a Department of Epidemiology and Population Health, Faculty of Health Sciences , American University of Beirut , Beirut , Lebanon.
b Infectious Disease Epidemiology Group , Weill Cornell Medicine-Qatar, Qatar Foundation, Education City , Doha , Qatar.
Ethn Health. 2017 Oct;22(5):490-509. doi: 10.1080/13557858.2016.1244736. Epub 2016 Oct 15.
This paper examines differentials in self-rated health (SRH) among older adults (aged 60+ years) across three impoverished and ethnically diverse neighborhoods in post-conflict Lebanon and assesses whether variations are explained by social and economic factors.
Data were drawn from the Older Adult Component (n = 740) of the Urban Health Survey, a population-based cross-sectional study conducted in 2003 in a formal community (Nabaa), an informal settlement (Hey El-Sellom), and a refugee camp for Palestinians (Burj El-Barajneh) in Beirut, Lebanon. The role of the social capital and economic security constructs in offsetting poor SRH was assessed using multivariate ordinal logistic regression analyses.
Older adults in Nabaa fared better in SRH compared to those in Hey El-Sellom and Burj El-Barajneh, with a prevalence of good, average, and poor SRH being respectively, 41.5%, 37.0%, and 21.5% in Nabaa, 33.3%, 23.9%, and 42.7% in Hey El-Sellom, and 25.2%, 31.3%, and 43.5% in Burj El-Barajneh. The economic security construct attenuated the odds of poorer SRH in Burj El-Barajneh as compared to Nabaa from 2.57 (95% confidence interval, CI: 1.89-3.79) to 1.42 (95% CI: 0.96-2.08), but had no impact on this association in Hey El-Sellom (odds ratio, OR: 2.12, 95% CI: 1.39-3.24). The incorporation of the social capital construct in the fully adjusted model rendered this association insignificant in Hey El-Sellom (OR: 1.49, 95% CI: 0.96-2.32), and led to further reductions in the magnitude of the association in Burj El-Barajneh camp (OR: 1.18, 95% CI: 0.80-1.76).
The social context in which older adults live and their financial security are key in explaining disparities in SRH in marginalized communities. Social capital and economic security, often overlooked in policy and public health interventions, need to be integrated in dimensions of well-being of older adults, especially in post-conflict settings.
本文考察了黎巴嫩冲突后 3 个贫困且族裔多样的社区中，60 岁以上老年人的自评健康（SRH）差异，并评估了这些差异是否可以用社会经济因素来解释。
数据来自 2003 年在黎巴嫩贝鲁特一个正规社区（纳巴阿）、一个非正规住区（海埃尔-塞勒姆）和一个巴勒斯坦难民营（布尔吉巴拉杰内赫）进行的城市健康调查的老年人群体部分（n=740），这是一项基于人群的横断面研究。使用多变量有序逻辑回归分析评估社会资本和经济安全结构在弥补较差的 SRH 方面的作用。
与海埃尔-塞勒姆和布尔吉巴拉杰内赫的老年人相比，纳巴阿的老年人在 SRH 方面表现更好，良好、一般和较差的 SRH 患病率分别为 41.5%、37.0%和 21.5%、33.3%、23.9%和 42.7%、25.2%、31.3%和 43.5%。经济安全结构将布尔吉巴拉杰内赫与纳巴阿相比，降低了较差的 SRH 的可能性，从 2.57（95%置信区间，CI：1.89-3.79）降至 1.42（95% CI：0.96-2.08），但对海埃尔-塞勒姆没有影响（比值比，OR：2.12，95% CI：1.39-3.24）。在完全调整的模型中纳入社会资本结构，使海埃尔-塞勒姆的这种关联变得不显著（OR：1.49，95% CI：0.96-2.32），并导致布尔吉巴拉杰内赫营地的关联程度进一步降低（OR：1.18，95% CI：0.80-1.76）。
老年人生活的社会环境和他们的经济安全是解释边缘化社区中 SRH 差异的关键。社会资本和经济安全在政策和公共卫生干预措施中往往被忽视，需要纳入老年人福祉的各个方面，特别是在冲突后环境中。
