Socioeconomic Determinants of Health and Well-Being in a Low Resource Setting: A Case of Older Adults Living in a Rural Setting in the Northwestern Cambodia

资源匮乏环境下健康和福祉的社会经济决定因素：以柬埔寨西北部农村地区老年人为例

• 批准号: 10573527
• 负责人: Kakada Kuy
• 金额: $ 4.49万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-22 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10573527
• 关键词: Address; Age; Aging; Asian; Cambodia; Cambodian; Characteristics; Child; Communities; Conflict (Psychology); Country; Data; Dependence; Development; Disparity; Economics; Educational Status; Elderly; Emotional; Equation; Family; Friends; Gender; General Population; Goals; Government; Health; Health Status; Household; Income; Individual; Infrastructure; International; Intervention; Investigation; Knowledge; Life Cycle Stages; Literature; Marital Status; Measurement; Measures; Mediating; Mediation; Mental Health; Mission; Modeling; Older Population; Outcome; Personal Satisfaction; Policies; Policy Developments; Population; Positioning Attribute; Program Development; Province; Public Health; Publications; Publishing; Recording of previous events; Research; Research Personnel; Resource-limited setting; Resources; Role; Rural; Self Perception; Social Network; Social Welfare; Social support; Socioeconomic Factors; Socioeconomic Status; Southeastern Asia; Support System; Surveys; Underrepresented Populations; United Nations; Violence; Well in self; Work; aged; aging population; community intervention; comparison intervention; disparity reduction; economic indicator; health determinants; improved; indexing; low and middle-income countries; physical conditioning; psychological distress; public health intervention; response; rural area; rural dwellers; rural residence; rural setting; social; socioeconomics; welfare assistance

PROJECT SUMMARY / ABSTRACT BACKGROUND: Socioeconomic differentials and their influence on health of older adults is disproportionately documented in high-income countries. Given socioeconomic, cultural and historical differences between these countries and low- and middle-income countries (LMICs), findings could be biased or even invalid for a universal generalization. Thus, aging studies on socioeconomic characteristics and health must be examined contextually. Among older adults, such investigations are rare and just published in the last twenty years. The hypothesis central to the socioeconomic status-health association is the negative relationship between socioeconomic characteristics and health outcomes, but the extent to which this association exists within a low-resource setting is not known among older adults of LMICs in Southeast Asia, particularly Cambodia. Considering individual nations' cultural and historical differences may impact how socioeconomic characteristics are conceptualized and measured, a precise examination of the topic is required. From the life course perspective, the older population with histories of violence and psychological distress must be studied within their cultural and historical context. Using survey data collected by this investigator in 2019, this study proposes to examine physical and psychological health of older Cambodians residing in a rural and low-resource setting in the northwestern Cambodia, using contextually sensitive measures and a rigorous theoretical framework. AIMS: This project aims 1) to characterize older Cambodians in terms of demographic characteristics, social support, socioeconomic characteristics, and physical and psychological health, 2) to examine associations of socioeconomic characteristics with physical health and psychological health among older Cambodians, and 3) to investigate potential mediating roles of social support and welfare support in the associations. METHODS: This study will use the most recent aging data of 220 older adults living in a rural setting of three Cambodian provinces. Dependent variables include the number of health complaints and psychological well-being index. Independent variables are household wealth index and a latent variable derived from three subjective self-perceived economic circumstances. Social support and welfare support are operationalized using Social Support and Social Network scale and status of welfare assistance, respectively. Descriptive analysis will be used to achieve Aim 1. Structural equation modeling will be used to examined Aim 2 and Aim 3. IMPLICATION: Findings will reduce disparity in social aging research in LMICs and have practical significance for development of programs and policies targeting older adults living in rural and low-resource settings. This investigation will further our understanding of the contextual socioeconomic characteristics and social support that may be modifiable to influence health for older adults in low-resource communities. This project is in direct response to Objective F-3 of the NIA 2020-2025 Strategic Direction to develop and implement strategies to increase inclusion of underrepresented populations in aging research. 1

项目摘要 /摘要 背景：社会经济差异及其对老年人健康的影响是 在高收入国家中记录了不成比例的。鉴于社会经济，文化和历史 这些国家与低收入和中等收入国家（LMIC）之间的差异，发现可能会有偏见 甚至是无效的普遍概括。因此，关于社会经济特征和健康的老化研究 必须在上下文上进行检查。在老年人中，这种调查很少 二十年。社会经济地位健康协会的假设是负面的 社会经济特征与健康成果之间的关系，但是这在多大程度上 在低资源环境中存在协会，在东南亚的LMIC老年人中不知道 特别是柬埔寨。考虑到各个国家的文化和历史差异可能会影响 社会经济特征是概念性和衡量的，对该主题的精确检查是 必需的。从生活课程的角度来看，老年人口具有暴力和心理的历史 必须在其文化和历史背景下研究困扰。使用此收集的调查数据 研究人员在2019年，这项研究提议检查柬埔寨老年人的身体和心理健康 使用上下文敏感的西北柬埔寨的农村和低资源环境 措施和严格的理论框架。目的：该项目的目的1）表征较老的柬埔寨人 就人口特征，社会支持，社会经济特征以及身体和 心理健康，2）研究社会经济特征与身体健康和 老年柬埔寨人的心理健康和3）调查潜在的社会支持角色 和协会中的福利支持。方法：本研究将使用220的最新衰老数据 居住在三个柬埔寨省的农村环境中的老年人。因变量包括 健康投诉和心理健康指数。自变量是家庭财富指数和一个 潜在变量来自三种主观的自我感知的经济环境。社会支持和 福利支持使用社会支持和社交网络规模和福利地位进行运营 分别协助。描述性分析将用于实现目标1。结构方程建模将 被用来检查目标2和目标3。含义：发现将减少社会老龄化研究的差异 在LMIC中，对于针对老年人生活的计划和政策的制定具有实际意义 在农村和低资源环境中。这项调查将进一步我们对背景的理解 社会经济特征和社会支持可能会改变，以影响老年人的健康 低资源社区。该项目直接响应NIA 2020-2025战略的目标F-3 制定和实施策略以增加衰老中代表性不足的人群的指示 研究。 1