Health and Well-Being of Older Populations in Six Low- to Middle-Income Countries Examined in Census Bureau Report

WASHINGTON, May 7, 2012 /PRNewswire-USNewswire/ -- Health levels varied greatly among people 50 and older in China, Ghana, India, Mexico, Russia and South Africa, but hypertension and arthritis were the two most common chronic conditions in all six countries (Figure 1), according to the first-ever U.S. Census Bureau report to use data from the Study on Global Ageing and Adult Health (SAGE).


Commissioned by the National Institute on Aging (NIA) of the National Institutes of Health, the report, Shades of Gray: A Cross-Country Study of Health and Well-Being of the Older Populations in SAGE Countries, 2007-2010, examines the health status and access to health care among older populations in the aforementioned six low- to middle-income countries, which are each among the world's 50 most populous.

"Relatively few countries have age-specific health and disability data, and those that do are primarily high-income countries," notes Census Bureau demographer Wan He, one of the report's co-authors, along with Mark Muenchrath of the Census Bureau and Paul Kowal of the World Health Organization (WHO). "SAGE provides much needed cross-country comparable health data that will shed light on our understanding of similarities and differences in the health of older adults across low-, middle- and high-income countries."

The wide range of health levels is evident when looking at the prevalence of disability. The percentage of people 50 and older in SAGE countries reporting a disability ranged from 68 percent in China to 93 percent in India.

According to the report, high levels of risky health behaviors often continued into older ages, particularly for men. For instance, more than half of older Chinese and Indian men still smoked tobacco and the majority of older Ghanaian, Mexican and Russian men reported daily moderate or heavy alcohol consumption. However, there were signs of lifestyle changes toward healthier behavior: more older Ghanaian men had given up smoking than were still smoking, and about the same percentages of current smokers and past smokers were recorded for Mexican men (Figure 2).

Editor's note: The report can be accessed at

"Population aging is changing the world in many ways," said Richard Suzman, director of the Division of Behavioral and Social Research at the NIA, which commissioned the report. "We are seeing a transition in which chronic, noncommunicable diseases are becoming much more important in low- and middle-income countries. SAGE provides evidence of this transition and how lifestyles may need to be changed and prevention increased in these countries."

Other highlights:

  • The majority of SAGE countries' older people reported being satisfied with their lives. Older Mexicans recorded the highest rate of life satisfaction (eight in 10), compared with only a little more than half of older Ghanaians.
  • Older people with chronic conditions were more likely to be diagnosed with depression. For example, older Ghanaians with arthritis were six times more likely to be depressed than those without arthritis.
  • Two notably different patterns of health care payment emerged from the SAGE statistics – in Mexico, Russia and South Africa, health care to a large extent was free; in contrast, in China, Ghana and India, the bulk of the cost of medical care was borne by the patients themselves or their families.
  • Most older Indians had insufficient fruit and vegetable intake, and older South Africans had low levels of physical activity.

Future waves of SAGE statistics will provide the longitudinal information needed to examine trends and shed additional light on some of the health, cultural and contextual differences documented in this report and found in aging research in general.

SAGE is designed as a multiwave panel study designed by WHO and supported by NIA. There are six participating countries – China, Ghana, India, Mexico, Russia and South Africa. The first wave was conducted during the period of 2007-2010. Wave 2 will be implemented in 2012 and Wave 3 is planned for 2014. For additional SAGE survey related information such as sampling, sample size, response rate, weighting, and data validation and comparability, see "Sources of the Data and Accuracy of the Estimates" and Appendix C "SAGE Surveys" of the report.

Statistics from sample surveys are subject to sampling and nonsampling error.  All comparisons made in this report have been tested and found to be statistically significant at the 90-percent confidence level, unless otherwise noted.  Please consult Table B-1 of the report for specific margins of error. For more information, contact WHO at

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SOURCE U.S. Census Bureau


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