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Title: Ageing in Mexico : modelling health and frailty and its relationship to the use of health services and the supply of informal care
Author: Lopez-Ortega, Mariana
ISNI:       0000 0004 2700 9996
Awarding Body: London School of Hygiene & Tropical Medicine
Current Institution: London School of Hygiene and Tropical Medicine (University of London)
Date of Award: 2009
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Mexico is still a "young" country with pressing burdens on education, especially at secondary and high school levels, and high percentages of the population entering the work force each year. Yet, it will complete its "demographic transition" in the next 20-25 years with a rapid increase in the percentage of population 65 years and older. As with most Latin American countries, Mexico is experiencing what experts call a "mixed" epidemiological transition with increasing trends in prevalence of chronic diseases and a marked decrease in communicable diseases in some areas, but with a continuing moderate or high incidence of the latter in some regions of the country. In addition, there are no long-term care programmes that cater to the specific health and social care needs of the older population. Services for the elderly are comprised of isolated strategies mainly recreational and information programmes, and health services similar to those provided to all other age/condition groups in the country. At the moment, social development and health sectors are unprepared to cater for the needs of the increasing elderly population. Currently, the majority of the older population live with their children, or other close relatives, and most of the care provided to them is done at home by their family members. Nevertheless, changes in fertility rates, constant rural-urban migration within Mexico and international migration, women's increasing participation in the labour force, among other factors have changed family size and composition and may pose future challenges to the availability of household care and support. Given the rapid ageing process Mexico is going through, the absence of dedicated strategies for the older population and the possible decrease in availability of informal care, there is a pressing need to have detailed information on the conditions of the older population and how they are experiencing the ageing process. Mainly, on their health and disability status, on their use of services by the elderly, and on the characteristics of the informal care that is provided to them. The main objective of this research is to generate significant information in order to provide health system institutions with information on specific needs and on the provision of social and health care services for the elderly in Mexico in the next decades. The aim of the thesis was to generate information on the dynamics of the ageing process in Mexico and how the Mexican population is facing old age. This was done by exploring four main topics. First, a comprehensive study of their health and disability status was done, including the generation of a Frailty Index in order to have an additional indicator of their overall health and frailty status at individual and population level. Secondly, overall survival in the Mexican ageing population was investigated. Through the analysis, possible differences between sub-samples of the population were explored. Given that there are no formal long-term care services for the older population in Mexico, the remaining topics are related to the care for this population group. On one hand, the thesis explores the use of health services by the ageing population in Mexico. This includes the use of different types of care such as general practitioner, specialist doctors, as well as inpatient and outpatient hospital visits. On the other hand, it explores the supply of informal care for the older population by their (co- resident and non-resident) children. The thesis then addresses future challenges regarding the ageing process and formal and informal care-giving. Finally, following the identified challenges, the thesis includes recommendations for future research and inputs for future - health and social-ageing policies and strategies in Mexico. Data for the research come from the two existing waves of the Mexican Health and Ageing Study, MHAS (2001 and 2003). This is a prospective panel study of health and aging in Mexico which includes a nationally representative sample of population 50 years and older.
Supervisor: Cairns, J. Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral