For older individuals, living in familiar surroundings continuously is one of important aspects of achieving well-being. However, in sparsely populated rural areas where healthcare and social resources are limited, sustaining life at their home can be as a significant challenge. This study examined the relationship between participation in social activities and mutual support relationships with neighbours, as key elements of well-being, and self-rated health and happiness amongst inhabitants of mountainous rural areas. From analysis of responses of long-term care needs survey (N=1,496, mean age: 76.9 years, female 56%), regular participants in social activities such as hobbies, sports, cultural pursuits, and community gatherings enhances self-rated health and happiness, regardless of physical strength. Additionally, having mutual support relationships with neighbours in seeking advice when facing difficulties or receiving care when bedridden was associated with higher self-rated health and happiness. Mutual support relationships existed amongst neighbours who were not families nor relatives, and whether acting as a supporter or a recipient, self-rated health and happiness were better than having no relationship at all. Therefore, creating opportunities for participation in social activities and neighbourhood mutual support relationship, regardless of physical strength or health status, was considered useful for sustaining life in mountainous rural areas.
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