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Depression, disability in older Thai adults

This study seeks to find out what effect the migration of young people from rural to urban areas has on older people in the family who are ‘left behind’. It seeks to ascertain whether these older people are at risk from depression and disability, and whether their social and economic status changes as a result of the migration of younger members of their family.

There are rapidly increasing numbers of young people who migrate from rural to urban areas in many low-income countries. It has been suggested that this may have a negative impact on parents who remain in the rural home area. In Thailand, families traditionally take responsibility for older adults, and most older Thais live with or near to one of their adult children. There are concerns that migration could lead to loss of social and economic support for parents, which may in term lead to poor health and increased risk of depression and disability. If this is the case, governments need to plan for and provide systems of care to support older adults in provincial areas.

This study will contribute to the accumulation of knowledge about migration and mental health and complement the bulk of studies that have looked at the effects of migration on young people who leave their home. In the long term, the results of the study will inform the development of policies for older people living in rural areas without traditional support.

Between 1999 and 2004, researchers from the Institute of Population and Social Research at Mahidol University collected information about population change in an annual census of a large sample of households in Kanchanaburi Province.

The Kanchanaburi Demographic Surveillance Survey, funded by the Wellcome Trust, has a list of 2,678 village households containing at least one older person who was aged more than 60 at the time of the 2004 census and who participated in all five annual surveys. One or more children in 1,277 of these households migrated between 1999 and 2004, and 1,401 households had no experience of migration. For this project, the research team is going to randomly select 477 older people from each group to compare their experiences.

Participating older adults will be interviewed again to find out about their emotional and economic support and experience of mental ill health. The groups will be followed up a year later.

Kanchanaburi Province is in west Thailand, and is mostly rural. Many families use land for plantation cash crops, animal husbandry or rice growing. The Province also has industry and tourist attractions and a large number of young people are migrating from rural family households.

The lead researchers are Dr Melanie Abas, who is co-ordinating the project and Professor Martin Prince in the Section of Epidemiology and Dr Bencha Yoddumnem-Attig and Dr Sureeporn Punpuing from the Institute for Population and Social Research at Mahidol University, Thailand. 

The project is funded by the Wellcome Trust.



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