Impact of Children's Migration on Health and Health Care-seeking Behavior of Elderly Left Behind

Ramesh Adhikari; Aree Jampaklay; Aphichat Chamratrithirong


BMC Public Health. 2011;11 

In This Article


Sociodemographic and Economic Characteristics of the Sample Population

More than half of the sampled respondents were aged 60–69 while about one out of seven were aged 80 or above, and nearly three out of five were female. The large majority had only an elementary-level education. Respondents had an average of 4 children. About three in five respondents were from rural areas. Half reported that their household income per year was about 30,000 baht or less. Only about one in ten elderly lived alone, and two-thirds had at least one migrant child. About four in five elderly (79%) who had at least one migrant child had received money from their child(ren) during the 12 months preceding the survey (Table 1).

Health Status and Health Care-seeking Behavior

Table 2 shows that a slightly higher proportion of elderly who had migrant child(ren) had at least one symptom of poor mental health during the month before the survey compared to those whose children had not migrated (56%). Furthermore, more than half (56%) of the elderly rated their health as poor, and nearly half (44%) reported that they suffered from at least one chronic disease. Overall, about two-thirds of the elderly had symptoms of an illness (65%) during the five years preceding the survey. No observed differences were found among elderly (by migration status of children) in terms of self-assessed health, number of chronic diseases, or illnesses during the previous 5 years.

It is encouraging to note that an overwhelming majority of elderly who felt sick (88%) had sought treatment for their most recent illness. Interestingly, a higher proportion of the elderly who had migrant child(ren) had sought treatment for the last illness compared to those whose children did not migrate (Table 2).

Multivariate Analysis

Logistic regression was used to assess the net effect of the migration of children on the health of the elderly left behind and their treatment-seeking behavior after controlling for the other control variables in the model.

Separate logistic regressions were run for 5 dependent variables. The odds ratio is presented in Table 3. Control variables used in this logistic analysis were categorical indicators of age (60–69, 70–79, and 80 or above), sex (male, female), place of residence (rural, urban), level of education (higher than secondary, secondary, and primary and below), living arrangements (living alone, with children, with other relatives), number of children respondents had, and average household income per year (100,000 baht or more, 30,000–99,999 baht, and less than 30,000). In the model, the reference group of the independent variable is "no migration of adult children."

Migration of children was found to have a strong association with poor mental health symptoms among the elderly left behind. Those elderly who had at least one migrant child were more likely (OR = 1.10; 95% CI 1.05–1.17) to have poor mental health symptoms than those whose children had not migrated. On the other hand, no significant association was observed with physical health, such as experience of chronic disease, self-rated health status, or experience of symptoms of illness during the previous 5 years.

Furthermore, the results show that the migration of children is a significant predictor of treatment-seeking behavior among the elderly left behind. For instance, those elderly who had at least one migrant child were more likely (OR = 1.22; 95% CI 1.11–1.33) to seek treatment for their most recent illness than were those who had no migrant children (Table 3).


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