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Peprah P, Oduro MS, Okwei R, Adu C, Asiamah-Asare BY, Agyemang-Duah W. Cyberbullying victimization and suicidal ideation among in-school adolescents in three countries: implications for prevention and intervention. BMC Psychiatry 2023; 23:944. [PMID: 38098109 PMCID: PMC10720188 DOI: 10.1186/s12888-023-05268-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 10/09/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Countries in South and Central America and the Caribbean are among the countries with the highest adolescent cyberbullying crimes. However, empirical evidence about the effect of cyberbullying victimization on suicidal ideation among in-school adolescents in these countries remains limited. The present study examined the association between cyberbullying victimization and suicidal ideation among in-school adolescents in Argentina, Panama, St Vincent, and the Grenadines. METHODS A representative cross-sectional data from 51,405 in-school adolescents was used. Hierarchical logistic regression analysis was used to estimate the association between cyberbulling victimization and suicidal ideation. RESULTS Overall, 20% and 21.1% of the adolescents reported cyberbullying victimization and suicidal ideation, respectively in the past year before the survey. Suicidal ideation was higher among adolescents who experienced cyberbullying victimization (38.4%) than those who did not experience cyberbullying victimization (16.6%). Significantly higher odds of suicidal ideation were found among adolescents who had experienced cyberbullying victimization than those who had not experienced cyberbullying victimization [aOR = 1.88, 95% CI: 1.77-1.98]. CONCLUSION This finding calls for developing and implementing evidence-based programs and practices by school authorities and other relevant stakeholders to reduce cyberbullying victimization among adolescents in this digital age. Protective factors such as parental support and peer support should be encouraged.
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Affiliation(s)
- Prince Peprah
- Social Policy Research Centre, University of New South Wales, Sydney, Australia
- Centre for Primary Health Care and Equity, University New South Wales, Sydney, Australia
| | - Michael Safo Oduro
- Department of Applied Statistics and Research Methods, University of Northern Colorado, Greeley, CO, USA
- Pfizer Worldwide Research and Development, Pharm Sci and PGS Statistics, Groton, CT, USA
| | - Reforce Okwei
- Department of Geography and Environment, Western University, 1151 Richmond Street, N6A 3K7, London, Ontario, Canada
| | - Collins Adu
- Department of Health Promotion, Education and Disability Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
- Centre for Social Research in Health, University of New South Wales, Sydney, NSW, Australia.
| | - Bernard Yeboah Asiamah-Asare
- Curtin School of Population Health, Curtin University, Kent Street, Bentley, WA, Australia
- Health Psychology, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
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Braimah JA, Agyemang-Duah W, Amoak D, Sano Y, Antabe R, Dassah E. Healthcare seeking behaviour during illness among older adults in Ghana: does food security status matter? BMC Geriatr 2023; 23:327. [PMID: 37231374 DOI: 10.1186/s12877-023-04023-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 05/06/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Ghana's growing older adult population raises critical questions regarding healthcare for these older adults. At the same time, food insecurity is high among older adults in Ghana. This underscores the need to investigate the issues of food security and healthcare seeking behaviour among older adults. However, research on the association between food security status and healthcare seeking behaviour among older adults is scant in the Ghanaian context. In this study, we advance the social gerontology literature by examining the association between food security status and healthcare seeking behaviors among older adults. METHODS Using a multi-stage sampling framework, we collected data from a representative sample of older adults across three regions in Ghana. Data were analyzed using logistic regression technique. We determined the significance of the test at a probability value of 0.05 or less. RESULTS Over two-thirds (69%) of respondents did not seek care during their last illness. Additionally, 36% of respondents were severely food insecure, 21% were moderately food insecure, 7% were mildly food insecure, and 36% were food secure. After controlling for theoretically relevant variables, our multivariable analysis revealed a statistically significant association between food security status and healthcare seeking behaviors with older people who are food secure (OR = 1.80, p < 0.01) and mildly food insecure (OR = 1.89, p < 0.05) being more likely to seek healthcare compared with their counterparts who are food insecure. CONCLUSION Our findings highlight the need for sustainable intervention programs to improve food access and health service use among older adults in Ghana and similar contexts.
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Affiliation(s)
- Joseph Asumah Braimah
- Department of Health and Society, University of Toronto Scarborough, Toronto, Canada
| | | | - Daniel Amoak
- Department of Geography and Environment, Western University, London, Canada
| | - Yujiro Sano
- Department of Sociology, Nipissing University, North Bay, Canada
| | - Roger Antabe
- Department of Health and Society, University of Toronto Scarborough, Toronto, Canada
| | - Ebenezer Dassah
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
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Zahirian Moghadam T, Zandian H, Shirin Bonyad H. Utilization of elderly health promotion services during COVID 19 in Iran: A cross-sectional study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:297. [PMID: 36439010 PMCID: PMC9683442 DOI: 10.4103/jehp.jehp_1315_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 12/09/2021] [Indexed: 06/16/2023]
Abstract
BACKGROUND The outbreak of COVID-19 pandemic has made it difficult for older adults to utilize ordinary elder services. This cross-sectional study investigated the status of feeling the need, seek, and utilization of health promotion services among older adults in Ardabil, Iran, covered by the country's comprehensive health system during the pandemic. MATERIALS AND METHODS This descriptive-analytical and cross-sectional study was conducted on 739 elderly people in Ardabil province. Cluster random sampling method was used for sampling. Data were gathered by referring trained individuals to the place of residence of the selected older adults Questionnaires were consisted of three parts: demographic information, household's economic status, and feeling the need, seek, and utilization from health promotion services. Multivariate logistic regression was used to separately model the need, seeking for, and utilization of health promotion services in STATA ver. 14. RESULTS The mean age of the older adults in this study was 68.88 ± 4.72 years. The results indicate that men showed significantly greater need, seek for, and utilization of health promotion services during COVID- 19 than women. According to the results, people over the age of 80 had 4.08 times (95% confidence interval [CI]: 1.99-12.60) more need and utilization of health services than the older adults under 65 years. The results also indicate that use of health promotion services was significantly associated with being married (3.74, 95% CI: 1.22-2.62), having primary insurance and supplementary insurance (1.92, 95% CI: 1.21-3.12), and obesity (2.05, 95% CI: 1.13-3.76) in P < 0.05 level. Based on the results, people with chronic disease and obesity were more likely to utilize health promotion services. CONCLUSION Findings suggest that the access and utilization of inpatient and outpatient health services by the elderly in the COVID-19 pandemic has somewhat decreased, which could be due to the fear of the disease being referred to health centers by the elderly. Hence, enabling conditions such as parental health care were major factors affecting health-seeking habits among the Iranian elder population.
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Affiliation(s)
- Telma Zahirian Moghadam
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Hamed Zandian
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
- Department of Community Medicine, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Hadi Shirin Bonyad
- Department of Community Medicine, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
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Physical activity and gender buffer the association of retirement with functional impairment in Ghana. Sci Rep 2022; 12:12832. [PMID: 35896681 PMCID: PMC9329384 DOI: 10.1038/s41598-022-17178-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 07/21/2022] [Indexed: 11/30/2022] Open
Abstract
Females on average live longer but with higher rates of functional impairment and lower physical and economic activities than men. However, research linking retirement to functional impairment and the modifying role of gender and physical activity (PA) is limited especially in low- and middle-income countries. This paper examines the association between retirement and functional impairment in Ghana and evaluates the effect modification of the association by gender and PA. The sample included 1201 adults aged ≥ 50 years from a population-based study. Functional impairment was assessed with the activities of daily living scale. Ordinary least squares regression models adjusted for confounding variables and estimated gender-wise and PA heterogeneity effect of retirement on functional impairment. Regressions showed that retirement predicted an increase in functional impairment score in the full sample (β = .76, p < .001) and in men (β = 1.96, p < .001), but not in women. Interestingly, retirement significantly increased functional impairment in ≥ 65 age cohort (full sample: β = .71, p < .005; men: β = 1.86, p < .001) although not in women. However, the effect was significantly moderated by PA such that retirement × PA predicted a decrease in functional impairment in the full sample (β = −.81, p < .005) and the ≥ 65 age group (β = −.43, p < .005). Functional impairment risk of retirement is gender-specific, but PA buffers the relationship. Retirement is generally commonplace, but these findings imply that promoting PA may hold promise for addressing functional impairment in old age. Attending to the physical health needs of men during retirement should be a social policy priority.
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Gyasi RM, Aboderin I, Asiki G. Prevalence and Social Risk Factors of Functional Limitations Among Slum-Dwelling Older Adults: Findings From the Nairobi Urban Health and Demographic Surveillance System. Gerontol Geriatr Med 2022; 8:23337214221088700. [PMID: 35573080 PMCID: PMC9102122 DOI: 10.1177/23337214221088700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 03/01/2022] [Accepted: 03/03/2022] [Indexed: 11/15/2022] Open
Abstract
Objective: In this study, we investigate the patterns and the risk factors of functional limitations in a sample of 1323 slum-dwelling older adults in Kenya who participated in the Nairobi Urban Health and Demographic Surveillance Systems. Methods: We conducted crude and adjusted logistic regression analyses to evaluate the associations. Results: The prevalence of activities of daily living (ADL) and instrumental ADL (IADL) limitations were approximately 5% and 8%, respectively; some 4.5% reported both limitations. Estimates varied significantly between sexes and age (p < .001). After adjustments, age, female, and Garre ethnic group were associated with ADL and IADL limitations. ADL decline was determined by co-residence (aOR = 0.93, 95% CI = 0.34–0.95), household size (aOR = 1.19, 95% CI = 1.04–1.37) and educational level (aOR = 0.45, 95% CI = 0.05–0.72). Conclusions: Older slum-dwellers in Nairobi experience functional impairments with marked age and sex differences. These findings may encourage salient policy planning and public health interventions to promote healthy aging in informal settlements.
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Affiliation(s)
- Razak M. Gyasi
- African Population and Health Research Center (APHRC), Nairobi, Kenya
- Faculty of Health, Southern Cross University, Lismore, NSW, Australia
| | - Isabella Aboderin
- Africa Research and Partnerships, Perivoli Africa Research Centre (PARC), School for Policy Studies, University of Bristol, Bristol, UK
| | - Gershim Asiki
- African Population and Health Research Center (APHRC), Nairobi, Kenya
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Gyasi RM, Adam AM. Does financial inclusion predict a lower risk of loneliness in later life? Evidence from the AgeHeaPsyWel-HeaSeeB study 2016-2017. Aging Ment Health 2021; 25:1254-1261. [PMID: 32597193 DOI: 10.1080/13607863.2020.1786006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE For many older people, loneliness represents a common source of impaired quality of life particularly in the context of poor access to financial services. This article examines the association between financial inclusion and loneliness in older adults and explores the moderating effects of gender and physical activity in this association. METHODS One thousand two-hundred participants completed the Short Form Revised UCLA Loneliness Scale assessing loneliness during 2016-2017 Aging, Health, Psychological Well-being and Health-seeking Behavior (AgeHeaPsyWel-HeaSeeB) Study. Financial inclusion was assessed using an 8-item Financial Instrument Scale. RESULTS Multiple ordinary least squares (OLS) regressions showed that increases in financial inclusion were associated with decreases in loneliness in the total sample (β = -0.679, p < 0.001) and in women (β = -0.787, p < 0.001) but not in men (β = -0.594, p = 0.084). The negative effect of financial inclusion on loneliness was pronounced among those who engaged in physical activity (β = -0.646, p < 0.042). CONCLUSIONS Findings underscore the importance of financial inclusion for loneliness in later life particularly among older women and those who engage in physical activity. Encouraging and strengthening financial inclusion may crucially improve psychological health and emotional well-being among aging adults.
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Affiliation(s)
- Razak M Gyasi
- African Population and Health Research Center (APHRC), Nairobi, Kenya
| | - Anokye M Adam
- Department of Finance, School of Business, University of Cape Coast, Cape Coast, Ghana
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Gyasi RM, Frimpong S, Amoako GK, Adam AM. Financial inclusion and physical health functioning among aging adults in the sub-Saharan African context: Exploring social networks and gender roles. PLoS One 2021; 16:e0252007. [PMID: 34111127 PMCID: PMC8191946 DOI: 10.1371/journal.pone.0252007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 05/09/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND It remains poorly understood how financial inclusion influences physical health functioning in later life in sub-Saharan African context and whether the association differs by gender and social relationships. We aim 1) to examine the associations of financial inclusion with functional impairment during older age in Ghana; and 2) to evaluate whether gender and social networks modify this association. METHODS The cross-sectional analyses are based on a sample (N = 1,201) of study participants aged 50 years and over (M = 66.5 years, SD = 11.9, 63.3% female) deriving from the 2016-2017 AgeHeaPsyWel-HeaSeeB Study. Ordinary least squares (OLS) regression analyses with interactions were performed to estimate the link between financial inclusion and functional health and how the association is modified by gender and older age social networks. RESULTS The mean financial inclusion score was 1.66 (SD = 1.74) in women and 2.33 (SD = 1.82) in men whilst mean activities of daily living (ADL) score was 13.03 (SD = 4.99) and 14.85 (SD = 5.06) in women and men respectively. We found that financial inclusion was associated with decreases in ADL (total sample: β = -.548, p < .001; women: β = -.582, p < .001; men: β = -1.082 p < .001) and instrumental ADL (IADL) (total sample: β = -.359, p = .034; women: β = -.445, p = .026 but not in men). Social networks significantly moderated the association of financial inclusion with ADL such that the financially included who were embedded in a stronger constellation of social networks were 6% less likely to report ADL impairment compared to those with weaker social networks (β = -.062, p = .025). CONCLUSIONS The study provides empirical evidence for a better understanding of the association between financial inclusion and physical health functioning in the context of later life social networks. Interventions for functional health through financial inclusion in sub-Saharan Africa should include improving interpersonal and social networks for older adult and also through gender lenses.
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Affiliation(s)
- Razak M. Gyasi
- African Population and Health Research Center (APHRC), Nairobi, Kenya
| | - Siaw Frimpong
- Department of Finance, School of Business, University of Cape Coast, Cape Coast, Ghana
| | - Gilbert Kwabena Amoako
- Department of Accountancy and Accounting Information Systems, Kumasi Technical University, Kumasi, Ghana
| | - Anokye M. Adam
- Department of Finance, School of Business, University of Cape Coast, Cape Coast, Ghana
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Yamson P, Tetteh J, DeGraft-Amoah D, Quansah H, Mensah G, Biritwum R, Yawson AE. Unmet Needs of Healthcare Services and Associated Factors among a Cohort of Ghanaian Adults: A Nationally Stratified Cross-Sectional Study Design. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2021; 58:469580211028172. [PMID: 34180280 PMCID: PMC8243108 DOI: 10.1177/00469580211028172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 05/26/2021] [Accepted: 06/07/2021] [Indexed: 11/29/2022]
Abstract
We estimated the prevalence of unmet needs of healthcare services (UNHS) and its associated factors among a cohort of older Ghanaian adults. World Health Organization (WHO) Study on Global AGEing and Adult Health for Ghana was used with a total of 4735 participants. Logistics regression analysis was performed using Stata 16 to assess associated factors. The overall UNHS was 3.7% (95% CI = 2.7-4.8) and the prevalence was significantly high amongst older adults aged 60 to 69 years (5.9%). Could not afford the healthcare (56.4%) was the main contender for UNHS. UNHS was influenced by; those aged 60 to 69 years [OR (95% CI) = 1.86 (1.19-2.91)]; no formal educational [aOR (95% CI) = 4.71 (1.27-17.38)], and no NHIS [OR (95% CI) = 1.78 (1.03-3.09)]. Participants needed care for joint pain (25.4%), and communicable diseases (19.1%). The inability to access healthcare was relatively higher for older adults more advanced in age, with low education, and for those without health insurance. Health system strengthening including financial protection by expanding the National Health Insurance Scheme to all Ghanaians in line with Ghana's Universal Health Coverage Roadmap would reduce the unmet healthcare needs of older adults.
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Affiliation(s)
- Phaedra Yamson
- Department of Community Health,
University of Ghana Medical School, College of Health Sciences, University of Ghana,
Accra, Ghana
| | - John Tetteh
- Department of Community Health,
University of Ghana Medical School, College of Health Sciences, University of Ghana,
Accra, Ghana
| | - Daniel DeGraft-Amoah
- Department of Community Health,
University of Ghana Medical School, College of Health Sciences, University of Ghana,
Accra, Ghana
| | - Henry Quansah
- Department of Community Health,
University of Ghana Medical School, College of Health Sciences, University of Ghana,
Accra, Ghana
| | - George Mensah
- Department of Community Health,
University of Ghana Medical School, College of Health Sciences, University of Ghana,
Accra, Ghana
| | - Richard Biritwum
- Department of Community Health,
University of Ghana Medical School, College of Health Sciences, University of Ghana,
Accra, Ghana
| | - Alfred Edwin Yawson
- Department of Community Health,
University of Ghana Medical School, College of Health Sciences, University of Ghana,
Accra, Ghana
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Gyasi RM, Anderson EA. Whither are we bound? Rethinking the gendered frailty during COVID-19 pandemic. PUBLIC HEALTH IN PRACTICE 2020; 1:100019. [PMID: 34171046 PMCID: PMC7287439 DOI: 10.1016/j.puhip.2020.100019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 06/07/2020] [Indexed: 11/27/2022] Open
Abstract
The outbreak of the novel coronavirus disease 2019 (COVID-19) has demonstrated the urgency to reconsider social behavior and the health system quality to efficiently support and improve global health. Diverse global and country-specific mechanisms to fight COVID-19 have been displyed, but the gendered analysis of these efforts still remain too little too late. A critical consideration of the brunt of health and socioeconomic crises through gender lenses can improve understanding and direction of our efforts during pandemics. We, therefore, argue that building gender responsive national policies and practices will ensure equitable and salient public health opportunities during COVID-19.
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Affiliation(s)
- Razak M Gyasi
- African Population and Health Research Center (APHRC), Nairobi, Kenya
| | - Eugenia A Anderson
- Department of History and Political Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Gyasi RM, Phillips DR. Risk of Psychological Distress Among Community-Dwelling Older Adults Experiencing Spousal Loss in Ghana. THE GERONTOLOGIST 2020; 60:416-427. [PMID: 31094419 DOI: 10.1093/geront/gnz052] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Spousal loss, common in older age, has been linked to negative mental health outcomes and well-being, yet the mechanisms linking spousal loss and mental health are still unclear. OBJECTIVE To investigate whether physical activity, social support, and gender modify the psychological distress effects of marital loss among community-dwelling older persons in Ghana. METHODS Data from a 2016/2017 Ageing, Health, Psychological Well-being, and Health-seeking Behavior Study (N = 1,200) were examined. OLS regression models examined associations between spousal loss and psychological distress outcomes and interaction terms. RESULTS Spousal loss (widowhood and divorce/separation) was associated with psychological distress (measured by the Kessler Psychological Distress Scale [KPDS-10]) for the full sample (β = .798, p < .001), women (β = .831, p < .001) and for men (β = .533, p < .05). After adjusting for potential confounders, the associations between spousal loss and psychological distress persisted for the full sample (β = .727, p < .001) and females only (β = .730, p < .001). In particular, when experiencing spousal loss, those with meaningful social support (β = -.856, p < .005) and engaged in physical activity (β = -.258, p < .001) were less likely to be psychologically distressed. CONCLUSIONS Spousal loss precipitates an independent risk of psychological distress in older age particularly among women, but social support and physical activity engagements moderate the relationship. These findings support the premise that providing opportunities to improve social support and regular physical activity may buffer the effects of psychological distress among older persons experiencing spousal loss. Providing support for older adults in times of divorce and widowhood, and working towards changes in social attitudes towards divorce are important considerations.
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Affiliation(s)
- Razak M Gyasi
- Aging and Development Unit, African Population and Health Research Center, Nairobi, Kenya
| | - David R Phillips
- Department of Sociology and Social Policy, Lingnan University, Tuen Mun, Hong Kong
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Morgan AK, Awafo BA. Lessons for Averting the Delayed and Reduced Patronage of non-COVID-19 Medical Services by Older People in Ghana. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2020; 63:728-731. [PMID: 32807031 DOI: 10.1080/01634372.2020.1808142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Anthony Kwame Morgan
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology (KNUST) , Kumasi, Ghana
| | - Beatrice Aberinpoka Awafo
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana; Department of Planning, Kwame Nkrumah University of Science and Technology (KNUST) , Kumasi, Ghana
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Ouedraogo R, Attané A, Gyasi RM. Aging in the Context of HIV/AIDS: Spaces for Renegotiation and Recomposition of Mutual Solidarity in Burkina Faso. J Int Assoc Provid AIDS Care 2020; 18:2325958219881402. [PMID: 31615300 PMCID: PMC6900609 DOI: 10.1177/2325958219881402] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
PURPOSE The HIV-infected older people in sub-Saharan Africa are inevitably vulnerable to chronic health-related conditions, yet the needed social support for these people is mostly inadequate. Drawing on the anthropology of disease and health paradigms, this study explores the recomposition of multidimensional and multidirectional nature of mutual familial support for older people living with or affected by HIV/AIDS in Burkina Faso. METHODS We conducted multiple in-depth interviews among 147 individuals recruited from nonprofit organizations in Ouagadougou, Bobo-Dioulasso, Ouahigouya, and Yako through 2 projects funded by the National Agency for AIDS Research. Thematic and narrative analytical frameworks were used to analyze the data. RESULTS We found that older people suffered serious socioeconomic and psychological challenges associated with HIV/AIDS. Older people were particularly vulnerable to the double burden of HIV/AIDS and caregiving responsibility for family members infected with the disease. However, the infected older people who received adequate treatment and familial support regained sociocultural positions as agents for cultural transition and material/emotional resources. CONCLUSIONS Although HIV/AIDS potentially renegotiated the nature, intensity, and direction of familial support for vulnerable older people, the extrafamily solidarity seems an integral part of the great cycle of reciprocity and intrafamily mutual support. Health and policy interventions targeted at strengthening the interpersonal relationships and support for HIV/AIDS-infected and HIV/AIDS-affected older people are needed to improve their independence and well-being.
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Affiliation(s)
- Ramatou Ouedraogo
- African Population and Health Research Center (APHRC), Nairobi, Kenya
| | - Anne Attané
- Institut de Recherche pour le Developpement (IRD)/LPED, Marseille, France
| | - Razak M Gyasi
- African Population and Health Research Center (APHRC), Nairobi, Kenya
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Gyasi RM, Peprah P, Appiah DO. Association of food insecurity with psychological disorders: Results of a population-based study among older people in Ghana. J Affect Disord 2020; 270:75-82. [PMID: 32275223 DOI: 10.1016/j.jad.2020.03.088] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 01/25/2020] [Accepted: 03/25/2020] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Food insecurity has been related to poor health, and the effect may be heightened in later life. This study examines age and gender differences in the association of food insecurity with psychological disorders (PD) in older people in Ghana. METHODS Ordinary Least Squares (OLS) regressions separately examined the associations between food insecurity and PD score using data from the 2016-2017 AgeHeaPsyWel-HeaSeeB Study. PD was assessed with the Kessler Psychological Distress Scale (K10) whilst food insecurity was assessed with past 30-day hunger (H), breakfast skipping (BS) and time of first daily meal. RESULTS Among 1,200 individuals aged ≥50 years, the prevalence of food insecurity indicators of hunger (36%), skipped breakfast (29%) and late intake of first daily meal (5%) were revealed. After full adjustment, moderate (H: β = 0.705, p < 0.001; BS: β = 0.824, p < 0.001) and severe (H: β = 1.813, p < 0.001; BS: β = 1.096, p < 0.001) food insecurity significantly increased PD score compared to no food insecurity. Moreover, having late daily meal was associated with increased the risk of PD (β = 1.035, p < 0.001). These associations were moderated by gender and age (men and 65+ age group had increased risk of PD compared to women and 50-64 age cohorts). CONCLUSIONS Food insecurity independently increases PD in older people. These findings are relevant for public health and policy interventions aimed at improving mental health of older people.
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Affiliation(s)
- Razak M Gyasi
- Aging and Development Unit, African Population and Health Research Center, Manga Close, Off-Kirawa Road, P. O. Box 10787 - 00100, Nairobi, Kenya.
| | - Prince Peprah
- Social Policy Research Centre, University of New South Wales, Sydney, Australia
| | - Divine Odame Appiah
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Gyasi RM, Obeng B, Yeboah JY. Impact of food insecurity with hunger on mental distress among community-dwelling older adults. PLoS One 2020; 15:e0229840. [PMID: 32231372 PMCID: PMC7108730 DOI: 10.1371/journal.pone.0229840] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 02/14/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Hunger frequently and persistently occur in older populations in low-income countries especially in sub-Sahara Africa. The aim of this study was to examine the associations between food insecurity with hunger and psychological distress among older people in Ghana. METHODS A total of 1200 individuals aged ≥50 years were recruited during 2016/2017 Ageing, Health, Psychological Well-being and Health-seeking Behavior Study. Associations between psychological distress (assessed with the Kessler Psychological Distress Scale) and hunger (assessed with a 30-day subjective scale) were evaluated using linear regression modeling. RESULTS The overall prevalence of food insecurity was 36% with approximately 27% and 9% respectively for moderate and severe levels of hunger whilst the mean score of psychological distress was 9.5 (±4.10). Persons experiencing moderate hunger (β = 0.71, SE = 0.160, p < 0.001) and severe hunger (β = 1.81, SE = 0.280, p < 0.001) significantly reported increased psychological distress outcome compared to those without hunger. These associations varied between women (β = 1.59, SE = 0.359 p < 0.001) and men (β = 2.33, SE = 0.474, p < 0.001) as well as 50-64 age group (β = 1.48, SE = 0.368, p < 0.005) and 65+ age group (β = 2.51, SE = 0.467, p < 0.001). CONCLUSIONS The results suggest that experiencing hunger is associated with psychological distress and the effect may be aggravated with advancing age and in men. These findings may inform social policy initiatives and health programmatic interventions for older people exposed to food insecurity.
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Affiliation(s)
- Razak M. Gyasi
- African Population and Health Research Center (APHRC), Nairobi, Kenya
| | - Bernard Obeng
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Joseph Y. Yeboah
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Gyasi RM, Yeboah AA, Mensah CM, Ouedraogo R, Addae EA. Neighborhood, social isolation and mental health outcome among older people in Ghana. J Affect Disord 2019; 259:154-163. [PMID: 31445342 DOI: 10.1016/j.jad.2019.08.024] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 07/05/2019] [Accepted: 08/14/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Loneliness and living alone have been strongly related to mental health but limited empirical evidence of these relationships exists among older people in Ghana. We examine the pathways of independent and interactive impacts of loneliness and living alone on psychological distress (PD) risk among older people in Ghana and to investigate whether the associations are moderated by neighborhood characteristics. METHODS Data were analyzed for 1200 community-dwelling adults aged ≥50 years from a 2016/2017 Aging, Health, Psychological Wellbeing and Health-seeking Behavior Study. Mental health and loneliness were respectively assessed using the Kessler Psychological Distress Scale (KPDS-10) and the Three-Item Loneliness Scale of the University of California, Los Angeles. OLS models estimated the associations and interactions. RESULTS Participants were mostly women (63.3% [95%CI: 60.5-66.0%]) with a mean age of 66.2 ± 11.9. Mean scores for PD and loneliness were 15.9 ± 4.7 and 5.3 ± 3.9 respectively whilst the prevalence of living alone was 38.2% (95%CI: 35.4-41.0%). After full adjustment, the OLS regressions showed that loneliness (β = 1.474, SE = 0.151, p < 0.001), living alone (β = 0.381, SE = 0.162, p < 0.05) and the interaction between them (β = 0.917, SE = 0.308, p < 0.05) significantly increased the PD risk. However, engagement in regular physical activity, family contacts and social participation decreased PD outcomes among the socially isolated. LIMITATION The cross-sectional nature of the data may prohibit any causal and directional inferences. CONCLUSIONS Social connectedness and neighborhood engagements strongly buffer against the risk of later life mental disorders in the context of loneliness, and living alone. Moderate-to-rigorous physical activity and social cohesion should be effectively and strategically included in interventions targeted to improve older age mental health.
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Affiliation(s)
- Razak M Gyasi
- African Population and Health Research Center (APHRC), Manga Close, Off-Kirawa Road, P. O. Box 10787 - 00100, Nairobi, Kenya.
| | - Abigail Assuamah Yeboah
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Charlotte Monica Mensah
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Ramatou Ouedraogo
- African Population and Health Research Center (APHRC), Manga Close, Off-Kirawa Road, P. O. Box 10787 - 00100, Nairobi, Kenya
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Gyasi RM, Adam AM, Phillips DR. Financial Inclusion, Health-Seeking Behavior, and Health Outcomes Among Older Adults in Ghana. Res Aging 2019; 41:794-820. [PMID: 31046598 DOI: 10.1177/0164027519846604] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE This study examines the associations between financial inclusion, health-seeking behavior, and health-related outcomes in older persons in Ghana. METHOD Employing data from a 2016/2017 Aging, Health, Psychological Well-Being and Health-Seeking Behavior Study (N = 1,200; mean age = 66.2 years [standard deviation = 11.9], we estimated regression models of self-rated health (SRH), psychological distress (PD), and health-care use (HCU) on a variable representing compositional characteristics of financial inclusion. RESULTS Multivariate logistic and generalized Poisson models showed that financial inclusion is positively associated with SRH (β = .104, standard error [SE] = .033, p < .001) but inversely related to both PD (β = .038, SE = .032, p < .005) and HCU (β = -.006, SE = .009, p < .05) independent of other factors. However, after adjusting for socioeconomic and health-related factors, the associations were tempered and the effect of SRH decreased by 0.094 and PD increased by 0.065 points but HCU became statistically insignificant (β = -.020, SE = .0114, p > .05). CONCLUSIONS Financial services inclusion profoundly appears to buffer against and retard health-related challenges in later life. Social and health policies targeted at improving the health outcomes of older people should include and build on the growing recognition of the importance of inclusive financial services and strategies.
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Affiliation(s)
- Razak M Gyasi
- 1 Aging and Development Unit, African Population and Health Research Center, Nairobi, Kenya
| | - Anokye M Adam
- 2 Department of Finance, School of Business, University of Cape Coast, Cape Coast, Ghana
| | - David R Phillips
- 3 Depatment of Sociology and Social Policy, Lingnan University, Tuen Mun, Hong Kong
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