Persistent and growing socioeconomic disparities in disability among the elderly: 1982-2002
Persistent and growing socioeconomic disparities in disability among the elderly: 1982-2002
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DOI：
10.2105/ajph.2004.048744
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发表时间：
2005-11-01
影响因子：
12.7
通讯作者：
Freedman, VA
中科院分区：
文献类型：
--
作者：
Schoeni, RF;Martin, LG;Freedman, VA
目标。我们试图确定在过去20年中，70岁以上残疾率的社会经济和种族/民族差异是否扩大或缩小。我们使用了1982 - 2002年全国健康访谈调查的数据，这是美国非机构人口的全国代表性横断面调查。参与者包括172227名年龄在70岁及以上的人。主要结果测量是两种自我报告的残疾测量的流行率的平均年百分比变化：日常生活活动需要帮助（“ADL残疾”）和日常生活活动需要帮助或工具性活动（“任何残疾”）。在1982年至2002年期间，所有群体的年龄和性别调整后的残疾患病率均有所下降。然而，在最弱势的社会经济群体中，平均每年下降的百分比要小一些。不同种族/民族之间的趋势差异没有统计学意义。在较有利的群体中，ADL残疾率下降，但在最低收入和受教育程度的群体中，ADL残疾率上升。非西班牙裔白人和少数族裔在ADL残疾方面经历了相似的年均下降百分比。在过去20年里，老年残疾方面的种族/民族差异持续存在，而社会经济差异却有所扩大。
Objective. We sought to determine whether socioeconomic and racial/ethnic disparities in prevalence of disability over age 70 have widened or narrowed during the past 2 decades.Methods. We used data from the 1982 - 2002 National Health Interview Surveys, which are nationally representative cross-sectional surveys of the noninstitutionalized population of the United States. Participants included 172227 people aged 70 years and older. The primary outcome measure was the average annual percentage change in the prevalence of 2 self-reported disability measures: the need for help with activities of daily living ("ADL disability") and need for help with either ADL or instrumental activities of daily living ("any disability").Results. All groups experienced declines in the age- and gender-adjusted prevalence of any disability during the 1982 to 2002 period. However, the average annual percent declines were smaller for the least advantaged socioeconomic groups. Differences in trends across racial/ethnic groups were not statistically significant. ADL disability prevalence decreased for the more advantaged groups but increased among the lowest income and education groups. Non-Hispanic Whites and minorities experienced similar average annual percent declines in ADL disability.Conclusions. Racial/ethnic disparities in old-age disability have persisted over the last 20 years, whereas socioeconomic disparities have increased.