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 在高收入国家的记录不成比例。考虑到社会经济、文化和历史 由于这些国家与中低收入国家之间存在差异，研究结果可能存在偏差 或者甚至不适用于普遍的概括。因此，老龄化研究的社会经济特征和健康 必须在上下文中进行检查。在老年人中，这样的调查是罕见的，刚刚发表在最后一次。 二十年社会经济地位-健康关联的核心假设是消极的 社会经济特征和健康结果之间的关系，但在多大程度上， 在东南亚低收入国家的老年人中， 尤其是柬埔寨。考虑到各个国家的文化和历史差异可能会如何影响 社会经济特征的概念化和衡量，一个精确的检查的主题是 必需的.从生命历程的角度来看，有暴力和心理暴力史的老年人 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年的调查员，这项研究建议检查老年人的身心健康 居住在柬埔寨西北部的农村和低资源环境中， 一是严格的理论框架。AIMS：该项目旨在1）描述老年人的特征 在人口统计学特征、社会支持、社会经济特征、身体和 心理健康，2）检查社会经济特征与身体健康的关联， 探讨社会支持在老年人心理健康中的中介作用 和协会的福利支助。方法：本研究将使用220名老年人的最新老化数据， 生活在柬埔寨三个省农村地区的老年人。因变量包括 健康投诉和心理健康指数。自变量为家庭财富指数和a 潜变量来源于三个主观自我感知的经济环境。社会支持与 利用社会支持和社会网络量表和福利状况来实施福利支持 援助，分别。描述性分析将用于实现目标1。结构方程模型将 用于检查目标2和目标3。研究结果将减少社会老龄化研究中的差距 在中低收入国家，对制定针对老年人生活的方案和政策具有实际意义。 在农村和低资源环境中。这项调查将进一步加深我们对上下文的理解。 社会经济特征和社会支持，可能是可修改的影响健康的老年人， 低资源社区。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，以增加老龄化中代表性不足人口的参与 research. 1