Environmental and social determinants of aging perception in metropolitan and rural areas of Southern Italy

The increasing life expectancy is accompanied by a growing request of social and health care services, and social inequalities may contribute to a poor quality of life (QoL) and an increased risk of cognitive impairment and disability. The purpose of the present study was to investigate the role of social, environmental, and economic factors in determining subjective perception of aging in older people coming from two different areas (metropolitan and rural) of Southern Italy. We used data from a survey carried out in three metropolitan and three rural communities in Southern Italy. The cross-sectional descriptive study was performed by conducting structured interviews and assessments during home visits. Life conditions and health at older ages were investigated with a questionnaire. Elderly people were divided into two population cohorts, namely 304 subjects (152 from metropolitan and 152 from rural area) controlling demographic, social, environmental, and health characteristics. For this study we used the multiple correspondence analysis (MCA), a statistical technique used to highlight the interrelationships between qualitative variables describing a population. More significant environmental and social variable categories linked to negative aging perception were poor education, low income, female gender, widowhood, unsatisfactory health perception, perceived high functional disability, life arrangements, difficulty in reaching services, and environmental problems. Social, ecological, and environmental factors could play a relevant role in determining health status and disability with increasing request of social and health care services.