Social variations in self-rated health among elderly in Kazakhstan: a cross-sectional study

Tuesday, 19 August 2014
Exhibit hall (Dena'ina Center)
Akmaral Abikulova , Kazakh National Medical University, Almay, Kazakhstan
Ainur Eshmanova , Kazakh National Medical University, Almaty, Kazakhstan
Gulnar Esnazarova , Kazakh-Russian Medical University, Almaty, Kazakhstan
Ainash Oshibaeva , Kazakh School of Public Health, Almaty, Kazakhstan
Ainur Kumar , Kazakh National Medical University, Almaty, Kazakhstan
Sundetgali Kalmahanov , Kazakh National Medical University, Almaty, Kazakhstan
Alma Mansharipova , Kazakh-Russian Medical University, Almaty, Kazakhstan
Bolat Zhanturiyev , Kazakh National Medical University, Almaty, Kazakhstan
Andrej M Grjibovski, PhD , Northern State Medical University, Arkhangelsk, Russia
Tolebay Rakhypbekov, PhD , Semey State Medical University, Semey, Kazakhstan
INTRODUCTION:  Self-rated health (SRH) is frequently used to assess health inequalities in both developed and developing settings. Elderly represent a part of the population with the lowest SRH. Moreover, elderly population is vulnerable to social and economic changes in transitional economies of the former Soviet Union characterizing by increase in inequalities. However, no studies on health inequalities among elderly have been performed in Central Asia. The aim of the study was to assess gender-, ethnic-, and social inequalities in SRH among the elderly in Almaty (former Alma-Ata), Kazakhstan.

METHODS:  Altogether, 582 randomly selected adults aged 60 years or older participated in a cross-sectional study. SRH was classified as poor, satisfactory, good and excellent. Multinomial logistic regression was applied to study associations between poor SRH and socio-demographic characteristics. Crude and adjusted odds ratios (OR) for poor vs. other categories of SRH were calculated using multivariable logistic regression.

RESULTS: The prevalence of poor, satisfactory, good and excellent SRH was 17.9%, 60.3%, 20.4% and 1.4%, respectively. Clear gradient was observed across the categories of social deprivation: those who reported not having enough money to buy food (OR=5.40, 95%CI: 2.35-12.41), and those with enough money to buy food, but not cloths (OR=3.31, 95%CI: 1.44-7.62) had greater odds for reporting poor SRH compared to the most privileged group. Responders with vocational (OR=2.82, 95%CI: 1.38-5.77) and secondary (OR=2.83, 95%CI: 1.22-4.60) education were more likely to report poor SRH than those with higher education. Men tended to be less likely to report poor SRH (OR=0.58, 95%CI: 0.33-1.02). No differences in SRH were observed by ethnic background or marital status. 

CONCLUSIONS: We observed considerable variations in SRH by the index of social deprivation and education, but not marital status or ethnic background among elderly in Almaty, Kazakhstan. The factors that may explain the findings will be discussed.

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