Socioeconomic Status and Health Condition of the Older Adult and Elderly Population in Thailand

Abstract

Socioeconomic status (SES) related to health inequalities is assessed by education, employment, income, wealth, and social status. Low socioeconomic status is associated with excess morbidity and mortality. A deterioration in health that accompanies aging is a predictor of a decline in perceived socioeconomic status. SES has a significant impact on people’s physical health. Health status can be measured by an individual subjectively rating the perceptions of their health status. This research aimed to identify socioeconomic factors associated with health condition in the elderly, and to provide support for national policy makers who are responsible for developing financial strategies for an aging society, via financial and healthcare services and special systems assistance, to promote good health status in aging societies in the future.

The elderly population surveys conducted by the National Statistical Office of Thailand use a stratified, two-stage, sampling procedure. There are 77 provinces in Thailand, each of which is defined as a block or stratum. Each stratum is separated into two parts according to the structure of the local administration, namely, municipal and non-municipal areas. These areas include individual households and are set as the primary- and secondary-sampling units, respectively. The elderly population surveys are population-based surveys that are systematically carried out by skilled interviewers. In 2017, they polled 39,992 people aged 50 years or older.

Results showed that about 34.3% of the respondents did not have good health. 17.4% of respondents did not have any savings, and approximately four out of ten (43.5%) did not have adequate income. Multivariate modelling demonstrated that respondents aged 60 and above (AOR = 0.49, 95% CI = 0.47 to 0.52, p<0.001), females (AOR = 0.76, 95% CI = 0.73 to 0.80, p<0.001), separated, widowed, or divorced respondents (AOR = 0.86, 95% CI = 0.77 to 0.96, p=0.008), and private sectors workers (AOR = 0.84, 95% CI = 0.79 to 0.89, p<0.001) were less likely to have a good health condition.  Respondents who had received education up to elementary level (AOR =1.20, 95% CI = 1.08 to 1.33, p<0.001), primary level (AOR =1.39, 95% CI = 1.21 to 1.50, p<0.001), secondary level (AOR =1.58, 95% CI = 1.39 to 1.79, p<0.001), and bachelor’s degree level or higher (AOR =2.21, 95% CI = 1.89 to 2.58, p<0.001) were more likely to have a good health condition. Respondents who were categorized in the middle wealth index (AOR = 1.12, 95% CI = 1.05 to 1.20, p=0.001), high wealth index (AOR = 1.08, 95% CI = 1.02 to 1.15, p=0.014), those who had income adequacy (AOR = 1.94, 95% CI = 1.86 to 2.03, p<0.001), respondents with any savings (AOR = 1.16, 95% CI = 1.09 to 1.22, p<0.001), and those who had social security (AOR = 1.16, 95% CI = 1.04 to 1.29, p=0.010) were more likely to have a good health condition.

The government should consider socioeconomic factors, especially education, income, and financial support to reduce the cost of living. In addition, campaigns should be conducted to encourage saving behaviors and a sufficiency economy among members of the low-income population. Investment in public healthcare services and facilities for the elderly, such as public nursing homes and home healthcare services, are also recommended.