INFLUENCE OF HEALTH CHALLENGES ON NUTRITIONAL LIFESTYLE OF THE ELDERLY IN RURAL AND URBAN HOUSEHOLDS (A CASE STUDY OF SURULERE L.G.A, OYO STATE)

CHAPTER ONE

INTRODUCTION

1. BACKGROUND OF THE STUDY

Recently, the challenges of health in the elderly have drawn a great deal of attention worldwide, and there are more people devoting themselves to the field of the elderly. Since the aged have a better and healthier life by participating in leisure activities. The Elderly comprise a considerable portion of the Nigeria nation population; based upon 2009 data, they represent 7.4% of the total population, and 57.2% of those aged 65 and above (Nigeria Bureau of Statistics 2010). Indeed, it is projected that the proportion of individuals between 65 years of age or older will increase to 11.7% of the Nigerian population by the year 2026 (Nigeria Bureau of Statistics 2010). Moreover, many aged or elderly people are poor; 21.5% of people 65 years of age or older were considered low income in 2012, as measured by the Nigeria Bureau of Statistics low-income cut-offs (NBS 2010). In fact, older people are more likely than younger people to be poor at each stage of their lives, as well as being more likely to be ensnared in a lifetime of poverty (Lochhead & Scott, 2012). This general trend of poverty among the elderly is worrisome, given that income is a major determinant of health (Bolig, Borkowski & Brandenberger, 2009). Thus, given that the Aged 65 and older will make up an ever greater portion of the Nigerian population in the future, their health and well-being will also be of increasing importance. Additionally, more than 75% of aged in Nigeria is living in rural areas (Nigeria Bureau of Statistics 2010), and as shown, these elderly have unique challenges and experiences due to their rural residency. Research establishes that rural residency can have both a positive and negative effect on health (Gerritsen, Wolffensperger & Van Den Heuvel, 2010; Mitura & Bollman, 2012). Notably, individuals with low income are more prevalent in rural areas, and are associated with poorer health status. Research also suggests that rural residents receive more community support (indicating a higher level of “social capital”), which may suffer the effects of low-income on health status (McCulloch, 2011; Pearson, Scott & Roberto, 2012). An enormous proportion of the world’s elderly live in rural areas and show wide variations in health status. Many, particularly those in the developing countries, are vulnerable to greater socioeconomic and health marginalization mainly due to inadequate provision of services and economic deprivation. As with the urban elderly, locomotors, visual and hearing disabilities, as well as life-threatening conditions of coronary heart disease, diabetes and hypertension are common among rural elders also. Infections continue to take a heavy toll in the lives of the elderly in many parts of the world. The 20th century witnessed in many regions of the world, increased numbers of the elderly. This was mainly due to the control of perinatal and infant mortality, a decline in birth rates, improvement in nutrition, basic health care, and the control of many infectious diseases. This combination of factors has resulted in an increasing number and proportion of persons surviving into the advanced stages of life. The continued increase in the proportion of the elderly is projected to continue to occur more in the developing countries than their developed counterparts in the future decades. This is due to the fact that the developing countries are in the second stage of demographic transition, where there is high birth rate and low death rate compared with the developed countries that are in fourth stage of the demographic transition, where low birth rate balances low death rate. In Nigeria, the life expectancy has increased from 37 years at independence in 1960 to about 50 years currently. Increase in life expectancy has been associated with increasing prevalence of chronic diseases, disability dependent life, and utilization of costly health care services.Similarly, the increasing number of elderly persons poses peculiar health, social, and economic challenges. However, surveys carried out in Nigeria have been mainly hospital-based, and in major cities and therefore have not provided sufficient information on the health problems at the community level. In order to develop adequate health care strategies targeted at the needs of the elderly, information on the pattern of specific acute and chronic health conditions is required. This information would be important for the development of appropriate primary health care programs for the elderly at the community level.

STATEMENT OF PROBLEM

In Nigeria, poverty and poor infrastructural development which perpetrated rural and urban communities where most elderly people reside constraint them from achieving good well- being. Traditionally, the elderly are expected to rely primarily on their families for economic and emotional support. At times if family support mechanism fails, community help may be available. However, the collapse in family ties and structure also have negative effect on elders who are used to enjoy supports from extended joint families where traditionally the elders are respected and properly catered for. Due to the youthful nature of Nigeria age structure, government believes that the health problems that manifest among children and youths need more attention than that of the elderly. As a result, very little consideration is given to elderly in Nigeria by both the research community and policymakers. Average household sizes are large and a substantial proportion of older adults live alone. The economies of the elderly (65 years and above) in Surulere where the current study was conducted are predominantly supported by subsistence agriculture, which provides little or no pension coverage and limited health care services.

Nigerians age 65 and over are an important and growing segment of Nigeria population, there remains a gap in knowledge. In Nigeria, there has been limited research on influence of health challenges on nutritional lifestyle of the elderly, especially in rural and urban settings.

AIMS OF THE STUDY

The major purpose of this study is to examine influence of health challenges on nutritional lifestyle of the elderly in rural and urban households. Other general objectives of the study are:

1. To examine the living conditions and food intake of the elderly in rural and urban households in Surulere L.G.A.

2. To examine the alcohol consumption patterns in relation to health problems among elderly persons in rural and urban households.

3. To examine the influence of health challenges on nutritional lifestyle of the elderly in rural and urban households.

4. To assess and compare the nutritional status of elderly people living in rural and urban households in Surulere L.G.A.

5. To examine the relationship between health challenges and nutritional lifestyle of the elderly in rural and urban households.

6. To examine the risk factors associated with nutritional vulnerability and recommend strategies for promoting better nutrition among elderly in rural and urban households.

RESEARCH QUESTIONS

1. What are the living conditions and food intake of the elderly in rural and urban households in Surulere L.G.A?

2. How are the alcohol consumption patterns in relation to health problems among elderly persons in rural and urban households?

3. What is the influence of health challenges on nutritional lifestyle of the elderly in rural and urban households?

4. How is the nutritional status of elderly people living in rural and urban households in Surulere L.G.A?

5. What is the relationship between health challenges and nutritional lifestyle of the elderly in rural and urban households?

6. What are the risk factors associated with nutritional vulnerability and recommended strategies for promoting better nutrition among elderly in rural and urban households?

RESEARCH HYPOTHESES

Hypothesis 1

1.  there is no significant influence of health challenges on nutritional lifestyle of the elderly in rural and urban households.
2. there is significant influence of health challenges on nutritional lifestyle of the elderly in rural and urban households.

Hypothesis 2

H0: There is no significant relationship between health challenges and nutritional lifestyle of the elderly in rural and urban households

H1: There is a significant relationship between health challenges and nutritional lifestyle of the elderly in rural and urban households.

SIGNIFICANCE OF THE STUDY

This study has the following significance: Owing to the high level of poverty, health challenges and its prevalence in Oyo State, Nigeria and the world in general, there is a need to study the health challenges associated with Nutritional lifestyle of these elderly people so as to assist them to understand how to modify their diet. This will improve their health condition and also the development of the community.

SCOPE OF THE STUDY 

The study is based on the influence of health challenges on nutritional lifestyle of the elderly in rural and urban households of Surulere L.G.A of Oyo state.

LIMITATION OF STUDY

Financial constraint- Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).

Time constraint- The researcher will simultaneously engage in this study with other academic work. This consequently will cut down on the time devoted for the research work.

DEFINITION OF TERMS

Health: As defined by the World Health Organization (WHO), are "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity

Nutrition: Is the science that interprets the interaction of nutrients and other substances in food in relation to maintenance, growth, reproduction, health and disease of an organism. It includes food intake, absorption, assimilation, biosynthesis, catabolism, and excretion.

Lifestyle: Lifestyle is a term to describe the way individuals, family circles, and societies live and which behaviour they manifest in coping with their physical, psychological, social, and economic environments on a day-to-day basis. It is closely related with the concept of risk, with multiple and complex interferences. 

Nutritional Lifestyle: It includes getting a healthy diet that helps to maintain or improve overall health. A healthy diet provides the body with essential nutrition: fluid, macronutrients, micronutrients, and adequate calories. For people who are healthy, a healthy diet is not complicated and contains mostly fruits, vegetables, and whole grains, and includes little to no processed food and sweetened beverages. The requirements for a healthy diet can be met from a variety of plant-based and animal-based foods, although a non-animal source of vitamin B12 is needed for those following a vegan diet. 

Rural: A rural area or countryside is a geographic area that is located outside towns and cities. The Health Resources and Services Administration of the U.S. Department of Health and Human Services define the word rural as encompassing "...all population, housing, and territory not included within an urban area.

Urban: An urban area or urban agglomeration is a human settlement with high population density and infrastructure of built environment. Urban areas are created through urbanization and are categorized by urban morphology as cities, towns, conurbations or suburbs.