Methods: And electronic search was performed using the PubMed for English articles published in peer-reviewed journals up to August 2018 with the following the combinations of the search terms were two patterns as follows; 1) ‘urban’ and ‘rural’ and ‘comparison of community’ and ‘elderly health’; 2) ‘urban’ and ‘rural’ and ‘comparison of community health’. Identified articles were screened on the basis of title and abstract, and selected articles subjected to full-text assessment and critical review according to the following inclusion criteria: studies in which the comparison of urban community and rural community about the health of the elderly people was performed. And the studies of which the participants were the people living in urban or rural and they had no limited disease was defined. The significant differences of the elderly health between urban and rural communities were categorized through collecting the similar kind of the results in each article.
Results: A total of 35 articles were identified by the electronic search, of which seven were selected on the basis of title and abstract. Among these, six articles met the inclusion criteria after a critical review of the full text and were included in the analysis. The definitions of urban and rural areas were mainly set up in five articles as follows; Urban means Metropolitan Statistical Area (MSA) or Centralized area based on the characteristics such as population size or population density or environmental aspects. It was not clearly explained about the definition of the each area in one article. The participant in two articles was only female. The age of the elderly participants was 65 years and over in four articles and 60 years and over in two articles. The number of participants in each study ranged from 72 (39 in urban and 33 in rural) to 1,005 (678 in urban and 327 in rural). The main ten instruments used about the health in six articles were as follows; 20-item Short-Form Health Survey (SF-20), Social Class Scale, Perceived Health Scale (PHS), Exercise of Self-Care Agency Scale (ESCAS), Positive Affect Scale (PAS), Geriatric Depression Scale (GDS), Functional disability in ADL activities, HPLP=Ⅱ, WHOQOL-BREF, and GHQ-28. The significant differences of the elderly health between urban and rural area in six articles were classified into the three categories; functional abilities, health, and health perception. In functional abilities, three elements were included; physical function, role function in daily life, and social function. Three articles in the six showed the significant differences about social function between urban and rural. Social aspect such as social relationships or very few close friend was showed to be one of thr significant factors associated with mental health or depression between urban or rural. Other elements; physical function and role function in daily life, showed the significance in each one article. In health, two elements were included; physical health and mental health or depression. Four articles showed the significant differences about mental health or depression. And among the four, in two articles, the mental health or depression of the elderly in urban was showed to be significant better in urban than in rural. Other two articles showed that the mental health or depression of the elderly in rural was significant better in rural than in urban. Physical health showed the significant difference in one article. About health perception, the significant difference between urban and rural was showed in one article. It was also showed in one article that the quality of life (QOL) was higher in urban than in rural.
Conclusion: In the current study through the literature review, particularly, it was seemed that the significant different aspects might be social function and mental health or depression between urban and rural, although there were a few research papers about the elderly health based on the both communities, urban and rural. When the person-centered effective integrated community care is developed in order to promote QOL of the residents, considering the characteristics of the community, urban and rural, it was suggested that social aspects and mental health or depression about the elderly health might be recognized as important factors. And then, when further research about the effective integrated community care for the elderly considering the characteristics of the community is conducted in near future, it was also suggested that the definition of the characteristics of the community, urban and rural, should be cleared.