Household living arrangements and self-rated health status among older adults in Ghana

Household living arrangements for older adults play a critical role in ensuring positive health outcomes for older people. Although this subject has been investigated in the global north due to evolving dynamics of family systems, empirical research on the subject remains limited in developing countries, including Ghana. To address this knowledge gap, the paper aims to (1) examine how household living arrangements affect self-rated health status among older persons and (2) identify the socio-demographic and health factors that influence their self-rated health status in Ghana. The study focused on older adults living alone, living with immediate family only (spouse and children), living with immediate family and others, and living with others only. The World Health Organisation (WHO) SAGE 2014/2015 data for Ghana was used for this study. A sample size of 2,106 older adults aged 60 years and above was used for this study. Two multinomial logistic regression models were fitted using STATA. Reporting relative risk ratios (RRR) were used to examine the effects of the independent variables on the dependent variable (Self-rated Health status). 95% confidence intervals were used to establish the relationship between variables and interpret the findings of the study. A p-value less than 0.05 was used for statistical significance. The mean age of participants was 71.5 ± 7.7 years, and the age of participants was categorized into three groups: 60–69, 70–79, and 80 years and above; 48.6% of older adults were aged 60–69, 70–79 years (33.4%), and 18.0% were aged 80+. More than half (52.6%) of participants reported having good health. Also, about a third (34.4%) of older adults have moderate health, while 13.0% of them report poor health. Older adults living with immediate family and those living with immediate family and others were less likely to report poor health compared to those who lived alone (RRR = 0.46; p < 0.001; RRR = 0.52; p < 0.001). Also, age, employment status, household wealth status, physical activity, physical disabilities, chronic diseases, and functional limitations were significant predictors of the self-rated health status of older adults. Our findings underscore the urgent need for multi-sectoral policy frameworks that integrate social support with healthcare services. To promote healthy ageing and improve quality of life, public health interventions must seek to promote family and/or community support for the elderly’s health in their home.