Determinants of The Physical Problems of The Geriatric Population at Adamdigi Thana of Bogra District in Bangladesh

Tapan Kumar Roy¹ and Md. Mosiur Rahman¹,
Institutions1Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi-6205, Bangladesh.

INTRODUCTION

Aging of population is gradually emerging as an issue in Bangladesh. It is a formidable problem of rural Bangladesh as well as a national problem (Abedin S, 1994). It has many socio economic effects on national development. In the demographic context and view of age structure, aged people are considered as a dependent portion of manpower (Amin and Sajeda, 1998). Health is a major concern of old age. The overall level of health of older persons in Bangladesh is not so good. They are prone to age related diseases. In old age the elderly are found to suffer from diseases like arthritis, back pain, high blood pressure, diabetes, asthma, peptic ulcer and so on. Prevalence of malnutrition, eyesight problems, hearing problems and mental disorders among the old are also observed (Kabir M and Humayun, 1993). The health problems in old age are often compounded by attributing ailment to onset of old age. Every elderly population has the right to lead a healthy, active life with minimal suffering. For this they need clothing, housing facilities, medical and social care. Many of the health problems can be overcome or delayed by changing their lifestyle (Sattar MA, 1996). This thesis aims to investigate the determinants of physical problems of elders in Bangladesh by examining the situation prevailing in one particular area at Adamdigi thana of Bogra district.

MATERIALS AND METHODS

The data were collected from a field survey conducted at Adamdigi thana in the district of Bogra in Bangladesh. These data were collected from both, rural and urban areas of Adamdigi thana. Information was collected of 400 elderly (Population aged 60 and over) by interview method, 200 of them were taken from rural areas and 200 from the urban areas respectively. Respondents were selected by purposive sampling method. For rural areas we have selected three villages under Adamdigi thana , and for urban areas we have selected 3 wards under Adamdigi thana. Data analytic methods envisaged in this paper are percentage distribution and logistic regression analysis.

RESULTS

Deterioration of one's physical well-being is a natural part of aging. From Table 1 we see that among all the major health problems faced by the elderly population a major portion of them suffered from eye diseases (19.7%) followed by back pain (16.3%), heart diseases (12.7%), kasi (11.0%), others (7.0%), diabetes (9.7%), dysentery (6.7%), high pressure (6.0%), hapani (6.0%) and paralysis (5.0%). Therefore, the present study reveals that health conditions of the elderly are not fair.

Table 1 Percentage distribution of respondent's diseases

Medical services are limited in Bangladesh and create greater problems for the elderly. As a part of a vulnerable group, the older population has a greater need for, but less access to, health care. The medical facilities are not adequate to meet the health care requirements of 129 million people, let alone the 7.8 million elderly.

Table 2 Percentage distribution of respondent's treatment

From Table 2 it is observed that majority of the elderly received Allopathic treatment (82.7%) and only a few received kobiraji treatment (3.0%).

Table 3 contains the results of contingency analysis. From this Table it can be seen that elder's educational qualification is statistically significantly associated with occupation, type of latrine, house type, family type, habit, income, expenditure and treatments. Thus, from a statistical point of view, the above socio-economic variables collected from the elderly are greatly influenced by education. The degree of association between education and occupation ishigher. It is true that education is the only single most predominant variable, which has an inhibiting effect on the above variables. But education has a statistically insignificant effect on children ever born. Hence the degree of association with education and this variable is poor. With respect to the age of elderly, age is significantly associated with eye vision, hearing ability, physical fitness, present job, working ability, main food and use of latrine but insignificantly associated with talking ability, digestion, and sleep. From Table 3 we see that major diseases are statistically significantly associated with health status of the elderly. The significant health states such as eye vision and physical fitness are highly significant with disease. So we conclude that, health status of the elderly is mostly influenced by disease.

Table 3 Results of contingency analysis with degrees of freedom and significant level

Note : At 5% level of significance, if the Asymp. Sig (2-sided) value is less than 0.05 then the test of association is significant, otherwise insignificant.

Table-4 shows the factors associated with the determinants of physical problems of the elderly population. Six variables were found to influence the physical problems of the elderly. It can be seen from Table 4 that elders who were literate were 0.963 times less likely to be affected by physical problems than illiterate persons. Elders who lived in family units were1.605 times more likely to suffer from physical problems compared to those elderly who lived in joint families. The table also reveals that rural elders were 2.253 times more likely to suffer from physical problems than their urban counterparts. With regard to occupation, elders who have business were 0.489 times less likely to have any physical problems than those elders who were engaged in service and elders who have agricultural occupations and who were day labourers were 0.698 and 0.385 times less likely to have any kind of physical problem than the service holder elderly population.

Table 4 Results of logistic regression analysis according to physical problem of aging people by selected characteristics.

Characteristics	Co-efficient ()	S.E.	Odds Ratio Exp ()
Educational status Illiterate (Ref) Literate	-- -.038	-- .621	1.000 0.963**
Family Type Joint (Ref) Unit	-- .473	-- .527	1.000 1.605***
Place of residence Urban (Ref) Rural	-- 0.968	-- 0.253	1.000 2.253***
Occupation Service (Ref) Business Agriculture Day labor Others	-- -.715 -.360 -.955 7.226	-- 1.159 1.164 1.092 44.301	1.000 .489 .698 .385 1.17
Electricity facility No (Ref) Yes	-- .144	-- .523	1.000 1.155
Problem to use Latrine No (Ref) Yes	-- -1.536	-- .649	1.000 0.215*
Old age salary No (Ref) Yes	-- -7.455	-- 26.305	1.000 .001***
Any bad habit Yes (Ref) No	-- .078	-- .494	1.000 0.925**

DISCUSSION

The study revealed that health conditions of elderly are not so good. Among all the major health problems faced by the elderly population a major portion of them were suffering from eye diseases followed by back pain, heart diseases, kasi, diabetes, dysentery, high blood pressure, hapani and paralysis. In Bangladesh the medical facilities are not adequate to meet the health care requirements of 129 million people, let alone the 7.8 million elderly. It is observed from our study that a major portion of the elderly received allopathic treatment and only a few of them received kobiraji treatment and since most of the kabiraji treatment has no appropriate training to identify diseases but still serving as a good doctor in Bangladesh, as a result, very often valuable lives are lost by receiving such kinds of treatment. In contingency analysis we have found a significant association between education and some other socio-economic variables, such as education with occupation, type of latrine, house type, family type, habits, income, expenditure and treatments. Thus, from a statistical point of view, the above socio-economic variables collected from the elderly are greatly influenced by education. With respect to the age of elderly, age is significantly associated with eye vision, hearing ability, physical fitness, present job, working ability, main food and use of latrine; also the health status of the elderly in such areas as eye vision and physical fitness, are highly significant with disease. So we conclude that, the health status of the elderly population is mostly influenced by disease. The logistic regression model unveils that elders who lived in a family unit were one and half times more likely to suffer from physical problems compared to those elderly lived in joint families. It was also found that rural elders were suffering more from various kinds of physical problems than their counterparts in urban areas. This is likely to be attributed to unavailability of healthcare facilities in rural areas. Moreover, in Bangladesh, especially in rural areas, there is a problem of communication and transportation, which involves both, time and cost (Ahmed et al., 1998). Education of the respondents shows strong positive association with physical problems of the elder population. The educated elders are usually more conscious about their health and thereby seek assistance from health professionals. The other contributing factors found to affect the physical health status of the elderly were family type, problems in using latrines, old age, salary and any kinds of bad habits of the elder population.

The overall scenario of the health status of the geriatric population is not satisfactory. Still much work has to be done in this arena to improve health status of the elders. In the light of the above discussions, the following recommendations are made:

• · The traditional joint family system should be strengthened in order to provide basic needs and psychosocial support to the elderly.
  
• The government should take necessary steps to enhance the care-giving capacity of family where appropriate.
  
• The government should take necessary steps for the welfare of the aged by undertaking mass education programs and awakening the people about the duty towards people.
  
• Government should give economic security (like pension, medical allowance, recreational facility etc.) for geriatrics.
  
• Government, NGOs and all other organizations have to build care homes and have available recreational facilities there for elders.
  
• Access to treatment facilities should be available and cheap for elders and special emphasis on care of geriatrics should be taken in health centers, medical colleges, and community clinics in both rural and urban areas.
  

REFERENCES

Abedin S (1994). The demographic aspects of aging in South Asia with special reference to Bangladesh: Trends and implication. Paper Present at the conference of CMIG, Calcutta.

Ahmed, S., Sobhan, F. & Islam, A. (1998) Neonatal morbidity and care-seeking behaviour in rural areas in Bangladesh. Operational Research Project- Health and Population Extension Division. Working Paper No. 148. Dhaka: International Center for Diarrhoeal Diseases Research, Bangladesh.

Amin A (1998). Family structure and change in rural Bangladesh. Population Studies, vol. 8 No. 3.

Kabir and Humayan (1993). Local level of policy development to deal with the consequences of population aging in Bangladesh. ESCAP, UN New York, Asian Population Studies Center.

Sattar MA (1996). Aging population of Bangladesh and its policy implication in an overview. The elderly in Bangladesh and India. Department of Statistics, University of Rajshahi, Bangladesh.