Rural aging in Thailand: determinants and challenges of elderly health status in Phayao Province 10.55131/jphd/2025/230213
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Abstract
Thailand is experiencing rapid population aging, with elderly citizens representing 20.36% of the total population. Phayao Province has an especially high proportion of elderly residents (26.54%), particularly in rural areas where healthcare access and support may be limited. This cross-sectional study aimed to assess health status and identify its determinants among rural elderly in Phayao Province. Using multi-stage cluster sampling, 453 participants aged ≥60 years were selected from three districts. Data were collected from May to July 2024 using validated questionnaires (Cronbach's alpha 0.701-0.974) covering health status, quality of life, mental health, family relationships, and activities of daily living (ADL). Results showed that 42.6% of participants had moderate health status, while 39.3% had poor health status. The majority were female (58.9%), with a mean age of 69.06 years. Bivariate analysis identified significant factors (p<0.05) including employment status, income, income sufficiency, living arrangements, exercise, health information, mental health, quality of life, family relationships, and ADL. Stepwise Multiple Linear Regression revealed five significant predictors: family relationships (β=0.355, p<0.001), income sufficiency (β=-3.328, p<0.001), exercise (β=5.640, p<0.001), ADL (β=0.511, p<0.001), and quality of life (β=0.120, p=0.001), explaining 30.9% of health status variance. These findings suggest the need for integrated interventions addressing both social and health dimensions. Recommendations include developing elderly employment programs, strengthening family support systems, promoting exercise programs, and enhancing community mental health services. Policy makers and healthcare providers should consider these factors when designing targeted interventions for rural elderly populations.
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References
Department of Older Persons. Situation of the thai older persons 2022 [Internet]. [Cited 2024 Sep 23]. Available from: https://www.dop. go.th/download/statistics/th1696238995-2521_0.pdf.
Department of Older Persons. Statistics of the Elderly, June 2024 [Internet]. [Cited 2024 Sep 23]. Available from: https://www.dop.go.th/th/know/side/1/1/2449.
Nanthamongkolchai S. Family and long-term elderly care [Internet]. [Cited 2024 Mar 20]. Available from: https://phfh.ph.mahidol.ac.th/article/5.pdf.
Gadudom P, Apinyalungkon K, Janjaroen K, Wae N. Family roles to increase quality of life of older persons in a changing situation. SCNJ. 2018;5(3):300-10.
Kulprateepunya K, Atsawametakul W, ThasanoaElter P, Saelue J, Pisaipan P, Namwong A. Health statusof elderly in Thai society. UMT Poly J. 2020; 17(2):581-95.
Panyathorn K. Healthcare behaviors of the elderly living alone in Ban Tad, Muang, Udon Thani. NHEJ. 2018; 1(2):33-8.
Khakhuen S, Kongmaha H, Thasanoh P, Phantong W. Activities of Daily Living and Quality of Life among older adults in Nakhon Ratchasima province. NJPH. 2020;30(1):104-20.
Yanarueng S, Laohasiriwong WL, Phimha S, Yotha N, Phanyotha S, Pinsuwan C, et al. Health determinant factors associated with smoking behaviour of older adults in Thailand. J Public Hlth Dev. 2022;21(1):32-44. doi: 10.55131/jphd/2023/210103.
Thammawongsa P, Laohasiriwong W, Yotha N, Nonthamat A, Prasit N. Influence of socioeconomics and social marketing on smoking in Thailand: A National Survey in 2017. Tob Prev Cessation. 2023;9(September):28. doi: 10.18332/tpc/169501.
Prasit N, Laohasiriwong W, Phimha S, Bouphan P, Senahad N, Yotha N, et al. Evaluation of binge drinking behavior among working-age populations in Thailand using GIS: A national survey in 2017. J Public Hlth Dev. 2023; 21(2):140-51. doi: 10.55131/jphd/ 2023/210212
Prasit N, Laohasiriwong W, Nonthamat A, Sresutham P, Nidthumsakul N, Nilnate N, et al. Investigating the challenges in alcoholic beverage control and law enforcement: Analyzing binge drinking prevalence among the working-age population in Thailand based on 2017 national survey. JPSS. 2024;32:481-93. doi: 10.25133/JPSSv322024.029
Rattanahon P, Laohasiriwong W, Nilnate N, Yotha N, Phanyotha S, Thammasarn K, et al. The influence of the density of Buddhist temples on the spatial distribution of happiness of the elderly in Thailand. IJG. 2022; 18(3):123-30. doi: 10.52939/ijg.v18i3. 2213
Ohta R, Sano C. Integrating clinical and socio-environmental approaches in managing rheumatoid arthritis with social determinants of health: A case study of an elderly patient in rural Japan. Cureus. 2023;15(12):e50915. doi:10.7759/cureus.50915.
Han Y, Xing F, Huang J, Wang M. Associated factors of health-promoting lifestyle of the elderly based on the theory of social ecosystem. Aten Primaria. 2023;55(9):102679. doi: 10.1016/j.aprim.2023.102679
Wang X, Wu Y, Miao J, Pu K, Ming WK, Zang S. Factors associated with eating behaviors in older adults from a socioecological model perspective. BMC Public Health. 2023;23:1726. doi: 10.1186/s12889-023-16651-2
Meghani NAA, Hudson J, Stratton G, Mullins J. Older adults' perspectives on physical activity and sedentary behaviour within their home using socio-ecological model. PLoS One. 2023;18(11):e0294715. doi: 10.1371/ journal.pone.0294715
Jiang F, Liu H. Community home elderly care services, multidimensional health and social participation of chronically ill elderly—Empirical analysis based on propensity score matching and multiple mediation analysis. Front Public Health. 2023; 11:1121909. doi: 10.3389/fpubh.2023. 1121909.
Daniel WW, Cross CL. Biostatistics: A foundation for analysis in the health sciences. 10th Edition, John Wiley & Sons, Hoboken; 2013.
Department of Mental Health, Ministry of Public Health. The World Health Organization's Quality of Life measurement tool, the abbreviated Thai version (WHOQOL–BREF-THAI) [Internet]. [Cited 2024 Mar 20]. Available from: https://dmh.go.th/ test/download/files/whoqol.pdf
Department of Mental Health, Ministry of Public Health. Thai Mental Health Indicator (TMHI-15) [Internet]. [Cited 2024 Mar 20]. Available from: https://dmh.go.th/test/download/files/TMHI15_thai.pdf
Suthisukon K, Chompikul J, Thamma-Aphiphol K. Factors affecting relationships in Thai families. Local Administration J. 2017;10(2):151-68.
Jitapunkul S, Suriyawongpaisal P, Kunanuson C, Pooncharoen W. Thai elderly health problems. Bangkok: Holistic-Publishing. 1999.
Lima-Costa MF, Cesar CC, Chor D, Proietti FA. Self-rated Health Compared With Objectively Measured Health Status as a Tool for Mortality Risk Screening in Older Adults: 10-Year Follow-up of the Bambuí Cohort Study of Aging. AJE. 2011;175(3):228-35. doi: https://doi.org/10.1093/ aje/kwr290
O’brien RM. A caution regarding rules of thumb for variance inflation factors. Quality & Quantity. 2007;41:673-90. doi: 10.1007/s11135-006-9018-6
Parkpoom P, Laohasiriwong W, Mahato RK. Factors affecting the desire to work among elderly people in Thailand: 10.55131/jphd/2024/220316. J Public Hlth Dev. 2024;22(3):187-201. doi: https://doi.org/10.55131/jphd/ 2024/220316
Park J-H, Prochnow T, Amo C, Curran L, Smith ML. Differences in physical activity, sedentary behavior, and Mental Health of the older Population in South Korea based on marital status and gender. Int J Environ Res Public Health. 2023;20(3):1726. doi: 10.3390/ ijerph20031726
Smith L, Shin JI, Jacob L, López Sánchez GF, Schuch F, Tully MA, et al. Food insecurity and physical multimorbidity among adults aged≥ 50 years from six low-and middle-income countries. Eur J Nutr. 2023;62(1):489-97. doi: 10.1007/s00394-022-02999-5
Muhammad T, Maurya P. Gender differences in the association between perceived income sufficiency and self-rated health among older adults: A population-based study in India. J Women Aging. 2023;35(2):168-82. doi: 10.1080/08952841.2021.2002663
Domínguez-Martínez T, Sheinbaum T, Fresán A, Nieto L, López SR, Robles R, et al. Psychosocial factors associated with the risk of developing psychosis in a Mexican general population sample. Front Psychiatry. 2023;14:1095222. doi: 10.3389/fpsyt.2023.1095222
Zheng R, Yu M, Huang L, Wang F, Gao B, Fu D, et al. Effect of intergenerational exchange patterns and intergenerational relationship quality on depressive symptoms in the elderly: An empirical study on CHARLS data. Front Public Health. 2022;10:1009781. doi: 10.3389/fpubh.2022.1009781
Sundaracaro P, Matham S. A model of monks’ health care driving according in situation covid-19 in Nakhon Ratchasima province. JMCR. 2024; 7(3):342-357.
Suwanakitch P, Suankul P, Ketklornklao S, Ngoksin A, Wongsena W. Association between Metabolic Syndrome and Arterial Stiffness in Aging People, Tha Pho Subdistrict, Muang District, Phitsanulok Province. JHS. 2023;32(S2):S251-60.
Cohen SA, Greaney ML. Aging in Rural Communities. Curr Epidemiol Rep. 2023;10(1):1-16. doi: 10.1007/ s40471-022-00313-9
Photjaroen T, Tanaree W. Health behaviors management that affect the quality of Life of the elderly in Maepum sub-district, Muang district, Phayao province. STC. 2023;1(3):12-24. doi: https://doi.org/10.57260/stc.2023.533
Kayom W, Ratpongporn T, Roopsing T, Shoosanuk A. Factors influencing the quality of life and revisit intention of the elderly using the elderly care services in Thailand. ISSC. 2023;6(2):81-91.doi: https://doi.org/ 10.14456/issc.2023.27
Wang L-Y, Feng M, Hu X-Y, Tang M-L. Association of daily health behavior and activity of daily living in older adults in China. Sci Rep. 2023; 13(1):19484. doi: 10.1038/s41598-023-44898-7
Anwar A, Yadav UN, Huda MN, Rifat M, Ali AM, Mondal PK, et al. Prevalence and determinants of self-reported functional status among older adults residing in the largest refugee camp of the world. BMC Geriatr. 2023;23(1):345. doi: 10.1186/s12877-023-04067-x.
