Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada.
Am J Public Health. 2011 Jan;101(1):94-100. doi: 10.2105/AJPH.2009.176784. Epub 2010 Mar 18.
We assessed the prevalence and adjusted odds of 4 types of disability among 7 groups of older Asian American/Pacific Islander (AAPI) subpopulations, both separately and aggregated, compared with non-Hispanic Whites.
Data were from the nationally representative 2006 American Community Survey, which included institutionalized and community-dwelling Hawaiian/Pacific Islander (n = 524), Vietnamese (n = 2357), Korean (n = 2082), Japanese (n = 3230), Filipino (n = 5109), Asian Indian (n = 2942), Chinese (n = 6034), and non-Hispanic White (n = 641 177) individuals aged 55 years and older. The weighted prevalence, population estimates, and odds ratios of 4 types of disability (functional limitations, limitations in activities of daily living, cognitive problems, and blindness or deafness) were reported for each group.
Disability rates in older adults varied more among AAPI subpopulations than between non-Hispanic Whites and the aggregated Asian group. Asian older adults had, on average, better disability outcomes than did non-Hispanic Whites.
This study provides the strongest evidence to date that exclusion of institutionalized older adults minimizes disparities in disabilities between Asians and Whites. The aggregation of Asians into one group obscures substantial subgroup variability and fails to identify the most vulnerable groups (e.g., Hawaiian/Pacific Islanders and Vietnamese).
我们评估了 7 组不同的老年亚裔美国/太平洋岛民(AAPI)亚群中 4 种残疾类型的流行率和调整后的比值比,分别与非西班牙裔白人进行比较。
数据来自全国代表性的 2006 年美国社区调查,其中包括机构居住和社区居住的夏威夷/太平洋岛民(n = 524)、越南人(n = 2357)、韩国人(n = 2082)、日本人(n = 3230)、菲律宾人(n = 5109)、印度裔(n = 2942)、中国人(n = 6034)和非西班牙裔白人(n = 641 177),年龄在 55 岁及以上。报告了每种人群中 4 种残疾类型(功能障碍、日常生活活动受限、认知问题、失明或失聪)的加权流行率、人口估计数和比值比。
老年 AAPI 亚群之间的残疾率差异大于非西班牙裔白人和亚洲综合群体之间的差异。亚洲老年人的残疾结局平均优于非西班牙裔白人。
这项研究提供了迄今为止最强有力的证据,证明排除机构居住的老年人可以最大限度地减少亚洲人和白人之间残疾差异。将亚洲人归入一个群体掩盖了大量的亚群变异性,并未能确定最脆弱的群体(例如夏威夷/太平洋岛民和越南人)。