Subjective Well-Being, Health and Healthcare Utilization: A Study of Rural Elderly in Odisha

Health and well-being have a significant impact on economic security, level of independence and social interaction among the elderly. As there is a rapid decline in the joint and extended family system in India, the communities no longer protect the rights of the elderly people as they used to do in the past. This makes the elderly largely displaced in the community and they are more vulnerable to isolation, deteriorating health leading to disability, psychological distress, physical/mental abuse and relatively have less satisfaction in life. Socio-economic inequalities in health and healthcare utilization are more rampant among the rural elderly in comparison to their urban counterpart. Moreover, the issues of health inequalities, prevalence of morbidity, disability and psychological distress, physical/mental abuse and overall well-being are neglected especially among the rural population. The objectives of the study are five-fold: first, to assess the prevalence of multi-morbidity and socio-economic inequalities in various chronic health conditions among rural elderly; second, to examine the association of morbidity with disability and psychological distress; third, to analyze the pattern of healthcare utilization and financing among the elderly; forth, to examine the association of elderly abuse with morbidity and disability and finally, to examine the various covariates of life satisfaction among the rural elderly. In this thesis, a cross-sectional survey has been conducted by using multi-stage random sampling procedure among 310 elderly (60+ years) in Bargarh District of Odisha. Different statistical and econometrics tools such as logistic regression, generalized linear regression model and hierarchal regression have been used to address the above objectives. The findings of the study indicate that the most common prevalent diseases among the elderly are arthritis, chronic obstructive pulmonary disease, high blood pressure and cataract. Age, state of economic dependence and life style indicators are the most important measured predictors of multi-morbidity among the rural elderly. Life satisfaction is associated with various socio-economic and demographic factors including physical, cognitive health and social networks. Results also indicate that abused elderly are more prone to disability, morbidity and psychological distress. Consequently, a multidimensional approach is required to address the issues of health inequalities and overall subjective well-being among the rural elderly