According to UN by the year 2025 the total number of elderly people in the
world will reach at 1200 million, which indicates that by this time 15% of the
total populations will reach 60 year or more (UN, 1997).
UN also stated that the world is experiencing an age-quake. Every month, one
million people reach at 60 years of age. In 1999 there were 593 million elderly
people in the world and this figure will be triple to nearly 2 billions by the
year 2050 (UN, 1999). It is true that the number of elderly
people is increasing rapidly in the developed countries but it is also increasing
in the developing countries with a great speed. More than half of the worlds
older population lives in developing countries (UNFPA, 2002).
In fact, the number of elderly people is increasing day by day in a very alarming
rate. In the USA, there are a lot of care services for their elderly people.
There are old homes, day-care centers and elderly societies for elderly people.
Eberstadt (1997) found that population aging is a great
challenge for the health care systems as nations age, the prevalence of
disability, frailty and chronic diseases, Alzheimers disease, cancer and
many other diseases is expected to increase dramatically. Rush
(2006) found that the incidence of lifestyle diseases increases among the
elderly people over the whole world which is not a sudden onset phenomenon but
an accumulation of changes in the expression of genes in response to nutrition
and environment from conception.
In Bangladesh, over the past decade there has been a significant decline in
infant and child mortality rate. Control and prevention of diseases, such as
measles, poliomyelitis and diphtheria along with extensive use of oral saline
for diarrheal diseases have greatly reduced childhood mortality, Bangladesh
is on the margin of Polio eradication and has already achieved the elimination
goal for leprosy at the national level. Kabir (1987,
1994) found that in poor families, both in rural and
urban areas, older people often unable to meet the demand due to extreme poverty
where food is the top priority needs. Ismail Hossain et
al. (2006) found that aged people in Bangladesh are mostly suffered
from various complicated physical diseases and the number is increasing day
by day but the services provided through government hospitals are inadequate
in compare to needs. A small proportion (around 6%) of the total population
of Bangladesh constitutes the elderly population, but the absolute number of
them is quite significant (about 7.2 million) and the rate of their increase
is fairly high. This change in population characteristics will have serious
consequences on society as well as on the overall socio-economic development
of the country (Banglapedia, 2006). In order to improve
the lives of older people in Bangladesh, the national health system should allocate
resources and design strategies to prevent and treat chronic disease. After
the independence, the government of Bangladesh initiated some programs like
pension, gratuity, welfare fund, aged fund (Boyosko Bhata), group insurance
and provident fund for retired government officials and employees. SSocio-economic
and health care issue of the elderly people in Bangladesh has not yet gotten
any importance though it is increasing alarmingly. The following table of population
projection of Bangladesh may knock our sense to take proper steps for the health
care issue of our elderly people.
Adult children, particularly sons, are considered to be the main source of
security and economic support to their parents, particularly in the time of
disaster, sickness and in old age (Cain, 1986). As an
Asian country, Bangladesh has a long cultural and religious tradition of looking
after the elderly and it is expected that families and communities will care
for their own elderly members. But rapid socio-economic and demographic transitions,
mass poverty, changing social and religious values, influence of western culture
and other factors, have broken down the traditional extended family and community
care system. Most of the elderly people in Bangladesh suffer from some basic
human problems, such as poor financial support, senile diseases and absence
of proper health and medicine facilities, exclusion and negligence, deprivation
and socio-economic insecurity (Rhaman, 2000). Aging
is one of the emerging problems in Bangladesh. This problem has been gradually
increasing with its far reaching consequences. A clear indication of increasing
Bangladesh demographic aging process has been found in the works of Nath
and Nazrul (2009) and Islam and Nath (2010). The
present study is done to gather overall information on socio-economic and health
profiles of the senior citizen in Bangladesh. This is motivated by the recognition
that the best approach to enhance the aged people's welfare in Bangladesh is
to increase their self-reliance and to provide them proper health care facilities
so that they can make themselves to have contribution to their family as well
as their society. Specifically it tries to investigate the determinants those
influence the socio-economic specially job status of the elderly people in Bangladesh.
MATERIALS AND METHODS
The present study was based on data collected from three selected districts (Sylhet, Mymensingh and Noakhali) of Bangladesh during October and November in 2007. A questionnaire was adopted. A pilot survey was taken to make reliable and concise questionnaires. Personal interview approach was followed for data collection from the field. The districts and areas within the districts are selected purposively and random sample was collected from the selected areas of each district. Finally a sample of 300 elderly people were selected for interview where 100 from each district. The data were analyzed by SPSS. Frequency distribution table and logistic regression model were used to analyze the data.
Variables for the Logistic Regression Model
Dependent variable (Y): Occupation of the Elderly (coded 0 for not in job and 1 for the elderly at job).
The explanatory variables used in the model are:
||Age of the respondents (coded 1 for 60-64
years, 2 for 65-69year and 3 for 70
||Looking after family (coded 0 for others and 1
||Level of education of the respondents (coded 0 for literate
and 1 for illiterate)
||Monthly income (coded 0 for 0-5000.00Tk. and 1
for 5000.00Tk. and above)
||Present state of health (coded 0 for not good
and 1 for average)
||Present physical problem (coded 0 for heart disease,
1 for diabetes and 2 for others)
||Bearing of medical expenditure by son and daughter (coded 0
for noand 1 for yes)
||Ability to remember important events of childhood or student life (coded
0 for noand 1 for yes)
RESULTS AND DISCUSSION
Bio-demographic characteristics of the elderly: This part of the study
aimed to gather the basic data about respondents age, gender, religion,
marital status (Table A1 in the appendix). Majority of the
respondents are in the age group 64-65 followed by age group 65-69 and 70 and
above. Among the respondents 73.3% were male and 26.3% were female. This finding
of the sex distribution of the elderly supports the work of Hossain
(2006) where he observed that female elderly were much lower than that of
male. This may be due to unpaid family labor and sex discrimination of healthcare
and food consumption, more female population in the study area died than that
of male. Among the three hundred respondents 88.3 % of them are Muslim, 10%
were Hindu. About 85% elderly were married and a very few (1%) were divorced.
The remarriage rate of the elderly is higher at Mymensingh than other two districts.
In Bangladesh older people-including married couples- traditionally like to
live with their sons. A vast majority of older people (53%) like to live in
joint or extended families (Khan et al., 2006).
Among the 300 elderly people in the study sites 53.7, 33.3 and 13% of them are
living in joint, unitary and extended respectively. Most of the family (43.3%)
has the total member between three and five and only 16.7% of them have up to
two members. It was observed that respondents of these three study sites in
respect of level of looking after family among them 44% were found that still
they are able to supervise their family and in 45.3% cases son of the elderly
people lead or take care of their family. A very few cases (2.3%) daughter take
care of their family. It was observed that among the three study sites 80% respondents
has number of son not more than three in the total sample where only 4% of the
respondents were found with having number of sons six or more. About 86% respondents
have number of daughters not more than three.
Socio-economic characteristics of elderly: This part of the survey investigated
the respondents income, expenditure, level of education, occupation, sanitation
etc. (Table A2 in the appendix). Most of the elderly people
in Bangladesh live in rural areas where health and recreation facilities are
very limited. The majority of them are illiterate; economic facilities and job
opportunities are limited. More than half of the elderly are widowed, divorced
or single. A large proportion of elderly men are still in labor force both in
rural and urban areas (Abedin, 1996).
The results showed that among the three study sites with respect to level of education, about 30% of elderly were found educated up to S.S.C. where 8% of them were found that they were able to read only the religious books the Holy Quaran, the Geta etc. Hence, it also showed that among three hundred elderly respondents 45% of them were illiterate. In this study, it is found that 33% of them were their previous occupation was agriculture whereas, a very few of them were engaged in fishing. It was also found that 22% elderly were engaged in business and 15.3% were in Government services.
It was found that 77% elderly using tube well water followed by 21.3% supply water and only 1.3% pond water. About 49% of the elderly were found with monthly income between one and five thousand taka where only 10% were found with monthly income around one thousand taka. Only 11% of the respondents had monthly income more than ten thousand taka. Again, it was found that 46.7% of elderly monthly expenditure varies between one and five thousand taka. About 18% elderly were doing their monthly expenditure within one thousand taka. The poor number (7.7%) of elderly was living with monthly expenditure more than ten thousand taka. About 66% of them were dwellers of tin shade house followed by 21% in building and slightly more than 8% in semi-building. Approximately 93 and 84% of them had their own house and land respectively. Most of the respondents (66%) have electricity facilities. The result also showed that a significant number of elderly (88%) had changed their economic status last fifty years. About 20% of the elderly get remittance from their family members. About 46% elderly expressed that they werent engaged in job due to lack of physical fitness followed by 15% due to other causes (age limitations, gender discrimination etc.). There were only 2% of them didnt find work. Majority of the family (54%) use wood as fuel in their cooking system followed by 22% having gas facilities.
Socio-economic determinants of current occupation of elderly: This section
of the study investigated the factors that are strongly connected with getting
the job of elderly population (Table 1). According to the
socio-economic framework of Bangladesh, current occupation is a vital determinant
of measuring socio-economic condition. More than 70% of men in both rural and
urban areas are paid workers and the proportion of elderly men in paid work
is found to decline with increasing age (Kabir et al.,
1998). It was found that most of the cases (63%) elderly people were jobless
whereas only 15 and 14% of them were continuing with agricultural works and
business respectively. This result is worse than that of Tehran city of Iran
where 85% elderly are unofficially employed (Kaldi, 2005).
Almost half (45.7%) of the elderly are illiterate. Among the secondary level
educated person 30% were found with jobless while 35% were found with some sort
Similarly, the percent of jobless elderly completed higher secondary and graduated level are 54 and 74, respectively. The findings reveal a clear indication that the jobless elderly was increasing according to their level of education. So, it can be inferred that education plays a key role on the current occupation of elderly people. Ownership of land also plays an important role on the over all solvency of elderly as well as their family. According to the present socio-economic framework of Bangladesh, elderly current job status depends on the number of family members residing in foreign country. Our sample profile indicates that only a few families having elderly person get foreign remittance. Again, it is found that maximum number of elderly without having any job belong lower class family.
Results of logistic regression analysis: In this part of the study,
the logistic regression model was fitted considering current occupation as a
dependent variable and tried to identify different factor that are related to
elderly occupation (Table 2). The odds ratio shows that the
young elderly (60-64) are almost three times more likely to have some sort of
job than elderly aged 70 and above. Similarly elderly aged between 65 and 69
is slightly (1.15 times) more likely to have some job than the elderly having
age more than 70.
|| Distribution of current occupation of the respondents according
to socio-economic determinants
|Values within the afterthought indicate percent of the column.
*Significant at 5% level, **Significant at 10% level
|| Logistic regression analysis of current occupation according
to some selected background characteristics
These findings indicate a negative association between age of the elderly
and current occupation of them. It was observed that elderly who look after
their family by themselves is 1.53 times more likely to involve with some sort
of job than those whom arent.
Again, there is a positive association has been found between the current occupation
of the elderly with their level of education. It is observed that educated elderly
were 1.42 times more likely to have some sort of job than those of illiterate.
Monthly family income is also associated with the current occupation of the
aged person where higher elderly of higher income family is more likely to involve
with some type of job. Elderly with average health condition is 1.59 times more
likely to continue some sort of job than that with not good health status. The
elderly, having diabetes, are 1.56 times more likely to involve with some sort
of job than those of suffering from heart diseases. It was also found that elderly
people who are suffering from other kind of diseases (high pressure, low pressure
and digestion problem) are 1.74 times more likely to have some sort of job than
those who are suffering from heart diseases. So, there is a significant association
between current occupation and type of physical problems of the respondents.
Again, there is a positive association between bearing medical cost of the elderly
by their offspring and current occupation of them.
This study is an attempt to obtain a better understanding about socio-economic
and health status of the elderly people. Various socio-economic and bio-demographic
characteristics that are related to the elderly people had been studied in this
study. From this study, it is found that age of the elderly, educational qualification,
monthly income, present health status, physical problems are statistically significant
with their occupational status. Majority of the elderly are without having any
job. For the betterment of the socio-economic status of the elderly some initiatives
should be started. At first, to ensure the financial solvency of the elderly
people, proper regulations should be developed to encourage their offspring
so that they could help their parents much more. Secondly, employment opportunity
should be made for the elderly people according to their physical and mental
fitness, educational qualification, needs and preferences. Thirdly, elderly
people mostly suffer from some physical illness and they need comprehensive
medical care services. So, separate ward or unit in a hospital or clinic need
to establish for elderly people. Finally, poor elderly people should be involved
in the development and implementation of programs and policies according to
their minimum needs. Since, the data does not represent the whole Bangladesh,
generalization of the findings and recommendations are risky. A comprehensive
study is needed to explore the exact status of the elderly, their needs and
proper recommendation for their well being.
||Percentage distribution of bio-demographic characteristics
of the respondents
||Percentage distribution of socio-economic characteristics
of the respondent