A portrait of older adults in naturally occurring retirement communities in Ontario, Canada: A population-based study

Rachel D Savage; Tai Huynh; Shoshana Hahn-Goldberg; Lavina Matai; Alexa Boblitz; Azmina Altaf; Susan E Bronskill; Kevin A Brown; Patrick Feng; Samantha E Lewis-Fung; Maya S Sheth; Christina Yu; Jen Recknagel; Paula A Rochon

doi:10.1111/jgs.19278

A portrait of older adults in naturally occurring retirement communities in Ontario, Canada: A population-based study

J Am Geriatr Soc. 2024 Dec 1. doi: 10.1111/jgs.19278. Online ahead of print.

Authors

Rachel D Savage^{1

2

3

4}, Tai Huynh⁵, Shoshana Hahn-Goldberg^{5

6}, Lavina Matai³, Alexa Boblitz³, Azmina Altaf³, Susan E Bronskill^{2

3

4

7}, Kevin A Brown^{3

7

8}, Patrick Feng⁴, Samantha E Lewis-Fung⁵, Maya S Sheth^{1

2

7}, Christina Yu^{1

2}, Jen Recknagel⁵, Paula A Rochon^{1

2

3

4

9}

Affiliations

¹ Women's Age Lab, Women's College Hospital, Toronto, Ontario, Canada.
² Women's College Research and Innovation Institute, Women's College Hospital, Toronto, Ontario, Canada.
³ ICES, Toronto, Ontario, Canada.
⁴ Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
⁵ NORC Innovation Centre, University Health Network, Toronto, Ontario, Canada.
⁶ Leslie Dan School of Pharmacy, University of Toronto, Toronto, Ontario, Canada.
⁷ Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
⁸ Public Health Ontario, Toronto, Ontario, Canada.
⁹ Division of Geriatric Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.

PMID: 39618101
DOI: 10.1111/jgs.19278

Abstract

Background: Naturally occurring retirement communities (NORCs) are geographical areas that have naturally become home to a large concentration of older adults. This density means that NORCs have the potential to become a pillar for aging in place strategies, but at present, there is limited data on residents and their health needs. Our objective was to describe and compare the health and healthcare use of older adults living in high-rise NORC buildings to those in all other housing types in the community.

Methods: We conducted a population-based descriptive study of community-dwelling older adults aged ≥65 years by linking a provincial NORC registry in Ontario, Canada with health administrative records. Individuals were classified as NORC residents if their residential postal code on January 1, 2020 matched the NORC registry. Sociodemographic, clinical, and healthcare use characteristics were compared by NORC status using standardized differences (STD) and stratified by rurality, and further by age and sex in urban settings.

Results: Overall, 219,995 (7.7%) of 2,869,706 older adults were NORC residents. Compared to community-dwelling older adults, NORC residents were older (mean 77.4 vs 74.6 years; STD 0.34), and more were female (61.8% vs 52.2%; STD 0.19) and had low income (16.0% vs 9.3%; STD 0.11). NORC residents also had more active chronic conditions (mean 1.9 vs 1.5; STD 0.27), medications (mean 3.4 vs 2.8; STD 0.21), home care use (15.3% vs 9.8%; STD 0.17), and primary care visits (mean 9.7 vs 7.6 visits in prior 2 years; STD 0.22). Findings were robust across rurality, age, and sex.

Conclusions: Our findings suggest that NORC residents have greater health needs than other older adults living in the community and underscore NORCs as important targets for equity-focused strategies to support aging in place.

Keywords: health services use; living environments; population aging.

Abstract

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