Massey Emma, Smith James, Roberts Bayard
London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH UK.
Confl Health. 2017 Dec 11;11:29. doi: 10.1186/s13031-017-0133-x. eCollection 2017.
The combination of global demographic changes and a growing number of humanitarian crises in middle-income countries that have a higher life expectancy has led to an increase in the number of older populations affected by humanitarian crises. The aim of this review was to systematically examine evidence on the health needs of older populations in humanitarian crises, including both armed conflicts and natural disasters, in low- and middle-income countries (LMICs).
A systematic review methodology was used. The search strategy used terms related to older populations and humanitarian crises in LMICs. Five bibliographic databases were used, along with relevant grey literature sources. Descriptive analysis was used, and a quality assessment conducted using the Newcastle-Ottawa Scale and CASP instruments.
A total of 36 studies were eligible for review. The majority of the studies were cross-sectional, three were cohort studies, and four used qualitative methodologies. The main health outcomes were mental health, physical health, functioning, and nutrition. Vulnerability factors included older age, female gender, being widowed, increased exposure to traumatic events, prior mental health problems, low income and education, and rural residency. Ten studies addressed the responsiveness of health systems and access to such services. The quality of the included studies was generally low.
There is an urgent need to strengthen the evidence base on the health needs of older populations in humanitarian crises.
全球人口结构变化,以及预期寿命较高的中等收入国家中日益增多的人道主义危机,导致受人道主义危机影响的老年人口数量增加。本综述的目的是系统地研究低收入和中等收入国家(LMICs)中受人道主义危机(包括武装冲突和自然灾害)影响的老年人口健康需求的证据。
采用系统综述方法。检索策略使用了与LMICs中老年人口和人道主义危机相关的术语。使用了五个文献数据库以及相关的灰色文献来源。采用描述性分析,并使用纽卡斯尔-渥太华量表和CASP工具进行质量评估。
共有36项研究符合综述条件。大多数研究为横断面研究,三项为队列研究,四项采用定性方法。主要健康结果包括心理健康、身体健康、功能和营养。脆弱性因素包括高龄、女性、丧偶、遭受创伤事件的机会增加、既往心理健康问题、低收入和低教育水平以及农村居住。十项研究探讨了卫生系统的响应能力以及获得此类服务的情况。纳入研究的质量普遍较低。
迫切需要加强关于人道主义危机中老年人口健康需求的证据基础。