Comparison of General Health and Happiness in Elderly Women With and Without a Spouse Referring to Health Centers in Bandar Abbas in 2018

The dramatic increase in life expectancy in the twentieth century has been one of the greatest health achievements in the world, which has led to an increasing trend in the overall age of the population compared to the past. With increasing life expectancy and declining fertility rates, it can be said that in most countries, including Iran, the slope of population growth for people over 60 is higher than other age groups, and this causes the world's population to age.According to the Iranian National Statistics Portal (2016), the life expectancy of Iranian men has increased from 45 to 69 and then 74 years in 1960, 2000 and 2015, respectively, and for women from 44 to 71 and then 76 years. Accordingly, the ratio of the elderly to the total population has been increasing in recent decades, and it is estimated that the percentage of elderly people in Iranian society will be 6.6-6.6% in 2025, 19% in 2030, and 21.7% to 30.8% in 2050.In this regard, due to the higher life expectancy of women than men, older women are more exposed to potential health threats, such as increased incidence of chronic diseases, loneliness and isolation, and lack of social support. The aim of this study was to compare the general health and happiness of elderly women with and without a spouse referring to health centers in Bandar Abbas, one of the deprived areas in southern Iran, in 2018.

This descriptive-analytical study was performed on 390 women over 60 years of age (260 with spouses and 130 widows) referred to 8 selected health centers in Bandar Abbas, Iran, in 2018, using quota cluster sampling method. Data collection tools included a demographic information questionnaire, the Goldberg and Hiller General Health Questionnaire, and the Oxford Happiness Questionnaire. The collected data were processed using SPSS software version 21. Descriptive statistics (frequency, percentage, mean and standard deviation) and analytical statistics (chi-square, and independent t-test, analysis of covariance) were used to analyze the data and a significant level of P <0.05 was considered.

In this study, out of 260 elderly women with a spouse, 218 (83.8%), and out of 130 elderly women without a spouse, 83 (63.8%) were under 70 years old. Most women without a spouse (67.6%), and with a spouse (65%), have 5 to 9 children, and more than half of them in both groups (58.4% of the group with a spouse and 51.9% of the group without spouse) had 5 to 9 married children. About half of women in the two groups (48.5% in the group with a spouse and 50% in the group without a spouse) had primary education, most (94.2% in the group with a spouse, and 95.4% in the group without a spouse) were housewives. In terms of economic status, most of the two groups (61.5% of each group) were at a moderate level, and often (48.1% of the group with a spouse, and 50.8% of the group without a spouse) were financially dependent. The two groups were homogeneous in terms of demographic variables except age and number of years of living with a spouse (P <0.001). The results showed that although older women with a spouse had a higher level of general health and happiness than the other group, the results of analysis of covariance showed that this difference was not statistically significant.

According to the results of this study, the average general health score in both groups was lower than the cut-off points for the whole test (23), which means that in terms of general health, most women in both groups have a good level of health. However, the mean health score in this study is higher than the mean health score of the elderly in Yazdani study in Tehran (Yazdani, 2010), and Nejati study in Qom (Nejati, 2005). This shows that the elderly in Tehran and Qom have higher general health. Perhaps the reason for this can be attributed to the deprivation of Bandar Abbas city and the lower quality of health services provided to the elderly in deprived areas compared to the center.Also, although the average general health score, and each of its areas, is lower in the group of women with a spouse, and it seems that women with husbands have higher general health, but the results of analysis of covariance showed that this difference is statistically Not significant (P = 0.38).Perhaps one of the reasons for the insignificance of this difference can be attributed to the factor of social support provided by children, which according to Okabayashi et al, can have a greater impact on the mental health of older women than other sources of support, including spouses, friends and acquaintances.Also, in relation to the physical dimension of elderly women's health, according to the results of the Bennet study, the decrease in the level of physical health in older women is more a function of burnout and aging, than widowhood and lack of spouse support. This could be a justification for the lack of significance of this relationship in our study.The results of this study also showed that the mean score of happiness is higher in women with a spouse, but this difference is not statistically significant (P = 0.17). According to Hughes and Waite, regarding the role of marriage and its relationship with feelings of health and happiness, although some changes in physical and mental health can be explained by marital status, marriage seems to be only part of this relationship. Also, Ryan, and Ryan and Willits, believe that it is the quality of family relationships that can contribute to the psychological well-being of the elderly, not just the presence of a spouse and the number of children.

 Although some changes in physical and mental health can be explained by marital status, other factors besides just having a spouse may also affect the sense of well-being, health, and happiness of these older women, and identifying them requires further research.