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

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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