Healthy Ageing: A Comparative Analysis of Health Promoting Lifestyle among Elderly Males and Females in Shiraz

علوم اجتماعی دانشگاه فردوسی مشهد

Article 7, Volume 12, Issue 1 - Serial Number 25, September 2015, Pages 197-223   

Document Type: Scientific-Research

DOI: 10.22067/jss.v12i1.17888

Authors

Majid Movahed¹; Halimeh Enayat¹; Nasibeh Zanjari^{* 2}

¹University of Shiraz, Shiraz, Iran

²University of Welfare and Rehabilitation, Tehran, Iran

Abstract

Extended Abstract

1- Introduction
Worldwide growth of ageing population has increased debate on healthy ageing in both academic research and day to day discourse. Likewise, due to the change in the population age structure in Iran, research on healthy ageing has developed. According to the main and determinant role of gender on health promotion lifestyle, the aim of this article is to analyze the effect of gender on health promotion lifestyle among older adults.

2- Theoretical Framework
Three main approaches employed in the research on health promotion life style among older adults include: healthy life style models that are used for all age ranges, theories and models of healthy ageing, and the extensive models and theories of healthy behaviors and health promotion lifestyle. In this study we utilized the third approach and adopted the Pender’s (2006) Health Promotion Model (HPM) to explain the health promotion of the elderly as it comprehensively shows the relation between individuals and their environment. Healthy lifestyle is an individual choice made within the social context and structural limitations such as gender and socio economic status. The effect of gender on the health related behaviors among older adults is well documented (Budesa, Erin, & Lauren, 2008; Nolen-Hoesksema, 2006; Ostlinetal, 2006; Segal, Demos, & Kronenfeld, 2003; Von Bothmer & Fridlund, 2005). Males and females engage differently in health related risky behaviors. Men pay less attention to health promotion behaviors than women (Patel, 2005; Moore, 2010). The literature Also shows although women report diseases more often than men, they live longer (Chiello & Hutchison, 2010). This article shows the effect of gender differences in socio-economic status, self-efficacy, and health status on health promotion lifestyle.
3- Methodology
The data was collected in 2011 through random sampling survey using a structured questionnaire in the city of Shiraz, Iran. There were 86444 people aged 60 and older in 2011. The sample size of this study was 400 older adults (aged 60+). The participants were chosen by proportional stratified-sampling method. Data were gathered through face-to-face interviews. According to the aim of this study, gender was the independent variable and health promotion life style was the dependent variable. The effect of gender on health promotion lifestyle was estimated with and without controlling for the socio-economic variables including age, marital status, occupational status, educational levels, household income and life arrangement, self-reported health status, and self-efficacy. Multi Classification Analysis (MCA) was adopted to examine the effect of gender on health promotion lifestyle with controlling for the effect of other variables.

4- Results
Results showed significant differences between males and females regarding socio-demographic characteristics. Married men were more likely to be living with their spouse compared to women. This means the rate of widowed women who lived alone was higher than men. The differences may be explained by different patterns of remarriage between men and women which were more common among men. The literacy rate was higher among older men than older women. Among the sampled men, half were employed. This figure was only one percent for women. Women were in the lower level of physical and mental health. Men had a significantly higher average score in some items of self-efficacy such as ability to solve health problems and using any means like money and time for their health promotion.
Binary analysis indicated significant gender differences in the four out of six subscales of health-promoting lifestyle. The results showed that females had higher scores of health responsibility and interpersonal relations than their counterparts, while males had higher scores of physical activity and stress management than females. However, there was no significant difference in the two subscales of nutrition and spiritual growth between the genders. The overall health-promoting lifestyle score was higher for men. MCA showed that health promoting lifestyle scores were significantly associated with gender. When controlling for socio-economic variables (such as age, education, occupation, income, living arrangement, self-efficacy, and so on), the mean score of health promoting lifestyle was higher for females.

5- Conclusion
In conclusion, apart from the biological differences between women and men, inequalities in socio-economic conditions also cause different and unfair consequent health-related behaviors among older men and women. In other words, socio-economic variables can moderate the effect of gender on health promotion life style. Policy makers should be concerned about grounded variables such as gender and socio-economic status which affect the main determinants of health promotion of lifestyles such as self-efficacy. Therefore, welfare policies focused on equal health promotion for men and women should emphasize equal opportunity and economic resources (especially those related to education and careers) and also consider specific needs and different behaviors of men and women.

Keywords

gender; Health promoting lifestyle; Self-efficacy; Multiple classification analysis; Older adults

References

1. پورطاهری، م. و پوروردی نجات، م. (1388). سنجش نابرابری جنسیتی در بین زنان روستایی: مطالعۀ موردی استان گیلان. دانشنامۀ علوم اجتماعی. 1 (2). صص 155-115.

2. حبیبی‏سولا، ع.؛ نیکپور ص.؛ سیدالشهدایی م. و حقانی ح. (1387). بررسی رفتارهای ارتقا‌دهندة سلامت و کیفیت زندگی سالمندان. مجلۀ دانشگاه علوم پزشکی اردبیل. 8 (1). صص36-29.‬‬

3. ریاحی، م. ا. (1387). تفاوت‏های جنسیتی در دانش و باورهای مرتبط با سلامتی و رابطۀ آنها با رفتارهای مرتبط با سلامتی. مجلۀ مطالعات اجتماعی ایران. (3). صص 227-190. ‬‬

4. ریاحی، م.ا. (1384). بررسی تطبیق تفاوت‏های جنسیتی در عادت‏های غذایی دانشجویان ایرانی و هندی. مطالعات زنان. 3 (8). صص 126-97. ‬‬‬‬

5. شارع‏پور، م.؛ ودادهیر ا. و قربان زاده، س. (1389). تحلیل جنسیتی تصادف با تأکید بر مفهوم سبک زندگی سالم. مطالعۀ موردی جوانان شهر تهران. زن در توسعه و سیاست (پژوهش زنان). 8 (2). صص 92-69.

6. صادقی، ر. (1390). سازگاری اجتماعی و جمعیتی نسل دوم افغان‏ها در ایران. (پایان‏نامه منتشر-نشدۀ دکتری) جمعیت‏شناسی. دانشگاه تهران، ایران. ‬‬‬‬‬‬

7. صالحی، ل.؛ افتخار اردبیلى، ح. ؛ تقدیس، م.ح.؛ جزایری، ا.؛ رشیدیان، آ. و شجاعی‏زاده، د. (1387). عوامل تسهیل‏کننده و بازدارنده شیوه زندگی سالم در سالمندان. مجلۀ دانشکده بهداشت و انستیتو تحقیقات بهداشتی. 6 (2). صص 57-49.‬‬‬‬

8. قاسمی، و؛ ربانی، ر؛ ربانی، ع؛ علیزاده اقدم، م. ب. (1387). تعیین‏کننده‏های ساختاری و سرمایه‏ای سبک زندگی سلامت محور. مجلۀ مسائل اجتماعی ایران. 16 (63). صص 213-181. ‬‬‬‬‬‬

9. قاضی‏طباطبایی، م.؛ پاولاک، د. و ودادهیر، ا. (1385). برساخت یک مسألۀ اجتماعی-جمعیتی: درآمدی بر جمعیت‏شناسی اجتماعیـ انتقادی اچ‏آی‏وی/ ایدز در ایران. نامۀ انجمن جمعیت‏شناسی ایران. (2). صص170-136

10. مرکز آمار ایران (1388). سرشماری عمومی نفوس و مسکن 1385: جمعیت شهرهای کشور برحسب سن و جنس. معاونت برنامه‏ریزی و نظارت راهبردی مرکز آمار ایران. تهران: مرکز آمار ایران.‬‬

11. مروتی، م.ع. (1384). بهینه‏سازی الگوی ارتقای سلامت و ارزیابی به‏کارگیری آن همراه با تئوری آموزش بزرگسالان در تغییر رفتارهای ارتقای سلامتی در سالمندان شهر یزد. (رسالۀ منتشر‌نشدۀ دکتری آموزش بهداشت). دانشگاه تربیت مدرس. ایران.‬‬‬‬

12. Andrews, M. (1999). The seductiveness of agelessness. Aging and Society, 19, 301-318.

13. Budesa, T., Erin, E., & Lauren, H. (2008). Gender influence on perceptions of healthy and unhealthy lifestyles. Retrieved from http://digitalcommons.unf.edu/ ojii_volumes/3.

14. Chiello, P. P., & Hutchison, S. (2010). Health and well-being in old age: The pertinence of a gender mainstreaming approach in research. Gerontology, 56, 208–213.

15. Janssen, L. T. (2007). Sex, gender and health: Developments in research. European Journal of Women's Studies, 14, 9-20.

16. Kuhlmann, E. (2009). From women's health to gender mainstreaming and back again: Linking feminist agendas and new governance in healthcare. Current Sociology, 57(2), 135-154.

17. Kurtz, A. C. (1996). Correlates of health-promotion lifestyles among women with Rheumatoid Arthritis (Unpublished doctoral dissertation). Columbia University, USA.

18. McCormick, M. L. (2008). Women's bodies aging: Culture, context, and social work practice. Affilia, 23, 312-323.

19. Moore, S. E. H. (2010). Is the healthy body gendered? Toward a feminist critique of the new paradigm of health. Body & Society, 16(2), 95-118.

20. Nolen-Hoesksema, S. (2006). Possible contributors to the gender differences in alcohol use and problems. Journal of General Psychology, 133(4), 357-374.

21. Ojanuga, D. N., & Gilbert, C. (1992). Women's access to health care in developing countries. An International Journal of Social Sciences and Medicine, 35(4), 613-617.

22. Ostlin, P., Eckermann, E., Mishra, U. S., Nkowane, M., & Wallstam, K. (2006). Gender and health promotion: A multi-sectorial policy approach. Health Promotion International Journal, 21(1), 25-35.

23. Patel, V. (2005). Poverty, gender and mental health promotion in a global society. IUHPE-Promotion & Education Supplement, 2, 26-29.

24. Pender, J. N., Murdaugh, L. C., & Parsons, A. M. (2006). Health promotion in nursing practice (5th ed.). Upper Saddle River, Nurs J: Prentice Hall.

25. Potempa, K. M., Butterworth, S. W., Flaherty-Robb, M. K., & Gaynor, W. L. (2010). The healthy ageing model: Health behavior change for older adults. Collegian, 17, 51-55.

26. Renehan, E., Dow, B., Lin, X., Blackberry, I., Haapala, I., Gaffy, E., … Hendy, S. (2012). Healthy ageing literature review. State of Victoria: National Ageing Research Institute (NARI) and Council on the Ageing.

27. Segal, L., Demos, V., & Kronenfeld, J. J. (2003). Gender perspectives on health and medicine (Vol. 7). United Kingdom: Emerald.

28. Sen, G., George, A., & Östlin, P. (2002). The case for gender equity in health research. Journal of Health Management, 4, 99-117.

29. Soffer, M. (2010). The role of stress in the relationships between gender and health-promoting behaviors. Journal of Caring Science, 24(3), 572-580.

30. Theobald, S., Elsey, H., & Tolhurst, R. (2004). Gender, health and development: Gender equity and sector wide approaches. Progress in Development Studies, 4, 58–63.

31. Von Bothmer, M., & Fridlund, B. (2005). Gender differences in health habits and in motivation for a healthy lifestyle among Swedish university students. Nursing and Health Sciences, 7, 107-118.

32. Wharton, A. S. (2005). The sociology of gender: An introduction to theory and research. USA: Blackwell Publishing.