The association between living arrangements and subjective health and well-being among older adults in Thailand: a special focus on skip-generation households.

Abstract

Objectives: Older adults in skip-generation households (SGHs) play a valuable role in maintaining the cohesion of extended families in the absence of the middle generation. Little is known about the health and well-being of older adults in SGHs or how it varies depending on their age. This study aimed to examine 1) the association between living in SGHs and subjective health and well-being and 2) the association between subjective health and well-being of older adults in SGHs across age groups. Methods: Drawing data from the 2017 national survey of older people, older adults aged ≥60 years without disability in activities of daily living (n=38,088) were included for multiple regression analyses. Living arrangements were classified into SGHs and non-SGHs. Subjective health was evaluated based on self-rated health, whereas subjective well-being was evaluated using a happiness score. Ordinal logistic regression and linear regression models, stratified by age groups (young-old, 60-69; middle-old, 70-79; and old-old, ≥80), compared subjective health and well-being of older adults in SGHs and non-SHGs, while controlling for potential covariates. Results: Among older Thai adults, 10.1% lived in SGHs, and 11.1%, 9.5%, and 6.3% were among the young-old, middle-old, and old-old, respectively. Across age groups, older adults living in SGHs reported better health status but worse well-being than those living in non-SGHs. Older adults from the old-old group living in SGHs seemed to report the best health status, whereas those in the young-old and old-old groups tended to report the worst well-being. The direction of the association between living arrangements and subjective health and well-being did not differ by age group. Conclusion: Better health status but worse well-being were observed in SGHs. Social sectors should pay attention to the well-being of these older adults.