Chronic disease and severe disability among working-age populations
Chronic disease and severe disability among working-age populations
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DOI：
10.1097/mlr.0b013e3181484335
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发表时间：
2008-01-01
期刊：
影响因子：
3
通讯作者：
Lakdawalla, Darius
中科院分区：
文献类型：
--
作者：
Bhattacharya, Jay;Choudhry, Kavita;Lakdawalla, Darius
背景：最近的研究表明，工作年龄人口的严重残疾率（以无法进行基本日常生活活动来衡量）一直在上升。与此同时，在劳动年龄人口中，重要慢性疾病的患病率一直在上升，而其他疾病的患病率则在下降。慢性病患者比其他人更有可能出现日常生活活动受限。目的：我们研究慢性病趋势在多大程度上可以解释这些残疾趋势。数据：我们使用 1984-1996 年全国访谈调查的全国代表性调查数据，该调查提出了有关该时期日常生活活动限制的一系列一致的问题。方法：我们将残疾趋势分解为两部分：一部分由于慢性病患病率趋势，另一部分由于慢性病患病率趋势结果：我们的主要发现是，对于 1984 年至 1996 年间的工作年龄人口：(1) 非慢性病患者的残疾患病率急剧下降； (2) 肥胖率上升约 40% 归因于慢性病趋势造成的残疾增加； (3) 慢性病人群残疾患病率上升约 60% 归因于慢性病趋势。结论：工作年龄人口的残疾预防工作应侧重于降低慢性病人群的肥胖患病率和限制残疾。鉴于这些人群的残疾率上升，目前尚不清楚老年残疾率是否会进一步大幅下降。
Background: Recent work has shown that rates of severe disability, measured by the inability to perform basic activities of daily living, have been rising in working age populations. At the same time, the prevalence of important chronic diseases has been rising, while others falling, among working age populations. Chronically ill individuals are more likely than others to have activity of daily living limitations.Objective: We examine the extent to which chronic disease trends can explain these disability trends.Data: We use nationally representative survey data from the 1984-1996 National Interview Survey, which posed a consistent set of questions regarding limitations in activities of daily living over that period.Methods: We decompose trends in disability into 2 parts-1 part due to trends in the prevalence of chronic disease and the other due to trends in disability prevalence among those with chronic disease.Results: Our primary findings are that for working age populations between 1984 and 1996: (1) disability prevalence fell dramatically among the nonchronically ill; (2) rising obesity prevalence explains about 40% of the rise in disability attributable to trends chronic illness; and (3) rising disability prevalence among the chronically ill explains about 60% of the rise in disability attributable to trends in chronic illness.Conclusions: Disability prevention efforts in working age populations should focus on reductions in obesity prevalence and limiting disability among chronically ill populations. Given the rise in disability among these population subgroups, it is unclear whether further substantial declines in elderly disability can be expected.