ArticleJournal of family medicine and primary care2026
Exploring pension access and health-seeking behavior among older adults in South Kerala: A mixed-methods study.
Article in Journal of family medicine and primary care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: India has overtaken China as the most populous country, causing an increase in the proportion of older adults. 8.6% of India's population is olde adults and is projected to rise to 19% by 2050; in Kerala, the proportion is already 12.6%. Financial insecurity is a major determinant of poor health and inequitable healthcare access among the elderly. Social security measures such as pensions play an important role in influencing health-seeking behaviour, particularly in primary care settings. This study assessed the prevalence of pension coverage among community-dwelling older adults, examined their health-seeking behaviour, and healthcare utilization pattern. Methods: A mixed-methods community-based cross-sectional study was conducted in Mallapuzhassery Panchayat, Kerala, from March 2021 to July 2022 among 124 adults aged ≥65 years selected using simple random sampling. Data were collected using an interviewer-administered semi-structured questionnaire. Statistical analysis was performed using SPSS. Associations were assessed and p <0.05 was considered statistically significant. Qualitative data were collected through purposive in-depth case studies among participants who experienced a major health event in the preceding year and analyzed using content analysis. Results: Pension coverage was observed in 82.3% of participants, predominantly through non-contributory social pensions. Possession of a below-poverty-line ration card was the only significant predictor of pension receipt. Pensions met health-related expenses for 65.3% of participants. Good health-seeking behaviour was observed in 60.4%. Government health facilities were the primary source of treatment (48.4%) and medicines (54%). Pension amount explained 43.4% of the variation in monthly medication expenditure. Conclusion: Social pensions enhance access to primary healthcare among older adults. Strengthening social security measures and addressing socioeconomic determinants are essential to improve health-seeking behaviour in an ageing population.
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