IMCC Journal of Science

Abstract: 

Widowed older adults who remain economically active may face unique barriers to healthcare despite statutory coverage in the Philippines. Evidence on this subgroup particularly in Southern Philippines is limited. This study aims to examine determinants of healthcare utilization among widowed, working elders. An analytic cross-sectional study was conducted among community-dwelling widowed adults aged ≥60 years engaged in paid work across 24 barangays in Southern Philippines (N=520). Outcomes were any healthcare use in the past three months and visit count over the same period. Exposures followed Andersen’s model (predisposing, enabling and need). Multivariable logistic regression (for any use) and negative binomial models (for visit count) were fitted with province fixed effects and robust standard errors clustered at the barangay level. Overall, 54.2% of the respondents reported any visit; utilization was higher in formal vs informal workers. In adjusted models, insurance, higher social support, greater multimorbidity per condition, and shorter travel time predicted higher odds of any use. Informal employment and longer weekly work hours predicted lower odds. For visit counts, multimorbidity, basic self-care and more complex activities limitation, and insurance were associated with higher frequency, while informal employment, weekly hours, and travel time were associated with fewer visits. Among widowed, working elders, realized healthcare use reflects a balance of need and enablers versus work/time and distance constraints. Converting coverage into care will likely require benefit navigation targeted to widowed informal workers, extended or mobile services aligned with work schedules, transport support, and leveraging social support networks.

Keywords: healthcare utilization; older adults; Philippines; widowhood