Influence of socioeconomic determinants on health literacy and self- management practices among elderly residents in Thailand

Abstract

Background Socioeconomic factors are known to influence health literacy and self- management among elderly populations. This study investigated the influence of socioeconomic determinants on health literacy and self- management among elderly people living in both rural and urban areas in Thailand. Methods This study was conducted among elderly people living in one rural area (Phon Ngam village) and one urban area (Tha Ka Suem village). Data were collected between 1 March and 31 July 2021 using multiple validated tools with appropriate data analyses. Results A total of 2870 participants were recruited; comprising of 1430 participants in the rural area and 1440 participants in the urban area with a mean age of 69.7 ± 7.77 years. There was a significantly higher proportion of elderly people with financial dependent status in the rural area compared to those in the urban area (91.0% vs 81.3%, respectively, p < 0.001). Participants in the rural area significantly received health information more than those living in the urban area (95.1% vs 80.9%, p < 0.001), particularly health information from community health workers (88.5% vs 33.1%, respectively p < 0.001). The proportion of poor health literacy in many perspectives were significantly higher in the rural group than their urban counterpart, nonetheless the elderly in the rural area were more likely to perform self-care practices based on provided health information compared to those living in the urban area (42.5% vs 35.7%, respectively, p < 0.001) Overall, participants were overweight (mean BMI = 23.2 ± 3.9 Kg/m²), but the rural group had healthier BMI than the urban group (BMI 22.8 ± 4.01 vs 23.5 ± 3.80 Kg/m² respectively, p < 0.001). Receiving health information was a significant predictor of appropriate self-management practices such as healthy weight management, healthy diet and being active. Conclusions Majority of the study population have received health information and had fair health literacy and self-management practices. Nonetheless, differences in health literacy and self-management existed between rural and urban areas. Future investigation of this public health issue is warranted to gain deep insights into the needs and barriers elderly people face in both rural and urban areas in Thailand. This will assist create health interventions and policies for this vulnerable population.