Ghosh, Gargi (2021) The impact of obesity on health and social care needs among older adults (50+) in England. Doctoral thesis, University of West London.

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Abstract

Background: The prevalence of obesity and its implication on individual health and public health was a worldwide concern for the last few decades. Along with the increasing longevity, particularly in high income countries, there is a noticeable shift in the disease profile of the population towards more long-term non-communicable diseases due to socio-demographic transitions. From an economic viewpoint, the effect on health and social care cost related to overweight and obesity is getting more attention, but the less visible mental health and wellbeing effects have often been missed. The key theories that underlie the findings of the present study are, seeing obesity through a life course approach and social cognitive theory lens. In addition, understanding disability through a human rights approach and social model of disability.
Aim and objectives: The purpose of the study is to explore the factors that influence the health, wellbeing, and the future burden on social care services for overweight and obese older adults in England. The present study critically reviews the literature on the causes and consequences of obesity among older adults (aged 50 years and over) and their health, wellbeing, and social care needs. Gaps identified during literature review led to formulation of four research questions to satisfy the research objectives: 1) Is there any relationship between obesity, disability, and morbidities in older adults? 2) Is there any link between current health status and the overall wellbeing of obese older adults in England? 3) Is there any association between high body mass index and social care needs in older adults? 4) What are the dynamics of unmet needs for the social care of obese older adults?
Methods: A literature search was conducted to identify gaps in knowledge. A mixed-method approach is adopted that included quantitative secondary data analysis of data from the English Longitudinal Study of Ageing (ELSA) population survey and qualitative primary data collection and analysis of patients from a National Health Service (NHS) General Practice (GP) surgery. The secondary data was statistically analysed with the help of Statistical Package for the Social Sciences (SPSS) V.25.0. The primary qualitative interview data was analysed using narrative analysis. Two conceptual models were developed. The first one, to map out the theoretical threads and answer the research questions. The second one to conceptualise the unmet care needs for overweight and obese older adults.
Findings: The findings of the quantitative data analysis show that high Body Mass Index (BMI) compared to normal weight is positively correlated with self-reported impairment of functional activity in older adults. High BMI is also positively associated with subjective and objective health status, subjective wellbeing, and the amount of social care received by older adults after adjusting for other environmental factors. The findings of the narrative analysis of the qualitative interview data were that there is a range of unexpressed and partially expressed unmet needs among overweight and obese older adults.
Contribution to knowledge: The study has advanced not only the knowledge base of consequences of high BMI and other environmental factors on the health, wellbeing, and social care need of overweight/obese older adults, but also for the first time, the nature of unmet care needs among this population.
Implications of future research: The study outcomes will enable policymakers and the health and social care providers to have a new perspective and insight into the needs of overweight and obese adults and how they can design an obesity management service for overweight and obese older adults in England that considers their both health and social care needs in a more holistic way. Social care providers and policy makers should take a life course and human rights approach when designing social care services. They should also take account of the wider social and environmental context when delivering social care services by using a social cognitive and social model of disability framework.

Item Type:	Thesis (Doctoral)
Subjects:	Medicine and health > Health promotion and public health
Depositing User:	Ghosh Gargi
Date Deposited:	22 Dec 2021 11:47
Last Modified:	22 Dec 2021 12:01
URI:	https://repository.uwl.ac.uk/id/eprint/8510

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