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

项目概要/摘要 背景：社会经济差异及其对老年人健康的影响 高收入国家的记录不成比例。鉴于社会经济、文化和历史 由于这些国家与低收入和中等收入国家 (LMIC) 之间存在差异，研究结果可能存在偏差 甚至对于普遍概括来说是无效的。因此，关于社会经济特征和健康的老龄化研究 必须结合上下文进行审查。在老年人中，此类调查很少见，并且刚刚发表在去年 二十年。社会经济地位与健康关联的核心假设是负面的 社会经济特征与健康结果之间的关系，但这种关系的程度 在东南亚中低收入国家的老年人中，尚不清楚资源匮乏环境中是否存在这种关联， 特别是柬埔寨。考虑各个国家的文化和历史差异可能会影响如何 社会经济特征被概念化和测量，对该主题的精确检查是 必需的。从生命历程的角度来看，有暴力史和心理问题的老年人口 必须在其文化和历史背景下研究苦难。使用本网站收集的调查数据 2019年，这项研究旨在检查柬埔寨老年人的身心健康状况 居住在柬埔寨西北部的农村和资源匮乏的环境中，使用上下文敏感的 措施和严格的理论框架。目标：该项目的目标是 1) 描绘柬埔寨老年人的特征 人口特征、社会支持、社会经济特征以及身体和 心理健康，2）检查社会经济特征与身体健康的关联 柬埔寨老年人的心理健康，3) 调查社会支持的潜在中介作用 以及协会的福利支持。方法：本研究将使用 220 名患者的最新老龄化数据。 生活在柬埔寨三个省份农村地区的老年人。因变量包括数量 健康投诉和心理健康指数。自变量是家庭财富指数和 潜在变量源自三种主观自我感知的经济环境。社会支持和 福利支持通过社会支持和社交网络规模以及福利状况来实施 分别提供帮助。将使用描述性分析来实现目标 1。结构方程建模将 用于检验目标 2 和目标 3。意义：研究结果将减少社会老龄化研究中的差异 中低收入国家，对于制定针对老年人生活的计划和政策具有实际意义 在农村和资源匮乏的地区。这项调查将进一步加深我们对背景的了解 可以改变以影响老年人健康的社会经济特征和社会支持 资源匮乏的社区。该项目直接响应 NIA 2020-2025 战略目标 F-3 指导制定和实施战略，以增加代表性不足的人口参与老龄化的程度 研究。 1