Comparisons of structure of physical health among the elderly in four Pacific cultures.

Abstract

Since health is closely related to sociocultural factors, a simple application of measures of health devised in Western developed countries to different societies might misrepresent reality. The aging of the population in developing countries adds to the importance of examining concepts and measures of health for their aged population within their particular sociocultural contexts. In addressing these issues, this dissertation examined a model of physical health for the elderly in Malaysia, the Philippines, Korea, and Fiji by using structural equation modeling technique. The evaluated model was further explored for its similarities and differences across these four cultures. This study identified chronic condition, functional limit, and self-evaluated health as three major dimensions of physical health across the cultures studied. Age, gender, education, and marital status explained less than 2.5% of the variance of chronic condition. These factors together explained from 21.7% to 26.9% of the variance of functional limit, while about one third to one half of the variance of self-evaluated health was explained by all these factors. The effects of the sociodemographic factors on each dimension of physical health were only partly supported with sampling variability in some instances. Across the four cultures, older elderly experienced more functional limit than their counterparts. More educated elderly had better self-evaluated health after controlling for the other dimensions. The effects of marital status on functional limit and self-evaluated health were not significant in all four cultures. Cross-cultural comparisons revealed different patterns of defining each dimension of physical health between the four cultures except between the Korean and the Fijian elderly. Inequivalent structural coefficients between the dimensions indicate that no two cultures shared the same causal process. The sociodemographic effects on each dimension were similar between the Korean and the Fijian elderly only. The findings from cross-cultural analysis support the belief that physical health is strongly associated with sociocultural factors. Since there are cultural differences in the effects of being older, being a woman, and being educated on physical health, transferring evaluations of physical health among the elderly to other societies is not justified without careful examination of sociocultural contexts.