우리나라 노인의 가구형태와 주관적 건강상태의 관련성: 2017년 노인실태조사 자료를 이용하여

Abstract

In Korea, the growth of the elderly population has increased and an aging society has started, so it resulted in a change of household type of the elderly. This change could influence health status, health behaviors, desire for care of the elderly, and also it could affect health of the elderly. Self-rated health of the elderly is a valuable health indicator, which provides an integrated representation of the elderly’s health status as well as physical, mental and functional health. This study has a purpose to divide and analyze the association between household types and self-rated health depending on each gender for the elderly in Korea, and this study is to provide basic information on health promotion and health and welfare policies for the elderly. This study selected 10,299 people who are aged 65 or older, by using the 2017 National Survey of Older Koreans. For the accuracy of the analyzed data, this study chose 9,910 people as a research sample, which excluded proxy responses, dementia patients, and non-response. Among them 3,994 were men and 5,916 were women. This study implemented technical analysis, univariate analysis using the Rao-Scott Chi-square test, and logistic regression analysis reflecting survey characteristics by separating them into each gender. As a result of analysis by controlling all social-demographic and health-functional characteristics in this study, the self-rated health ‘bad’ of households “couple with unhealthy spouse" and "live with children" was significantly higher than that of household “couple with healthy spouse", and it was the same for the men and women. Particularly, it was significant in the group of the “couple with unhealthy spouse" household. In the group of “couple with unhealthy spouse" household, odds ratio of the item that the self-rated health was "bad" was 2.54(95% CI,2.05-3.15) in the case of male and 2.11(95% CI,1.70-2.62) in the case of female. In the group of " live with children" household, odds ratio of the item that the self-rated health was "bad" was 1.43(95% CI,1.09-1.87) in the case of male and 1.42(95% CI,1.15-1.75) in the case of female. And it was more significant in the case of women. This study found that the elderly's household types are associated with self-rated health, and there are gender differences in the results of the study and that the health status of a spouse and cohabitation with children have a great influence on the self-rated health of the elderly. This study expects that the This study selected 10,299 people who are aged 65 or older, by using the 2017 National Survey of Older Koreans. For the accuracy of the analyzed data, this study chose 9,910 people as a research sample, which excluded proxy responses, dementia patients, and non-response. Among them 3,994 were men and 5,916 were women. This study implemented technical analysis, univariate analysis using the Rao-Scott Chi-square test, and logistic regression analysis reflecting survey characteristics by separating them into each gender. As a result of analysis by controlling all social-demographic and health-functional characteristics in this study, the self-rated health ‘bad’ of households “couple with unhealthy spouse" and "live with children" was significantly higher than that of household “couple with healthy spouse", and it was the same for the men and women. Particularly, it was significant in the group of the “couple with unhealthy spouse" household. In the group of “couple with unhealthy spouse" household, odds ratio of the item that the self-rated health was "bad" was 2.54(95% CI,2.05-3.15) in the case of male and 2.11(95% CI,1.70-2.62) in the case of female. In the group of " live with children" household, odds ratio of the item that the self-rated health was "bad" was 1.43(95% CI,1.09-1.87) in the case of male and 1.42(95% CI,1.15-1.75) in the case of female. And it was more significant in the case of women. This study found that the elderly's household types are associated with self-rated health, and there are gender differences in the results of the study and that the health status of a spouse and cohabitation with children have a great influence on the self-rated health of the elderly. This study expects that the results will be used as basic data for establishing a health management system and establishing health and welfare policies for the elderly, which could adopt the characteristics of the household type of the elderly.

노인 인구의 증가와 고령화 사회 진입으로 인하여 노인의 가구형태가 다양화되고 있으며, 이에 따라서 우리 사회의 부양 구조와 돌봄에 대한 노인의 욕구도 변화하고 있다. 노인의 가구형태 변화는 노인의 건강 상태, 건강 행태 및 욕구 등에도 변화를 야기하고, 더불어 노인의 건강에 영향을 미친다. 노인의 주관적 건강상태는 신체적, 정신적, 기능적 건강과 더불어 삶의 질 전반을 통합적으로 나타낼 수 있는 가치 있는 건강 지표이다. 본 연구의 목적은 우리나라 노인을 대상으로 가구형태와 주관적 건강상태의 관련성을 성별로 구분하여 분석하고, 노인의 가구형태 특성을 반영한 노인의 건강 증진 및 보건·복지 정책 마련을 위한 기초 정보를 제공함에 있다. 본 연구는 우리나라 노인 인구를 조사대상으로 하여 대표성이 있는 2017년 노인실태조사 자료를 이용하여, 만 65세 이상 노인10,299명을 대상으로 하였다. 분석 자료의 정확성을 위하여, 대리 응답, 치매진단을 받은 자, 미 응답을 제외한 9,910명을 연구대상자로 선정하였으며, 이 중에 남성은 3,994명이고 여성은 5,916명이었다. 이에 대하여 기술 분석, Rao-Scott Chi-square 검정을 이용한 단변수 분석 그리고 Survey 특성을 반영한 Logistic regression 분석을 성별로 구분하여 시행하였다. 인구사회적 관련 특성과 건강 및 기능상태 관련 특성을 모두 보정하여 분석한 결과, 남녀 노인 모두‘건강한 유배우자 부부’가구에 비하여 ‘건강하지 않은 유배우자 부부’가구와 ‘자녀 동거’가구에서 주관적 건강상태 ‘나쁨’이 유의하게 높았고, 특히 남녀 모두 ‘건강하지 않은 유배우자 부부’가구에서 매우 유의했다. ‘건강하지 않은 유배우자 부부’가구에서 주관적 건강상태 ‘나쁨’의 교차비는 남성의 경우 2.54(95% CI,2.05-3.15) 였고, 여성의 경우 2.11(95% CI,1.70-2.62)였다. 그리고 ‘자녀 동거’가구에서 주관적 건강상태 ‘나쁨’의 교차비는 남성의 경우 1.43(95% CI,1.09-1.87) 이었고, 여성의 경우 1.42(95% CI,1.15-1.75)으로 남성보다 여성이 더 유의하였다. 이러한 연구 결과를 통하여 노인의 가구형태와 주관적 건강상태가 관련성이 있고, 노인의 주관적 건강상태에 배우자의 건강 및 자녀와의 동거가 큰 영향을 미친다는 것을 알 수 있었다. 본 연구는 주관적 건강상태에 영향을 미치는 인구사회적 관련 특성, 건강 및 기능상태 관련 특성들을 보정하여 노인의 가구형태와 주관적 건강상태의 관련성을 성별로 구분하여 분석한 연구라는 점에서 의의가 있다. 본 연구의 결과가 노인의 가구형태 특성을 반영한 건강 관리 체계 구축, 노인 보건∙복지 정책 수립을 위한 기초자료로 활용되기를 기대한다.