Income Inequality in Quality of Life among Rural Communities in Malaysia: A Case for Immediate Policy Consideration

Thangiah, Govindamal; Said, Mas Ayu; Majid, Hazreen Abdul; Reidpath, Daniel D.; Su, Tin Tin

doi:10.3390/ijerph17238731

Cited by 20 publications

(26 citation statements)

References 45 publications

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“…The counterevidence point towards the overwhelming effect of age on HRQOL [15,20,[36][37][38], similar to the present study. The implications of an ageing phenomenon include structural changes to families and households, social networks and interaction, leisure, housing and transportation, welfare services and pension, saving and consumption behaviour, and labour markets [39]. Hence, it is imperative to uplift the QOL of the older generation.…”

Section: Discussionmentioning

confidence: 99%

Health-related quality of life of younger and older lower-income households in Malaysia

et al. 2022

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Background Globally, a lower income is associated with poorer health status and reduced quality of life (QOL). However, more research is needed on how being older may influence QOL in lower-income households, particularly as older age is associated with an increased risk of chronic diseases and care needs. To this end, the current study attempts to determine the health-related QOL (HRQOL) among individuals from lower-income households aged 60 years and over compared to lower-income adults aged less than 60 years. Methods Participants were identified from the Department of Statistics Malaysia sampling frame. Surveys were carried out with individual households aged 18 years and older through self-administered questionnaires. Information was collected on demographics, household income, employment status, number of diseases, and HRQOL assessed using the EuroQol 5-Dimension 5-Level (EQ-5D-5L) tool. Results Out of a total of 1899 participants, 620 (32.6%) were female and 328 (17.3%) were aged 60 years and above. The mean (SD) age was 45.2 (14.1) and mean (SD) household income was RM2124 (1356). Compared with younger individuals, older respondents were more likely to experience difficulties in mobility (32.1% vs 9.7%, p<0.001), self-care (11.6% vs 3.8%, p<0.001), usual activities (24.5% vs 9.1%, p<0.001), pain/discomfort (38.8% vs 16.5%, p<0.001) and anxiety/depression (21.4% vs 13.5%, p<0.001). The mean (SD) EQ-5D index scores were lower among older respondents, 0.89 (0.16) vs 0.95 (0.13), p = 0.001. After adjusting for covariates, age was a significant influencing factor (p = 0.001) for mobility (OR = 2.038, 95% CI:1.439–2.885), usual activities (OR = 1.957, 95% CI:1.353–2.832) and pain or discomfort (OR = 2.241, 95% CI:1.690–2.972). Conclusion Lower-income older adults had poorer HRQOL compared to their younger counterparts. This has important implications concerning intervention strategies that incorporate active ageing concepts on an individual and policy-making level to enhance the QOL and wellbeing, particularly among the older lower-income population.

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Section: Discussionmentioning

confidence: 99%

Health-related quality of life of younger and older lower-income households in Malaysia

et al. 2022

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“…In the study, a person was deemed to have poor insight when he indicated unawareness, misattribution and inaction, either alone or together. Monthly household income groups were categorized into three categories, which were the bottom 40% (B40), middle 40% (M40) and top 20% (T20), based on the income thresholds provided by the Department of Statistics Malaysia in 2014 [ 24 ]. Full-time HCPS was considered when the pharmacist’s essential duty was to conduct home medication reviews on all working days.…”

Section: Methodsmentioning

confidence: 99%

Home medication management problems and associated factors among psychiatric patients using home care pharmacy services at government hospitals in western Malaysia

Lau

Hor

Ong

et al. 2022

BMC Health Serv Res

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Background Proper home medication management plays a role in improving medication adherence, preserving drug efficacy and ensuring safe medication practices, which is crucial to establish positive treatment outcomes. However, no published studies are available on home medication management among psychiatric patients. The study aimed to identify home medication management problems among psychiatric patients in Malaysia and to examine the associations of inappropriate medication storage and lack of a medication administration schedule with sociodemographic factors, disease insight, number of medications and type of home care pharmacy services (HCPS). Methods This multicentre cross-sectional study was conducted among psychiatric patients using HCPS in six government hospitals in western Malaysia. Data were extracted from the HCPS form used for each visit as per the protocol published by the Pharmaceutical Services Division, Ministry of Health Malaysia. A minimum sample size of 169 was needed. Proportional random sampling was applied. The associations of inappropriate medication storage and lack of medication administration schedule with study parameters were analysed using multiple logistic regressions. Results A total of 205 home visits were conducted with 229 home medication management problems identified; inappropriate medication storage and lack of medication administration schedule topped the list. Inappropriate medication storage was significantly associated with low income [AOR = 4.34 (95% CI 1.17:15.98), p = 0.027], alcohol consumption [AOR = 14.26 (95% CI 1.82:111.38), p = 0.011], poor insight [AOR = 2.34 (95% CI 1.08:5.06), p = 0.030] and part-time HCPS [AOR = 2.60 (95% CI 1.20:5.67), p = 0.016]. Lack of administration schedule was significantly associated with low income [AOR = 6.90 (95% CI 1.46:32.48), p = 0.014], smoking [AOR = 2.43 (95% CI 1.20:4.92), p = 0.013], poor insight [AOR = 5.32 (95% CI 2.45:11.56), p < 0.05] and part-time HCPS [AOR = 2.96 (95% CI 1.42:6.15), p = 0.004]. Conclusions Inappropriate medication storage and a lack of a medication administration schedule are common among psychiatric patients. The study also highlighted the potential of HCPS to improve disease insight and home medication management among psychiatric patients if the service is utilized fully.

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“…Education, ethnic group or social class, income, and employment are typical indicators of socioeconomic status [19]. Community-based studies from LMICs have revealed the relationship between low socioeconomic status (SES) and common mental disorders [20][21][22][23]. Recent literature revealed that low socioeconomic status was linked to lower health literacy with higher stigma [24,25] and lack of mental health help-seeking [26].…”

Section: Introductionmentioning

confidence: 99%

Psychosocial factors associated with mental health and quality of life during the COVID-19 pandemic among low-income urban dwellers in Peninsular Malaysia

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Background and aims Mental well-being among low-income urban populations is arguably challenged more than any other population amid the COVID-19 pandemic. This study investigates factors associated with depression and anxiety symptoms and quality of life among Malaysia’s multi-ethnic urban lower-income communities. Methods This is a community-based house-to-house survey conducted from September to November 2020 at the Petaling district in Selangor, Malaysia. Five hundred and four households were identified using random sampling, and heads of eligible households were recruited. Inclusion criteria were age ≥18 years with a monthly household income ≤RM6960 (estimated $1600) without acute psychiatric illness. The PHQ-9, GAD-7 and EQ-5D were used for depression, anxiety, and quality of life, respectively. Multivariable logistic regression was performed for the final analysis. Results A total of 432 (85.7%) respondents with a mean age of 43.1 years completed the survey. Mild to severe depression was detected in 29.6%, mild to severe anxiety in 14.7%, and problematic quality of life in 27.8% of respondents. Factors associated with mild to severe depression were younger age, chronic health conditions, past stressful events, lack of communication gadgets and lack of assets or commercial property. While respiratory diseases, marital status, workplace issues, financial constraints, absence of investments, substance use and lack of rental income were associated with mild to severe anxiety. Attributing poverty to structural issues, help-seeking from professionals, and self-stigma were barriers, while resiliency facilitated good psychological health. Problematic quality of life was associated with depression, older age, unemployment, cash shortage, hypertension, diabetes, stressful life events and low health literacy. Conclusions A high proportion of the sampled urban poor population reported mild to severe anxiety and depression symptoms. The psychosocial determinants should inform policymakers and shape future work within this underserved population.

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Income Inequality in Quality of Life among Rural Communities in Malaysia: A Case for Immediate Policy Consideration

Cited by 20 publications

References 45 publications

Health-related quality of life of younger and older lower-income households in Malaysia

Health-related quality of life of younger and older lower-income households in Malaysia

Home medication management problems and associated factors among psychiatric patients using home care pharmacy services at government hospitals in western Malaysia

Psychosocial factors associated with mental health and quality of life during the COVID-19 pandemic among low-income urban dwellers in Peninsular Malaysia

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