Lin Jielu, Kelley-Moore Jessica A
National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland.
Department of Sociology, Case Western Reserve University, Cleveland, Ohio.
J Gerontol B Psychol Sci Soc Sci. 2017 Jan;72(1):168-179. doi: 10.1093/geronb/gbv081. Epub 2015 Aug 29.
Despite a long tradition of attending to issues of intra-individual variability in the gerontological literature, large-scale panel studies on late-life health disparities have primarily relied on average health trajectories, relegating intra-individual variability over time to random error terms, or "noise." This article reintegrates the systematic study of intra-individual variability back into standard growth curve modeling and investigates the age and social patterning of intra-individual variability in health trajectories.
Using panel data from the Health and Retirement Study, we estimate multilevel growth curves of functional limitations and cognitive impairment and examine whether intra-individual variability in these two health outcomes varies by age, gender, race/ethnicity, and socioeconomic status, using level-1 residuals extracted from the adjusted growth curve models.
For both outcomes, intra-individual variability increases with age. Racial/ethnic minorities and individuals with lower socioeconomic status tend to have greater intra-individual variability in health. Relying exclusively on average health trajectories may have masked important "signals" of life course health inequality.
The findings contribute to scientific understanding of the source of heterogeneity in late-life health and highlight the need to further investigate specific life course mechanisms that generate the social patterning of intra-individual variability in health status.
尽管老年学文献长期以来一直关注个体内部变异性问题,但关于晚年健康差异的大规模面板研究主要依赖于平均健康轨迹,将个体随时间的变异性归结为随机误差项或“噪声”。本文将个体内部变异性的系统研究重新纳入标准增长曲线模型,并研究健康轨迹中个体内部变异性的年龄和社会模式。
利用健康与退休研究的面板数据,我们估计了功能受限和认知障碍的多层次增长曲线,并使用从调整后的增长曲线模型中提取的一级残差,检验这两种健康结果的个体内部变异性是否因年龄、性别、种族/民族和社会经济地位而异。
对于这两种结果,个体内部变异性均随年龄增长而增加。少数族裔和社会经济地位较低的个体在健康方面往往具有更大的个体内部变异性。仅依赖平均健康轨迹可能掩盖了生命历程健康不平等的重要“信号”。
这些发现有助于科学理解晚年健康异质性的来源,并强调需要进一步研究产生健康状况个体内部变异性社会模式的具体生命历程机制。