Study on global AGEing and adult health (SAGE) | 1 |1 | Health of older Ghanaians: Health Risks and...
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Transcript of Study on global AGEing and adult health (SAGE) | 1 |1 | Health of older Ghanaians: Health Risks and...
Study on global AGEing and adult health (SAGE) |1 |
Health of older Ghanaians: Health Risks and Chronic Non-communicable
Diseases
Dr Alfred E Yawson
Study on global AGEing and adult health (SAGE) |2 |
Introduction
Globally, low fertility and mortality rates are contributing to rapid increase in older populations
Ghana is also experiencing progressive increases in the percentage of the older population
o The population of those aged 60 years and above in Ghana is projected to increase from 6.5% in 2010 to 11.9% in 2050
o In low and middle income countries there is a double burden of disease (high levels of both communicable and non-communicable diseases)
Study on global AGEing and adult health (SAGE) |3 |
IntroductionSocio-demographic characteristics of Ghana show
fertility rates and mortality rates to be falling gradually over the years : implication is the upward movement of the percentage of older population
There is a need for information to address policy
The goal of SAGE survey is generally to strengthen, gather, process and manage data on older persons and to respond to health needs
Study on global AGEing and adult health (SAGE) |4 |
Methodology The multi-country Study on global AGEing and adult health (SAGE)
Wave 1 (China, Ghana, India, Mexico, Russia, and South Africa)
Interviewed a nationally representative sample of adults aged 50 years and older, with a smaller comparison group of adults aged 18-49 years.
Health, disability, subjective well-being, quality of life, social cohesion, risk factors, performance tests, anthropometric measurements and biomarkers.
Data were collected in 2007-08.
Study on global AGEing and adult health (SAGE) |5 |
Assessment tools
Study on global AGEing and adult health (SAGE) |6 |
Enumeration Areas Visited
Study on global AGEing and adult health (SAGE) |7 |
Health Risks: older adults and health risk identify health risks
focus on interventions that improve health
through effective health promotion
in a supportive health and social policy environment
Study on global AGEing and adult health (SAGE) |8 |
Health Risks: five major risk factors Tobacco use,
alcohol consumption,
intake of fruit and vegetables,
physical activity levels and
environmental risk factors
Morbidity and Interventions
Study on global AGEing and adult health (SAGE) |9 |
Tobacco useThe prevalence
was higher among males,
those with no education,
the currently married
rural residents and the poorest income quintile group
Overall prevalence of current daily smokers among older adults in Ghana was 7.6%. Men were three times as likely as women to be current tobacco users
Study on global AGEing and adult health (SAGE) |10 |
Alcohol Use
Generally, alcohol use declined with increasing age
frequent heavy drinkers were highest among those who had completed Secondary and High school
Life time abstention from alcohol increased as income quintiles increased (Q1=48.2% and Q5=61.4%)
Proportion of older persons who reported heavy alcohol use was 3%
Study on global AGEing and adult health (SAGE) |11 |
Nutrition: intake of fruits and vegetables Over two-thirds of older adults (males and females)
had insufficient intake of fruits and vegetables in their diet
Insufficient dietary intake was worse for:
o Those 70 years or more . It worsened with increasing age!
o Rural residents
o Lowest income group . It worsened with decreasing income!
o Those with little or no education. Relatively better for those with higher educational levels.
Study on global AGEing and adult health (SAGE) |12 |
Levels of Physical ActivityHigh level of physical activity decreased with
increasing age, (70% in 50-59yrs vs. 46.5% in 80+ age group)
High level physical activities was more common amongst
o Males ; Rural residents and the currently married (compared to the widowed and divorced/separated )
o Lowest income quintiles (75%) than the higher income groups (Q5= 49%)
o and those with little or no education (level of physical activity decreased as educational level increased)
Study on global AGEing and adult health (SAGE) |13 |
Obesity and overweight The overall prevalence of obesity was 30%
More common among :
o Females (35% vs. 25% in males)
o separated/divorced or widowed
o Urban residents
o Older persons with higher education and
o Those in highest income group
Study on global AGEing and adult health (SAGE) |14 |
Access to improved water sources and sanitation
Urban household had improved sources of domestic water and sanitation, (95% and 19%) than Rural households (75% and 11%).
Highest income quintile households had the highest improved water and sanitation and easier access to drinking water
A fifth of all rural households spends more than 30 minutes to get to source of drinking water (10% for urban households)
Study on global AGEing and adult health (SAGE) |15 |
Indoor air pollution:cooking fuel used by Households(HH)Huge difference existed in type of cooking fuel by
urban and rural HH (17% of urban HH used clean fuel; <1% by rural HH)
Almost all the rural households (98.9%) used solid fuel.
Use of clean fuel increased with increasing income quintile.
Study on global AGEing and adult health (SAGE) |16 |
Health State: self-reported health Respondents were asked to rate their
“overall health today” and
level of difficulty with “household and work activities over the last 30 days”.
Rating of health states worsened with increasing age
Women always rated their health worse than men
Study on global AGEing and adult health (SAGE) |17 |
Health State: Mean health scoresMean health score generally showed higher values
for
males than females
urban residents than rural residents
In addition mean health score
decreased as age increased and
decreased as income levels decreased.
Study on global AGEing and adult health (SAGE) |18 |
Frailty by country-SAGE Wave 1
50 55 60 65 70 75 80 85 900
0.05
0.1
0.15
0.2
0.25
0.3
0.35
0.4
0.45
0.5
ChinaIndiaMexicoRussiaSouth AfriGhanaM
ean
frai
lty in
dex
Study on global AGEing and adult health (SAGE) |19 |
Frailty by sex in Ghana
50 55 60 65 70 75 80 85 900
0.05
0.1
0.15
0.2
0.25
0.3
0.35
0.4
0.45
MaleFemale
Frai
lty in
dex
Study on global AGEing and adult health (SAGE) |20 |
Morbidity and Intervention
In most countries, as in Ghana, the contribution from chronic conditions to overall burden of disease is increasing.
More older persons self-reported chronic non-communicable diseases compared to acute conditions, (21.8% vs. 11.6%).
Study on global AGEing and adult health (SAGE) |21 |
Chronic non-communicable diseases
Arthriti
sStr
oke
Angina
Diabetes
Chronic L
ung Dise
ase
Asthma
Depression
Hyperte
nsion
Cataracts
Endentulism
0
2
4
6
8
10
12
14
16
Prevalence (%) of Chronic conditions in the 50+ group
Study on global AGEing and adult health (SAGE) |22 |
Chronic non-communicable diseases: high prevalence groups
Prevalence of chronic diseases was higher among:
o Females
o urban residents
o separated/divorced and the widowed
o the highest income quintile.
Clear sex and rural-urban differences existed: Women (≥50 years) and Urban residents had higher self-reporting of the chronic diseases.
Study on global AGEing and adult health (SAGE) |23 |
Chronic diseases- Example sex, rural-urban difference
Chronic condition
Prevalence (%) P- value Female: Male ratio
Urban Rural
Hypertension 22.8 7.3 0.001 1.8
Diabetes 6.4 2.2 0.001 1.3
Stroke 4.0 1.7 0.004 1.2
Study on global AGEing and adult health (SAGE) |24 |
Health care responsiveness: Health Care Received in last 12 months
Overall 97% of older persons said they needed health care in last 12 months and only 71% actually received care
Quality of care: older persons rated responsiveness of inpatient care as 73% and out patient care as 63%
Study on global AGEing and adult health (SAGE) |25 |
Health care responsiveness: health services coverage
Inpatient care was lowest among:
o females
o > 60 years (Retired)
o lowest income quintile
o rural residents
o the widowed
These are vulnerable groups among the older population
Study on global AGEing and adult health (SAGE) |26 |
Health care responsiveness: preventive health care
Two indicators were used : Breast cancer screening and Cervical cancer screening
only 3% of women > 50 yrs had access to breast cancer screening through mammography
only 3% of women > 50 yrs had access to cervical cancer screening through Pap smear
Study on global AGEing and adult health (SAGE) |27 |
Policy implicationHealth risks and chronic non-communicable
diseases are prevalent among older persons in Ghana
Health services do not seem responsive to the health care needs of vulnerable groups among the older adult population
These issues clearly deserve special attention as Ghana implements the 2010 National ageing Policy
Study on global AGEing and adult health (SAGE) |28 |
Take Home Message: As we grow old
We slow down – become obese, less mobileWe lose income – less able to afford We lose our partners – issues with widows We become frail- unable to support our selvesWe lose some functions_ sight, teeth, hearingUnable to access healthUnable to fight infections,Susceptible to all kinds of afflictions
Study on global AGEing and adult health (SAGE) |29 |
For more information
http://apps.who.int/healthinfo/systems/surveydata/index.php/catalog/6/study-description
www.who.int/healthinfo/sage
Thank you very much