The Explorer Islamabad: Journal of Social Sciences ISSN: 2411-0132(E), 2411-5487(P) Vol-1, Issue (9):343-347 www.theexplorerpak.org
HEALTH AND SOCIAL EXCLUSION: COMPARATIVE ANALYSIS BETWEEN SOCIAL EXCLUSION AND HEALTH STATUS OF OLDER PERSONS Aftab Ahmed1, Dr. Abid Ghafoor Chaudhry2 Anthropologist, Pakistan Association of Anthropology, Islamabad, 2Incharge Department of Anthropology, PMAS-Arid Agriculture University, Rawalpindi
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Corresponding Author: Aftab Ahmed Office-2, Lower Ground, Faysal Bank Atta Arcade, Main PWD Road Islamabad, Pakistan huda.aftab@gmail.com Abstract: Background: Ageing with all its definitions explains the time of increased dependency (social and economical), less social participation, and poor physical and mental health. It is an undeniable reality that every individual born faces abuse, isolation, exploitation or discrimination in various forms in the elder stage of life. It can rightly be said that older age is the age of exploitation, discrimination, sickness/disease and dependency. Thus these factors are all interrelated and realities of the current-day world. Hypothesis, we can assume that there is no significant relationship between social exclusion and disease prevalence among Older Persons (OPs). Methodology: A structured interview schedule was implemented to collect the data. Data was entered in EpiData and analyzed in SPSS. Results: The results show that there is a significant relationship between disease prevalence and social exclusion of OPs. Acute social exclusion puts elders at risks of diseases. Conclusion: If the society expects to see older persons as active and healthy members, the society ought to identify means to involve OPs in social life to reduce the intensities and trickledown of social exclusion.
Key Words: Social exclusion, Older Persons (OPs), Elders health, Social Exclusion and Health Short Title: OPs’ Health and Social Exclusion INTRODUCTION “Older persons” and “social exclusion” are terms most commonly used together, as the effects of social exclusion on the health status of elders are diverse. Most of the literature depicts that ageing is most painful countries that are more developed especially USA, where the ratio of aged person is comparatively very higher than the rest of the world. But according to the projections of population data, by different organization and census bureau’s report, the population of elderly people will soar in 2050. As a consequence if we fail to give serious attention towards it then, as with the increase of aged population, their issues and problems graph will also move upward more rapidly. On one hand population ageing is one of the greatest achievements on humanity’s part; as older people are a precious treasure of
knowledge. However, they are often ignored, even though they can make important contribution to the fabric of our society. Whereas on the other hand it is also one of the greatest challenges for us; as we are entering the 21st century and the global ageing will increase economic and social needs as well as obligations of all the countries (WHO 2002). Globally, ageing factors have diverse impact on the human populations (of different countries) and is attributed to factors such as culture, gender, education, ethnicity and socio-economic status. In USA elderly population has increased in figure and variety, as in 2003 over 36 million individuals or you can say 12 percent of the American population was of 65 years age or older than that. And it is also estimated that between 2011 to 2030 elderly Americans will make up 20 percent of the population. Recent statistical
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figures show a greater percentage of Black American’s (54%) and White American’s (59%) over the age of 65 years than the Hispanic population (49%). On the other hand, this supremacy of white older Americans will decline in the coming 30-50 years of 21st century, as more Hispanic and Black aged adults will supplant a predominately white aged population (U.S. Census Bureau 2007; Smith 2003; Hillier and Barrow 2007) Previous research highlights that un-healthy social relationships can increase the risk of death more then the well-established threats such as smoking and alcohol consumption (Ollonqvist, et al. 2008). Thus negligence, loneliness and social ignorance/isolation can prove to be the key factors in this regard. "Isolation is common to almost every vocational, religious or cultural group of a large city. Each develops its own sentiments, attitudes, codes, even its own words, which are at best only partially intelligible to others" (Thrasher 1926). An estimate shows that 5% to 16% of the people above the age of 65 report loneliness and feel isolated or ignored by the society and even their own families. These population representative figures are expected to move upward due to the demographic developments, which include; family dispersion and ageing of the population. Studies have shown that severe social isolation, ignorance and loneliness can seriously influence the quality of life and well-being, with selfevident harmful health effects especially in older life. Being lonely has a noteworthy and lasting negative effect predominantly observed in form of blood pressure problem. Such an effect has been found to be independent of age, gender, race, cardiovascular risk factors, medications, health conditions and the effects of depressive symptoms (Greaves and Farbus 2006; Hawkley 2010). It is also associated with depression (either as a cause or as a consequence) and higher rates of mortality (Ollonqvist, et al. 2008; Pitkala, et al. 2009; Mead, et al. 2010). Recent analysis of a previous research has found that people with stronger social bonds and relationships have a 50 percent increased probability of endurance than those individuals having weaker social contacts and associations (Holt-Lunstad, et al. 2010). Social exclusion establishes feelings of loneliness, ignorance and social negligence among
individuals no matter what age group they belong to. The affects of social exclusion are more severe in elders as compared to those who are young. Social exclusion not only damages social participation of elders but is also a reason behind developing different psychological issues, which then transform into serious diseases like; heart problems, hypertension and mental health issues etc. Currently, 6 percent of the Pakistan’s population is over the age of 60 years (7.3 million people), at the same time 40 percent of the households serve to an elderly person. The elderly have stayed at approximately 6% of the population since 1961. By 2050 this ratio is assumed to rise to 15% (Nation 2004). Present study was focused to test the mentioned hypothesis; H0: There is no significant relationship between social exclusion and health status of elder persons H1: There is significant relationship between social exclusion and health status of elder persons MATERIALS AND METHODS Present study was conducted in urban areas of Rawalpindi city. A sample of 384 was equally divided in Tehsil Municipal Administration (TMA) Rawal Town and TMA Potohar Town. A structured questionnaire was developed and to enhance the quality of tool pilot testing was conducted under similar urban settings. According to the findings of pilot test research tool was upgraded. The data was collected from respondents by giving them complete introduction and inform them objective of study and after getting their verbal consent the data was collected by researcher. After data collection code plan was develop of respective tool and data was entered according to code plan in EpiData and analyzed in SPSS. Chi-square test was applied to test the hypothesis of study. RESULTS AND DISCUSSION To satisfy the requirement of topic starting age of every participant was 60 years to onwards. Among 384 (Table I) respondents 53.9% were fall under the category of 60-65 years of age, participation from 66-70 years age group was 20.8%. Percentiles also depicts the 3.9% of the respondents were belongs to 80 and above years of age.
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Table I Age Distribution of the Respondents Response 60-65
Frequency 207
Percent 53.9
66-70
80
20.8
71-75
51
13.3
76-80
31
8.1
80+
15
3.9
Total
384
100.0
Figure 1 explains the cross-tabulated results of disease occurrence and feelings of social exclusion/ignorance. Among 384 respondents 237 OPs reported feelings of social isolation while 147 were comfortably happy in their homes. Those respondents who claimed the existence of social exclusion; among them 17 respondents reported hypertension, 24 cases of heart problem were observed, 31 belonged to the category of diabetes, 13 responses revealed asthma patients. The figure also shows that OPs that faced no feelings of social exclusion/ignorance reported less frequency of disease prevalence.
Social Exclusion and Disease Status 120
29
100
29
80 60 40 20 0
25 14 17
24
27 31
77
57 Social exclusion/ignorance? No
14 13
9 18
Social exclusion/ignorance? Yes
Figure. 1 Cross Comparison of Social Exclusion and Disease Status “Calculated p Value of Chi-Square is .028. As isolated within their respective community calculated p value is less than 5%, so we reject H0 claimed more disease occurrence as compared to and conclude the hypothesis as to mention there the group who revealed that they did not feel is a significant relationship among social socially excluded. Findings of Chi-Square test also exclusion and disease status of elder persons” support the phenomenon, as depicted in the DISCUSSION graph that as elders are more socially isolated or WRVS in year 2012 reported in a number of excluded they have to face more burden of reports the happening of loneliness and isolation disease. Hypothesis conforms that the significant among elder’s population and also health risks relationship between disease status and social associated with it. Especially as the familial ties exclusion existed among study participants. weakened, the mental and physical health Results were also verified by existing literature on declined as it effects and influences their life style that explains that when the graph of social quality. Exclusion, negligence or isolation has a isolation moves upward it also gives an upward much wider public health impact, as it is linked thrust to the graph of disease prevalence and with a figure of depressing health outcomes associated health risks. Some of the earlier which includes mortality, morbidity, depression studies also reveal that positive relationship and suicide as well as health service use (Victor, exists among social exclusion and negative health et al. 2006). outcome (Victor, et al. 2006). Figure 1 explains the relationship between social The benefits of reduced loneliness and social exclusion and disease prevalence among older isolation are self-evident to the individuals and persons of study. It shows that the respondents the wider community, “for the peoples mitigating who felt sad and were more socially excluded or loneliness will recover quality of life” (Pitkala, et
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al. 2009; Findlay 2003; Savikko, et al. 2010). Similarly, such changes can increase the popularity of succeeding health and social care service thus limiting dependence on more costly intensive services and contributing to the ‘healthy ageing’ agenda by ‘compressing’ morbidity (Dickens, et al. 2011; Jagger, et al. 2011). Supporting social engagement can also be of great benefit to the wider community. Reducing social isolation enables a possible ‘harnessing’ and can be a probable contribution to the community, through for example volunteering (Bowers, et al. 2006; Butler 2006; Rabiner, et al. 2003). CONCLUSION Present study focused on two interrelated concerns of older persons, one is their feelings of social exclusion and second is their disease status. Results identifies that if the level of social exclusion is high then disease status shows a positive relation with that. Much of the cited literature also indicates the same scenario. Thus we can conclude this study in a way that some serious intervention/involvement from individual and community should be implemented with the help of Government and private organization by especially those who are working on ageing issues. “If social participation increases, social exclusion decreases and health status improved” and “if we scarifies for others someone will do for us”. Do try to involve your elders in your life and events to let them enjoy happy ending life. REFERENCES Butler, Sandra S. 2006 Evaluating the Senior Companion Program: a mixed-method approach. Journal of Gerontological Social Work 47(1-2): 45−70.
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