Exploring access to critical health services for older adults in rural America from 1990 to 2020

Purpose: Rural America has experienced a rapid loss of hospitals since the turn of the century, making access to high-quality health care the top rural health priority. Coinciding with this hospital decline is the growth of a rural population age 65 years or older. The health needs of older adults can require specialty care to support healthy aging. To date, minimal research has been conducted on trends in aging-related health care services in rural areas beyond hospital closures. Methods: This study uses a 30-year lookback of data from the Area Health Resource Files to describe the trends in local access to hospitals and critical health services important for conditions experienced by older adults in rural America. Results are presented across measures of rurality and population age. Findings: Local aging-related access to services such as chemotherapy, oncology, emergency department, geriatric, and home health agencies have been stagnant or declining over time in rural areas. Concerningly, the most remote communities with the highest percent of older adults have the lowest service access. Conclusion: These findings shed light on the growing need for policies to support healthy aging among the increasingly older rural population.