Gender Dimensions Of Population Ageing And Older Adults’ Health-Related Quality Of Life (Hrqol) In Ghana

Abstract

The global rise in life expectancy has led to a growing proportion of older adults, particularly in sub-Saharan Africa, including Ghana. This demographic shift presents both challenges and opportunities for health systems, as older persons experience distinctive and often complex health needs. Despite improvements in longevity, understanding of health-related quality of life among older adults in Ghana remains limited, especially with regard to gender differences. The health survival paradox, in which women outlive men but often experience poorer health outcomes, highlights the need for a deeper exploration of gendered ageing experiences. This study examines the gendered dimensions of HRQoL among older adults in Ghana across physical, psychological, social, and environmental domains. It analyses how socio-demographic factors such as age, marital status, education, and employment influence HRQoL, and how these associations differ between men and women. The study addresses a critical knowledge gap by providing evidence on gender-specific health patterns among older adults and offering insights for policy formulation. A cross-sectional design was employed using data from the World Health Organisation’s SAGE Wave 2 survey for Ghana. Multinomial logistic regression analysis was used to assess the associations between socio-demographic variables and HRQoL domains. The analysis also explored how gender shapes these relationships, considering key factors such as occupation, education, and marital status The study found significant associations between socio-demographic characteristics and HRQoL among older adults. Age emerged as a key determinant, with individuals aged sixty to sixty-four reporting higher physical and psychological health satisfactions compared with those aged eighty and above. Clear gender differences were observed. Men reported better physical health outcomes, while women experienced sharper declines in psychological well-being as they grew older. Marital status was associated with improved social and psychological outcomes, with married individuals reporting better levels of satisfaction. Employment, especially within the informal sector, played an important role in strengthening overall well-being and perceptions of quality of life in later years. The findings underscore the need to incorporate both gender and socio-demographic contexts into policies and interventions targeting the health of older adults in Ghana. While men report relatively better physical health, women face greater psychological vulnerabilities in later life. These disparities call for gender-sensitive health strategies and social support systems tailored to the diverse needs of older men and women. The study also highlights the significance of informal sector work in sustaining older adults’ well-being, underscoring the importance of extending social protection to informal workers. This research enriches the limited literature on gendered HRQoL in Ghana by providing empirical evidence that supports gender-sensitive health and social policy development. It demonstrates the multidimensional nature of ageing and emphasises the interplay between gender, sociodemographic factors, and wellbeing. The findings serve as a foundation for future research on ageing in sub-Saharan Africa, including comparative analyses across similar contexts.