Grundy E, Holt G
Centre for Population Studies, London School of Hygiene and Tropical Medicine, UK.
Soc Sci Med. 2000 Oct;51(7):1061-74. doi: 10.1016/s0277-9536(00)00023-x.
In Britain and other developed countries older people comprise a large majority of all those reporting long term illness or disability. However, most studies of socio-demographic variations in health have focussed on those in younger age groups. Moreover approaches to the study of health variations are often fragmented. In this study we have adopted a life course approach to analyse differentials in health in early old age. The data comes from the Retirement and Retirement Plans Survey and follow-up, a two-wave study of persons aged 55-69 in 1988/9. As well as information on current circumstances, the data set includes occupational, marital, and fertility history information. At baseline a nationally representative sample of the population of Great Britain were interviewed at home by trained interviewers (n = 3543). The sample was followed up and in 1994, 2247 survivors were re-interviewed, a response rate of 70% (of survivors). The data were weighted to adjust for non-response bias. Two outcome measures were used: self rated health and presence or absence of disability assessed from a scale derived from detailed questions on thirteen domains of disability. The severity score used was that developed for the 1985/6 ONS Surveys of Disability. The findings indicate that health and disability status at baseline and at follow up were associated with socioeconomic and geographic variables, such as proportion of adult life spent unemployed and residence outside the Southeast of England; demographic factors, such as early age at marriage and high parity; and experience of adverse events, such as the death of a child and being dismissed from work. The results show that socio-economic, demographic, and geographical and life events' factors are all associated with health status in early old age and that integrated, rather than bifurcated, approaches to the study of health differentials are needed.
在英国和其他发达国家,在所有报告患有长期疾病或残疾的人群中,老年人占了绝大多数。然而,大多数关于健康方面社会人口统计学差异的研究都集中在较年轻的年龄组。此外,健康差异研究方法往往零散。在本研究中,我们采用了生命历程方法来分析老年早期的健康差异。数据来自退休与退休计划调查及后续跟踪,这是一项针对1988/1989年55 - 69岁人群的两阶段研究。除了关于当前状况的信息外,数据集还包括职业、婚姻和生育史信息。在基线阶段,由经过培训的访谈员在英国全国具有代表性的样本家中进行访谈(n = 3543)。对该样本进行了跟踪,1994年,对2247名幸存者进行了再次访谈,回复率为70%(幸存者)。对数据进行了加权处理,以调整无回应偏差。使用了两项结果指标:自我评估健康状况以及根据从关于13个残疾领域的详细问题得出的量表评估是否存在残疾。所使用的严重程度评分是为1985/1986年国家统计局残疾调查制定的。研究结果表明,基线和随访时的健康及残疾状况与社会经济和地理变量相关,如成年期失业时间占比以及居住在英格兰东南部以外地区;人口统计学因素,如早婚和多子女;以及不良事件经历,如子女死亡和被解雇。结果显示,社会经济、人口统计学、地理和生活事件因素均与老年早期的健康状况相关,并且需要采用综合而非分叉的方法来研究健康差异。