The comprehensive research was conducted during the latter half of 2025 by a cross-border team of experts led by Thika Marliana from Respati Indonesia University, in collaboration with Budi Anna Keliat (Universitas Indonesia), Tri Budi Wahyuni Rahardjo (Respati Indonesia University), Yunita Restu Safitri (Ministry of Health, Republic of Indonesia), and Suhailla Binti Osman (Ministry of Health, Sabah, Malaysia). Published in early 2026, this study arrives at a critical moment as a rapidly aging global population exacerbates risks for late-life mental disorders, such as depression and anxiety, providing actionable guidance for policymakers to design precision welfare programs.
The Social Dilemma: Aging in Rural vs. Urban Settings
The global surge in the elderly population poses serious public health challenges. Beyond experiencing physical decline, older adults face profound psychosocial vulnerabilities. Historically, public health strategies have applied a one-size-fits-all model to geriatric mental health without accounting for geographical disparities.
However, the structural realities of urban and rural settings are starkly different. Seniors in cities benefit from superior healthcare infrastructure but are highly vulnerable to social isolation and loneliness due to weakened neighborhood ties. Conversely, rural older adults enjoy strong informal support systems and social cohesion but must constantly grapple with a severe lack of formal mental health professionals and resources.
A Mixed-Methods Approach to Capturing Social Realities
To map these dynamics accurately, Thika Marliana and her team utilized a sequential explanatory mixed-methods approach. For the quantitative phase, the researchers engaged 60 respondents aged 60 and older, divided evenly into 30 rural residents and 30 urban residents. Their mental states were assessed before and after the program using structured five-point Likert scale questionnaires.
The community-based mental health intervention spanned an intensive eight-week period. Core activities featured psychosocial education, focus group discussions, cross-generational family activities, and peer-led social support. For the qualitative phase, the team conducted in-depth interviews with 12 key informants—including the elderly participants, cross-generational family members, and community facilitators—to uncover nuanced emotional shifts that numbers alone could not capture.
Key Findings: Local Environments Moderate Intervention Success
Statistical and qualitative analyses showed that the community intervention yielded robust positive outcomes across both cohorts. However, regional context acted as a powerful moderating factor, shifting which psychological dimensions improved the most:
Rural Seniors Excelled in Social Happiness: Older adults in rural areas experienced a more pronounced increase in their overall happiness index (+0.76) and a massive spike in intergenerational engagement (+0.82). The natural communal lifestyle of the village allowed the program to strengthen pre-existing social bonds.
Urban Seniors Built Superior Resilience: City-dwelling seniors displayed a significantly higher gain in psychological resilience (+0.84). Lacking spontaneous informal safety nets in individualistic urban areas, these participants learned to utilize the program to foster emotional independence and self-empowerment.Intergenerational Lifestyles Drive Well-Being: Routine interaction, emotional validation, and shared activities with children and grandchildren acted as a vital mechanism for improving happiness in the countryside, whereas urban setups saw fragmented familial contact due to modern lifestyles."In the past, I often felt easily anxious and had trouble sleeping, but after participating in this activity, I feel calmer and can accept my current situation," noted a rural elderly participant during the field interviews.
Public Policy Implications: Crafting Place-Based Interventions
The scientific insights from this study carry extensive practical weight for social security, corporate corporate-wellness structures, and public policy. The data empirically demonstrates that building psychological resilience is a direct pipeline to long-term life satisfaction in old age. When an individual possesses strong adaptive capacities, their subjective happiness remains insulated even against physical declines or changing social roles.
Consequently, Thika Marliana emphasizes the transition toward place-based interventions. Health authorities and social services can no longer rely on identical blueprints for rural and urban sectors. Urban geriatric programs should center on fostering emotional independence and carving out artificial community networks to break urban isolation. Meanwhile, rural frameworks must maximize existing social capital by embedding interventions directly into intergenerational family dynamics and community-wide gatherings.
Profile of the Research Team
Thika Marliana, S.Kep., M.Kep.: Lecturer and researcher at the Faculty of Health Sciences, Respati Indonesia University. Expert in community nursing and geriatric mental health.
Prof. Dr. Budi Anna Keliat, S.Kp., M.App.Sc.: Professor at the Faculty of Nursing, Universitas Indonesia. A prominent pioneer and expert in psychiatric nursing in Indonesia.
Prof. Dr. Tri Budi Wahyuni Rahardjo, drg., MS: Director of the Center for Family and Ageing Studies (CeFAS), Respati Indonesia University. Specialized in gerontology and demographic aging studies.
Yunita Restu Safitri: Researcher and health policy specialist at the Ministry of Health, Republic of Indonesia.
Suhailla Binti Osman: Public health management specialist at the Ministry of Health, Sabah, Malaysia.
Study Reference
Article Title: Rural-Urban Impact of Community-based Mental Health Intervention on the Intergenerational Lifestyle, Resilience, and Happiness Index among the Elderly
Journal Name: Asian Journal of Healthcare Analytics (AJHA), Vol. 5, No. 1, 2026: 71-84
Publication Year: 2026
Official DOI: https://doi.org/10.55927/ajha.v5i1.16154
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