The Intersectional Effects of Ethnicity/Race and Poverty on Health Among Community-Dwelling Older Adults Within Multi-Ethnic Asian Populace: A Population-Based Study

Abstract

Background: Ethnicity/race and poverty are among determinants of health in older persons. However, studies involving intersectional effects of ethnicity/race and poverty on health of older adults within multi-ethnic Asian populace is limited. Hence, this study aimed to examine the intersectional effects of ethnicity/race and poverty on cognitive function, depressive symptoms, and multimorbidity among community-dwelling older adults in Malaysia.Methods: Data were obtained from the first wave of a Peninsular Malaysia national survey - “Identifying Psychosocial and Identifying Economic Risk Factor of Cognitive Impairment among Elderly”. Multivariate logistic regression was used to identify intersectional effects and associations between control variables and health outcomes. A comparison between Malay and non-Malay older adults within the same poverty group, as well as hardcore poor and non-hardcore poor older people within the same ethnicity groups, were conducted to understand the intersectional effects of ethnicity/race and poverty on health. Results: Prevalence of cognitive impairment was highest among the hardcore poor group while risk of depression and multimorbidity were highest among non-Malays. Malay older adults were more prone to developing cognitive impairment regardless of their poverty status whereas non-Malay from the hardcore poor group had higher tendency for risk of depression and multimorbidity. Hardcore poor older adults residing alone were associated with higher depressive symptoms. But fewer older adults currently working reported multimorbidity. Conclusions: Health outcomes of Malaysian older adults differ according to ethnicity and socioeconomic status. Given the importance of demographic characteristics on health outcomes, design of interventions targeting older adults within multi-ethnic settings must address specific characteristics, especially that of ethnicity and sociodemographic status so as to fulfil their needs. Several implications for future practice were discussed.