Abstract

Objectives: The aim of the current study is to examine the health status of elderly in rural, peri-urban and urban areas of residence in Ja-maica, and to propose a model to predict the social determinants of poor health status of elderly Jamaicans with at least one chronic disease. Methods: A sub-sample of 287 re-spondents 60 years and older was extracted from a larger nationally cross-sectional survey of 6783 respondents. The stratified multistage probability sampling technique was used to draw the survey respondents. A self-adminis-tered questionnaire was used to collect the data from the sample. Descriptive statistics were used to examine the demographic characteris-tics of the sample; chi-square was used to in-vestigate non-metric variables, and logistic re-gression was the multivariate technique chosen to determine predictors of poor health status. Results: Almost thirty six percent of the sam-ples had poor health status. Majority (43.2%) of the sample reported hypertension, 25.4% dia-betes mellitus and 13.2% rheumatoid arthritis. Only 35.4% of those who indicated that they had at least one chronic illness reported poor health status and there was a statistical relation be-tween health status and area of residence [χ2 (df = 4) = 11.569, P = 0.021, n = 287]. Rural residents reported the highest poor health status (44.2%) compared to other town (27.3%) and urban area residents (23.7%). Conclusions: Majority of the respondents in the sample had good health, and those with poor health status were more likely to report having hypertension followed by dia-betes mellitus and rheumatoid arthritis. Poor health status was more prevalent among those of lower economic status in rural areas who re- ported greater medical health care expenditure. The prevalence of chronic diseases and levels of disability in older people can be reduced with appropriate health promotion and strategies to prevent non-communicable diseases.

Highlights

  • IntroductionBetween 1960 and 1995, there was a 76.8% increase in the elderly population [1]

  • The Caribbean has been identified as the most rapidly ageing region of the world

  • Seventy percent of the sample was head of household; 35.5% had poor health status; 70.8% sought health care; 72.0% purchased the prescribed medication; 33.2% had public health insurance coverage; 39.7% were poor; 26.5% lived in urban areas, 19.2% in other towns and 54.4% in rural areas (Table 1)

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Summary

Introduction

Between 1960 and 1995, there was a 76.8% increase in the elderly population [1]. Among its regional island states, the average growth rate in the elderly population was approximately 5.3% for the 1995-2000 periods. In Jamaica, a similar pattern has been observed with a clear and rapidly rising trend in the elderly as a proportion of the population [2]. By 2025 as much as 1 in 7 persons will be elderly Characterizing this pattern of increasing elderly is the differential growth rates within the various sub-age groups over age 60, with the 75 years and above age group expected to double moving from 2.8% currently to 4.0 % in 2025 [3]. With a calculated life expectancy of 75.5 years [5], the burden on the healthcare system can be expected to increase

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