Health and quality of life among older people in rural England: Exploring the impact and efficacy of policy

There is increasing evidence that characteristics of place influence health and that the dimensions of rurality interlock with the process of ageing to produce a number of distinctive patterns. For the rising number of older people living in rural England, it is clear that, overall, the countryside promotes the health and wellbeing of the newly retired, fitter cohort who have access to financial and community resources. However, it carries a number of risks for elders who are frail, deprived or isolated; inequalities combine to undermine health and deepen exclusion. The efficacy of policy in taking account of the needs of rural elders is uneven. Analysis of the three most pivotal policy arenas - rurality, ageing and health, and community development suggests that while some initiatives do promote quality of life, significant limitations remain. Further, the overarching policy response is incoherent and fragmented. Key deficits relate to resource allocation, limited recognition of rural disadvantage, and minimal incorporation of the perspectives of rural elders. That the majority of policy is rurally blind is a fundamental challenge; for rural elders to benefit from policy investment, a systemic shift is required in the mechanisms that steer its development, funding and implementation.