Martin Linda G, Schoeni Robert F, Freedman Vicki A, Andreski Patricia
Institute of Medicine, 500 Fifth Street NW, Washington, DC 20001, USA.
J Gerontol B Psychol Sci Soc Sci. 2007 Jan;62(1):S11-21. doi: 10.1093/geronb/62.1.s11.
We addressed three questions: Have recent improvements in old-age disability been mirrored in changes in self-reported general health status? Are general health status trends similar for younger and older Americans? Have changes in general health status been uniform across demographic and socioeconomic groups?
Using logistic regression, we analyzed data from the 1982-2003 National Health Interview Surveys (n = 1,445,872 aged 18-69; n = 178,384 aged 70 and older).
The proportion of people aged 70 and older reporting disability declined at 1.38% per year and the proportion 70 and older reporting poor/fair health declined at 1.85% per year. There was less of a decline in reports of poor/fair health at younger ages. Trends for the 18-69 population showed widening health disparities by income but narrowing of the race/ethnicity and education gaps. In the older population, there was no change for those aged 80-84 and 85 and older, the race/ethnicity gap persisted, and both education and income differentials widened over time.
Declines in proportions reporting poor/fair health among the older population in recent decades mirror declines in disability. Although the younger population has not experienced such progress, its prevalence of poor/fair health is low throughout the 21-year analysis period. Of concern are the growing socioeconomic disparities in health for both younger and older populations.
我们探讨了三个问题:老年人残疾状况最近的改善是否反映在自我报告的总体健康状况变化中?美国年轻人和老年人的总体健康状况趋势是否相似?总体健康状况的变化在不同人口统计学和社会经济群体中是否一致?
我们使用逻辑回归分析了1982 - 2003年全国健康访谈调查的数据(18 - 69岁的有1,445,872人;70岁及以上的有178,384人)。
70岁及以上报告有残疾的人群比例每年下降1.38%,70岁及以上报告健康状况差/一般的人群比例每年下降1.85%。较年轻年龄段报告健康状况差/一般的比例下降幅度较小。18 - 69岁人群的趋势显示,健康差距因收入而扩大,但种族/族裔和教育差距缩小。在老年人群中,80 - 84岁和85岁及以上人群没有变化,种族/族裔差距持续存在,随着时间推移,教育和收入差异都在扩大。
近几十年来,老年人群中报告健康状况差/一般的比例下降反映了残疾率的下降。虽然年轻人群体没有经历这样的进步,但在整个21年的分析期内,其健康状况差/一般的患病率较低。令人担忧的是,年轻和老年人群体在健康方面的社会经济差距都在扩大。