Przegląd Geograficzny (2025) vol. 97, iss. 2
Senior citizens’ utilisation of medical, cultural, recreational and sports services
Przegląd Geograficzny (2025) vol. 97, iss. 2, pp. 209-226 | 
Full text
doi: https://doi.org/10.7163/PrzG.2025.2.5
Abstract
This article examines the frequency with which older adults in Poland (aged 60 and over) use medical, cultural, and entertainment services, primarily in relation to their place of residence (functional type of local-authority area/municipality) and level of education. This age group is particularly vulnerable to social exclusion in terms of service accessibility, especially in rural areas, due to significant changes on the transport-services market (Ciechański, 2023), as well as age-related declines in ability to use private transport. The article also evaluates the organisational aspects of accessibility (accommodation; cf. Penchansky & Thomas, 1981) to medical services, and investigates the impact of the pandemic on accessibility to the analysed categories of services, which are medical, cultural, recreational and sports-related.
The frequency with which different types of services are used is found to relate to two main factors: their spatial availability and the needs of residents. Our research has shown that, in the 12 months prior to the survey, around 10% of respondents had not visited their general practitioner at all. Comparable studies conducted across different countries have revealed varying results. For example, the proportions of older adults not visiting a doctor in the previous six months proved to be 1% in Japan, 14% in Germany, 31% in Canada, 33% in the United Kingdom and 40% in the United States (Pilger, 2013). The frequency of use of medical services is also influenced by the functional type of municipality in which people reside. In general, residents of core municipalities access medical services more frequently than those living in peripheral areas (see Bowling et al., 1991). However, the degree of service centralisation moderates this pattern, as: the lower the level of centralisation, the more limited the variation in service utilisation between different functional types of municipality. Thus, functional and spatial structures shape service accessibility, though this effect is more significant for certain services, such as specialist medical or cultural services, than for others, such as pharmacies or general practitioners.
The medical services used by seniors are most often located within their municipality of residence (for basic medical services, e.g. general practitioners), or in another municipality within their county (for specialised medical services). Research in Sweden has shown that people’s frequency of utilisation of medical services is influenced, not only by transport (public and private) and the location of healthcare facilities, but also by the development of e-health services (Blusi et al., 2016). E-health solutions can increase the sustainability and accessibility of healthcare for patients and caregivers, and may reduce social exclusion, particularly among individuals with limited mobility (Keating, 2008; Manzoor & Vimarlund, 2017). However, in Poland, barriers remain, due to limited digital skills and Internet access among older people, particularly in rural areas (Kujawski, 2018; Czarnecka et al., 2023); as well as the slow implementation of e-services by healthcare providers. A study of 11,000 medical facilities revealed that almost 60% had not implemented basic e-services such as online appointment booking or access to lab results (Stawnicka, 2025).
Frequency of service use also varies in line with people’s ages and levels of education. Overall, utilisation tends to be lower at greater age. However, this does not apply to medical services, where visits to general practitioners, other doctors, and dentists/prosthodontists tend to increase in frequency with age. This pattern is consistent with the findings of other studies (e.g. Parslow et al., 2004; Pilger, 2013). Service use also correlates positively with educational level, in that the higher the level of education, the more frequently individuals engage with the various services analysed.
Poland’s over-60s rarely use cultural services, though this is more common among those living in urban centres and their surrounding areas. This is unsurprising, given the greater availability of cultural offerings in the latter areas. In contrast, recreational and sports services are only used with extreme rarity by the elderly. The most commonly cited reasons for non-participation in these two categories of service include health-related limitations, a perceived lack of need, and the lack of such services within the municipality of residence. Participation in cultural, recreational and sports activities is known to be influenced by a variety of demographic, cultural, economic and personal factors (Hillerås et al., 2001; Banerjee & Duflo, 2007; Panriansaen et al., 2024). Empirical studies have demonstrated a positive correlation between participation in sports and recreational activities, and overall life satisfaction (Lee & Hung, 2011).
Respondents offered surprisingly positive assessments of the organisational dimension to access to medical services (i.e. accommodation; cf. Penchansky & Thomas, 1981). Thus respondents were relatively positive about the organisational aspect of access to medical services (thus displaying accommodation). The highest ratings were given to pharmacies (likely due to their commercial approach), as well as to medical services like laboratory testing used only relatively infrequently. By contrast, the lowest ratings were those assigned to the accessibility of primary-care physicians other than general practitioners. Medical services are essential at all stages of life, though the frequency and type of services used vary with age. As the study indicates, frequency of use increases with advancing age. This trend poses a significant challenge to authorities at all administrative levels, which are to ensure adequate access to medical services amid rapid demographic changes, particularly population ageing. Of particular concern is the growing proportion of people aged 85 and over (a phenomenon referred to as ‘double ageing’), alongside rising average life expectancy.
Keywords: accessibility of services, perception of accessibility, seniors, social exclusion, Poland
[rafwis@twarda.pan.pl], Instytut Geografii i Przestrzennego Zagospodarowania im. S. Leszczyckiego PAN
Citation
APA: Wiśniewski, R. (2025). Aktywność seniorów w zakresie korzystania z usług medycznych, kulturalnych i rekreacyjno-sportowych. Przegląd Geograficzny, 97(2), 209-226. https://doi.org/10.7163/PrzG.2025.2.5
MLA: Wiśniewski, Rafał. "Aktywność seniorów w zakresie korzystania z usług medycznych, kulturalnych i rekreacyjno-sportowych". Przegląd Geograficzny, vol. 97, no. 2, 2025, pp. 209-226. https://doi.org/10.7163/PrzG.2025.2.5
Chicago: Wiśniewski, Rafał. "Aktywność seniorów w zakresie korzystania z usług medycznych, kulturalnych i rekreacyjno-sportowych". Przegląd Geograficzny 97, no. 2 (2025): 209-226. https://doi.org/10.7163/PrzG.2025.2.5
Harvard: Wiśniewski, R. 2025. "Aktywność seniorów w zakresie korzystania z usług medycznych, kulturalnych i rekreacyjno-sportowych". Przegląd Geograficzny, vol. 97, no. 2, pp. 209-226. https://doi.org/10.7163/PrzG.2025.2.5