Abstract
Over the last 2 decades (1988-2007), poverty in Jamaica has fallen by 67.5%, and this is within the context of a 194.7% increase in inflation for 2007 over 2006. It does not abate there, as Jamaicans are reporting more health conditions in a 4-week period (15.5% in 2007) and at the same time this corresponds to a decline in the percentage of people seeking medical care. Older people’s health status is of increasing concern, given the high rates of prostate cancer, genitourinary disorders, hypertension, diabetes mellitus and the presence of risk factors such as smoking. Yet, there is a dearth of studies on the health status of older people in the two poor quintiles. This study examined 1) the health status of those elderly Jamaicans who were in the two poor quintiles and 2) factors that are associated with their health status. A sample of 1,149 elderly respondents, with an average age of 72.6 years (SD = 8.7 years) were extracted from a total survey of 25,018 Jamaicans. The initial survey sample was selected from a stratified probability sampling frame of Jamaicans. An administered questionnaire was used to collect the data. Descriptive statistics were used to examine background information on the sample, and stepwise logistic regression was used to ascertain the factors which are associated with health status. The health status of older poor people was influenced by 6 factors, and those factors accounted for 26.6% of the variability in health status: Health insurance coverage (OR = 13.90; 95% CI: 7.98-24.19), age of respondents (OR = 7.98; 95% CI: 1.02-1.06), and secondary level education (OR=1.82; 95% CI: 1.35-2.45). Males are less likely to report good health status than females (OR = 0.56; 95% CI: 0.42-0.75). Older people in Jamaica do not purchase health insurance coverage as a preventative measure but as a curative measure. Health insurance coverage in this study does not indicate good health but is a proxy of poor health status. The demand of the health services in Jamaica in the future must be geared towards a particular age cohort and certain health conditions, and not only to the general population, as the social determinants which give rise to inequities are not the same, even among the same age cohort.
Highlights
Factors determining the poor health status of the elderly in Jamaica can be viewed from the perspective of a socio-medical dichotomy
This study examined 1) the health status of those elderly Jamaicans who were in the two poor quintiles and 2) factors that are associated with their health status
The health status of older poor people was influenced by 6 factors, and those factors accounted for 26.6% of the variability in health status: Health insurance coverage (OR = 13.90; 95% CI: 7.98-24.19), age of respondents (OR = 7.98; 95% CI: 1.02-1.06), and secondary level education (OR=1.82; 95% CI: 1.35-2.45)
Summary
Factors determining the poor health status of the elderly in Jamaica can be viewed from the perspective of a socio-medical dichotomy. In 2005, the World Health Organization began a thrust in examining the social determinants of health, and despite that reality there is a lack of literature in this regard on the elderly poor people in Jamaica. These parameters were explored in the current research by using a sample of 1,149 elderly poor Jamaicans. It is noted that income is positively correlated with a higher standard of living and life expectancy In support of this claim, studies have shown that life expectancy in many developing countries [1], in particular the Caribbean (Barbados, Guadeloupe, Jamaica, Martinique, Trinidad and Tobago) has exceeded 70 years, Published Online July 2010 in SciRes. http://www.scirp.org/journal/jbise
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