Women in India – Longevity, Health Disparities and Empowerment

Being over 65 years and living in India is an increasingly common phenomenon. The Indian population over 65 years is steadily on the rise, totaling to a whopping 90 million people in 2011. Estimates suggest that this number will exceed 227 million by 2050. Within this giant aging population, there is a unique sub-section of disadvantaged people who are women. Women in India live longer than men, but consistently report poor health, higher disabilities, lower cognitive function and lower utilization of health services.

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A study in 2008 showed wide health disparities between elderly men and women. Even after controlling for demographics, medical conditions and known risk factors, the gap still existed. Controlling for economic independence, however, reduced the gaps significantly. This emphasizes the necessity for financial empowerment among older women for them to enjoy a healthier life. Financial empowerment may be the key to improving health outcomes of elderly women. However, the barriers of gender discrimination and poor education are hard to overcome.

The Longitudinal Aging Study in India (LASI), the first of its kind in the country, found that elderly women have lower cognitive function than elderly men, and linked this discrepancy to gender discrimination. This study was conducted in two southern states, Karnataka and Kerala, and two northern states, Rajasthan and Punjab. In the southern states, the gender difference was accounted for by poorer education, health and social engagements. However, the disparity in the two northern states existed even after controlling for these known risk factors, indicating a high level of discrimination against women.

Gender bias is evident in all life stages of a woman – female infanticide, poor education facilities, dowry practices, stereotypical roles of women as home-makers and discrimination against widows. It is exceptionally hard for elderly women to have good health and quality of life. Stigma needs to the fought at the grassroots level. The existing government initiatives for the girl child are commendable, but they do little for the current generation of elderly women who continue to face discrimination, poor health, poor education and economic dependence. While the ongoing LASI study will continue to provide a comprehensive understanding of geriatric health in India, targeting elderly women will go a long way in improving health outcomes among the elderly population. The provision of medical, financial and social support for elderly women is empowering, and can improve their overall health and quality of life.

Namratha Rao is currently pursuing her MSPH in International Health in Social and Behavioral Interventions at the Johns Hopkins University Bloomberg School of Public Health. 

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A Comparative View of Elder Abuse in Israel and the United States

Photo Credit: Hamed Masoumi

I spend every Tuesday morning visiting a dear friend at a local nursing home. My friend is a Holocaust survivor and at 90 years old, her mind is sharp since she easily recounts the story of her life – from the horrors of the camps to the beauty of Israel and finally to the hard work, freedom, and challenges of America. As I am ready to leave her and return to school each week, a look of loneliness washes over the smile on her face and I am reminded that her only other visitors are nurses and her daughter who can visit once a week.

The elderly comprise a significant amount of the U.S. population and statistics indicate that 10,000 baby boomers will turn 65 each day for the next 15 years. As the U.S. population ages, older adults are often viewed in a negative light, and hence a target group for all kinds of abuse: physical, sexual, verbal and financial exploitation. It is estimated that a shocking 500,000 older adults are abused each year in the United States, with family members as the overwhelming majority of abusers (mainly partners and children of the individual). Most of these cases go unreported because the victim does not have the physical capability or mental capacity to inform an official of the mistreatment.

Elder abuse is a major issue currently plaguing Israel as well. A report by the University of Haifa indicated that 18 percent of elderly participants were subject to some form of abuse. The most common form is verbal abuse, indicating a potential problem in interpersonal relationships as people age. Verbal abuse may also be used as a method to instill terror and power in a relationship, lending the way to more types of abuse.

Many religions teach people to respect and revere the elderly. In short, an individual’s exterior does not properly convey the depth of its contents. My dear friend appears to be a frail old woman with a failing body but her mind is very active. The elderly are people above all else and they deserve to be treated as such.

It is impossible to ignore the fact that everyone will grow old one day. With this in mind, I urge you to take some time and think about giving back by volunteering with a senior in your area. You may be the only contact the person has with the outside world beside the caregiver, and can advocate on their behalf if you suspect abuse. For U.S. residents, visit Give Back to Seniors to search for volunteer opportunities in your community.

Linda Nakagawa is a rising senior at Brandeis University. She is a double major in Psychology and Politics with a minor in Social Justice Social Policy. Linda is originally from Newburgh, New York and is a member of Temple Beth Jacob. As a Machon Kaplan participant, Linda was a public policy intern at the National Association of States United for Aging and Disability.

Aging, Health, and Social Networks

Across the globe, nearly every country of the world is experiencing population aging. According to the United Nations, the number of people aged 60 years or older is expected to increase to more than 2 billion by 2050. While this shift in demographics carries implications for the social and economic makeup of our global society, it is important to also consider the unique health needs of the aging population.

Included among the most pressing health needs for the aged are managing chronic disease, preventing falls, maintaining cognitive function, and ensuring improved quality of life throughout the life span. Of additional importance to healthy aging, particularly in terms of health related quality of life, is the social support older adults receive from their family, friends, and communities. A known contributor to health related quality of life (HRQOL) is the strength of one’s social networks. It has been shown that individuals who report close bonds with family and friends are more likely to positively self-report their health. This was shown to remain true among elderly in the U.S., who reported improved health if they felt satisfied with the support available to them from family members, friends, and their communities.

From the perspective of the elderly, however, changes that occur late in the lifespan also translate to changes in their social networks and their social support. Social networks have been defined to include family members, friends and acquaintances, work and school connections, and relationships built in formal and informal organizations. Among the elderly, connections may be lost for a variety of reasons throughout the aging process, including retirement, limited mobility that prevents participation in previous activities, as well as the aging and death of close connections. Such changes to the social fabric, that a person formerly engaged with, carries implications for the health related quality of life an individual experiences.

For the elderly, a strong social network often translates into diminished feelings of loneliness, support for mental and physical health needs, as well as improved cognitive functioning. The elderly who feel supported by their community are less likely to report feelings of isolation and report better health than those who do not feel supported. With global population aging, ensuring that all individuals age with dignity, respect, and support should be of paramount importance.

The lengthening of the lifespan should also come as an increase in the number of years lived in high quality health. To protect the health of the aging population, concerted efforts should be made on the part of health care providers, communities, governments, families, and friends to ensure that all individuals enter into the late stages of life with the support that is necessary to live positively and healthfully.

Diana Kingsbury is a PhD student and graduate assistant in prevention science at the Kent State University College of Public Health.

Quality of Life for Elders: Lessons from South Africa and Bolivia

Photo Credit: Pixabay
                                                                                               Photo Credit: Pixabay

Last year, the Global AgeWatch Index published a report on the quality of life for elders in 91 nations. The report included several factors such as income security, health and well-being, employment and education. African nations did not fare well. South Africa was the highest ranked African nation at number 65 while Ghana, Morocco, Nigeria, Malawi, Rwanda and Tanzania came in at numbers 69, 81, 85, 86, 87 and 90 respectively. Other African nations were not included in the report because there was not sufficient data. With South Africa leading the pack in elderly well-being, it helps to decipher the various ways South Africa deals with its senior citizens.

South Africa has the second largest and most developed economy in Africa with the old age pension reaching 72% of the older population. The pension system is the second most distributed of the African countries that are in the Index. Namibia is the first at a whopping 167.3% although there was not enough data in other areas to include the nation in the report. While South Africa performed moderately well in income security, the nation ranked low in elderly health status. There are only eight registered geriatric doctors to serve an older population of 4 million in South Africa. Since 1994, dramatic changes have taken place in the structure of health services. The government prioritized maternal and child healthcare because of the HIV/AIDS pandemic in the 90’s.

Although South Africa was ranked at number 65, Bolivia, one of the poorest countries on the list was ranked at number 46. This shows that higher-income does not always correlate with better quality of life. In fact, some lower-income countries that invested in aging saw positive impacts. Bolivia, for instance, implemented a national plan on aging and free health care for older people, which vastly improved quality of life.

The rankings illustrate that limited resources need not be a barrier to countries providing for their older citizens, that a history of progressive social welfare policies makes a difference, and that it is never too soon to prepare for population aging. This is important for African nations because the elderly are a significant boon. African nations can do better by learning from each other as well as non-African nations. The outcomes may vary but the collective goal is to improve the elders’ quality of life for present and future generations.

Sophie Okolo is the Founder of Global Health Aging.