fitness news
Font size Women’s Health
Disability among Older Women and Men in Fiji
– Reported, April 05, 2012
The purpose of this study is to employ the limited data available on disability in Fiji to examine the composition of the elderly population at risk of disability and to speculate the impact of disability on the quality of their lives and their longevity. Using census and survey data, estimates of unimpaired life expectancy across time are presented for older people as well as the risk of being impaired as of 1996. From a planning perspective, the study discusses medical and support services that may be needed to support other older individuals in Fiji. The study also describes policy implication of the findings focusing on older women and considers the implications for older women of other developing countries.
Fiji consists of 330 islands, of which one third are inhabited. Located in the lower apex of the Polynesian triangle, northeast of New Zealand and bordering the International Dateline, this multi-ethnic society has benefited through primary industries in agriculture (specifically sugar), tourism and recently manufacturing. The elderly population in Fiji has been growing steadily over the past 30 years with the median age increasing from 16.5 to 21.2 years between 1966 and 1996. In the same period the size of the elderly population 60 and older increased from 3.5 percent to 5.4 percent. This growth among the elderly is expected to continue, reaching 7.0 percent of the population by the year 2006 and 13.0 percent by 2026 (Fiji Bureau of Statistics, 1998; U.S. Census Bureau, 1999). The total Fiji population is almost evenly divided between ethnic Fijians and Indians whose ancestors served as indentured laborers when Fiji was under British colonial rule. In 1996 there were 37,034 individuals 60 and older of which 57 percent were Fijians and 42 percent were Indians. Elderly women outnumbered elderly men with a sex ratio of 1.06. Women also have a longer life expectancy of 69 years compared to 65 years for men (Fiji Bureau of Statistics, 1998).
Like many developing nations, care and support for the elderly in Fiji is anchored in the family. National level entitlement programs such as social security and Medicare are non-existent and old age pensions are limited to only a few. Traditionally women have cared for elderly parents at home but this type of arrangement is changing as women become educated and enter the labor force reducing the pool of potential caregivers. The shift to a cash based economy in Fiji has also required women to increasingly engage in wage employment to help with family expenses .
A descriptive analysis of the total elderly population at risk of disability in the first column and then broken down by gender in the last two columns for Fiji in 1996. Overall, there are 37,034 elderly of which less than 10 percent experienced a disabling condition. Contrary to developed countries, disability is slightly more prevalent among men than women. Marriage remains common among the elderly with only 35 percent of the total elderly population widowed, though this is more a function of older men who remarry compared to older women where the option to remarry is limited. Overall, disability is most prevalent among older widowed women and married older men. The majority of older Fijians are classified as a household head or spouse. The prevalence of disability is higher among older individuals classified as a relative or parent; this is true for both older females and males. While a large proportion of older women have no education compared to older men reflecting a bias toward men, the prevalence of disability is negatively associated with increasing levels of education. As we would expect old age disability is more prevalent in rural than urban areas where 85 percent of the elderly reside.
A comparision changes in disability rates among the elderly in 1985 and 1996. As expected, the risk of becoming disabled increased at older ages; this is true for all subgroups examined. In terms of overall rates, it appears that while the pattern of disability has remained consistent across time among women and men and subgroups examined, the onset of disability has increased at a faster rate between 1985 and 1996. Table 2 presents a multivariate survival model that predicts the waiting time to the onset of disability by select demographic characteristics. The first two columns represent population estimates and population odds ratios, and this sequence is then repeated for
males and females. Accordingly the overall impacts of the control variables on the timing of disability, while highly significant, remain relatively modest. According to the overall population model, gender and urban residence represent the most powerful variable in terms of explanatory power. Women have an 11 percent slower rate of becoming disabled than men. The same is true for urban compared to rural residents. The onset of becoming disabled is 6 percent slower for Indians than Fijians with Indian females having the longest delay before becoming disabled.
As would be expected, lower levels of education are associated with an increased hazard of disability with those having a grade school education or less experiencing a decline in the timing to disability of 5 percent compared to those elderly with more than a grade school education. Women obtain the greatest benefit from residing in urban areas gaining a 14 percent increase in the timing to disability compared to women in rural areas .
While men residing in urban areas gain a 9 percent increase in disability free life compared to males in rural areas.
A multivariate logistic regression model of the likelihood of being disabled based on select demographic variables. Consistent with the increased risk of chronic morbidity associated with the aging life course, the likelihood of becoming disabled increases by 6 percent for each year increase in age. Overall, females are 39 percent less likely to be disabled than males, a potential outcome of cumulative differences in the roles and activities performed by men and women in Fiji and also lifestyles with drinking and smoking habits that tend to be common among men. Overall, being widowed increases the risk of being disabled by 6 percent while widowed females are 59 percent more likely to be disabled than others. [Sela, it is not clear how the result in the previous sentence differs from the results when women and men are models independently. Please clarify] When males and females are modeled independently this difference is even sharper. Widowed males are 8 percent more likely to be disabled compared to married males, but widowed females are 63 percent more likely to be disabled when compared to married females. These relationships are highly significant.
Consistent with the previous analysis, the logistic model finds Indians as 23 percent less likely to be disabled compared to older Fijians with Indian females being 20 percent less likely to be disabled compared to others. Increases in the level of education have a slight insulating effect on the risk of disability regardless of gender. As expected, elderly residents in urban areas are 39 percent less likely to be disabled compared to elderly rural residents. The likelihood of being disabled increases significantly if you are the spouse or parent of the household head by over 60 percent compared to being a non nuclear relative.
This study show that widowed women represent a subpopulation of females at high risk of disability compared to other elderly subpopulations. Widowed females are also particularly vulnerable to poverty and unmet need for health care and support services. The pattern of selectivity towards disabled widows is also reflective of marriage market processes within Fiji. Even healthy women surviving into older ages are unlikely to remarry and the very weak may die early compared to men who often remarry after widowhood despite disabilities. Qualitative work has suggested that women who are not disabled enough to die, but disabled enough to be unattractive in the remarriage market often go on to form small independent households when they are not absorbed into the household of a child.These independent households are typically poor and these disabled females may receive little or no direct support from family members as their disabilities leave them unable to contribute to the large family economies that underlie Pacific exchange networks.
This study suggests patterns and prevalence rates of disability that will need to be addressed in the very near future. Although the pace and prevalence of disability among the elderly has grown markedly since 1985, little parallel growth has occurred in the provision of services for the elderly. This must change as the needs of the elderly will increase in the coming decades. Without substantial input from government infrastructures, families will be challenged to support the increased needs of growing numbers of older people.
While the government of Fiji is unlikely to provide direct support for the elderly they can provide services and health care institutions for the elderly. These kinds of indirect supports allow the elderly to obtain a higher quality of life that in turn will help them maintain a productive family role. Productive contributions to the family economies increase the likelihood that they will remain within the traditional support networks that provide the direct care the government cannot duplicate. As argued in this paper, these systems are complex and heavily interdependent. Without a fuller understanding of how these interdependencies operate it is difficult to generate rational policy.
Credits: Sela V. Panapasa
More Information at: http://www.psc.isr.umich.edu/pubs/pdf/rr02-501.pdf
For more Fiji News Click Here