scholarly journals Urban-rural and Gender Differential in Depressive Symptoms Among Older Adults in India

Author(s):  
Shubham Kumar ◽  
Shekhar Chauhan ◽  
Ratna Patel ◽  
Manish Kumar

Abstract Background: To date, evidence remained inconclusive explaining rural-urban and male-female differential in depression. Unlike other previous research on the association of several risk factors with depressive symptoms among the elderly, this study focussed on the socio-economic status-related inequality in the prevalence of depression among the elderly along with focussing urban-rural and male-female gradients of depression among the elderly.Methods: This study used data from Longitudinal Ageing Study in India (LASI) wave-I, 2017-18, survey. The outcome variable for this study was self-reported depression. Bivariate analysis was used to understand the prevalence by sociodemographic clusters. Fairlie decomposition analysis has been done to measures rural-urban inequalities for depression among older men and women.Results: Results found that around 22 percent of urban elderly and 17 percent of rural elderly reported depression. A higher proportion of female elderly (22.6% vs. 18.4%) reported depression than male elderly. Almost one in every five elderly (20.6%) reported depression in India. The results found that a higher percentage of women in rural and urban areas reported depression than their male counterparts. While examining SES-related inequality in the prevalence of depression, education was a significant factor explaining the SES-related inequality in the prevalence of depression among female elderly and not in male elderly.Conclusion: Given the large proportion of elderly reporting depression, this study highlights the need for improving health care services among the elderly. The increasing burden of depression in specific sub-populations also highlights the importance of understanding the broader consequences of depression among rural and female elderly.

2021 ◽  
Author(s):  
Shubham Kumar ◽  
Shekhar Chauhan ◽  
Ratna Patel ◽  
Manish Kumar

Abstract Background To date, evidence remained inconclusive explaining rural-urban and male-female differential in depression. Unlike other previous research on the association of several risk factors with depressive symptoms among the elderly, this study focussed on the socio-economic status-related inequality in the prevalence of depression among the elderly along with focussing urban-rural and male-female gradients of depression among the elderly. Methods This study used data from Longitudinal Ageing Study in India (LASI) wave-I, 2017-18, survey. The outcome variable for this study was self-reported depression. Bivariate analysis was used to understand the prevalence by sociodemographic clusters. Fairlie decomposition analysis has been done to measures rural-urban inequalities for depression among older men and women. Results Results found that around 22 percent of urban elderly and 17 percent of rural elderly reported depression. A higher proportion of female elderly (22.6% vs. 18.4%) reported depression than male elderly. Almost one in every five elderly (20.6%) reported depression in India. The results found that a higher percentage of women in rural and urban areas reported depression than their male counterparts. While examining SES-related inequality in the prevalence of depression, education was a significant factor explaining the SES-related inequality in the prevalence of depression among female elderly and not in male elderly. Conclusion Given the large proportion of elderly reporting depression, this study highlights the need for improving health care services among the elderly. The increasing burden of depression in specific sub-populations also highlights the importance of understanding the broader consequences of depression among rural and female elderly.


2021 ◽  
Author(s):  
Shekhar Chauhan ◽  
Shobhit Srivast ◽  
Pradeep Kumar ◽  
Ratna Patel

Abstract Background: Multimorbidity is defined as the co-occurrence of two or more than two diseases in the same person. With rising longevity, multimorbidity has become a prominent concern among the older population. Evidence from both developed and developing countries shows that older people are at much higher risk of multimorbidity, however, urban-rural differential remained scarce. Therefore, this study examines urban-rural differential in multimorbidity among older adults by decomposing the risk factors of multimorbidity and identifying the covariates that contributed to the change in multimorbidity.Methods: The study utilized information from 31,464 older adults (rural-20,725 and urban-10,739) aged 60 years and above from the recent release of the Longitudinal Ageing Study in India (LASI) wave 1 data. Descriptive, bivariate, and multivariate decomposition analysis techniques were used.Results: Overall, significant urban-rural differences were found in the prevalence of multimorbidity among older adults (difference: 16.3; p<0.001). Moreover, obese/overweight and high-risk waist circumference were found to narrow the difference in the prevalence of multimorbidity among older adults between urban and rural areas by 8% and 9.1%, respectively.Conclusion: There is a need to substantially increase the public sector investment in healthcare to address the multimorbidity among older adults, more so in urban areas, without compromising the needs of older adults in rural areas.


2019 ◽  
Vol 7 (2) ◽  
pp. 147 ◽  
Author(s):  
Ratna Dwi Wulandari ◽  
Agung Dwi Laksono

Background: Urban always attracts investors to invest. Health facilities in urban areas are growing rapidly compared to villages. This condition is estimated to contribute to the disparity of urban-rural areas in the utilization of health services. Studying the utilization of health services is a way to evaluate the performance of the health care system through its output.Aim: This study analyzed the urban-rural disparity in the utilization of primary healthcare center by the elderly.Method: This study used in the 2013 Basic Health Research raw data. The 2013 Basic Health Research was designed as a cross-sectional survey. With the multi-stage cluster random sampling method, 25,813 elderly people in East Java Province participated. Data were analyzed using Multinomial Logistic Regression tests.Results: Elderly people in urban areas have a better probability of outpatient use of 1.208 than those living in rural areas (OR 1.208; 95% CI 1.057-1.380). The elderly who have a primary school and under education have the possibility of 1.558 times more utilizing outpatients in primary healthcare centers than the elderly who have college education levels (OR 1.558; 95% CI 1.001-2.424).Conclusion: There was a disparity between urban and rural areas in the utilization of outpatient primary healthcare centers in East Java by the elderly. Policymakers in East Java are recommended to improve facilities and infrastructure of the primary healthcare centers in rural areas by paying attention to the results of this study.Keywords: elderly, urban-rural disparities, primary healthcare center, healthcare utilization, inpatient-outpatient. 


2020 ◽  
Author(s):  
Debashree Sinha ◽  
Prem Shankar Mishra ◽  
Shobhit Srivast ◽  
Pradeep Kumar

Abstract Background Violence against older adults is a well-recognised socio-psychological and public health problem worldwide. It is uncared-for, undiagnosed, and untreated problem that is widespread across both developed and developing countries. Therefore, this paper aims to understand the extent of socio-economic status related inequality in violence against older adults. Methods Data for this study came from Building a Knowledge Base on Population Aging in India (BKPAI). Violence against older adults was the outcome variable for this study and defined as older adults who faced any abuse or violence or neglect or disrespect by any person. Bivariate analysis and regression-based decomposition technique is used to understand the relative contribution of various socioeconomic factors to violence among (N = 9541) older adults. Results The most dominant form of violence is verbal (10%) followed by disrespect (5.8%) and economic violence (5.2%). Older adults aged 80 + years [OR: 1.49; CI: 1.14–1.93] and working [OR: 1.26; CI: 1.02–1.56] had higher likelihood to suffer from violence than their counterparts. On the other hand older adults who were currently in union [OR: 0.79; CI: 0.65–0.95], living with children [OR: 0.53; CI: 0.40–0.72] and belonging to richer wealth quintile [OR: 0.35; CI: 0.24–0.51] had lower likelihood to suffer from violence than their counterparts. The decomposition results revealed that poor older adults are more prone to violence (Concentration index: -0.20). Household’s wealth status was responsible for 93.7% of the SES-related inequality whereas living arrangement of older adults explained 13.7% SES-related inequality. Education and working status of older adults made a substantial contribution to the inequalities in reported violence, explaining 3.7% and 3.3% of the total inequality, respectively. Conclusion With no or meagre income of their own, older adults belonging to the poorest wealth quintile have little or no bargaining power to secure a violent free environment for themselves. Therefore, special attention in terms of social and economic support should be given to the economically vulnerable older population.


Author(s):  
Sufyan Anwar ◽  
Maiza Duana ◽  
. Marniati

Aims: The study aims to prove the correlation between demographic factors and the eating habits of the elderly in Aceh, Indonesia. Study Design:  A cross-sectional study. Place and Duration of Study: The study was conducted in Aceh Barat district, Aceh province-Indonesia between June and October 2019. Methodology: This cross-sectional study was carried out by involving the elderly (age of 60 years or above) in 483 participants. Bivariate analysis was conducted through a chi-square test using SPSS version 21 to answer the research hypothesis. Results: Four hundred and eighty three (483) elderly people with mean age of 69.76 years were enrolled, of these, 68.9% were women and 58.2% were unemployed. Fifty-nine percent of respondents live in rural areas and 64.39% had good eating habits. Finding unveiled that age had a significant correlation with eating habits (P=0,05), gender did not correlate with eating habits (P>0,05). Occupation correlated with eating habits (P=0.05), and area of residence correlated with eating habits (P=0,05).. Conclusion: The study concluded that younger age (60-69 years old), employed, and living in urban areas positively contribute to establishing healthy eating habits in the elderly in Aceh. Furthermore, it is necessary to conduct intervention studies in the occupation variable as a modifiable variable.


2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Debashree Sinha ◽  
Shobhit Srivastava ◽  
Prem Shankar Mishra ◽  
Pradeep Kumar

Abstract Background Although existing research supports the correlation of hereditary and psychological factors with an adolescent’s deliberate self-harm, there is a dearth of research that focus on their socio-economic characteristics. This paper intends to identity the potential risk factors that influence an adolescent’s deliberate self-harm. Methods Data for this study was obtained from Understanding the Lives of Adolescents and Young Adults (UDAYA) study conducted in 2015–16 with sample of 5,969 adolescent boys and 9,419 girls aged 10–19 years. The outcome variable was deliberate self-harm among adolescents. The explanatory variables added in the study were age, current schooling status, working status, media exposure, access to internet, parental abuse, involvement in fights, substance use, depressive symptoms, caste, religion, wealth index, residence and states. Bivariate analysis along with binary logistic regression analysis was done to fulfill the study objectives. Results About 4.5% and 3.2% of adolescent boys and girls, respectively had deliberate self-harm. The odds of deliberate self-harm were 50 per cent more likely among adolescent girls who had internet access [OR 1.50; CI 1.05–2.16]. The likelihood of deliberate self-harm was 49 per cent and 61 per cent significantly more likely among adolescent boys [OR 1.49; CI 1.11–2.0] and girls [OR 1.61; CI 1.27–2.04] who experienced parental physical abuse respectively. With reference to minimal/mild depressive symptoms, adolescents who had moderate [boys-OR 2.10; CI 1.29–3.4 and girls-OR 2.50; CI 1.774–3.59] or moderately high/severe [boys-OR 4.58; CI 2.88–7.29 and girls-OR 4.18; CI 3.1–5.63] depressive symptoms had significantly higher odds of deliberate self-harm. Conclusions Internet access, parental abuse, involvement in fights, and depressive symptoms emerged as significant predictors of deliberate self-harm among adolescent boys and girls. Results suggest that an early identification of the predictors and intervention might prevent deliberate self-harm among adolescents. Since parents play a major role in the lives and development of adolescents, it is highly recommended that they initiate open and supportive communication with their children.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Debashree Sinha ◽  
Prem Shankar Mishra ◽  
Shobhit Srivastava ◽  
Pradeep Kumar

Abstract Background Violence against older adults is a well-recognised socio-psychological and public health problem. It is uncared-for, undiagnosed, and an untreated problem that is widespread across both developed and developing countries. The present paper aims to understand the extent of the socio-economic status related inequality in violence against older adults in India. Methods The study uses data from Building a Knowledge Base on Population Aging in India (BKPAI). Violence against older adults is the outcome variable for the study and is defined as older adults who faced any abuse or violence or neglect or disrespect by any person. Bivariate analysis and regression-based decomposition technique is used to understand the relative contribution of various socio-economic factors to violence against older adults (N = 9541). Results The prevalence of violence faced by older adults was 11.2%. Older adults aged 80+ years [OR: 1.49; CI: 1.14–1.93] and working [OR: 1.26; CI: 1.02–1.56] had higher likelihood to face violence than their counterparts. On the other hand, older adults who were currently in union [OR: 0.79; CI: 0.65–0.95], lived with children [OR: 0.53; CI: 0.40–0.72] and who belonged to richer wealth quintile [OR: 0.35; CI:0.24–0.51] had lower likelihood to suffer from violence than their counterparts. The decomposition results revealed that poor older adults were more prone to violence (Concentration index: − 0.20). Household’s wealth status was responsible for explaining 93.7% of the socio-economic status related inequality whereas living arrangement of older adults explained 13.7% of the socio-economic related inequality. Education and working status of older adults made a substantial contribution to the inequalities in reported violence, explaining 3.7% and 3.3% of the total inequality, respectively. Conclusion Though interpretation of the results requires a cautious understanding of the data used, the present study highlights some of the relevant issues faced by the country’s older adults. With no or meagre income of their own, older adults belonging to the poorest wealth quintile have little or no bargaining power to secure a violent free environment for themselves. Therefore, special attention in terms of social and economic support should be given to the economically vulnerable older population.


Author(s):  
Liangwen Zhang ◽  
Yanbing Zeng ◽  
Lixia Wang ◽  
Ya Fang

Background: Long-term care (LTC) needs for the elderly have become increasingly crucial policy concerns in rapidly aging Asia, especially in China, the most populous nation. However, very few studies have examined the cohort differences in terms of their existing and expected utilization of LTC services, above all urban–rural differences. This study aims to evaluate the differences of LTC current status and needs between urban–rural areas and age groups, and to identify influencing factors causing the different LTC needs. Methods: The data come from the Chinese Longitudinal Health Longevity Survey in 2014. A total of 7192 home-based elderly aged ≥65 years by multistage sampling were enrolled. The Andersen Model was applied to categorize the influential factors into three components including predisposing, enabling and needs. Multivariate logistic regression analysis was used to analyze the influential factors of the three levels of LTC needs. Results: A total of 6909 valid sample sizes were included in this study. The overall LTC needs of the elderly showed a rapidly increasing trend among which older people had the highest needs for bathing (27.29%) and toileting (15.8%). It was also demonstrated the aged cohort between urban and rural exerted an impact on all aspects of LTC status and needs to varying degrees (p < 0.05). Compared with urban areas, the LTC needs for the elderly in rural areas was more vigorous, but the supply was seriously inadequate. The elderly who were older, living in rural areas, unmarried, non-farming, with low income, in poor health and having less autonomy had higher anticipated needs for LTC services (OR > 1, p < 0.01). Compared with the young-old in rural areas, the young-old in urban areas were prone to live alone (OR = 1.61, p < 0.01). The elderly who were older, living in rural areas, farming, with low income, lonely and depressed had higher anticipated needs for community-based services (1 < OR < 1.69, p < 0.05). Conclusions: The aged cohort in urban–rural distinction were facing an increasing need for immediate care due to the inadequate support being provided, especially among rural elderly. The oldest elderly in rural areas had higher LTC needs, and different levels of needs were affected by age, economic level, family support, health status and other related effects. This study provides evidence-based recommendation for further improving the construction and development of the LTC system in China.


Author(s):  
Jian Zhang ◽  
Dan Li ◽  
Jianmin Gao

Background: China is becoming an aging society, and the proportion of the population aged 60 years and above is increasing. There is a dualistic urban–rural economic structure between urban and rural areas in China, but there are few comparative health studies on the self-assessed health (SAH) status of the elderly between urban and rural areas. The aim of this study is to explore the SAH status of the elderly in China, and to identify the health disparity between the urban and rural elderly. Methods: The data from the fourth wave of the China Health and Retirement Longitudinal Study (CHARLS) in 2018 were adopted. A total of 9630 participants aged 60 and above were included in this study. SAH was used as the indicator, measuring the health status. Fairlie decomposition analysis was conducted to find the SAH disparity. Results: The proportion of good SAH of the rural elderly (24.01%) was significantly higher than the urban elderly (19.99%). The association of SAH was widely different between the rural and urban elderly. There was a stronger association between SAH and sleeping time in the urban elderly (Odds ratios (OR) = 3.347 of 4–8 hours; OR = 3.337 of above 8 hours) than the rural elderly (OR = 1.630 of 4–8 hours; OR = 2.293 of above 8 hours). Smoking and social activity were significant only in the urban elderly, while region and assets were significant only in the rural elderly. Drinking (11.45%), region (−33.92%), and assets (73.50%) were the main factors contributing to the urban–rural health disparities. Conclusions: This is the first comparative study examining SAH disparity, focusing on the elderly aged 60 and above in China. From the perspective of drinking, region, and assets, our study highlighted substantial urban–rural health disparities, and provided evidence for policy making on narrowing the health gap between urban and rural areas in China.


2021 ◽  
Vol 19 (1) ◽  
pp. 87-97
Author(s):  
Mihaela Ghenţa ◽  
Elen-Silvana Bobârnat

The paper presents the results of a qualitative research conducted among providers of social and socio-medical services for older persons. The research objectives were to collect opinions with regard to the societal transformations that constitute risk factors for the social inclusion of the elderly; to identify the dimensions of social inclusion of the elderly in Romania most impacted by the societal transformations, as well as measures and actions that could counter acting the negative effects of social exclusion of the elderly. Data collection included semi-structured interviews with experts from social and health care services providers. Technological transformations, the ageing phenomenon, the migration, the negative perceptions regarding the elderly population; the uneven development of urban areas compared to rural areas, are most likely to influence the social exclusion of older persons. Participation in cultural, sports, and voluntary activities, access to appropriate social and health care services and housing conditions may lead to a better social inclusion.


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