Robert Stephanie A, Cherepanov Dasha, Palta Mari, Dunham Nancy Cross, Feeny David, Fryback Dennis G
School of Social Work, University of Wisconsin-Madison, 1350 University Avenue, Madison, WI 53706, USA.
J Gerontol B Psychol Sci Soc Sci. 2009 May;64(3):378-89. doi: 10.1093/geronb/gbp012. Epub 2009 Mar 23.
We examine whether multiple health-related quality of life (HRQoL) measures are stratified by socioeconomic status (SES) and age in the United States.
Data are from the 2005/2006 National Health Measurement Study, a telephone survey of a nationally representative sample of U.S. adults. We plot mean HRQoL scores by SES within age groups. Regression analyses test whether education, income, and assets each have independent associations with three "preference-based" HRQoL measures and self-rated health (SRH). We test whether these associations vary by age.
There are SES disparities in HRQoL and SRH among adults in the United States at all age groups. Income differentials in HRQoL are strong across current adult age cohorts, except the 75-89 age cohort. Education and assets have statistically significant but weaker associations with HRQoL. All three SES measures are associated with SRH (net of each other) at every age group. Those in the lowest income and education groups in the 35-44 age cohort have worse HRQoL and SRH than those in higher SES groups in the 65+ age cohort.
Significant improvements in HRQoL at the population level will only be possible if we improve the HRQoL of people at the lowest end of the socioeconomic distribution.
我们研究在美国多种与健康相关的生活质量(HRQoL)指标是否按社会经济地位(SES)和年龄进行分层。
数据来自2005/2006年全国健康测量研究,这是一项对美国成年人具有全国代表性样本的电话调查。我们绘制了各年龄组内按SES划分的平均HRQoL分数。回归分析检验教育、收入和资产是否分别与三种“基于偏好的”HRQoL指标和自评健康(SRH)存在独立关联。我们检验这些关联是否因年龄而异。
在美国所有年龄组的成年人中,HRQoL和SRH存在社会经济地位差异。除了75 - 89岁年龄组外,当前各成年年龄组中HRQoL的收入差异都很明显。教育和资产与HRQoL有统计学上显著但较弱的关联。在每个年龄组中,所有三种社会经济地位指标都与SRH相关(相互独立)。35 - 44岁年龄组中收入和教育水平最低的人群,其HRQoL和SRH比65岁及以上年龄组中社会经济地位较高的人群更差。
只有当我们改善社会经济分布最底层人群的HRQoL时,才有可能在人群层面显著提高HRQoL。