A study on health consciousness among the elderly in a rural population of Katihar, Bihar

INTRODUCTION

Population ageing is gaining momentum in developing countries, as demographic transformation has profound consequences for all individuals, families, communities and nations.¹ Globally about 11% of population is above 60 years of age with 8% of this population residing in South East Asian countries including India.² Elderly population in India has increased to 8.3 per cent till 2013.³ Elderly are vulnerable to chronic illnesses with insidious onset such as cardiovascular diseases, carcinomas, diabetes, musculoskeletal and mental disorders. From the morbidity point of view, at least 50% of the elderly in India have chronic diseases.⁴ They use to suffer from multiple symptoms at a time due to debility of various body functions including immunity.⁵ The possible relationship between these diseases and intervening variables such as gender, race and addiction habit is already well established.

Apart from that, it can be beneficial to identify the determinants of health consciousness among the elderly. The findings could help policy makers in developing more effective and comprehensive strategies for improvement in public health in terms to elderly population. Therefore present cross-sectional study was undertaken to study health consciousness among the elderly in a rural population of Katihar, Bihar.

METHODS

The present community- based cross- sectional study was conducted in rural field practice area of Katihar medical college. The subjects in the age group of 60 years and above and residing in this area were included in the study during the period of one year, from Jan 2013 to Dec 2013. A total of 450 elderly persons were enrolled using multistage sampling and were interviewed regarding their health consciousness using pre-designed, pre-tested and semi-structured questionnaire after obtaining verbal consent from each individual. Descriptive statistics such as frequencies and percentages were used to describe the data regarding respondent demographic profile and Chi-square test was used for the two tested variables.

Health consciousness

Health consciousness was taken as an overall perception about their health and disease status. It also includes health seeking behaviour. Conscious people were those who were inclined towards seeking medical help at the outset of a medical problem and concerned about their health and hygiene. People who were conscious but not willing to go a health set up rather than taking medical aid from quacks or doing self-remedy at home were kept into category of conscious but reluctant and third group

RESULTS

Majority (51.7%) of the subjects were males 51.7% with sex ratio of 931 females per thousand males. About half (54.6%) of the people were in age group 60-74 years. Almost 70.0% of elderly were illiterate with comparatively higher proportion among females (89.0%). None of the female had any formal education. Most of the males were married (83.7%) while the percentage of widow and separated was quite high amongst females (58.9%). Majority of the elderly belonged to joint family (95.0%) with average family size of 12. Only 5% of the elderly population lived in a nuclear family. The percentage of financially independent people was only 32.8% and the remaining was either fully or partially dependent on others. Dependence on others was more in case of females (86.2%) and only 13.8% were financially independent. Majority of the elderly were in middle and lower middle social status (38.6% and 34.6% respectively) with a very small fraction in upper class (0.8%). A total of 56.4% elderly stayed at home unemployed while remaining 43.4% were involved in some kind of occupation, of which 48.1% were males and 38.6% were females. Majority (69.7%) of the elderly were conscious about health, followed by reluctant group (16.6%), while 13.5% were not conscious about their health. Various factors like gender (p=0.00), marital status (p=0.02), social category (p=0.00), educational status (p=0.00), occupation (p=0.00) and financial dependency (p=0.04) were found to be associated with health consciousness among elderly.

Almost two-third (67.2%) of non-conscious subjects was male while 63.1% of the health conscious subjects were females. About 14.2% of married elderly and 12.8% of those who were divorced or separated were not conscious about their health. Majority (78.7%) of the non-conscious elderly belonged to backward castes. The highest proportion of non-conscious was illiterate (70.5%). However no significant association was found between socioeconomic status and health consciousness. Majority of those who were unemployed viz. mot engaged in any type of occupation (62.3%) were least conscious about their health.

DISCUSSION

Elderly people are the most vulnerable group of population. Sub optimal health consciousness is believed to be one of the major factors affecting utilisation of health services by people and determining their health seeking behaviour. Therefore the present study was conducted to study health consciousness among elderly in a rural population of Katihar, Bihar. In the present study awareness and concern about their own health was assessed and it was found that 69.7% of the people had broad awareness about seeking early medical help. A total of 16.6% people were seen conscious but reluctant about taking initiative to seek medical help. About 13.5% of the people didn’t show any consciousness. The health consciousness revealed in present study is comparatively much higher as reported in earlier studies.^6,7 However the results are much lower in comparison to finding reported by Kumar et al.⁸ in Varanasi who reported that 74% of elderly sought treatment for their illness. However similar to the findings of the present study Narapureddy et al. reported about 64.6% of elderly sought proper treatment and have health conscious about their health.⁹ This variation in the studies might be due to difference in knowledge, educational status and income of the study population which are found to be significant factors associated with health consciousness. Similar to present study Patle et al. also reported educational status and poverty status to be important factors determining health seeking behaviour.¹⁰ In the present study financial dependency of elderly on other was found to be significantly associated with health consciousness. The elderly who were more relied on other are less health conscious as compared to others. However since the study was conducted in rural field practice area, therefore results might not be generalizable.

*Udai Pareekh Socioeconomic scale

CONCLUSION

People of the village, elderly and their family members need to be explained through IEC (Information, education and communication) about various health problems with emphasis on importance of preventive steps and early recognition of any problems, importance of timely treatment and steps that can be taken to prevent the spread and recurrence of health problems. Role of motivation through prominent people of society and Sarpanchas should be recognised and brought in practice. These two community based intervention might increase the overall health consciousness among elderly.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: The study was approved by the institutional ethics committee

REFERENCES

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