Analysis of the social and health situation in elderly population assisted for the public health system in Medellin (Colombia)

INTRODUCTION: The rapid growth of elderly population in Colombia represents a challenge to social and health policies.  It is important to consider the burden of the chronic and oral diseases and the social determinants affecting this situation, especially in disadvantaged groups. The link between oral and general health are particularly pronounced in older populations and impairs their quality of life.  In this context, we aim to describe the social and health situation of older adults assisted for the public hospital network in the city of Medellin.

METHODS: Cross sectional study by means a 2-stage random sampling in the hospital units and health centers of the public health network “METROSALUD”. 352 adults ≥65 years participated of a face-to-face structured survey and a dental clinic examination. We described the socio-demographic characteristics, self-perceived general and oral health,  mental health (General Health Questionnaire GHQ-12), social support (Duke profile-11) and Oral Health-Related Quality of Life (OHRQL-GOHAI-12).  We conducted analyses separately for Men (M) and Women (W).

RESULTS: 84% of these adults live in low-income neighborhoods and 90% have studies ≤Primary. Prevalence of poor self-perceived health was 60% (similar in Men and Women). 69% considered their oral status as poor (M: 74%; W: 66%).  25% reported dental and oral problems in the last year (M: 20%; W: 28%). Poor mental health is referred for the 45% of respondents (M: 48.3%; W: 45.1%).  Low social support was observed in the 14.5% of elders (H: 15.4%; W: 16.3%). DTMF Index was 23.8; 95%CI 22.7-24.8  (M: 23.3; 95%CI 21.8-24.8 & W: 24.3; 95%CI 23.0-25.6).  67.9% of interviewed reported Poor OHRQL (M: 68.9%, W: 67.3%). No statistically significant differences were observed when analyzing  by sex.

CONCLUSIONS: The elderly population in Medellin is exposed to social vulnerability. Social policies and strategies based on a participatory model included multi-sectorial activities are acknowledged.