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.
[1] United Nation Organization (2004). Country profile: Sta- tus and implementation of national policies on ageing in Jamaica.
[2] Eldemire, D. (2001) Ageing—A New challenge to health care in the New Millennium. West Indian Medical J, 50, 95.
[3] James, K., Eldemire, D., Gouldbourne, J. and Morris, C. (2007) Falls and fall prevention in the elderly: The Ja-maican perspective. West Indian Medical Journal, 56, 534-539.
[4] Eldemire, D. (1993) An epidemiological study of the Jamaican elderly. PhD Thesis. The University of the West Indies, Jamaica.
[5] Plan of Action on Health and Ageing. (1999) Older Adults in the Americas ,1992-2000, Washington, PAHO.
[6] King, H, Aubert, R.E. and Herman, W.H. (1998) Global burden of diabetes, 1995-2025: prevalence, numerical es-timates, and projections. Diabetes Care, 21, 1414-1431.
[7] Murray, C.L. and Lopez, A. (1996) The Global Burden of Disease, World Health Organization, Geneva.
[8] Albala, C, Lebrao, M.L, Leon, D.E.M. et al. (2005) En-cuesta Salud, Bienestar y Envejecimiento (SABE): me-todologia de la encuesta y perfil de la población estudiada. Pam AM J Public Health, 17, 5-6.
[9] Rogers, R.G. (1996) The effects of family composition, health and social support linkage on mortality. Journal of Health and Social Behaviour, 37, 326-328.
[10] Braithwaite, S. (1990) The elderly in Barbados: problems and policies. Bull Pan Am Health Org, 24, 314-329.
[11] Manton, K.G., Stallard, E. and Tolley, H.D. (1991) Lim-its to human life expectancy: evidence, prospects, and implications. Population and Development Review, 17, 603-637.
[12] Suzman, R.M. Willis, D.P. and Manton, K.G. (1992) The oldest old. New York, Oxford University Press.
[13] Bourne, P. (2007) Using the biopsychosocial model to evaluate the wellbeing of the Jamaican elderly. West In-dian Medical J, 56(Suppl 3), 39-40.
[14] Abel-Smith, B. (1994) An introduction to health: Policy, Planning and Financing. Essex: Pearson Education.
[15] Asnani, M.R., Reid, M.E., Ali, S.B, Lipps, G. and Wil-liams-Green, P. (2008) Quality of life in patients with sickle cell disease in Jamaica: rural-urban differences. Rural and Remote Health, 8, 1-9.
[16] Planning Institute of Jamaica, (PIOJ). (2005) Economic and Social Survey, 2004. Kingston: PIOJ.
Socio-demographic determinants of health status of elderly with self-reported diagnosed chronic medical conditions in Jamaica — Oak Academic Publishing
[17] Planning Institute of Jamaica and Statistical Institute of Jamaica (PIOJ & STATIN). (2003) Jamaica Survey of Living Conditions 2002. Kingston.
[18] Homer, D. and Lemeshow, S. (2000) Applied Logistic Regression, 2nd edn. John Wiley & Sons Inc., New York.
[19] Cohen, L. and Holliday, M. (1982) Statistics for Social Sciences. London, England: Harper and Row.
[20] Grossman, M. (1972) The demand for health-a theoretical and empirical investigation. New York: National Bureau of Economic Research.
[21] Smith, J.P. and Kington, R. (1997) Demographic and economic correlates of health in old age. Demography, 34, 159-170.
[22] Bourne, P.A. and McGrowder D.A. (2009) Rural health in Jamaica: examining and refining the predictive factors of good health status of rural residents. Rural and Remote Health, 9, 1116.
[23] Hambleton, I.R, Clarke, K, Broome, H.L, Fraser, H.S, Brathwaite, F. and Hennis, A.J. (2005). Historical and current predictors of self-reported health status among elderly persons in Barbados. Rev Pan Salud Public, 17, 342-352.
[24] Smith, J. (1994) Measuring health and economic status of older adults in developing countries. Gerontologist, 34, 491-496.
[25] Idler, E.L. and Benjamin, Y. (1997) Self-rated health and mortality: A Review of Twenty-seven Community Stud-ies. Journal of Health and Social Behavior, 38, 21-37.
[26] Idler, E.L. and Kasl, S. (1995) Self-ratings of health: Do they also predict change in functional ability? Journal of Gerontology, 50B, S344-S353.
[27] Schechter, S., Beatty, P. and Willis, G.B. (1998) Asking survey respondents about health status: Judgment and response issues, In: Schwarz, N., Park, D., Knauper, B and. Sudman, S (ed.): Cognition, aging, and self-reports. Ann Arbor, Michigan: Taylor and Francis.
[28] Luteijn, B. (1996) Health status of the elderly in the Marigot Health District, Dominica. West Indian Medical Journal, 45(Suppl.2), 31.
[29] Rawlins, J.M, Simeon, D.T, Ramdath, D.D. and Chadee, D.D. (2008) The elderly in Trinidad: Health, social and economic status and issues of loneliness. West Indian Medical Journal, 57, 589-595.
[30] Benyamini, Y. and Idler, E. (1999) Community studies reporting association between self-rated health and mor-tality: additional studies, 1995 to 1998. Res Aging, 21, 392-401.
[31] Lebrao, M.L, Durate, Y.A.O, and Organizers. (2003) KNOW—Health, Wellness and Aging: the SABE project in the municipality of Sao Paulo: an approach starts Brasi-lia (DF): SABE project in the city of Sao Paulo: an initial approach. Brasília (DF): Pan American Health. Available in: http://www.opas.org.br/sistema/arquivos/l_saber.pdf
[32] Eldemire, D. (2005) Ageing the reality. Chapter 2. In Morgan, Owen, Health Issues in the Caribbean. UWI Press, Jamaica. 157-77.
[33] Alberts, J.F., Koopmans, P.O.C., Gerstenbluth, I. and Van der Heuvel, W.J. (1995) The health profile of Cura-cao: results from the Curacoa health study. West Indian Medical Journal, 44(Suppl. 2), 21-2.
[34] World Health Organization. (2001) Regional Core Health Data System: Country Profile–Jamaica. http://www.Documents and Settings\user\Desktop\Regional Core Health Data System - Country Profile JAMAICA.mht.
[35] Planning Institute of Jamaica and Statistical Institute of Jamaica (PIOJ & STATIN). (2004) Economic and Social Survey of Jamaica (ESSR).
[36] Eldemire, D. (1995) Health care in Jamaica. World Hea- lth Forum, 16, 344-347.
[37] Planning Institute of Jamaica and Statistical Institute of Jamaica (PIOJ & STATIN). (1995) Jamaica Survey of Living Conditions 1994. Kingston; December 1995.
[38] Caribbean Food and Nutrition Institute. (1999) Health of the elderly. Cajanus, 32, 217-240.
[39] Bourne, P. (2009) Good health status of older and oldest elderly in Jamaica. Are there differences between rural and urban areas? Open Geriatric Medicine Journal, 2, 18-27.
[40] Country profile and implementation of national policy on ageing in Jamaica. www.un.org/esa/socdev/ageing/documents/workshops/Vienna/jamaica.pdf
[41] Planning Institute of Jamaica and Statistical Institute of Jamaica (PIOJ & STATIN). (2002) Economic and Social Survey of Jamaica, 2002.
[42] Sargeant, L., Boyne, M., Bennett, F., Forrester, T., Coo-per, R. and Wilks, R. (2004) Impaired glucose regulation in adults in Jamaica: who should have the oral glucose tolerance test. Pan American Journal of Public Health, 16, 35-42.
[43] Wald, H., Markowitz, H., Zevin, S. and Popovtzer, M.M. (1990) Opposite effects of diabetes on nephrotoxic and ischemic acute tubular necrosis. Proc Soc Exp Biol Med, 195, 51-56.
[44] Kalavathy, M.C., Thankappan, K.R., Sharma, P.S. and Vasan R.S. (2000) Prevalence, awareness, treatment and control of hypertension in an elderly community-based sample in Kerala, India. Natl Med J India 13: 9-15.
[45] Desai, M., Zhang, P. and Hennessy, C. Surveillance for morbidity and mortality among older adults - United States 1995-1996. MMWR. Morbidity and Mortality Weekly Report, 48, 7-25.
[46] Samos, L. and Roos, B. (1998) Diabetes mellitus in older persons. Medical Clinics of North America, 82, 791-803.
[47] Meneilly, G. and Tessier, D. (2001) Diabetes in elderly adults. Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 56A(1), M5-M13 .
[48] Health Situation Trends. (1998) Situation Trends. Health in the Americas, 1988 Edition,. Washington, D.C.: PAHO. 1.
[49] Wilks, R., Sargent, L.A., Guilliford, M.C., Reid, M. and Forrester, T. (2001) Quality of care of hypertension in three clinical settings in Jamaica. West Indian Med J, 49, 220-225.
[50] Wilks, R.J., Sargent, L.A., Guilliford, M.C., Reid, M.E. and Forrester, T.E. (2001) Management of diabetes mel-litus in three settings in Jamaica. Rev Panam Salud Pub-lica, 9, 65-72.
[51] Statistical Institute of Jamaica, STATIN. Demographic statistics, 2007. Kingston; STATIN: 2008.
[52] Planning Institute of Jamaica, PIOJ. Economic and So-cial Survey Jamaica, 2007. Kingston.
[53] Edelman, M. and Menz, B. (1996) Selected comparisons and implications of a national rural and urban survey on health care access, demographics, and policy issues. Journal of Rural Health, 12, 197-205.
[54] Planning Institute of Jamaica (PIOJ). (2008) Statistical Institute of Jamaica (STATIN). Jamaica Survey of Living Conditions, 2007. Kingston: PIOJ & STATIN.
[55] Jamaica—medium term socioeconomic policy frame-work 2004-2007, February 2005. pioj.gov.jm/Documents/ MTPFJDP/33.pdf
[56] Pimple, F. and Rogers, R. (2004) Socioeconomic Status, Smoking and Health: A Test of Competing Theories of Cumulative Advantage. Journal of Health and Social Behaviour, American Sociological Association. 45(3), 306-321.
[57] Sobal, J. and Stunkard A.J. (1989) Socioeconomic status and obesity: a review of the literature. Psychol Bull, 105, 260-275.
[58] Astrup, A. and Finer, N. (2001) Redefining Type 2 dia-betes: Diabetes or obesity dependent diabetes. Obesity Reviews, 1, 57-59.