National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, US Department of Health and Human Services,Bethesda, MD, USA.
Am J Public Health. 2011 Jul;101(7):1322-9. doi: 10.2105/AJPH.2010.199455. Epub 2010 Dec 16.
We investigated whether a greater burden of disease among poorer individuals and ethnic minorities accounted for socioeconomic and racial disparities in self-reported physical functioning among older adults.
We used data from adults aged 60 years or older (n = 5556) in the Third National Health and Nutrition Examination Survey, 1988-1994 to test associations between education level, poverty index, and race/ethnicity and limitations in 11 functions. We adjusted for demographic features and measures of disease burden (comorbid conditions, smoking, hemoglobin level, serum albumin level, knee pain, body mass index, and skeletal muscle index).
Associations between education and functional limitations were attenuated after adjustment, but those with 0-8 years of education were more likely than those with 13 or more years of education to have limitations in 3 functions. Poverty was associated with a higher likelihood of limitations despite adjustment. The likelihood of limitations among non-Hispanic Blacks and Mexican Americans was similar to that of non-Hispanic Whites after adjustment.
Socioeconomic disparities in functional limitations among older Americans exist independent of disease burden, whereas socioeconomic differences and disease burden account for racial disparities.
我们调查了在较贫困人群和少数族裔中，疾病负担的加重是否导致了老年人中自我报告的身体机能的社会经济和种族差异。
我们使用了 1988-1994 年第三次国家健康和营养调查中年龄在 60 岁或以上的成年人（n=5556）的数据，来检验教育水平、贫困指数和种族/民族与 11 种功能障碍之间的关联。我们调整了人口特征和疾病负担的衡量指标（合并症、吸烟、血红蛋白水平、血清白蛋白水平、膝关节疼痛、体重指数和骨骼肌指数）。
在调整后，教育与功能障碍之间的关联减弱，但与受教育 13 年或以上的人相比，受教育 0-8 年的人更有可能出现 3 种功能障碍。尽管进行了调整，贫困与更高的功能障碍可能性仍有关联。在调整后，非西班牙裔黑人（Black）和墨西哥裔美国人（Mexican American）出现功能障碍的可能性与非西班牙裔白人（White）相似。
美国老年人中存在独立于疾病负担的功能障碍的社会经济差异，而社会经济差异和疾病负担则导致了种族差异。
