Population Ageing and the Well-Being of Older Persons in Thailand ...

Section 4: Health Status
While the concept of well-being incorporates many
different dimensions, perhaps none is of more central
concern to older persons than their physical health.
In virtually all populations, biological processes
ensure not only that the risk of mortality increases
steadily with age but so do functional limitations and
chronic illness. Thus population ageing has critical
implications for the demand for medical and related
services within the formal health care system and for
more general caregiving at the level of the family and
community. At the same time, the impact of the
biological processes that lead to an inevitable
deterioration of health at some point in old age are
affected by advancing medical technologies and
changing environments in which people live out their
lives. Thus there is considerable variation in
mortality, morbidity, and other aspects of health across
settings and over time. In this section we start by
presenting trends in older age mortality, which in a
sense is the ultimate measure of health, and estimates
of active life expectancy. This is followed by
discussions of self assessed health, selected health
problems and illness, and finally functional limitations
in activities of daily living. Much of the evidence
presented is based on the recent 2007 Survey of
Elderly in Thailand.
older years, estimates of older age mortality will be
understated and as a result life expectancy at older
ages exaggerated. Nevertheless, the Surveys of
Population Change provide the only empirically based
estimates of life expectancy at older ages in Thailand.
More recently, the United Nations published
projections to 2050 of life expectancy at older ages
for Thailand but estimates for the past are not
provided (UN 2007a).
Figure 4.1 presents estimates of life expectancy of older
persons based on these sources The NSO estimates
indicate substantial improvement in life expectancy
at age 60 for both men and women between the
mid-1980s and the mid-1990s. The most recent
Survey of Population Change, however, shows a
decline in life expectancy at age 60 for both men and
women based on data for the years 2005-06.
4.1 Older Age Mortality
Vital registration in Thailand is incomplete although
presumably improving. In order to estimate
mortality and fertility levels, the National Statistical
Office (NSO) periodically conducts Surveys of
Population Change. The methodology and quality
have varied over time. In addition, estimates of older
age mortality are particularly sensitive to the accuracy
of age-reporting, a potential problem in Thailand as
in most other countries (National Research Council
2001). To the extent that age tends to be overstated at
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