The health status of the elderly receiving an old age pension in urban communities in the City of Cape Town

[摘要] ENGLISH ABSTRACT: In developing countries the increasing number of the aged are often viewed as a problem. In particular, the indigent elderly residing in poor urban areas are at risk of becoming marginalised and underserved. The Western Cape has the third largest elderly population in proportion to the total population in the country. Social assistance in the form of a monthly pension is paid out to all elderly who pass a national means test carried out by South African Social Security Agency (SASSA).An assessment of the characteristics and health status of the elderly collecting old age pensions living in low-income urban poor communities in the City of Cape Town was carried out at pension pay points across four communities, i.e. Gugulethu, Khayelitsha, Mitchells Plain and Bonteheuwel.In community health surveys, choices regarding the methodology have to be made that can have profound effects on the study design and study outcomes. The milieu of the present study is one of urban poverty and specifically those urban elderly who qualify for non-contributory pensions (also called social cash transfers or government grants). The paucity of existing community-based studies on old-age pensioners in the City of Cape Town meant that a cross-sectional survey with wide-ranging coverage of demographic, social and health factors was the most logical design to employ in order to determine the extent of present needs and generate hypotheses for further controlled studies.A systematic random sample of 703 elderly was drawn at nine pension pay-out points in Cape Town Metropole. No pensioners refused to participate in the study. Structured interviews were carried out covering demographics, number of dependents, living conditions, socioeconomic circumstances, health status and needs and utilisation of health services.A reported 43% of participants lived in shacks and 88% reported regularly eating less than 3 meals a day. Eighty-seven percent of respondents reported waiting 3 hours or longer for medication at a clinic while 90% reported being dissatisfied with the service at their clinic. Fifty-eight percent of pensioners reported not being able to see well while 83% did not know where to get their eyes tested. Almost 70% of pensioners said that they have been ill-treated by a family member and 64% scored as severely depressed on the geriatric depression scale. In this study, 266 pensioners solely supported 471 children of which 65 (14%) were disabled children. In 95% of cases the pensioner does not receive any support from the child's parents.The study found that the elderly on a state grant had considerable unmet health needs and required assistance with activities of daily living. The indigent pensioners in this study bore a huge duty of care for minor children as custodial grandparents while not receiving a high level of health support themselves.

[发布机构] Stellenbosch University