EDUCATION, ARTHRITIS & DISABILITY AMONG MINORITY SENIORS

众所周知，社会经济地位与关节炎患病率有很强的相关性 以及严重、残疾和脆弱..但我们的计划有两个空白 相互关系的知识。首先，很少有研究调查 少数族裔(黑人、西班牙裔)老年人和 将其与白人进行比较。第二，只有一项研究(Leigh，Fries， 关节炎和风湿病，在新闻中)，我熟悉的 调查了社会经济地位的三个组成部分--教育， 职业和收入--作为脆弱的独立协变量。如果因果关系 从社会经济地位到脆弱，这是不幸的，因为 从预防的角度来看，教育、职业和收入是 独立的实体。如果收入是三者中最重要的，那么 例如，可以得出关于以下关系的暗示： 社会保障福利和脆弱性。如果是职业，或主要职业 在退休之前，是最重要的，那么影响可能是 为《职业安全与健康法规》抽签。如果，最终， 教育是最重要的，如果教育被推定为 影响力脆弱，而不是反之亦然，教育投资可能是 有效的预防药物。而职业和收入将是 考虑到，拟议的研究将最大限度地关注 自教育以来，教育一直是最受关注的研究课题。 将分析四个数据集：国民健康和营养 考试调查1 1971-75(NHANES 1)；II 1976-86(NHANES 11)； NHANES I(NHEFS)的流行病学随访，以及西班牙裔健康和 营养检查调查(HHANES)。因变量将包括 自我报告的关节炎，自我报告的医生对关节炎的诊断， 自我报告的工作或日常活动的健康限制，a 基于25个问题的残疾量表；关于关节疼痛的自我报告， 后背、脖子和膝盖。独立变量将包括性别、年龄、 年龄平方，婚姻状况，受教育年限，主要终身 职业、当前职业和收入。方法将包括普通 最小二乘、加权最小二乘、Logistic、加权Logistic和 解释选择偏差的工具变量。 黑人和白人将使用NHANES 1、11和 NHEFS。西班牙裔美国人将使用HANES的数据进行分析。注意 将仅限于65岁及以上的人。

Socioeconomic status is a known strong correlate of arthritis prevalence and severity, disability, and frailty.. But there are two gaps in our knowledge of the correlation. First, few studies have investigated the strength of the association among minority (Black, Hispanic) seniors and drawn comparisons to Whites. Second, only one study (Leigh, Fries, Arthritis and Rheumatism, in press) with which I am familiar has investigated the three components of socioeconomic status--education, occupation, and income--as separate covariates of frailty. If causation runs from socioeconomic status to frailty then this is unfortunate, since from a prevention point of view, education, occupation, and income are separate entities. If income is the most important of the three, then implications might be drawn concerning, for example, the relation between Social Security benefits and frailty. If occupation, or main occupation prior to retirement, is the most important, then implications might be drawn for Occupational Safety and Health regulations. If, finally, education is the most important, and if, again, education is presumed to influence frailty rather than vice versa, investments in education may be potent preventive medicine. While occupation and income will be considered, the proposed research will devote the greatest attention to education since education has received the most prior research attention. Four data sets will be analyzed: the National Health and Nutrition Examination Survey 1 1971-75 (NHANES 1); II 1976-86 (NHANES 11); Epidemiological Follow-up to NHANES I (NHEFS), and the Hispanic Health and Nutrition Examination Survey (HHANES). Dependent variables will include self-reported arthritis, self-reported doctors' diagnoses of arthritis, selfreported health limitations from working or daily activities, a disability scale based on 25 questions; self-reports on pain in joints, back, neck, and knees. Independent variables will include gender, age, square of age, marital status, years of schooling completed, main lifetime occupation, current occupation, and income. Methods will include Ordinary Least Squares, Weighted Least Squares, Logistic, Weighted Logistic, and Instrumental Variables to account for selection bias. Blacks and Whites will be analyzed with data from the NHANES 1, 11, and NHEFS. Hispanics will be analyzed with data from the HHANES. Attention will be restricted to persons 65 years of age and older.