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

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 在高收入国家有不成比例的记录。考虑到社会经济、文化和历史 这些国家与中低收入国家(LMIC)之间的差异，结果可能是有偏见的 或者甚至对于普遍的概括是无效的。因此，老龄化研究的社会经济特征与健康 必须根据背景进行检查。在老年人中，这样的调查很少见，而且只在最近一年发表 二十年了。社会经济地位-健康关联的核心假设是否定的 社会经济特征和健康结果之间的关系，但这种关系的程度 协会存在于低资源环境中，在东南亚LMIC的老年人中未知， 尤其是柬埔寨。考虑到各个国家的文化和历史差异可能会对 社会经济特征是概念化的和衡量的，对这个主题的准确检查是 必填项。从生命历程的角度来看，有暴力和心理病史的老年人口 必须在它们的文化和历史背景下研究苦难。使用由该机构收集的调查数据 2019年，这项研究建议检查柬埔寨老年人的身心健康 居住在柬埔寨西北部的农村和低资源环境中，使用上下文敏感的 措施和严谨的理论框架。目标：本项目旨在1)描述柬埔寨老年人的特征 在人口特征、社会支持、社会经济特征以及身体和健康方面 心理健康，2)检查社会经济特征与身体健康和 柬埔寨老年人的心理健康，以及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人的最新老龄化数据 老年人生活在柬埔寨三省的农村环境中。因变量包括 健康投诉和心理幸福感指数。自变量是家庭财富指数和a 潜在变量来源于三种主观的自我感知的经济环境。社会支持和 福利支持是通过社会支持和社会网络的规模和福利状况来运作的 分别提供协助。将使用描述性分析来实现目标1。结构方程建模将 被用来检验目标2和目标3。含义：研究结果将减少社会老龄化研究中的差距 并对制定针对老年人生活的方案和政策具有现实意义 在农村和资源匮乏的环境中。这项调查将进一步加深我们对语境的理解 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 资源匮乏的社区。该项目是对美国国家航空航天局2020-2025战略目标F-3的直接响应 指导制定和执行战略，以增加老龄人口中任职人数不足的人口 研究。 1

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