Convergence and divergence: Differences in disability prevalence estimates in the United States and Canada based on four health survey instruments
Convergence and divergence: Differences in disability prevalence estimates in the United States and Canada based on four health survey instruments
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DOI：
10.1016/j.socscimed.2009.06.017
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发表时间：
2009-08-01
影响因子：
5.4
通讯作者：
Gulley, Stephen P.
中科院分区：
文献类型：
--
作者：
Altman, Barbara M.;Gulley, Stephen P.
通过对加拿大/美国联合健康调查数据的分析，我们可以比较居住在加拿大或美国的一组答复者为评估残疾情况而设计的四套不同问题得出的流行率估计数。根据所使用的问题集和对答复所采用的编码，两国的年龄标准化流行率估计数差异很大。在美国非机构化成年人口中，残疾患病率估计值从低至15.3%到高达36.4%不等，而在加拿大，估计值从13.4%到37.3%不等。在这些问题集之间的一致性和不一致性，作为残疾人的识别也进行了检查。在这两个国家，当使用保守的回答编码来定义残疾时，在任何问题集上被确定为残疾的人中，只有不到20%的人在所有四个问题集上被确定为残疾。在这两个国家，对这些问题的一致性回答也与年龄较大、单身婚姻状况、教育程度低和收入低有关。两个国家的成套问题之间的不一致性相似，无论是基于相同的残疾领域还是不同的残疾领域的措施。根据这些研究结果，讨论了健康调查中残疾测量的理论、方法和未来。我们的结论是，要理解和解释国家流行率估计数，就需要更加认真地关注收集数据的目的、为此目的对残疾的具体定义和操作、数据收集和分析过程中使用的方法以及每个问题集所确定的人口共性和差异领域。在跨文化比较方面，使用一套共同的问题和答案类别以及类似的调查方法可以提供更可靠的结果。爱思唯尔有限公司出版
An analysis of data from the joint Canada/United States Survey of Health (JCUSH), allows us to compare prevalence estimates that result from four different question sets designed to assess disability from a group of respondents residing in either Canada or the United States. Depending upon the question set used and the coding applied to the responses, age-standardized prevalence estimates varied widely in both countries. In the U.S. noninstitutionalized adult population, disability prevalence estimates ranged from as low as 15.3% to as high as 36.4%, while in Canada the estimates ranged from 13.4% to 37.3%. Concordance and discordance in identification as disabled among these question sets were also examined. In both countries, less than 20% of those identified as disabled by any question set were identified as disabled on all four question sets when using conservative response coding to define disability. Concordance in answers to these questions was also found to be associated with older age, single marital status, low education and low income in both countries. Discordance between question set pairs was similar across both countries whether among measures based on the same domains of disability or different domains of disability. The theory, methods and future of disability measurement in health surveys are discussed in light of these findings. We conclude that understanding and interpreting national prevalence estimates requires more thoughtful attention to the purposes for which data are being collected, the specific definition and operationalizations of disability for those purposes, the methodology used in the data collection and analysis process and the areas of both commonality and difference in the populations identified by each question set. In terms of cross-cultural comparisons, the use of a common set of questions and answer categories and similar survey methodologies provides much more robust results. Published by Elsevier Ltd.