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Factors that influence overall health of individuals and societies

Persons' and societies' wellness is influenced by a variety of elements. The conditions as well as the setting in which individuals live affect if or if not they are fit. Where individuals reside, the status of local surroundings, heredity, wealth and education status, as well as the connections with relatives and friends all seem to have a significant influence on overall health. In combination, all of these factors are considered the determinants of health (Palmer et al. 2019). All of these factors can have a significant impact on the mental health of a person. These factors can increase the chance of leading to a poor lifestyle affecting mental health.

For this discussion, the chosen determinate of health is an economic or financial issue. The paper is going to discuss how financial issues are affecting the mental wellness of elderly people living in the UK using appropriate evidence.

Several studies have been conducted discussing the financial stress faced by elderly people. Countries vary greatly in regards to the rate and degree of advancement in such sectors, including an ageing population, often referred to as a Third Demographic Shift, which occurs at varying levels. The industrialised countries, which also make up the vast majority of the investment in research and development on this issue, are more concerned about population ageing as well as the attendant social and health effects (Huang et al. 2020). Considering these favourable demographic characteristics for the employment market as well as health industries, the effects of ageing on community health as well as development activities in emerging nations are no less difficult. Indeed, the socioeconomic consequences of ageing populations are more obvious within developing nations due to a lack of resources, logistical ability, and sophisticated healthcare to offer appropriate treatment for aged people (Chithra et al. 2021). Such obstacles are reciprocally detrimental as well as cyclical in essence, in the context that an absence of national potential could restrict the requirement of much-needed economic instability, social welfare, and wellness aged care that could impact the economy by fuelling food insecurity, illnesses, as well as social stress (Andrade and Andrade 2018).

According to the United Nations report (UN, 2022), the chance of getting impoverished increases significantly as one grows older. Individuals minimise their operating time or quit the job in older years due to retirement alternatives or health concerns, and if they do want or desire to operate, they often receive lesser pay. In OECD nations, the overall poverty rate for those over 75 years of age is 14.7 %, which is 3.5 % greater compared to the poverty rate for people aged 66-75 years of age (UN, 2022). A "oldest-old," those who are 80 years of age or more, are less likely to perform, are more prone to have squandered their resources, and thus are in greatest the need of age-appropriate healthcare along with long-term personal welfare services. Until the policy reforms are adopted, there is a major chance of rising old-age poverty levels. The number of people aged 60, as well as more, is expected to increase double within the next 35 years, representing approximately 2.1 billion. In 2015, 602 million individuals aged 60 and above lived in poor nations, whereas 298 million individuals aged 60 or up living in developed nations. Their populations are expected to expand to 1 billion approximately 375 million people by 2030, the deadline for a Sustainable Development Goals (SDGs) (UN, 2022).

Economic or financial issues as a determinant of health

Similarly, the financial condition of the older person in the United Kingdom (UK) is not good enough. According to the Health Profile for England report (Ferguson and Belloni, 2022), financial pressures arise as a result of an ageing society, since older persons are more prone to have chronic illnesses with numerous co-morbidities that are more expensive to cure. According to the Age UK report, a new analysis exposes the realities of attempting to handle the extra expenses of ageing upon the limited wage. Almost a million elderly persons are just one huge bill away from an economic calamity. As per newly revealed government estimates, the proportion of retirees having poverty has climbed once more, with 2 million currently struggling to make ends meet and almost one million (930,000) admitting they will be not able to afford an extra fee of £200. 'Struggling On,' depending on the in-depth discussions with elderly adults (Ferguson and Belloni, 2022), demonstrates how they are in need of extra funding because of poor health, impairment, residing in unsafe or bad housing, or being separated from friends and family.

Such a situation also has a significant effect on the local level. Many elderly people living in local areas are unable to meet their basic needs due to poor financial conditions. Doward (2019) mentions in the United Kingdom, the number of older persons living in extreme poverty has increased fivefold since 1986.

 fivefold

Figure 1 (Doward, 2019)

The United Kingdom is among 5 of the 16 nations where a rise in the number of persons aged 65 or up suffering from "severe poverty," is described as having money of 40% fewer than the national median. The UK is an instance of how the Beveridge-lite schemes, have struggled to tackle the old-age financial problem (Doward 2019). The most extensive Dutch basic pensions, as well as Nordic welfare systems, have the least poverty levels among the elderly, whereas the UK, Ireland, as well as Switzerland, which have basic old-age protection, have the greatest poverty levels.

The financial problem has a substantial impact on the overall health, and mental health. Throughout England, very little is known regarding the indebtedness, as well as mental health among persons aged 50 or above. Older adults, like their younger counterparts, could be vulnerable to the financial as well as emotional effects of indebtedness. Pensioners, especially, could have fewer options for increasing their earnings to pay debts, as well as strong emotions of humiliation and inadequacy for failing to meet their responsibilities (Purdam and Prattley, 2021). Hence, all of these factors can increase stress, leading to mental health problems. A multitude of cross-sectional as well as longitudinal research has discovered that holding debts, financial difficulties, the multitude of distinct debt files, or the quantity of debt is connected to a variety of poorer mental health, regardless of other socioeconomic characteristics. Stress levels, general distress, sleep issues, suicidal behaviour, as well as disability retirement caused by mental diseases are some of these effects (Harari, 2018). Regarding longitudinal research focused on within-individual fluctuation over time, a relationship between unsecured loans and self-assessed debt load, as well as psychological health, seems to be strong, however, the relationship is considerably weakened relative to cross-sectional research.

Financial stress faced by elderly people

According to a study on 17091 individuals, aged 50 or more, Hiilamo (2020) checks how the loan or debts or financial stress affects the mental health of the person. According to the findings, the author mention adults in the largest debt percentile would be at a greater risk of poor mental health, with more mood disorders and a worse standard of living. The non-mortgage loan was connected to worse psychological health in both categories following covariate correction; however, the mortgage loan was solely related to a decreased standard of living. There was a slight connection between modifications within higher non-mortgage borrowing costs and mental wellbeing results within the subset who encountered these shifts. Throughout the research process, both wanting to get rid of as well as accumulating new loans indicated symmetrically (minor) improvements and reductions in mental health, according to asymmetrical within-individual assessment. As a result, Hiilamo (2020) mentions that non-mortgage indebtedness is associated with low mental wellness amongst older people in England, according to the research.

Also, a study done by Ikpeme and Pang (2021) indicated that the income of a person can be correlated with their mental health status. As a person gets old, the chance of suffering from other diseases increases. This situation can increase the financial stress of a person. Moreover, with old age, the income gets limited. As a result, some older people might fail to meet their daily needs. This entire condition can be attributed to having a poor mental status among older person increase the chance of depression. Grief, loss of enthusiasm or enjoyment, low mood, interrupted sleep or hunger, weariness, and poor focus are all symptoms of depression, which are among the most frequent mental health conditions. Similarly, many aged people in the UK suffer from depression problems. Depression impacts roughly 22% of males as well as 28% of females aged 65 and more, however, it is believed that 85 per cent of those who are depressed do not receive any treatment. The amount of individuals having dementia globally is projected to reach 44 million, with this figure expected to almost double within 2030. The entire cost of dementia treatment within the UK is projected to be £26.3 billion, having an estimated price of £32,250 per individual (Mental Health Foundation, 2022). As a result, it can be stated that such treatment cost might be a huge burden for an older person, who is already limited to resources.

According to a study in several countries including the UK, Lu and Shelley (2019) mention presence of depression is common among older adults in the UK; however, it might be less than in other countries. This study also suggests financial problems experienced in older age can be a significant cause of developing depression. Findings suggest older people who have proper economic stability may have less chance to develop depressive symptoms compared to an older individual who has poor economic stability.

Moreover, the financial problem can increase the chance of having other chronic diseases, due to poor lifestyle choices.  However, the presence of chronic disease can increase the chance of a mental problem. For instance, the presence of type-2 diabetes can increase the chance of poor mental health due to certain lifestyle limitations. Therefore, as a person gets old, the presence of chronic disease makes it harder to live a prosperous life. Hence, it can lead to a poor mental state.  Pocklington (2017) discuss several factors, which can lead to the development of depression among older person living in the UK. Among them, according to the author financial or economic factors is important.  Results in diabetes mellitus show that the healthcare expenses of older persons having a comorbid physical condition as well as depression are considerably higher compared to those not having depression. The bulk of the increasing healthcare expenditures is related to chronic physical ailment rather than depression diagnosis and support. Missed consultations and a higher frequency of hospitalisations are linked to poor adherence to physical disease care; both of these factors have cost repercussions.

Conclusion

Financial hardship is a very common problem among older individuals throughout the globe. Older people living in the UK also suffer from a similar problem. Due to physical limitations and the presence of various diseases in old age, a person's earnings get limited. Older people mainly depend on their pensions. However, an increasing level of financial stress, according to the evidence can increase the chance of having poor mental health. Also, the presence of other chronic diseases and poor lifestyle choices can increase the chance of poor mental health.

References

Andrade, T.B.D. and Andrade, F.B.D., 2018. Unmet need for assistance with activities of daily life among older adults in Brazil. Revista de Saúde Pública, 52, p.75.

Chithra, N.K., Harbishettar, V., Gowda, G.S., Srinivasa, P. and Gowda, M., 2021. Assessment of the Financial Capacity in Elderly: Approach and Challenges in Indian Scenario. Indian Journal of Psychological Medicine, 43(5_suppl), pp.S19-S24.

Doward, J., 2019. UK elderly suffer the worst poverty rate in western Europe. [online] the Guardian. Available at: <https://www.theguardian.com/society/2019/aug/18/elderly-poverty-risen-fivefold-since-80s-pensions> [Accessed 20 April 2022].

Ferguson, B. and Belloni, A., 2022. Ageing and health expenditure - UK Health Security Agency. [online] Ukhsa.blog.gov.uk. Available at: <https://ukhsa.blog.gov.uk/2019/01/29/ageing-and-health-expenditure/> [Accessed 20 April 2022].

Harari, D., 2018. Household debt: statistics and impact on the economy. House of Commons Briefing Paper, 7584.

Hiilamo, A., 2020. Debt matters? Mental wellbeing of older adults with household debt in England. SSM-population health, 12, p.100658.

Huang, R., Ghose, B. and Tang, S., 2020. Effect of financial stress on self-rereported health and quality of life among older adults in five developing countries: a cross-sectional analysis of WHO-SAGE survey. BMC geriatrics, 20(1), pp.1-12.

Ikpeme, M. and Pang, D., 2021. Physical Activity Determinants in Older People: An Analysis of the UK Understanding Society Wave 2. European Journal of Public Health, 31(Supplement_3), pp.ckab164-370.

Lu, P. and Shelley, M., 2021. Retirement, pensions, and depressive symptoms among older adults in China, England, Mexico, and the United States. The International Journal of Aging and Human Development, 92(1), pp.40-64.

Mental Health Foundation, 2022. Mental health statistics: older people. [online] Mental Health Foundation. Available at: <https://www.mentalhealth.org.uk/statistics/mental-health-statistics-older-people> [Accessed 20 April 2022].

Palmer, R.C., Ismond, D., Rodriquez, E.J. and Kaufman, J.S., 2019. Social determinants of health: future directions for health disparities research. American Journal of Public Health, 109(S1), pp.S70-S71.

Pocklington, C., 2017. Depression in older adults. British Journal of Medical Practitioners, 10(1), p.a1007.

Purdam, K. and Prattley, J., 2021. Financial debt amongst older women in the United Kingdom–shame, abuse and resilience. Ageing & Society, 41(8), pp.1810-1832.

UN, 2022. Income Poverty in Old Age: An Emerging Development Priority. [online] United Nations (UN). Available at: <https://www.un.org/esa/socdev/ageing/documents/PovertyIssuePaperAgeing.pdf> [Accessed 20 April 2022].

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