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Health and Well-Being of Seniors in Low to Middle Income Countries

Author: U.S. Census Bureau

Published: 2012-05-09 : (Rev. 2017-10-23)


Examines health status and access to health care among older populations in most populous low to middle income countries.

Main Digest

Health and Well-Being of Older Populations in Six Low- to Middle-Income Countries Examined in Census Bureau Report.

SAGE, (Study on Global aging and Adult Health) A multi-wave panel study designed by WHO and supported by NIA. There are six participating countries - China, Ghana, India, Mexico, Russia and South Africa. The first wave was conducted during the period of 2007-2010. Wave 2 will be implemented in 2012 and Wave 3 is planned for 2014.

Health levels varied greatly among people 50 and older in China, Ghana, India, Mexico, Russia and South Africa, but hypertension and arthritis were the two most common chronic conditions in all six countries according to the first-ever U.S. Census Bureau report to use data from the Study on Global aging and Adult Health (SAGE).

Commissioned by the National Institute on Aging (NIA) of the National Institutes of Health, the report, Shades of Gray: A Cross-Country Study of Health and Well-Being of the Older Populations in SAGE Countries, 2007-2010, examines the health status and access to health care among older populations in the aforementioned six low- to middle-income countries, which are each among the world's 50 most populous.

"Relatively few countries have age-specific health and disability data, and those that do are primarily high-income countries," notes Census Bureau demographer Wan He, one of the report's co-authors, along with Mark Muenchrath of the Census Bureau and Paul Kowal of the World Health Organization (WHO). "SAGE provides much needed cross-country comparable health data that will shed light on our understanding of similarities and differences in the health of older adults across low, middle and high-income countries."

The wide range of health levels is evident when looking at the prevalence of disability. The percentage of people 50 and older in SAGE countries reporting a disability ranged from 68 percent in China to 93 percent in India.

According to the report, high levels of risky health behaviors often continued into older ages, particularly for men. For instance, more than half of older Chinese and Indian men still smoked tobacco and the majority of older Ghanaian, Mexican and Russian men reported daily moderate or heavy alcohol consumption. However, there were signs of lifestyle changes toward healthier behavior: more older Ghanaian men had given up smoking than were still smoking, and about the same percentages of current smokers and past smokers were recorded for Mexican men.

"Population aging is changing the world in many ways," said Richard Suzman, director of the Division of Behavioral and Social Research at the NIA, which commissioned the report. "We are seeing a transition in which chronic, noncommunicable diseases are becoming much more important in low- and middle-income countries. SAGE provides evidence of this transition and how lifestyles may need to be changed and prevention increased in these countries."

Other highlights:

Future waves of SAGE statistics will provide the longitudinal information needed to examine trends and shed additional light on some of the health, cultural and contextual differences documented in this report and found in aging research in general.

The report can be accessed at

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