Double burden of living alone and in poor socioeconomic conditions among urban-dwelling older Nigerians: a multilevel analysis
摘要
Living alone is associated with loneliness, depression and cardiovascular diseases. Living alone and in poor socioeconomic conditions (LAPSC) poses a greater risk of psychosocial health challenges, morbidity and mortality for older persons. The burden of this dyad on population health will likely increase in Nigeria, given the rising migration trends, changing family settings and the country’s ongoing economic crisis affecting household living arrangements and living standards. This study investigates the prevalence and determinants of LAPSC among urban-dwelling older Nigerians. Exploring these is relevant to achieving the sustainable development goals of eradicating poverty (SDG 1) and promoting a healthy life (SDG 3). The study analysed 5,106 weighted samples of older persons aged ≥ 60 from the 2024 Nigeria Demographic and Health Survey. Associations were examined using the multilevel multinomial logistic regression model. Based on the results, 11.0% live alone, of whom 62.6% live in poor conditions. As indicated by the adjusted relative risk ratio (aRRR), the risk of LAPSC was significantly higher for widows (aRRR = 8.12; p < 0.001; 95% C.I = 5.81–11.36) than for the married, and in the southern regions as well as other northern regions compared with the North West. However, the risk was 53% lower (aRRR = 0.47; p < 0.001; 95% C.I = 0.34–0.65) for women than men; 47% lower for those aged 80 + years than < 70 years; and 46–72% lower for those with primary/secondary (aRRR = 0.54; p < 0.001; 95% C.I = 0.39–0.75) and tertiary education (aRRR = 0.28; p < 0.001; 95% C.I = 0.17–0.45) compared with those with no formal education. At the community level, communities with middle or high levels of education and communities with low poverty levels had about 56–79% lower risk of LAPSC. The individual- and community-level factors accounted for 11.4% and 43.3% of the variations in LAPSC, respectively. This study suggests individual- and community-level interventions targeting poverty alleviation, access to education, and social inclusion among vulnerable individuals and communities.