Laditka James N, Laditka Sarah B, Olatosi Bankole, Elder Keith T
Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.
J Rural Health. 2007 Spring;23(2):124-32. doi: 10.1111/j.1748-0361.2007.00079.x.
Years lived with and without physical impairment are central measures of public health.
We sought to determine whether these measures differed between rural and urban residents who were impaired at the time of a baseline measurement. We examined 16 subgroups defined by rural/urban residence, gender, race, and education.
This is a 20-year retrospective cohort study, following 2,939 Americans who were aged 65-69 in 1982 and physically impaired at the time of the baseline measurement, with data from the National Long-Term Care Survey. Interpolated Markov chain analysis and microsimulation estimated life expectancy at age 65 and expected number of years with physical impairment. Impairment was defined as requiring help in 1 or more activities of daily living.
Among older individuals with physical impairments at baseline, rural residents lived notably longer than urban residents. In all but 1 group, rural residents lived more years with physical impairment, and they also had a notably larger proportion of remaining life impaired.
Results suggest a notable public health impact of rural residence for impaired individuals, a longer expected period of impairment. Needs for services for people with impairments may be greater in rural areas.
有身体损伤和无身体损伤情况下的存活年限是公共卫生的核心衡量指标。
我们试图确定在基线测量时存在身体损伤的农村和城市居民在这些指标上是否存在差异。我们研究了由农村/城市居住地、性别、种族和教育程度定义的16个亚组。
这是一项为期20年的回顾性队列研究，追踪了1982年年龄在65 - 69岁且在基线测量时存在身体损伤的2939名美国人，数据来自国家长期护理调查。内插马尔可夫链分析和微观模拟估计了65岁时的预期寿命以及存在身体损伤的预期年数。损伤被定义为在1项或多项日常生活活动中需要帮助。
在基线时存在身体损伤的老年人中，农村居民的寿命显著长于城市居民。除1个亚组外，在所有亚组中，农村居民有身体损伤的存活年限更长，而且他们剩余生命中存在损伤的比例也显著更高。
结果表明农村居住环境对身体损伤个体有显著的公共卫生影响，即预期损伤期更长。农村地区对身体损伤者的服务需求可能更大。
