EDUCATIONAL STATUS AND ACTIVE LIFE EXPECTANCY AMONG OLDER BLACKS AND WHITES
EDUCATIONAL STATUS AND ACTIVE LIFE EXPECTANCY AMONG OLDER BLACKS AND WHITES
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DOI：
10.1056/nejm199307083290208
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发表时间：
1993-07-08
影响因子：
158.5
通讯作者：
BRANCH, LG
中科院分区：
文献类型：
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作者：
GURALNIK, JM;LAND, KC;BRANCH, LG
研究背景与方法。众所周知，社会经济地位低的人预期寿命较短。在一项研究社会经济地位与老年人无残疾或活动寿命之间关系的研究中，我们前瞻性地分析了北卡罗来纳州皮埃蒙特地区2219名65岁及以上的黑人和1838名白人的数据。我们将残疾定义为不能独立完成一项或多项基本功能活动，如走路、洗澡、穿衣、吃饭和上厕所。对于按性别、种族和教育程度定义的亚组，使用统计模型来估计每个年龄的人从基线不残疾或残疾到一年后不残疾、残疾或死亡的概率。然后将这些过渡概率输入到递增-递减寿命表中，以产生总预期寿命、活动预期寿命和残疾预期寿命的估计值（总预期寿命等于活动预期寿命加上残疾预期寿命）。65岁的黑人男性的总预期寿命（11.4岁）和活动预期寿命（10岁）都低于白人男性（总预期寿命12.6岁；活动预期寿命11.2岁），尽管在我们控制了受教育程度后，差异有所缩小。65岁的黑人女性（总预期寿命为18.7岁；积极预期寿命为15.9岁）的估计与白人女性相似。75岁及以上的黑人男性和女性的总预期寿命和积极预期寿命高于白人，并且在教育分层后差异更大。与种族相比，教育与总体预期寿命和积极预期寿命的关系要强得多。在按性别和种族划分的四个亚组中，65岁时，受教育年限在12年及以上的人的实际预期寿命比受教育程度较低的人长2.4至3.9年。总的来说，总预期寿命和积极预期寿命较长的亚组也活得更久。在老年黑人和白人中，教育水平（衡量社会经济地位的一项指标）对总体预期寿命和积极预期寿命的影响大于种族。
Background and Methods. Persons of low socioeconomic status are known to have reduced life expectancy. In a study of the relation of socioeconomic status to disability-free or active life expectancy among older persons, we analyzed prospectively gathered data on 2219 blacks and 1838 whites who were 65 years of age or older in the Piedmont region of North Carolina. We defined disability as the inability to perform independently one or more basic functional activities such as walking, bathing, dressing, eating, and using the toilet. For subgroups defined by sex, race, and education, statistical models were used to estimate, for persons at each year of age, the probability of transition from not being disabled or being disabled at base line to not being disabled, being disabled, or having died one year later. These transition probabilities were then entered into increment-decrement life tables to generate estimates of total, active, and disabled life expectancy (with total life expectancy equal to active life expectancy plus disabled life expectancy).Results. Sixty-five-year-old black men had a lower total life expectancy (11.4 years) and active life expectancy (10 years) than white men (total life expectancy, 12.6 years; active life expectancy, 11.2 years), although the differences were reduced after we controlled for education. The estimates for 65-year-old black women (total life expectancy, 18.7 years; active life expectancy, 15.9 years) were similar to those for white women. Black men and women 75 years old and older had higher values for total life expectancy and active life expectancy than whites, and the differences were larger after stratification for education. Education had a substantially stronger relation to total life expectancy and active life expectancy than did race. At the age of 65, those with 12 or more years of education had an active life expectancy that was 2.4 to 3.9 years longer than the values for those with less education in all the four subgroups defined by sex and race. Overall, the subgroups with longer total life expectancy and active life expectancy also lived more years with a disability.Conclusions. Among older blacks and whites, the level of education, a measure of socioeconomic status, has a greater effect than race on total life expectancy and active life expectancy.