JMIR Publications

ABSTRACT

Background:

Swedish policy states that older adults should be able to age safely, with continued independence, and lead active lives. However, this plays out differently in different Swedish municipalities depending upon degrees of demographic change, globalization, and urbanization. Internationally, older adults living in deprived areas have worse physical and mental health, activity restrictions, and reduced life expectancy. In Sweden, research on how deprived areas impact older adults´ quality of life is virtually nonexistent. We argue that deprived areas exist in both urban and rural contexts.

Objective:

Investigate how home and neighborhood influence participation, quality of life, identity, and belonging of older adults living in urban and rural deprived areas in Sweden, and how these person-context dynamics are experienced by older adults in transitioning neighborhoods.

Methods:

The study has a mixed-methods design and includes three phases. Adults 65 years and older living in certain urban and rural deprived areas in the South of Sweden will be included. Phase 1 is an Interview Study in which qualitative data are collected on neighborhood attachment, identity, and belonging through semi-structured interviews and photo-elicitation interviews (n=40). Different qualitative data analysis procedures will be used. In phase 2, a Survey Study will be conducted to explore associations between observable and self-rated aspects of housing and neighborhood (physical, social and emotional), and participation and quality of life (n=40 + 400). The survey will include standardized measures and study-specific questions. Survey data will be analyzed with mainstream statistical analyses and structural equation modeling (SEM) to understand the interactions between quality of life, home and neighborhood factors, and socio-demographic factors. In phase 3, the Integration Study, survey data from participants who participated in both data collections (n=40) will be analyzed together with qualitative data in a mixed-methods analysis approach[1].

Results:

As of submission of this protocol (August 2022), recruitment for the Interview Study is completed (n=39), and 267 participants are recruited and have completed data collection in the Survey Study. We expect recruitment and data collection to be finalized by December 2022.

Conclusions:

With an increasing proportion of older adults, an increasing number of deprived areas, and with an increasing dependency ratio in more than 50% of Swedish municipalities, Swedish cities and municipalities are transforming and becoming increasingly segregated. This study will add unique knowledge on what it is like to be older in a deprived area and deepen the knowledge on housing and health dynamics in later life. Further, the design of the current study will allow future follow-ups to facilitate longitudinal analysis (granted funding) on aging in a transforming societal context.