Dual Sensory Impairment and Perceived Everyday Discrimination in the United States.
Dual Sensory Impairment and Perceived Everyday Discrimination in the United States.
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DOI：
10.1001/jamaophthalmol.2020.3982
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发表时间：
2020-12-01
影响因子：
8.1
通讯作者：
Swenor BK
中科院分区：
文献类型：
--
作者：
Shakarchi AF;Assi L;Ehrlich JR;Deal JA;Reed NS;Swenor BK
日常感受到的歧视是一种心理压力源，与包括死亡率在内的不良健康结果有关。评估视力障碍（VI）、听力障碍（HI）和双重感觉障碍（DSI）与日常辨别力的关系。健康与退休研究2006年和2008年调查的横截面分析，这是一项基于美国人口的调查，包括51岁及以上的非机构化成年人。对分析进行加权，以考虑复杂的样本设计和差异无应答。分析了2019年10月至2019年11月期间的数据。参与者使用眼镜和/或助听器（如适用），根据Likert量表（差、一般、好、非常好和优秀）对他们的视力和听力进行评级。感觉障碍定义为相关模态的能力差或一般，感觉障碍分为非感觉障碍（NSI）、单独VI、单独HI和DSI。感知日常歧视的有效5个问题的威廉姆斯规模（范围0至5）。线性回归模型估计了不同感官类别的歧视得分差异，调整了年龄，性别，种族，民族，非美国出生，体重指数，关系状况，家庭净财富和慢性疾病（糖尿病，高血压，心脏病，中风，肺病，非皮肤癌和关节炎）的数量。样本包括13092人。在对代表美国人群的样本进行加权后，11.7%的患者仅患有VI，13.1%的患者仅患有HI，7.9%的患者患有DSI。在完全校正的模型中，与NSI参与者相比，单独VI（β [辨别力评分变化]，0.07; 95% CI，0.02-0.13）、单独HI（β = 0.07; 95% CI，0.02-0.11）和DSI（β = 0.23; 95% CI，0.16-0.29）参与者感知到更大的辨别力。DSI组认为更大的歧视比VI单独或HI单独。在美国，患有VI或HI的老年人比患有NSI的老年人感受到更大的日常歧视，而患有DSI的老年人甚至比仅患有VI或HI的老年人感受到更多的歧视。这些结果提供了洞察感官丧失的社会影响，并强调需要确定和解决歧视老年人VI和HI的原因。
Perceived everyday discrimination is a psychosocial stressor linked to adverse health outcomes, including mortality. To assess the association of vision impairment (VI), hearing impairment (HI), and dual sensory impairments (DSI) with everyday discrimination. Cross-sectional analysis of the Health and Retirement Study 2006 and 2008 surveys, a US population-based survey that included noninstitutionalized adults 51 years and older. Analyses were weighted to account for complex sample design and differential nonresponse. Data were analyzed between October 2019 and November 2019. Participants rated their vision and hearing, using eyeglasses and/or hearing aids if applicable, on a Likert scale (poor, fair, good, very good, and excellent). Sensory impairment was defined as poor or fair ability in the relevant modality, and sensory impairment was categorized as neither sensory impairment (NSI), VI alone, HI alone, and DSI. Perceived everyday discrimination was measured on the validated 5-question Williams scale (range 0 to 5). Linear regression models estimated differences in discrimination scores by sensory categories, adjusting for age, sex, race, ethnicity, non-US birth, body mass index, relationship status, net household wealth, and number of chronic diseases (among diabetes, hypertension, heart disease, stroke, lung disease, nonskin cancer, and arthritis). The sample included 13 092 individuals. After weighting the sample to be representative of the US population, 11.7% had VI alone, 13.1% HI alone, and 7.9% DSI. In the fully adjusted model, participants with VI alone (β [change in discrimination score], 0.07; 95% CI, 0.02–0.13), HI alone (β = 0.07; 95% CI, 0.02–0.11), and DSI (β = 0.23; 95% CI, 0.16–0.29) perceived greater discrimination compared with participants with NSI. The DSI group perceived greater discrimination than VI alone or HI alone. Older adults with VI or HI in the United States perceive greater everyday discrimination than older adults with NSI, and those with DSI perceive even more discrimination than those with either VI or HI alone. These results provide insight into the social impact of sensory loss and highlight a need to identify and address reasons for discrimination toward older adults with VI and HI.
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