Camargos Mirela Castro Santos, Machado Carla Jorge, do Nascimento Rodrigues Roberto
Departamento de Demografia, Cedeplar, UFMG, Minas Gerais, Brazil.
J Biosoc Sci. 2007 May;39(3):455-63. doi: 10.1017/S0021932006001428. Epub 2006 May 17.
There is evidence that 'health life expectancy' (expected number of years to be lived in health) differs by socioeconomic status. Time spent in health or disability plays a critical role in the use of health care services. The objective of this study was to estimate 'disability life expectancy' by age, gender and education attainment for the elderly of the city of São Paulo, Brazil, in the year 2000. Data came from the SABE database, population censuses and mortality statistics (SEADE Foundation). Life expectancy with disability was calculated using Sullivan's method on the basis of the current probability of death and prevalence of disability by educational level. The prevalence of disability increased with age, for both sexes and both levels of educational attainment studied. Men showed a lower prevalence of disability, in general, and persons with lower educational attainment showed a higher prevalence of disability. Regarding life expectancy, women could expect to live longer than men, with and without disability. For both sexes, the percentage of life expectancy lived with disability decreased with increasing educational attainment. With increasing educational attainment, the sex differences in the percentage of remaining years to be lived with disability increased for most ages. Finally, the percentage of remaining years to be lived with disability increased with age for males and females, except for males with high educational attainment between the ages 70-75 and 75-80. The results may serve as a guide for public policies in the country, since health problems faced by older persons, such as disability, are the result of a number of past experiences during their life-times, such as health care, housing conditions, hygiene practices and education. Education influences health behaviours and is related, to some extent, to all these factors. Therefore, improvements in education for the disadvantaged may improve health.
有证据表明，“健康预期寿命”（预期健康生活的年数）因社会经济地位而异。健康或残疾状态下所花费的时间在医疗服务的使用中起着关键作用。本研究的目的是估计2000年巴西圣保罗市老年人按年龄、性别和教育程度划分的“残疾预期寿命”。数据来自SABE数据库、人口普查和死亡率统计（SEADE基金会）。基于当前的死亡概率和按教育程度划分的残疾患病率，使用沙利文方法计算了伴有残疾的预期寿命。在所研究的男女两性以及两个教育程度水平上，残疾患病率均随年龄增长而上升。总体而言，男性的残疾患病率较低，而教育程度较低的人群残疾患病率较高。关于预期寿命，无论有无残疾，女性预期寿命都比男性长。对于男女两性来说，伴有残疾的预期寿命百分比随着教育程度的提高而降低。随着教育程度的提高，在大多数年龄段，伴有残疾的剩余寿命百分比的性别差异增大。最后，除了70 - 75岁和75 - 80岁之间教育程度高的男性外，男性和女性伴有残疾的剩余寿命百分比均随年龄增长而增加。这些结果可为该国的公共政策提供指导，因为老年人面临的健康问题，如残疾，是他们一生中许多过往经历的结果，如医疗保健、住房条件、卫生习惯和教育。教育会影响健康行为，并且在一定程度上与所有这些因素相关。因此，改善弱势群体的教育状况可能会改善健康。
