Health needs of older populations affected by humanitarian crises in low- and middle-income countries: a systematic review

Massey, Emma; Smith, James; Roberts, Bayard

doi:10.1186/s13031-017-0133-x

Conflict and Health

Table 1 Factors associated with better (+) and worse (−) mental and physical health outcomes

From: Health needs of older populations affected by humanitarian crises in low- and middle-income countries: a systematic review

Factors	Mental health outcomes											Physical health outcomes
Factors	PTSD	Depression	Anxiety	Alcohol misuse	Adjustment disorder	Psych. quality of life	Psych. distress	somatic symptomsⁱ	Insomnia	Bitterness/ resentment	Aggressive behaviour	Quality of Life/general health status	Physical functioningⁱⁱ	Miscellaneousⁱⁱⁱ	Treatment interrupted	Mortality	Clinical complications	Malnutrition
Demographic and socio-economic:
Age (increasing)	- [33, 36, 39, 44, 53]	- [38, 52] [48] + [53]			-[53]	- [26, 56, 59]	- [37, 39]	- [38]		+ [38]	+ [38]	- [26, 56] - [52] β	- [27, 45, 52]			- [35, 54, 55] β	-[57]	- [24, 28, 45]
Gender (female)	- [33]	- [40, 48]	- [40, 58]			- [26, 56, 59]						- [26, 56]	-[27]			-[50]
Single/widowed/separated (vs. married)	- [33]	-[48]				-[59]						[56]				-[51]
Low education	- [33]	+ [52]					- [29]					- [52] β	-[27]
Low income	- [33]	- [30, 48]				-[59]
Loss of livelihood	- [58]
Loss of property																-[50]
Low socio-economic status^iv																		- [28]
Larger household size^v													-[52]
Living with others													+ [27]			-[51]
Dissatisfaction with living conditions						- [26]						- [26]
Living location (rural vs. urban)		- [31]				+ [26]			- [31]					-[31]	-[31]
Low social support	- [33]	- [42]	- [52]			-[59]
Regular religious attendance		+ [30]
Trauma exposure & forced displacement:
Exposure to individual traumatic events^vi	- [33, 36, 41, 44, 58]	- [41, 42, 48, 58]	- [58]	- [41]		- [26]	- [29, 41]					- [56]	-[27]			-[50]
Higher intensity of exposure	- [36, 41, 58]	[42, 58]	-[58]			- [26]	- [41]									-[50]
Forced displacement versus non-displacement		- [53]	- [53]			- [26]	- [29]									-[35]
Longer-term displacement vs. shorter-term displacement		- [52]	+ [40] - [52]										-[52]	-[52]			-[52]	+ [49]
Injury (to respondent or family member)	-[33] [44]	-[48]	-[58]			- [26] [59]	[29]					-[26]
Health factors:
Current or previous health/functioning problems	- [41]	- [30, 41]		- [41]		- [26, 56, 59]	-[29, 41]
Illness^vii												- [56]	-[52]			-[57]		-[24]
Poor physical functioningⁱⁱ												- [26]						-[24]
No physical exercise																		-[24]
Malnutrition													-[46]
History of falls																		-[24]
Needing dialysis																-[57]

Only quantitative studies included in Table
- associated with negative health outcome; + associated with positive health outcome; β did not include tests for statistical significance
ⁱ psychosomatic measure includes individual items on symptoms of insomnia, nightmares, distraction, forgetfulness, depression, emotional numbness, and fear. ⁱⁱ physical functioning includes ADL, IADL, AMA and hand grip strength, and general functional status measures. ^Iii misc. physical symptoms include dental, visual, weight loss, eating problem, hearing, headache, and known medical problems. ^iv includes caste, old age pension, occupation and land ownership. ^v Includes living with three or more generations, living with a married child. ^vi Including surviving earthquake, injury during crisis event, living in high impact area, trauma exposure inventory, initial fear, bereavement. ^Vii includes NCD’s, sepsis, chronic illness, >3 prescription drugs/day, fever, and ARI, dementia, poor vision, difficulty walking, poor health status

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ISSN: 1752-1505

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