# 01. Introduction: defining social exclusion in
                        later life

Moving from a qualitative analysis based on a total of 177 interviews (which involved 110 seniors and 71 social and health professionals and/or stakeholders, both in the Italian and Canadian territories) our article aims to highlight both seniors’ pre-pandemic needs and the dynamics of social exclusion with which the elderly in rural areas may have been faced in a pandemic situation such as the one caused by Covid-19, and to provide an understanding of the social, territorial, political and economic mechanisms through which the pandemic may have influenced the lifestyles of seniors living (in) the rural areas of the territories under study. In the article, our findings will be used to show the different attempts to respond to the complex issue of ageing (demographic dimension) in rural areas (socio-territorial dimension) in a pandemic situation (sociosanitary dimension), asking whether or not the initiatives and processes implemented by a variety of actors (non-profit associations, local or public institutions) can cope with the needs and requirements of seniors living in the areas under study.

Contemporary societies have recorded an increase in the ageing rate of the population that requires an adjustment of care and assistance for the elderly at different levels: “at the micro level, individuals and families, [but also] at the macro level populations and […] all sub-populations, understood both as groups of particular populations and as populations of individual territorial units […]. [Thus] the consequences of the ageing process are the most varied and involve all aspects of population, society and economy” <fnref n="1" /> (Golini, 2005:351-352; *Our Translation* ).

Therefore, the ageing process characterizing contemporary societies does not exclusively regard the individual dimension, but also the collective one. The nature of this process also leads to questioning and amplifying the concept of active ageing, which is framed by the World Health Organisation (WHO, 2002) as “an important strategy to address the social, health and economic challenges of an increasingly long-living population (Walker and Maltby 2012)” <fnref n="2" /> (Facchini, 2023:193; *Our Translation* ). The elderly population indeed represents a fragile category in contemporary societies, leading it to experience social exclusion and even developing a form of *ageism* and *stigma* in later life (Barrett and Barbee, 2022). Social exclusion can be described as the disconnection between social actors and groups from the mainstream culture (Commins, 2004; Moffatt and Glasgow, 2009). More in detail, this condition should be seen as a process combining variables, profiles and contexts that may bring social actors and/or groups of individuals to experience such a situation (Alberio *et al.* , 2022): “regardless of its origins, social exclusion is characterized by at least four common features. Firstly, it is a *relative* concept […] involves *agency* , where an act of exclusion is implied (Atkinson 1998). This might involve older individuals being excluded against their will, lacking the agency to achieve integration for themselves, or choosing to exclude themselves from mainstream society. Thirdly, exclusion is *dynamic* or *processual* […]. Fourthly, most definitions acknowledge the multidimensionality of exclusion” (Walsh *et al* ., 2018:83). As highlighted in the literature, the concept of social exclusion is not uniquely defined. It could be seen as and it could also represent a dynamic process: social exclusion can be perceived as a complex, multidimensional and relational process that can lead to negative consequences concerning the individual’s quality of life and well-being (Böhnke and Silver, 2014).

Regarding these aspects, “social exclusion is receiving growing attention within gerontology. Such interests reflect the combination of demographic ageing patterns, ongoing economic instability, and the susceptibility of ageing cohorts to increasing inequalities” (Walsh *et al* ., 2018:81): elderly social exclusion could be seen as a challenging process involving both the lack or the denial of resources, rights, goods and services in older age and the impossibility to take part in the mainstream society, which affects seniors’ quality of life as well as the cohesion of an ageing society overall (Levitas *et al* ., 2007 in Walsh *et al* ., 2018).

Indeed, even if in different and disparate forms, the ageing process could lead to discrimination in access to social life: the environments in which older people live have an important role to fulfil, e.g., “rural environments are cause of concern due to a general lack of public and telecommunication infrastructures […]. On the other hand, they have been indicated as age-friendly environments, being more likely to encompass informal support networks that enhance older people’s social inclusion” (Carlo and Bonifacio, 2021:462). Thus, rural environments might be a source of both social exclusion (lack of transport, infrastructures, etc.) and social inclusion (neighbourhood social relations, family network, etc.).

In the case of Italy, rural areas are often defined as internal areas that according to the Italian Strategy for Inner Areas (SNAI <fnref n="3" /> ) are “those areas significantly distant from the centres of supply of essential services (education, health and mobility), rich in important natural and environmental resources and valuable cultural heritage” <fnref n="4" /> ( *Our Translation* ). Although named differently, Canadian rural regions can experience similar phenomena (Alberio, 2018).

In rural areas, both in Canada and Italy, the social exclusion faced by the elderly could be associated with the decline of and the resulting lack of transport inside these areas and have possible negative effects on the elderly population – exclusion from services, amenities and mobility (Walsh *et al* ., 2018). In this sense, decline and/or the lack of transport could cause the elderly to experience limited conditions of access to services and the consequent inclusion of the latter in the area of reference. Furthermore, alongside these elements, as highlighted in the literature, it is underlined that rural areas suffer from a lack of distribution of health workers and auxiliary services, thereby forcing seniors in some cases to turn to distant services (Koff, 2019). The social exclusion experienced by the elderly in rural areas could also be due to the “lack of activities, interests and stimuli [capable of] accentuating the more problematic aspects of ageing (Havighurst 1963; Rowe and Kahn 1987)” <fnref n="5" /> (Facchini, 2023:193; *Our Translation* ).

The reduction of physical and social contacts limited social participation and even more reduced access to certain services during the pandemic crisis further increased the already high risk of social exclusion for the elderly population group within these territories. Thus, the pandemic crisis may have altered the fragile balance of the rural areas, causing seniors to experience conditions of difficult access to services and consequent social exclusion and may have underlined the effects and the action of globalization that can standardize

> “certain experiences of individuals but at the same time amplify the differences between them, especially concerning the capacities and possibilities of facing and managing these same experiences. […]. Whether everyone is exposed to the COVID-19 risk, yet everyone’s possibilities of protecting themselves from this risk and coping with its consequences change”<fnref n="6" /> (Caselli, 2020:266; *Our Translation*).

Nevertheless, rural areas – such as those object of our research –, from a social and territorial point of view, can embody a privileged place to observe, study and analyze social innovation: rural territories can allow both the understanding of the crises that societies go through, by changing their balance, and the identification of innovation practices implemented as a response to crises (Carrosio, 2019).

The other central concept here is the one of social innovation, which is extremely relevant in this perspective: “Innovation is not just an economic mechanism or a technical process. It is above all social phenomenon. […]. By its purpose, its effects, or its methods, innovation is thus intimately involved in the social conditions in which it is produced” (Cresson and Bangemann, 1995 in Cajaiba-Santana, 2014:43). Social innovations can be embodied by new products, services and systems that simultaneously meet social needs and create new social relationships and/or collaborations (Murray *et al* ., 2010). As the social environment changes and new issues emerge, therefore, social innovation can be understood as the interaction of different actors creating new alliances and collaborations for greater social impact (Alberio, 2023). Therefore, the urban collaborative dimension embodies a fundamental element “for the development of the city, where the participation of individuals provides the basis for the construction of participatory planning systems from below (bottom-up) that are able to best respond to the instances of development and liveability of the territory (Ciaffi, Mela, 2011)” <fnref n="7" /> (Viganò and Padua, 2018:49; *Our Translation* ), highlighting how collaborative urban and local territory management can thus enable to respond “to the need to provide real answers to the needs of local communities in a path of sustainable development” <fnref n="8" /> (Viganò and Padua, 2018:56; *Our Translation* ). In conclusion, it seems relevant to emphasise that,

> “the elderly, and with them the very elderly, constitute *de facto* the most problematic social category and at the same time, by necessity, the greatest resource that institutions will have to manage from the point of view of public policies […]. On the one hand, the expansion of expenditure for health services and the social costs to be dedicated to care and assistance, on the other hand work […] constitute the plates of a scale that will have to be calibrated with extreme care, in order to guarantee social balances”<fnref n="9" /> (Sarti, 2008:7; *Our Translation*).

Indeed, this research’s objective is to identify not only the possible deleterious effects that have accentuated the vulnerability of the elderly but also the protection and support measures that have enabled and are enabling seniors to cope with the pandemic crisis, emphasizing the advantages and disadvantages of their situation in an emergency health context and highlighting the available resources and community dynamics. In fact, the situation created by the health crisis may have disrupted the fragile balance of rural areas, accentuating both the possible difficulties in accessing care and services and the social exclusion of the most vulnerable populations, including the elderly (Balard and Corvol, 2020; Alberio *et al* ., 2022). The collaborative and community dimension represents

> “an attempt at collective governance of the complex matter of urban transformation – especially where re-generation processes are concerned, in which not only the tangible but also the intangible sphere of the territory is subject to modification and pressure – in order to achieve a common result, shared by the widest range of actors involved, and therefore socially sustainable”<fnref n="10" /> (Viganò and Padua, 2018:54; *Our Translation*).

<footnote n="1">“a livello micro, gli individui e le famiglie, [ma anche] a livello macro le popolazioni e […] tutte le sottopopolazioni, intese tanto come gruppi di particolari di popolazioni, quanto come popolazioni di singole unità territoriali […]. [Dunque] Le conseguenze del processo di invecchiamento sono le più varie e coinvolgono tutti gli aspetti della popolazione, della società e dell’economia” (Golini, 2005:351-352).</footnote>

<footnote n="2">“un’importante strategia per affrontare le sfide sociali, sanitarie ed economiche di una popolazione sempre più longeva (Walker e Maltby 2012)” (Facchini, 2023:193).</footnote>

<footnote n="3">Strategia Nazionale per le Aree Interne.</footnote>

<footnote n="4">“quelle aree significativamente distanti dai centri di offerta di servizi essenziali (di istruzione, salute e mobilità), ricche di importanti risorse naturali e ambientali e di patrimonio cultura di pregio”.</footnote>

<footnote n="5">“venir meno di attività, interessi e stimoli [in grado di] accentuare gli aspetti più problematici dell’invecchiamento (Havighurst 1963; Rowe e Kahn 1987)” (Facchini, 2023:193).</footnote>

<footnote n="6">“alcune esperienze degli individui ma al tempo stesso amplifica[re] le differenze tra gli stessi, in particolar modo con riferimento alle capacità e alle possibilità di affrontare e gestire queste medesime esperienze. […]. Se tutti siano esposti al rischio Covid-19, cambiano tuttavia le possibilità di ognuno di proteggersi da tale rischio e di affrontarne le conseguenze” (Caselli, 2020:266).</footnote>

<footnote n="7">“per lo sviluppo della città, laddove la partecipazione degli individui fornisce la base per la costruzione di sistemi partecipati di pianificazione dal basso (bottom-up) in grado di rispondere al meglio alle istanze di sviluppo e vivibilità del territorio (Ciaffi, Mela, 2011)” (Viganò and Padua, 2018:49).</footnote>

<footnote n="8">“alla necessità di fornire risposte reali alle esigenze delle comunità locali in un percorso di sviluppo sostenibile” (Viganò and Padua, 2018:56).</footnote>

<footnote n="9">“gli anziani, e con loro i grandi anziani, costituiscono de facto la categoria sociale più problematica e allo stesso tempo, per forza di cose, la più grande risorsa che le istituzioni dovranno gestire dal punto di vista delle politiche pubbliche […]. Da un lato l’espansione delle spese per i servizi sanitari e i costi sociali da dedicare alla cura e all’assistenza, dall’altro il lavoro […] costituiscono i piatti di una bilancia che dovrà essere calibrata con estrema attenzione, al fine di garantire gli equilibri sociali” (Sarti, 2008:7).</footnote>

<footnote n="10">“un tentativo di governance collettiva della complessa materia della trasformazione urbana – soprattutto laddove si tratta di processi di ri-generazione in cui sono sottoposte a modificazione e pressioni non solo la sfera tangibile ma anche quella intangibile del territorio – al fine di raggiungere un risultato comune, condiviso dalla più ampia fascia di attori coinvolti, e quindi socialmente sostenibile” (Viganò and Padua, 2018:54).</footnote>
# 02.
                     
                    Methodology

This research is collaborative research whose main objective was to build joint knowledge among the various actors, i.e. seniors, social and health professionals and researchers in order to be able to identify and analyze the dynamics of social exclusion that seniors may have faced in a pandemic situation in territories under study. It has involved rural areas both in Italy and Canada. More in detail, with regard to the Italian territory, three Italian rural areas belonging to different territories were investigated, namely the Forlì area (Emilia – Romagna), the Val Bisenzio area (Tuscany) and the Vulture area (Basilicata). While, with regard to the Canadian territory, three rural administrative regions of eastern Québec were selected (Lower Saint Laurence, Chaudière-Appalaches and Gaspésie-Madeleine Islands) <fnref n="11" /> . These are territories that group together municipalities (in some cases, they are unorganized territories that thus form an administrative unit with its own powers) and are distinguished by low density, a large proportion of the population over seventy, geographical, socio-economic and service diversity and mostly distant from the main urban centres.

The objective of our research project was to identify and analyze the dynamics of social exclusion which seniors in the rural areas under investigation may have experienced during the Covid-19 pandemic, as well as the possible social and territorial effects of the pandemic on the work and experiences of social and health professionals (social services, care services, community work) in the rural areas. Furthermore, the research aims to question the relevance of local dynamics in coping with the social, material and health needs of the elderly during the pandemic, as well as the challenges this poses in terms of social intervention in rural areas. The reference population consists of both elderly people (seniors seventy years old and over) and social and health professionals (including associative and community actors) to be able to draw a more exhaustive picture with respect to the implementation of initiatives responding to the needs emerging from the crisis.

The semi-structured interview tool was used as it allows the questions in the interview grid to be outlined according to the course of the interaction with the interviewee, facilitating flexible communication. In addition, in the Italian territory, 78 semi-structured interviews were conducted, which were carried out both remotely and in person, and involved 49 elderly people and 33 social and health professionals. While, in the Canadian territory 99 semi-structured interviews were conducted, which were carried out remotely (both by telephone and through the Zoom platform) and which involved 61 older people and 38 stakeholders working in the territorial and socio-political management of ageing and crisis management.

<figure><img src="image_1.png" /><figcaption>Figure</figcaption></figure>

<figure><img src="image_2.png" /><figcaption>Figure</figcaption></figure>

The sample was selected by means of snowball sampling, which is useful as it is a particular phenomenon with a reduced accessibility given the availability of a target considered to be a niche, but also a particularly sectoral field of investigation. A major difficulty encountered in the recruitment process is that of accessing the most isolated individuals, who have not been identified by the organizations. This aspect might have led to a representativeness distortion of the participants both within the Italian and the Canadian contexts <fnref n="12" /> .

In conclusion, the semi-structured interviews (with an average duration of about one hour) were subsequently transcribed and analyzed through a content analysis: each code that emerged was then linked back to one or more categories (conceptual units) through a classification process. The analysis resulted in codes and categories that were as representative and complete as possible with respect to the data that emerged. This process facilitated the comparative analysis between the two territories.

<footnote n="11">In addition, with regard to the Canadian territory, it is specified that two regional counties were selected for each territory: les Basques, Kamouraska, Bellechasse, les Etchemins, Bonaventure and Haute-Gaspésie.</footnote>

<footnote n="12">The research methodology also incorporated a quantitative component for the Canadian contexts only, based on a probabilistic survey handed out to seniors (aged seventy years old and over). This survey was mainly used to assess the entity of psychological distress, stress and social exclusion perceived by the elderly during the pandemic. Additionally, the survey enabled the seniors to indicate their intention to participate in the research. However, it has to be specified that only qualitative data will be used and analysed within this article.</footnote>
# 04.
                     
                    What governance for ageing at a local
                        level?

The preceding sections underline how in the territories studied the needs and requirements of the elderly actually preexisted the pandemic crisis, which accentuated the deleterious effects of the difficulties in accessing care and services that are central to crisis management. As a matter of fact, the pandemic period revealed several challenges that the elderly had to face: restrictive measures that changed their lifestyle and accentuated the condition of social exclusion they might experience. This condition has also altered the fragile balance of rural areas resulting in increased social exclusion and marginalisation of the most vulnerable populations, including the elderly who have found themselves disoriented:

> “At some point we had instructions that perhaps should not have been adopted for our region because there were no cases [of Covid infection, *ndr*] and we had the same instructions as the big cities” (*Elderly, female, 71 – 80 years old, Bonaventure*)

Social isolation – as seen in the previous sections – can be attributable to different elements that characterize rural areas such as those investigated in the research, i.e., access to services and care, economic security and the use of technology that can lead to exclusion from services, amenities and mobility (Walsh *et al* ., 2018) or to economic exclusion (Guberman and Lavoie, 2004). These aspects can lead to a lack of not only physical, and psychological but also social well-being in the life trajectories of the elderly population – such as the onset of anxiety and stress. Thus, it is of extreme relevance to question not only the factors and risks of social exclusion but also the strategies and measures put in place to successfully counter these phenomena. Therefore, it is important to question the solutions that have been put in place to deal with pre-existing and emerging problems since the difficulties of ageing and its consequences might also be due to government policies that do not or only partially reflect the needs and requirements of the elderly (Koff, 2019).

Primarily, in the studied territories, most of the elderly population under study emphasize a strong need to reorganize work and social intervention within the internal areas is underlined as a response: there is a specific need from the elderly, both in the Italian and in the Canadian territory, to implement new practices and new models of action. In fact:

> “Institutions [in thinking about and addressing seniors, *ndr*] are a bit lacking here” (*Elderly, male, 71 – 80 years old, Val Bisenzio area*)

Further on, it is specified how:

> “Our municipal authorities here do not seem to have been so bright […] in general it seems to me that we have been a bit abandoned by the institutions both at regional and Italian level, and at local level. There has not been much in the way of initiatives, or that I know the information on the management of the pandemic was limited to say even the information of putting a bulletin once a week on Facebook” (*Elderly, male, 71 – 80 years old, Val Bisenzio area*)

Especially highlighting, both in Canada and Italy, how responses have been lacking, especially in terms of health:

> “Doctors no longer made appointments […] [but, *ndr*] made appointments over the phone because [for example, *ndr*] the consultation with my doctor I made over the phone” (*Elderly, male, 71 – 80 years old, Gaspésie-Îles-de-la-Madeleine*)

And so on:

> “In my opinion yes, not much was done, some people, [the elderly, *ndr*] were treated badly even in hospitals [and later it’s added, *ndr*] it [this aspect, *ndr*] got worse with the pandemic because I saw people dying in loneliness, a brother-in-law of my husband dying in hospital of loneliness because his wife could not visit him” (*Elderly, female, 71 – 80 years old, Forlì area*)

However, this difficulty could be attributed to the fact that the administrations’ responses also depended on ever new and ever different directives:

> “We received e-mails every morning. The problem was that things were constantly changing from one day to the next […] by the time we started to use the new measures, to apply the instructions, the health department had already changed them” (*Social and health professional, Chaudière-Appalaches*)

In this way, responding with a reorganization of work was extremely difficult due to different elements. For example, on one hand – as seen above –, administrations responses depended and waited for instructions and, on the other hand, they had to learn to dialogue with new tools. As highlighted:

> “We had more work, much more work. What was different was that some organizations close to us shut down for different reasons […] they changed to remote work and this made services more complex” (*Social and health professional, Chaudière-Appalaches*)

In fact, it is underlined that there was a reorganization of work through different aspects. For example, it is emphasized by some social and health professionals how important the use of technology was and still is:

> “We are still working in this way [telephonically, *ndr*] because it allows us to contact many more people at more elastic hour […] socially we tried to hold on to everything we had and also with technology […] that allowed me thing” (*Social and health professional, Forlì area*)

More in detail, in both the Italian and Canadian territories under study, institutions took advantage of certain elements specific to rural areas to be able to respond to the care needs of the elderly. Thus, for instance, as a response to the needs and demands of the elderly, the social connections and territorial cohesion that characterise these territories have been promoted: a network of proximity not only with the administrative part of the territory, but also with the local and relational part, thereby establishing a solid constellation of relations (Alberio, 2023) not only family, but also neighbourhood relations that took place during the pandemic period were fundamental elements of response:

> “We have the luck of having very good relations with administrations and other associations, so for now, any requests for realization of initiatives, as soon as the request is made to the municipality, are always realized without problems” (*Social and Health Professional, Val Bisenzio area*)

In addition to these findings, it should be emphasized that rural areas have been affected since the twentieth century through processes of abandonment, depopulation and a crisis in the economic fabric (Osti, 2016). The result of these processes necessarily leads to an urgency – economic, social, demographic, etc. – of response that can be embodied in eco-sited practices, i.e. strategies capable of holding together both the production of goods and the provision of services (Farinella and Podda, 2020). Although there are fewer and fewer economic and social provisions for the design of services, it can be seen that network proximity and the role of the public actor are essential elements for their success (Ascoli and Pavolini, 2012; Andreotti and Mingione, 2014). However, as evidenced within the literature, there has been a shift from the hierarchical, paternalistic and welfare state to a network welfare able to generate social cohesion. As regards the realities of the research, it is noted that within the Italian territory the presence of a “synergy of all the realities present, really there was a collaboration of administrators” ( *Social and health professional, Vulture area* ).

And also:

> “Within the crisis management cell there are partners, including, for example, the RCM with whom I became close; I had never worked with our RCM director, but meeting new people on a regular basis has created links and helped solve problems in other cases” (*Social and health professional, Basques*)

On the other hand, within the Canadian context, community organizations, i.e. voluntary activities in the field of health, and social and neighbourhood services, play an important role: these are sources of solidarity that are useful for improving the living conditions of the population, especially the elderly.

Therefore, if, on one side, the territories have to mobilize themselves autonomously to be able to satisfy their needs – which implies a redefinition of the role of the State – on the other, there is a lack of public administration regarding the economic and institutional resources needed to create favourable conditions for the autonomous action of local social actors (Giry, 2020). Hence, if the mobilization of local and community organizations has made possible and allows some of the difficulties faced by the elderly to be circumvented, on the other hand, the criticality of the reality under consideration tends to increase the condition of dependence of the elderly on community resources that are able to offer – at least in part – support services.

It also seems crucial to reconsider “in terms of mutual cooperation with multiple social, economic, political and cultural effects. The objective is to create a context capable of increasing the common resources necessary for the work of all the actors involved (Magnaghi 2020)” (Macchioni and Prandini, 2022:364), so that the needs and requirements of seniors can be met through governance capable of generating community and social cohesion (Messina, 2019).

In conclusion, the advent of the pandemic crisis has brought to the agenda the necessity of a reorganization of work and social intervention within the rural areas – perhaps capable of responding not only to the needs of seniors living in these kinds of areas merging in the last 20 years due to the demographic changes, but also to the new needs resulting from the pandemic health crisis.
# 05. 
                    Conclusions

As we underlined the aim of this research was to analyze the situations and the experiences of the elderly (aged seventy and over) in the rural areas, both in Italian and Canadian territories, highlighting the socio-territorial effects that this health crisis has had on seniors. Indeed, the situation of the health crisis may have disrupted the fragile balance of rural areas, accentuating both the possible difficulties in accessing care and services and the social exclusion and marginalization itself of the most vulnerable populations, in our specific case the elderly (Balard and Corvol, 2020; Alberio *et al* ., 2022).

It is important to underline that the situations and the needs of the elderly are crucial to understanding the ageing process which involves not only individuals and families but also at a more macro level: different territories, populations and institutions. Indeed, the aging process involves in itself populations, society and the economy’s aspects (Golini, 2005).

As stated above, we questioned the situations and needs of older people living in rural areas. Especially since in rural areas, the social exclusion faced by the elderly could be associated with decline and the resulting lack of transport inside these areas and the possible negative effects on the elderly population. In this sense, decline and/or the lack of transport could cause the elderly to experience even more limited conditions of access to services and a consequent lack of inclusion at the spatial territorial level.

Furthermore, alongside these elements, as highlighted in the literature, rural areas suffer from a lack of distribution of health workers and auxiliary services, thereby forcing seniors in some cases to turn to non-in presence services or to travel to receive them (Koff, 2019).

All of these aspects – which emerged from our research – are key to understanding but also questioning the measures that have been put in place and are being implemented to cope with the emergence of new problems and the assertion of old ones – especially following the pandemic crisis.

In both territories under study –Italy and Canada – it emerges how in these areas both pre-existing and emerging problems have dialogued. We also questioned whether and which new models of intervention have been developed in the local contexts in order to respond to new and old needs during the pandemic period. Our research also shows how the solutions proposed and implemented often come from local civil society “as a spontaneous response to the constant backwardness of the public in the management of welfare systems, particularly in the most rural and remote areas” <fnref n="18" /> (Farinella and Podda, 2020:12; *Our Translation* ). Solutions and practices thus need not only a unified vision but also a rural development perspective (Barca *et al* ., 2014). Something which is true in both Italy and Canada, since both countries lack a real model of rural development (Alberio, 2022).

<footnote n="18">“come una risposta spontanea al costante arretramento del pubblico nella gestione dei sistemi di welfare in particolare nelle zone più rurali e remote” (Farinella e Podda, 2020:12).</footnote>
# 06. Author’s note

This research has been possible thanks to different actors (population at study, health and social professionals, decisions makers, researchers and collaborators, etc.) that have taken part and contributed to this study. We would like to thank all of them. In particular, referring to the Italian context, a thanks goes to: Annalisa Plava, Elisa Castellaccio and Alessandra Tamburriello, who were engaged and actively contributed to the research at different stages. Regarding the Canadian field, we thank everyone involved in this study, in particular: Mahée Gilbert-Ouimet, Nicole Ouellet, Cécile Van de Velde, Majella Simard, Joel Akoї Sovogui, Emanuele Lucia and Sylvie Côté. Manon Labarchède and Mame Salah Mbave worked as post-doctoral fellows and did most of the interviews in Canada. We also thank the Fond de recherche du Québec and all the Ministries involved in the “action concertée sur le viellissement et l’exclusion” that financed part of this research.

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