RESILIENCE AND HEALTH-RELATED QUALITY OF LIFE OF FILIPINO OLDER PERSONS IN FLOOD-PRONE COMMUNITIES: A MIXED METHODS STUDY

Climate change increases the stressors associated with aging, particularly in vulnerable populations in low- and middle-income countries, putting them at risk for poor health-related quality of life (HRQOL). In countries, such as the Philippines, where there is an increased frequency of natural disasters, particularly floods. Building resilience and optimizing quality of life for both individuals and communities and in the context of disaster preparedness is critically important. To date, there are limited data on the determinants of resilience and subsequent effects of disasters on HRQOL in Filipino older people. The study aims were to: 1) explore the experience of older people in dealing with adversities including floods and factors contributing to their resilience and 2) Using findings from the qualitative phase, examine if any sociodemographics, prior flood experience, and resilience are significantly associated with their HRQOL. A mixed-method study with exploratory sequential design was undertaken to address the study aims. Individual qualitative interviews were conducted (n=10) with community-dwelling older adults to capture context specific information. Interview data revealed five key themes: (1) past experiences shape the future, (2) strategies to deal with adversities in life, (3) resilience is based on prior experience and an individual’s strength and resources, (4) living with the continual threat of flooding, and (5) community and connection essential for preparedness. Individuals discussed drawing on individual, family, community, and on their religious beliefs for support. This was followed by a cross-sectional survey of 305 older adults in flood-prone communities in the City of Manila. The quantitative phase showed that the predictors of physical health-related quality of life were age, flood intensity experience, prior life experience and resilience. In addition, the significant predictors of mental health-related quality of life are age, flood adversity experienced, and resilience. Examining the flood experience in relation to HRQOL and other correlates such as resilience contributes to the needed evidence for a responsive policy and interventions in the Philippine aging population context