There are many definitions of social isolation which draw on structural indicators (e.g. living alone), functional indicators (e.g. social support) or both. This makes comparing prevalence rates across studies difficult and provides little guidance for practitioners and service providers to identify and target socially isolated clients. The purpose of the present study was to compare, within one large population-based data-set of Canadians aged 45–85, single-item and composite indicators of social isolation, by total sample and by socio-demographics (age, sex) and health. Data were from the Canadian Longitudinal Study on Aging (CLSA) which assessed features of social network, social support and social participation. Two composite scales were created to compare prevalence rates based on structural only or both structural and functional indicators. Results indicated overall low prevalence rates of social isolation, regardless of the measure used. A composite scale using only structural features identified 5.8 per cent socially isolated adults aged 45–85. This compared with a structural and functional scale that identified 9.8 per cent socially isolated adults. The composite measures showed less variation across socio-demographics than single-item measures. Results shed light on different ways in which social isolation can be defined and how single-item and composite definitions impact our understanding of identifying socially isolated adults in a given population. Results add to discussion of measures that can be used by researchers, services providers and practitioners.

Since the World Health Organization introduced the concept of ‘age-friendly’ communities in 2006, there has been rapidly growing interest in making communities more age-friendly on the part of policy makers world-wide. There is a paucity of research to date, however, that has examined age-friendliness in diverse communities, particularly in rural communities. The main objective of the study reported in this paper was to examine whether age-friendliness varies across community characteristics, such as a population size. The study was based on surveys administered in 56 communities throughout Manitoba, a mid-Western Canadian province, in the context of a needs assessment process for communities that are part of the Age-Friendly Manitoba Initiative. A total of 1,373 individuals completed a survey developed to measure age-friendliness. Domains included the physical environment; housing options; the social environment; opportunities for participation; community supports and health-care services; transportation options; and communication and information. Community characteristics were derived from census data. Multi-level regression analysis indicated that the higher the percentage of residents aged 65 or older, the higher the ratings of age-friendliness overall and, specifically, ratings of the social environment, opportunities for participation, and communication and information. Moreover, small communities located within a census metropolitan area and remote communities in the far north of the province emerged as having the lowest age-friendliness ratings. These findings suggest that communities are generally responsive to the needs of their older residents. That different results were obtained for the various age-friendly domains underscores the importance of considering age-friendliness in a holistic way and measuring it in terms of a range of community features. Our study further highlights the importance of differentiating between degrees of rurality, as different patterns emerged for communities of different sizes and proximity to a larger urban centre.

The concept of age-friendly communities has garnered international attention among researchers, policy makers and community organisations since the World Health Organization launched its Global Age-friendly Cities Project in 2006. Despite the growth of the age-friendly communities movement, few studies have examined age-friendly characteristics within different community contexts. The goal of the present study was to use a participatory methodology to explore older adults’ perceptions of age-friendliness. The study employed the photovoice technique with 30 community-based older adults in one urban community and three rural communities in the province of Manitoba, Canada. Participants were provided with cameras and took photographs to illustrate the relative age-friendliness of their communities and to generate discussion in interviews and focus groups. Themes from photographs, interviews and focus groups were organised into three broad categories: age-friendly features, contextual factors and cross-cutting themes. The age-friendly features we identified in this study generally correspond to the World Health Organization domains of age-friendliness. In addition, we identified three contextual factors that impact the experiences of older adults within their community environment: community history and identity, ageing in urban, rural and remote communities, and environmental conditions. Finally, independence, affordability and accessibility were identified as cross-cutting themes that intersect with various community features and contextual factors.

On the political and policy front, interest has increased in making communities more “age-friendly”, an ongoing trend since the World Health Organization launched its global Age-Friendly Cities project. We conceptualize age-friendly communities by building on the WHO framework and applying an ecological perspective. We thereby aim to make explicit key assumptions of the interplay between the person and the environment to advance research or policy decisions in this area. Ecological premises (e.g., there must be a fit between the older adult and environmental conditions) suggest the need for a holistic and interdisciplinary research approach. Such an approach is needed because age-friendly domains (the physical environment, housing, the social environment, opportunities for participation, informal and formal community supports and health services, transportation, communication, and information) cannot be treated in isolation from intrapersonal factors, such as age, gender, income, and functional status, and other levels of influence, including the policy environment.

Research indicates that self-rated health is related to a variety of health-related outcomes, such as mortality and functional disability, even when controlling for more “objective” health measures. The present study extends previous research by prospectively examining the relation between self-rated health and health care use among a representative sample of elderly Canadians (N = 1,181) interviewed in 1991/92. Survey data were linked to administrative records of health care use. Self-rated health was positively related to the number of physician visits during the 12 months following the survey, as well as to the number of tests incurred (e.g., laboratory tests, X-rays), even when controlling for demographic variables, functional disability, morbidity, and prior health care use. Older adults who rated their health as “bad/poor” or “fair” were also more likely to be hospitalized than those who rated their health as “excellent”. These results highlight the importance of considering global measures of health when examining health care use.

Trends in the health status of the entire senior population aged 65 years or older in Manitoba were examined over a 14-year period (1985–1999) using administrative data (about 150,000 individuals). Significant health gains were apparent for a number of important indicators, including acute myocardial infarction, stroke, cancer, and hip fractures, although some of these gains were restricted to urban areas. Improvements in these health indicators are significant, as they can have major implications for individuals' need for health services and ability to live independently. In contrast, chronic diseases were on the rise, with the prevalence of diabetes, hypertension, and dementia increasing substantially over the 14-year period. These trends suggest a need for a policy emphasis on prevention, such as reducing the prevalence of obesity, which is one risk factor for diabetes. Moreover, having sufficient care options in place for the growing number of individuals with dementia is an issue that will have to be addressed.

Hospital overcrowding has plagued Winnipeg and other Canadian cities for years. This study explored factors related to overcrowding. Hospital files were used to examine patterns of hospital use from fiscal years 1996/1997 to 1999/2000. Chart reviews were conducted to examine appropriateness of admissions and hospital stays during one pressure week. Results indicate that pressure periods in the hospital system were driven by an influx of older adults with influenza-associated respiratory illnesses. Moreover, examination of one specific pressure week showed that at least 100 beds were occupied by patients who likely did not require acute care. The chart review revealed that a substantial proportion of non-acute patient-days were spent awaiting home care, long-term care, or diagnostic testing services. These findings suggest future bed pressures might be prevented through influenza vaccination and an increase in the availability of – and timely transfer to – alternative levels of care.

Research has shown that the level of activity of the residents of a city's neighbourhood is related to the availability of activity-related resources. This study aimed to characterise the housing environment in which many older adults live by exploring what activity-related resources were available in senior apartment buildings in one Canadian city, Winnipeg. Of 195 senior apartment buildings in the city, 190 were surveyed to examine whether variation in the buildings' activity resources was related to neighbourhood characteristics, particularly socio-economic status. Resources were classified as those for physical activities (e.g. exercise classes), social activities (e.g. card games), and services (e.g. a grocery-store shuttle). The neighbourhood characteristics were taken from census data and included socio-economic and socio-demographic measures. The apartment buildings varied considerably in the resources available, and a positive relationship was found between neighbourhood income and physical and social activity programmes and services. Lower residential stability and a higher percentage of residents living alone were also related to the buildings' resource-richness, and senior apartment buildings with limited activity-related resources clustered in disadvantaged neighbourhoods. How senior apartments are resourced should be examined in relation to the neighbourhood in which they are located.