The social determinants of health influencing obesity for the aged in the Pakpoon community context: A qualitative study

OBJECTIVE: This study aimed to describe the social determinants of health influencing obesity for the aged in a community context and based on the perspectives of various stakeholders. METHODS: This was qualitative content analysis study using data from the focus group, individual in-depth interview, and observation. The study population was domiciled in Pakpoon Village, Mung District, Nakhon Si Thammarat Province, a tight-knit settlement typical of most retirement communities. Data were collected through two focus group discussions, direct observation, and in-depth interviews with 19 participants. Respondents represented key community groups: local nurses and public health officers, elderly residents, family caregivers (family members), and village health volunteers. RESULTS: The participants shared similar perspectives about the social determinants of health influencing obesity in the aged, which spanned three themes. These were: 1) neighborhood food environment (easy access to unhealthy food, no choice to recruit healthy food); 2) social networks influencing obesity (family affects food choices and prohibitions on exercise; belief, and socially imposed body image perceptions contributing to obesity in the aged); and 3) knowledge, attitudes, and beliefs behind lifestyle choices that cause obesity in the elderly (lack of awareness, personal attitudes, job and familial duties as barriers to engaging in physical activities; over-consumption behaviors lead to obesity in older people). CONCLUSION: These three themes were the root causes of obesity in the elderly in Pakpoon’s retirement community. This finding suggests that policymakers and nurses can create healthy environments, both to treat and prevent obesity, by raising awareness in younger generations, providing aging the provision of healthy food choices for older adults, encouraging health care professionals to share knowledge, and by modifying the attitudes and beliefs of both caregivers and older adults.