Study: Older people with persistent pain in rural areas face challenges in accessing healthcare

Reviewed by James Ives, M.Psych. (Editor)May 21 2020

A study led by Keele University has found that older people with persistent pain living in rural areas face challenges in accessing healthcare, which may mean they are less likely to seek treatment or engage in effective self-management.

The research published in Housing and Society explores how older people, aged 65 and over, living in rural areas manage persistent pain and suggests that factors such as difficulty accessing healthcare services, lack of public transport, and issues of stoicism may impact whether and how individuals seek treatment.

It is hoped that these findings will influence the development of future resources and treatments to improve engagement with healthcare services by older people in rural areas.

Evidence suggests that the onset of disabling pain is influenced by the place an individual lives, with associations found between certain chronic musculoskeletal conditions and rural living. Reasons for a reduction in wellbeing could be due to limited material resources, poor quality social relationships, lack of access to services, and changes within rural communities.

The study is led by Dr Tom Kingstone from Keele's School of Primary, Community and Social Care as part of his PhD, with support from Dr Bernadette Bartlam and Professor Carolyn Chew-Graham. To find out how older adults living in rural areas experience and manage their chronic pain, older people and their partners were interviewed to identify the impact that living in rural areas has on dealing with their experiences of pain.

Despite the findings, the study also found that some older people were better equipped to live well with pain than others as a number participants reported employing self-management strategies that support their quality of life. These include taking appropriate pain killing medication, learning to pace activities, physical activity, and alternative therapies. It was also found that aspects of living rurally can boost wellbeing with older people engaging in community activities and enjoying the environmental benefits of the countryside.

Dr Kingstone said: "Our publication highlights the challenges experienced by older people living with persistent pain in rural areas. All too often older people suffer in silence with persistent pain and do not seek appropriate help. Our findings provide positive examples of self-management that can support older people to live well with pain."

Living in a rural community can be both beneficial and challenging to our health and well-being. This research has helped uncover otherwise hidden issues affecting many older people living in rural areas. Publication of these findings should increase awareness and understanding and drive the development of more rural-sensitive healthcare structures and interventions in the future."

Dr. Vince Cooper, a retired rural GP and member of the advisory group that supported this research