Rural aging in Thailand: determinants and challenges of elderly health status in Phayao Province

Thailand is experiencing rapid population aging, with elderly citizens representing 20.36% of the total population. Phayao Province has an especially high proportion of elderly residents (26.54%), particularly in rural areas where healthcare access and support may be limited. This cross-sectional study aimed to assess health status and identify its determinants among rural elderly in Phayao Province. Using multi-stage cluster sampling, 453 participants aged ≥60 years were selected from three districts. Data were collected from May to July 2024 using validated questionnaires (Cronbach's alpha 0.701-0.974) covering health status, quality of life, mental health, family relationships, and activities of daily living (ADL). Results showed that 42.6% of participants had moderate health status, while 39.3% had poor health status. The majority were female (58.9%), with a mean age of 69.06 years. Bivariate analysis identified significant factors (p<0.05) including employment status, income, income sufficiency, living arrangements, exercise, health information, mental health, quality of life, family relationships, and ADL. Stepwise Multiple Linear Regression revealed five significant predictors: family relationships (β=0.355, p<0.001), income sufficiency (β=-3.328, p<0.001), exercise (β=5.640, p<0.001), ADL (β=0.511, p<0.001), and quality of life (β=0.120, p=0.001), explaining 30.9% of health status variance. These findings suggest the need for integrated interventions addressing both social and health dimensions. Recommendations include developing elderly employment programs, strengthening family support systems, promoting exercise programs, and enhancing community mental health services. Policy makers and healthcare providers should consider these factors when designing targeted interventions for rural elderly populations.