Self-rated health disparities among disadvantaged older adults in ethnically diverse urban neighborhoods in a Middle Eastern country

Abla Mehio Sibai, Anthony Rizk, Hiam Chemaitelly

Research output: Contribution to journalArticle

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Abstract

Objectives: 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. Design: 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. Results: 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). Conclusions: 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.

Original languageEnglish
Pages (from-to)490-509
Number of pages20
JournalEthnicity and Health
Volume22
Issue number5
DOIs
Publication statusPublished - 3 Sep 2017

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Vulnerable Populations
Health
health
Economics
Lebanon
social capital
social economics
Urban Health
Refugees
Health Surveys
Health Disparities
Palestinian
cross-sectional study
economic factors
social factors
Public Health
community
Cross-Sectional Studies
refugee
Logistic Models

Keywords

  • conflict
  • displacement
  • ethnicity
  • Lebanon
  • older adults
  • Self-rated health
  • urban health

ASJC Scopus subject areas

  • Cultural Studies
  • Arts and Humanities (miscellaneous)
  • Public Health, Environmental and Occupational Health

Cite this

Self-rated health disparities among disadvantaged older adults in ethnically diverse urban neighborhoods in a Middle Eastern country. / Sibai, Abla Mehio; Rizk, Anthony; Chemaitelly, Hiam.

In: Ethnicity and Health, Vol. 22, No. 5, 03.09.2017, p. 490-509.

Research output: Contribution to journalArticle

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N2 - Objectives: 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. Design: 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. Results: 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). Conclusions: 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.

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