What happens when California’s fastest-growing older population lives in communities where housing is scarce, healthcare can be hours away, and essential support services are difficult to find? For rural older adults, these challenges are already a reality—and they are only becoming more urgent. In this episode of the California State Rural Health Association Podcast, we hear from Dr. Pauline DeLange Martinez, a public health researcher and gerontologist at the UC Davis Betty Irene Moore School of Nursing’s Family Caregiving Institute. Dr. DeLange Martinez brings together research, community engagement, and policy expertise to examine how California can better support older adults and family caregivers in rural communities. Dr. DeLange Martinez explores why action is needed now. Nearly one in eleven Californians age 65 and older lives in a rural community, while rural counties have a higher proportion of older adults and higher rates of disability. Even more striking, California’s population age 85 and older is projected to increase by 158% between 2025 and 2040—creating an urgent need to rethink how rural communities approach aging, healthcare, housing, and caregiving. Drawing on a two-year Rural Master Plan for Aging initiative involving three California regions and 227 community participants, Dr. DeLange Martinez shares findings from older adults, caregivers, healthcare providers, and community leaders. The conversation examines three critical areas: Housing: Hidden homelessness, rising costs, manufactured-home challenges, limited affordable housing, and the impact of disasters such as wildfires.Long-Term Services and Supports: The growing pressure on family caregivers, shortages of direct care workers, limited rural services, and the need for better navigation and caregiver support.Healthcare: Long travel distances, provider shortages, delayed care, chronic disease, behavioral health needs, dementia care, transportation barriers, and persistent inequities affecting rural older adults. The episode also explores practical policy recommendations, including expanding home- and community-based services, strengthening the rural direct care workforce, improving transportation, increasing telehealth and community paramedicine, expanding geriatric expertise, and ensuring that older adults are meaningfully included in California’s Rural Health Transformation Plan. But perhaps the most important takeaway is that rural California is not one-size-fits-all. From wildfire recovery in the North State to nutrition access in the Central Valley and extreme geographic isolation in the Inland Empire, rural communities have very different needs—and effective policy must give local communities the flexibility to identify and address their own priorities. Listen to this important conversation to learn what rural aging looks like today, what California can do to prepare for the future, and why supporting older adults must be central to achieving true rural health equity. What You’ll Learn From This Episode:Meet the ResearcherWhy Rural Aging Needs ActionMaster Plan for Aging and Rural InitiativeHousing Instability SolutionsCaregiving and Workforce GapsHealthcare Fixes and Final Takeaways The CSRHA has been a go-to resource for rural healthcare and community leaders since 1995. The CSRHA brings an accumulation of actionable insights to the next generation of rural healthcare leaders. For more behind the scenes of this podcast follow @CSRHApodcast on Twitter or @csrha.advocate on Facebook. If you enjoy This Is Rural Health, we could use your support! Please consider leaving a 5-star rating and review, and share it with someone who needs to hear this! Learn more about the CSRHA at csrha.org. Connect with Dr. Pauline DeLange Martinez:LinkedIn Resources California Master Plan for AgingCalifornia Home & Community-Based Services (HCBS) Gap AnalysisNational Rural Age-Friendly Initiative — National Rural Health AssociationDementia Care Aware
