Kaneda Toshiko, Zimmer Zachary
International Programs, Population Reference Bureau, 1875 Connecticut Avenue NW, Washington, DC 20009, USA.
J Cross Cult Gerontol. 2007 Sep;22(3):303-22. doi: 10.1007/s10823-007-9041-7.
Consistent and robust associations between education and health have been found for older adults in developed countries, with effects generally being stronger for men than for women. Tests of the association in developing countries are still limited, existing results are inconsistent, and variations by gender have not been examined. Using two waves of data (1993 and 1997) from the Indonesian Family Life Survey, this analysis examines the association between education and functional transitions over a 4-year period and investigates gender differences in the association. A review of past evidence leads us to speculate that the association may be weaker among Indonesian elderly than among elderly in developed countries, particularly for women. This is because the elderly in Indonesia have substantially lower levels of education, lower returns on education from the labor market, and weaker linkages between education and factors that are considered to more directly influence health, including health-related behaviors and receipt of social support. Our results indicate that associations between education and functional transition depend upon gender and functional status at the beginning of the study period. Specifically, education is significantly associated with functional outcome for men who were functionally healthy at baseline, but not for women or those who were functionally limited. The conclusion speculates on the possible mechanisms behind these diverse findings.
在发达国家,已发现老年人的教育程度与健康状况之间存在一致且稳固的关联,一般而言男性的这种关联效应强于女性。在发展中国家,对这种关联的检验仍然有限,现有结果并不一致,而且尚未考察性别差异。本分析利用印度尼西亚家庭生活调查的两期数据(1993年和1997年),研究了4年期间教育程度与功能转变之间的关联,并调查了该关联中的性别差异。对以往证据的回顾使我们推测,印度尼西亚老年人中的这种关联可能比发达国家老年人中的关联更弱,尤其是对女性而言。这是因为印度尼西亚老年人的教育水平显著较低,劳动力市场上教育的回报较低,而且教育与被认为更直接影响健康的因素(包括与健康相关的行为和社会支持的获得)之间的联系较弱。我们的结果表明,教育程度与功能转变之间的关联取决于研究期开始时的性别和功能状态。具体而言,对于基线时功能健康的男性,教育程度与功能结果显著相关,但对女性或功能受限者则不然。结论推测了这些不同发现背后可能的机制。