availability of support services. Furthermore, harsh winter conditions can also hinder social participation and ability to engage in the community. Many residents lack adequate pensions and/or face a high cost of living and there are often resource gaps created when urban funding formulas and standards are applied to Northern or small urban/rural communities. Furthermore, pay-for-use programs, services, resources, and supports may not be sustainable due to distances.

AFC leads from small urban/rural communities provided additional context regarding limited resources. For instance, common infrastructure, resource and service barriers were highlighted by small urban/rural AFC community leads. Furthermore, other barriers identified include a lack of affordable or suitable housing options, limited access to services or gaps in services and support available, a high risk of isolation due to illness, abuse, poverty, geography, limited transportation, and income disparities in the community.

Small urban and rural communities often see early success with AFC planning, due to a strong sense of community and established community champions. However, when these same champions are called upon to champion new priorities, or when funding resources to support implementation are sparse, these same communities can find it difficult to sustain momentum.

Communication issues

Over four decades ago, Childers noted that … probably one of the most serious problems facing elderly people today is the lack of information and knowledge about existing programs and the avail- ability of community resources which could meet some of their needs.^{footnote 15[15]}  Despite the advent of the information age, the availability of information in print and now through on-line formats has not addressed this central issue for rural communities in particular.

The AFC consultations found that access to information can be impacted by limited or no internet connections, therefore, leveraging multiple communication strategies that include more traditional methods is best. These include direct contact (word of mouth), existing social networks (e.g., clubs, organizations, and community events), newsletters, newspaper and radio, and social media.^{footnote 7[7]}

In parts of rural Ontario where mobile data services and broadband networks are available, adopting more technologies such as online social media and apps that provide updates to mobile devices may have some merit. However, truly innovative thinking does not necessarily mean adopting the latest technology. It could also mean finding the means and resources to draw on local social capital and rely on word-of-mouth communication because it is the original and most trusted form of social media in those communities.^{footnote 16[16]}

Engaging older adults in AFC planning and implementation in small urban/rural communities

Given these factors, the following framework and checklist linked to the stages of the AFC Planning Cycle are offered to help meaningfully engage older adults in small communities, and plan initiatives that will best meet the needs of rural and small urban populations in Ontario.

COVID-19 advisory:

In-person activity may not be appropriate in your community while COVID-19 remains active in Ontario. All planning, implementation and evaluation activities and actions must follow local public health advice to prevent and stop the spread of COVID-19.

Read the Remote Events Planning Resource for information and tips on hosting safe and accessible virtual meetings.

Define local principles and conduct needs assessment

Secure community and organization buy in

Engage community organizations and area municipalities early to get buy-in, recruit committee members, and catalyze additional age-friendly planning efforts. Active municipal involvement is key to Age-Friendly (AF) initiative sustainability, especially after the implementation stage.^{footnote 17[17]} Note that there may be differences in lifestyle and living patterns (e.g., during harvest or cottage/camp seasons), which may make engagement difficult at certain times. Institutional partnerships with high schools, libraries and/or colleges/universities can also be beneficial for use of space or computer labs, for example.

Seek academic partnerships

Reach out to local academic institutions and partners who may be able to support the planning, implementation and/or evaluation processes, or who may have practicum or thesis students who can be involved. Academic partners are often more durable than time-limited consultant support.

Plan for geography

Plan ahead to be able to conduct focus groups/collect surveys in multiple small villages and communities to reduce travel-time for participants and ensure representation and input across broad geography.

Leverage multiple communication channels

An increasing number of older adults are now online and becoming more comfortable with technology. However, many rural and remote communities still face significant connectivity issues. It is recommended that communities consider using multiple communication channels to solicit feedback from community members, and raise awareness about local issues and events including: websites and online surveys, flyers in community centres, hard-copy documents, radio segments, and word of mouth within the community.

Dedicate a go-to person

Dedicate someone to act as the point-person for the community and lead the initiative. This could be a paid position dedicated to age-friendly initiatives, a blended position, or added to a complementary portfolio. If needed, consider seeking funding for this person. By investing in someone locally, the community will benefit long-term from the skills developed as part of this work. In addition, having a dedicated person will provide a consistent ‘touch-point’ through the project, alleviate pressure on volunteers (and subsequent burnout), and keep the work progressing.

Action plan

Align work

Stay ‘in the know’ about the priorities of local organizations, the municipality (including the work of the local Accessibility Advisory Committee (AAC), if established) and the province to be able to link AFC to these other priorities. This is particularly helpful in small urban and rural communities to help avoid competition for time and resources.

Avoid one-sizes-fits-all solutions

Urban approaches don’t always work in rural settings. Culture and service availability between small communities can differ greatly and impact the success of strategies.

Anticipate the need to respond to issues of:

• Housing options (See Petawawa case study)
• Transportation needs
• Access to health services.

Implementation strategies

Secure funding

Often, implementation in small communities is largely dependent on funding. Stay apprised of funding opportunities (join mailing lists/networks that share this type of information) so that the community can quickly respond to requests for proposals (RFPs).

Create local action groups

Support implementation in smaller sub-communities with their own culture by creating smaller, more localized action groups.

Develop community social programming

Leverage the strong sense of community and develop programming that can address social isolation and make newcomers feel welcome. (See Temiskaming Shores SipNLearn case study)

Partner with other initiatives

Identify actions that may align with or complement other established, larger initiatives that are addressing big-picture issues (e.g. housing or transportation) and partner as appropriate. Keep both community and municipal partners up-to-date on priorities and the progress of your action plan, as naturally opportunities to collaborate may emerge.

Case example: Hanover, Ontario

Steps 1 and 2: define local principles and needs assessment

In 2015, the Town of Hanover was awarded an age-friendly community planning grant by the Ontario Seniors’ Secretariat to undertake a needs assessment of the Town’s built environment and social programs and services. To support the development and analysis of their needs assessment, Hanover staff worked with researchers from the University of Waterloo’s School of Planning on a mixed methods research design. Though the needs assessment used conventional surveys to gather quantitative data broadly from the Hanover community, greater emphasis was placed on the collection of in-depth qualitative data through focus groups and one-on-one interviews with older Hanover residents. Guided by a set of questions that allowed participants to address each of the World Health Organization's eight age-friendly community domains, the focus groups and interviews were ‘semi-structured’ and allowed for some latitude in the conversations with Hanover participants. In other words, older adults were prompted to respond to the questions but were also free to identify and explore issues of particular concern in order to build depth around the aging experience in Hanover.

Two broad themes emerged from Hanover’s needs assessment process. The first is the importance of the Town’s physical and social environments for the quality of life of older residents. Participants spoke about the importance of the home and neighbourhood environment and the need for affordable housing, access to commercial services within reasonable travel time, and accessible pedestrian infrastructure to enhance the community’s walkability.

Sometimes you miss out on the social things during mid-wintertime especially. There may be an event happening at church but unless you can get a ride you’re pretty much on your own.

The latter concern is unsurprising as communities throughout rural Ontario confront the challenge of providing physical assets (e.g. benches) and services (e.g. transportation options) to older adults that will allow them to age independently. Underlying this challenge is access to the requisite financial resources that will help communities build and address many of the active transportation challenges that participants identified as limiting their ability to travel independently to community services and events and medical appointments.

The second theme relates to the importance of effective communication to maintain important social bonds with other community members. Several Hanover participants indicated that they rely on trusted and established sources in order to stay informed about community events and services. For the most part, this means relying on word-of-mouth communication or social networks to stay in touch about programmed as well as informal community social activities:

If I want to know about what’s going on in Town, I have a lot of people in my circle that I can get information from. Talking with the librarians is also a good way to stay connected.

However, the main challenge for older adults is keeping informed about the local and provincial government programs and services that are intended for them. This was clear from the large number of participants who indicated a lack of awareness about specific programs or services, despite their long-term availability from the Hanover and Grey County, and provincial governments.

In Hanover, as well as in other regions of rural Ontario, there are several disparate channels (e.g. websites, telephone help lines, social media, etc.) and providers (e.g. public agencies and businesses) of information for older adults on a wide range of topics. This leads to information and communication gaps. Programs and services are offered to older adults by several agencies in multiple levels of government, each with their own complex set of regulatory frameworks and eligibility criteria. This makes it a challenge to provide integrated services that focus on clients’ overall needs. For older adults, this can result in a confusing information maze.

A key lesson from Hanover’s needs assessment is that many of the resources needed to support a community’s older adults may already be in place. The larger challenge is finding novel solutions to efficiently and effectively connect residents to those resources. In some instances, solutions may also be rooted in established, low-tech modes of communication.

Step 3: Action plan

Ultimately, data from the needs assessment was used to inform the development of an age-friendly action plan that highlights Hanover’s strengths and, more importantly, underscores community assets and services that ought to be addressed for the benefit of its older residents. Key to the development of Hanover’s action plan was the appointment of Town staff to guide the transition from data collection to the discussion of action item priorities.

In addition, a committee of older adult residents and representatives of community organizations with an interest in AFC planning has been appointed to work through the needs assessment. Using a ‘bottom-up’ approach to action plan development, they refined the recommendations from the needs assessment as well as identified key partners and timelines for implementation.

The immediate priority that Hanover is pursuing through their action plan is to rethink how information is delivered to older adults – including providing information in print as well as digital formats. One approach is to develop a ‘one-stop-shop’ information source (e.g. the City of Waterloo’s Ageing Well directory) typically in the form of a printed guide, which consolidates information that is pertinent to older adults in a topic-based rather than agency-based format. Through the development of their action plan, Hanover’s staff and AFC committee have worked closely with other governments (e.g. Grey County) and agencies (e.g. The Alzheimer’s Society of Grey-Bruce) to ensure alignment with related programs and priorities.

Step 4: implementation and evaluation

Hanover is presently moving into the Implementation phase of their Action Plan.

Meeting the needs of older adults in small urban/rural communities checklist

Steps 1 and 2: define local principles and needs assessment

• Secure community and organization buy in
• Seek academic partnerships
• Plan for geography
• Plan for AFC accessibility needs in the community
• Leverage multiple communication channels
• Dedicate a go-to person.

Step 3: action plan

• Align work
• Avoid one-sizes-fits-all solutions
• Anticipate the need to respond to issues of:
  • Access to housing options
  • Access to transportation
  • Access to health services.

Step 4: implementation strategies

• Secure funding
• Create local action groups
• Develop community social programming.