The Self-Evaluated Health And Health Conditions Of Rural Residents In A Developing Country
2851-2863
Correspondence
Paul Andrew Bourne, Research Fellow, Department of Community Health and Psychiatry, the University of the West Indies, Mona, Kingston 7, St. Andrew, Jamaica, West Indies. Email: paulbourne1@yahoo.com. Tel.: (876) 457-6990. Fax: (876) 977-6346.
Background: In Jamaica, in 1989, the national poverty rate was 30.5% and this exponentially fell by 208.1% in 2007, but in the latter year, rural poverty was 4 times more than in the peri-urban areas and 3 times more than the urban poverty rate. Yet, there was no study on health status and health conditions in order to examine the changes among the rural residents. Aims: The present study aimed to (1) examine epidemiological shifts in the typology of the health conditions in rural Jamaicans, (2) determine the correlates and the estimates of the self-evaluated health status of the rural residents, (3) determine the correlates and estimates of the self-evaluated health conditions of the rural residents and (4) assist policy-makers in understanding how intervention programmes can be structured to address some of the identified inequalities among the rural residents in Jamaica.
Methods and Material: The current study involved the extraction of the samples of 15,260 and 3,322 rural residents from two national cross-sectional surveys (2002 and 2007 Jamaica Survey of Living Conditions).
Setting and Design: The survey was drawn using stratified random sampling. This design was a two-stage stratified random sampling design, where there was a Primary Sampling Unit and a selection of dwellings from the primary units.
Statistical Analyses: Statistical analyses were performed by using the Statistical Package for the Social Sciences. Descriptive statistics such as mean, standard deviation, frequency and percentage were used to analyze the socio-demographical characteristics of the sample. The Chi-square test was used to examine the association between the non-metric variables and multiple logistics were used to establish the factors that explained a dichotomous dependent variable.
Results: In 2002, 14% of the respondents indicated having an illness in the 4-week period of the survey as compared to 17% in 2007. In 2002, there were 12 determinants of health: 11 social and 1 psychological, whereas in 2007, there were 7 determinants of health: 6 social and 1 biological. The determinants accounted for 22.6% of the explanatory power of the health model for 2002 and 44.7% for 2007.
Conclusion: With the exponential increase in diabetes mellitus and the health inequalities that exist today in rural Jamaica, public health authorities and other policy-makers need to use multidimensional intervention strategies to address those inequalities.