Aging but not Forgotten: An Analysis of Older Adult Health Care Access in Elliot Lake
Bibliographic record
Abstract
The population of Elliot Lake in Northern Ontario, Canada is old and getting older, and small and getting smaller. It is Canada’s most severely shrinking city and is home to the nation’s second oldest population. After the loss of the uranium mining industry, Elliot Lake rebranded itself as a retirement community to meet the needs of its older population. In 2017, the city published a five-year Age-Friendly Action Plan to improve Elliot Lake in eight domains, including health care and transportation. Both domains are interconnected; for older adults who are unable to drive, barrier-free public transportation to health care facilities is crucial in ensuring they have the ability to access health care appointments. Elliot Lake already has a public transit service, making it well positioned to provide age-friendly transportation services and to set a precedent for rural transit. However, with Elliot Lake having a shrinking tax base and a population of only 11,372 with almost 40% being over the age of 65, it begs the question of whether older adults have adequate access to the community-based health care services needed to age in place? Using the novel Older Persons Walking and Transit Audit (OPWATA), we evaluated the accessibility of health care facilities in Elliot Lake. We found that the city’s topography and an inconsistent use of age-friendly features along walking routes and at bus stops discourage older adult public transportation use and create barriers to health care access. We outlined the geography of health care facilities in Elliot Lake and determined that 27 of 28 physician offices in the community are located in two health care facilities. Through a buffer analysis, we demonstrated that 76% of older adults live within 150 metres of a bus stop. Finally, we developed municipal-level recommendations to improve health care access in Elliot Lake and considerations for small cities and rural communities wishing to instate or improve public transportation services. This includes the creation of a universal age-friendly bus stop design, along with a universal design of pedestrian paths near bus stops, to further encourage active transportation and public transportation use.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.005 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".