y olog & G nt er o ia r tr e i c G f R o e l s Journal of e a a n r r c u Bourne et al., J Gerontol Geriat Res 2014, 3:3 h o J Gerontology & Geriatric Research DOI: 10.4172/2167-7182.1000153 ISSN: 2167-7182 Research Article Open Access Living Beyond the Life Expectancy: A Self-Rated Health Viewpoint Paul Andrew Bourne1, Ikhalfani Solan2, Charlene Sharpe-Pryce3, Jannine Campbell-Smith4, Angela Hudson-Davis5, Olive Watson-Coleman6 and Joan Rhule7 1Socio-Medical Research Institute, Jamaica 2Department of Mathematics and Computer Science, South Carolina State University, USA 3Chair, Department of History, Northern Caribbean University, Mandeville, Jamaica 4Cable and Wireless Company Limited, Jamaica 5Capella University, USA 6Southern Connecticut State University, USA 7University of Technology, Kingston, Jamaica *Corresponding author: Paul Andrew Bourne, Director, Socio-Medical Research Institute, 66 Long Wall Drive, Kingston 9, Kingston, Jamaica, WI, Tel: 876-566 3088; E-mail: [email protected], [email protected] Rec date: Feb 17, 2014; Acc date: Apr 11, 2014; Pub date: Apr 14, 2014 Copyright: © 2014 Bourne PA, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Introduction: One of the drawbacks to using life expectancy to evaluate the health status of a country is the absence of capturing ‘healthy’ years and/or the quality of lived years. Self-rated health provides more information to the health discourse, which are not supplied by life expectancy. Objectives: In the current study we seek to 1) determine the health conditions of people living beyond the life expectancy in Jamaica, 2) examine the health status of people living beyond the life expectancy in Jamaica, and 3) evaluate factors that influence good self-rated health status of people living beyond the life expectancy in Jamaica. Methods: For this work, data from 2007 Jamaica Survey of Living Conditions was utilised. The sub-sample for this study was 321 men and women beyond 71 years and 74 years respectively. Findings: Fifty-one percent of the sample reported an illness (females, 51.9%; males, 50.0%); 3.6 times more females were diagnosed with diabetes mellitus than males and 1.3 times more females having hypertension than males. However, 2.7 times more males were diagnosed with arthritis than their female aged counterparts (χ2 = 25.844, P < 0.0001). A statistical relationship existed between self-reported illness and self-rated health status (χ2= 51.547, P < 0.0001). Conclusion: The is enough empirical evidence to support gendered health and area-specific perspectives in the health care and management of people living beyond the life expectancy and that intervention programmes must be tailored with these new knowledge. Keywords: Elderly; Developing nation; Health; Life expectancy; Life tables emerged from mortality statistics and they were Surpassing the life expectancy; Social determinant employed by demographers, actuaries, and health practitioners to measure mortality patterns, which was a noble approach at the time to Introduction estimate health status. Since the first life table was developed and published in 1693 by Halley, where the researcher collected and used Life expectancy is a concept developed by demographers to data on birth and death registration for the city of Breslau during 1687 represent the number of years an infant is expected to live if he/she and 1691 [3], it is widely applied and primarily relied upon to subscribes to the mortality pattern of people in a particular locality. It determine the health of a population. In 2009, the Statistical Institute is an objective approach that essentially measures mortality; but is of Jamaica wrote that “Mortality improvements have been reflected in equally employed to evaluate longevity and health status of a overall life expectancy”[4], which accounts for the dominance of population. Embedded in life expectancy is its reliance on mortality mortality statistics in various statistical publications such as the World data in interpreting survivorship, life expectation and health status. It Health Statistics, US Census Bureau, United Nations Population assumes that living means one is healthy and that the individual who is statistics, and Demographic Statistics by STATIN. alive would have outlived ailment and injury, making him/her healthy. The use of mortality data to estimate health of a population dates back The rationale why healthy life expectancy is important in ageing to the late seventeenth century (the work of John Graunt entitled Bills discourse is primarily because ageing means increased dysfunctions of Mortality) [1] and even earlier by the Romans [2] because of its and the unavoidable degeneration of the human body. Therefore, in its positivistic nature - stressing an epistemological priority of models and attempt to capture ‘quality of lived years’, in 1999, the WHO has by extension causal explanations. introduced an approach that allowed us to evaluate this, ‘disability adjusted life expectancy’ (DALE) [5]. Today, health-adjusted life J Gerontol Geriat Res Volume 3 • Issue 3 • 153 ISSN:2167-7182 JGGR, an open access journal Citation: Bourne PA, Solan I, Sharpe-Pryce C, Campbell-Smith J, Hudson-Davis A, Watson-Coleman O, Rhule J (2014) Living Beyond the Life Expectancy: A Self-Rated Health Viewpoint . J Gerontol Geriat Res 3: 153. doi:10.4172/2167-7182.1000153 Page 2 of 8 expectancy (HALE, formerly DALE) is not only concerned with length Labour Force Survey (i.e., LFS) was selected for the survey. The sample of years to illustrate health and well-being status of an individual or a was weighted to reflect the population of the nation. nation, but the number of years an individual lives without disabilities. The researchers chose this survey based on the fact that it is the Such an approach is fitting in the ageing and health discourse as living latest survey on the national population and that it has data on self- beyond 60 years or even the calculated life expectancy for a particular rated health status of Jamaicans. A self-administered questionnaire geopolitical zone does not effectively estimate or measure quality of was used to collect the data which were stored and analyzed using life of these people. The WHO found that these account for a 14 SPSS for Windows 21.0 (SPSS Inc; Chicago, IL, USA). The percent reduction in life expectancy from poorer countries and 9 questionnaire was modelled from the World Bank’s Living Standards percent from developed nations [6]. This system is in keeping with a Measurement Study (LSMS) household survey [20]. There are some more holistic approach to the measure of health and well-being with modifications to the LSMS, as JSLC is more focused on policy impacts. which this study seeks to capture. By using the biopsychosocial model The questionnaire covered areas such as socio-demographic, in the evaluation of well-being of aged Jamaicans, we will begin to economic and health variables. For 2007, the non-response rate for the understand factors that are likely to influence the quality of lived years survey was 26.2 percent. of the elderly, and not be satisfied with the increased length of life of the populace. Descriptive statistics, such as mean, standard deviation (SD), frequency and percentage were used to analyze the socio-demographic With the WHO proposition that health is more than the absence of characteristics of the sample. Chi-square was used to examine the diseases (or dysfunctions) [7,8], many social scientists have sought to association between non-metric variables. Logistic regression use self-reported health status and/or quality of life (or well-being) examined the relationship between the dependent variable and some [9-14]. Caribbean scholars have joined the health discourse, predisposed independent (explanatory) variables, because the particularly ageing and health, [11,15-18], but a search of the literature dependent variable was a binary one (self-reported health status: 1 if revealed no study that has examined health status of those living reported moderate-to-good health status and 0 if poor-to-very poor beyond the life expectancy of their geopolitical locality, particularly health). Jamaica. There is much research on ageing (60+ years), ageing and self-rated health, and ageing and self-reported health conditions in the Binary logistic regression was utilized to examine factors that English-speaking Caribbean nations [11,14-18]; but they stop short of influence 1) moderate-to-excellent self-rated health status (1=yes and investigating health indices of people living beyond the life expectancy. 0=otherwise), and 2) self-reported illness (1=yes, 0=otherwise). The This study will provide pertinent information to fill the gap in the results were presented using unstandardized B-coefficients, Odds ratio literature by evaluating the health status of those living beyond the life and confidence interval (95% CI). The predictive power of the model expectancy of their localities. The objectives of the current study are 1) was tested using the Omnibus Test of Model to examine goodness of to determine the health conditions of people living beyond the life fit of the model. The correlation matrix was examined in order to expectancy in Jamaica, 2) to examine the health status of people living ascertain if autocorrelation (or multicollinearity) existed between beyond the life expectancy in Jamaica, and 3) to evaluate factors that variables. The Odds Ratio (OR) for the interpreting of each significant influence good self-rated health status of people living beyond the life variable, and Wald statistics were used to determine the magnitude (or expectancy in Jamaica. In 2007, the Statistical Institute of Jamaica contribution) of each statistically significant variable in comparison reported that the life expectancy at birth for males was 71.3 years and with the others.