The health and well-being of older people in Nairobi's slums

Background: Globally, it is estimated that people aged 60 and over constitute more than 11% of the population, with the corresponding proportion in developing countries being 8%. Rapid urbanisation in subSaharan Africa (SSA), fuelled in part by rural-urban migration and a devastating HIV/AIDS epidemic, has altered the status of older people in many SSA societies. Few studies have, however, looked at the health of older people in SSA. This study aims to describe the health and well-being of older people in two Nairobi slums. Methods: Data were collected from residents of the areas covered by the Nairobi Urban Health and Demographic Surveillance System (NUHDSS) aged 50 years and over by 1 October 2006. Health status was assessed using the short SAGE (Study on Global AGEing and Adult Health) form. Mean WHO Quality of Life (WHOQoL) and a composite health score were computed and binary variables generated using the median as the cut-off. Logistic regression was used to determine factors associated with poor quality of life (QoL) and poor health status. Results: Out of 2,696 older people resident in the NUHDSS surveillance area during the study period, data were collected on 2,072. The majority of respondents were male, aged 50-60 years. The mean WHOQoL score was 71.3 (SD 6.7) and mean composite health score was 70.6 (SD 13.9). Males had significantly better QoL and health status than females and older respondents had worse outcomes than younger ones. Sex, age, education level and marital status were significantly associated with QoL, while slum of residence was significantly associated with health status. Conclusion: The study adds to the literature on health and well-being of older people in SSA, especially those in urban informal settlements. Further studies are needed to validate the methods used for assessing health status and to provide comparisons from other settings. Health and Demographic Surveillance Systems have the potential to conduct such studies and to evaluate health and well-being over time.