Department of Global Health Entrepreneurship, Tokyo Medical and Dental University, Tokyo, Japan.
Faculty of Public Health, Naresuan University, Phitsanulok, Thailand.
Health Soc Care Community. 2022 Nov;30(6):e5213-e5222. doi: 10.1111/hsc.13940. Epub 2022 Jul 27.
A substantial number of skipped generation households (SGHHs), where grandparents live with grandchildren in the absence of the middle generation, is observed in Thailand. The functional health (FH) of older adults with SGHHs is a concern because many of them take care of their grandchildren. While some studies have indicated the socioeconomic vulnerabilities of SGHHs, a social value on intergenerational exchange is considered favourable to SGHHs. This study examined the FH of older adults in SGHHs in comparison with those in other living arrangements, after adjusting for sociodemographic variables based on a population-based survey in Thailand. A total of 41,752 adults aged ≥60 years were selected for the analysis from the 2017 Survey of Older Persons in Thailand (SOPT). The living arrangements considered were SGHHs, living alone, living with a spouse only and co-residing with children with or without grandchildren. The FH was evaluated based on basic activities of daily living (ADL), functional ability and instrumental ADL, and analysed according to living arrangements using multiple regression analysis. The proportion of older adults in SGHHs in Thailand was 8.9%. Among them, 72.9% were in rural areas, 88.7% did not attain primary education and 53.9% were in two poorer quintiles of wealth status. After adjustment for sociodemographic variables, the FH of older adults in SGHHs was significantly higher than that of those co-residing with children with or without grandchildren, but significantly lower than that of those living alone or with a spouse only. The study highlighted that despite better FH than those who co-reside with children, sociodemographic characteristics of older adults in SGHHs seem to be at a disadvantage. Attention should be paid to social services to help families in SGHHs.
泰国存在大量隔代家庭（SGHH），即祖父母与孙辈同住而没有中间一代。SGHH 中的老年人的功能健康（FH）是一个值得关注的问题，因为他们中的许多人需要照顾孙辈。虽然一些研究表明 SGHH 存在社会经济脆弱性，但代际交流的社会价值被认为对 SGHH 有利。本研究在调整基于泰国人口普查的社会人口学变量后，比较了 SGHH 中的老年人与其他生活安排中的老年人的 FH。从 2017 年泰国老年人调查（SOPT）中选择了 41752 名年龄≥60 岁的成年人进行分析。考虑的生活安排包括 SGHH、独居、仅与配偶同住以及与有或没有孙辈的子女同住。FH 根据基本日常生活活动（ADL）、功能能力和工具性 ADL 进行评估，并根据生活安排使用多回归分析进行分析。泰国 SGHH 中老年人的比例为 8.9%。其中，72.9%的人居住在农村地区，88.7%的人没有接受过小学教育，53.9%的人处于财富状况的两个较贫穷五分位数。在调整社会人口学变量后，SGHH 中老年人的 FH 明显高于与有或没有孙辈同住的老年人，但明显低于独居或仅与配偶同住的老年人。研究强调，尽管 SGHH 中的老年人 FH 比与子女同住的老年人好，但他们的社会人口学特征似乎处于不利地位。应注意为 SGHH 中的家庭提供社会服务。
