West Virginia University, Morgantown, WV, USA.
J Racial Ethn Health Disparities. 2016 Dec;3(4):635-645. doi: 10.1007/s40615-015-0182-z. Epub 2015 Nov 17.
Worldwide, the number of disabled individuals is used as a marker for population health status because of high morbidity and mortality burden associated with disability. The primary objective of the current study is to use the 2012 NHIS disability supplement and examine racial/ethnic disparities in disability after controlling for a comprehensive list of factors, using the World Health Organization's International Classification of Functioning, Disability, and Health (WHO-ICF).
A retrospective cross-sectional study design with data from 7993 individuals aged above 21 years from the 2012 National Health Interview Survey (NHIS) was adopted. Disability was defined based on a standard set of questions related to mobility, self-care, and cognition from the "Functioning and Disability" supplement of 2012 NHIS. Chi-squared tests and multinomial logistic regressions were conducted to examine the association between race/ethnicity and disability.
There were statistically significant racial/ethnic differences in disability status; 10.2 % non-Hispanic whites, 14.8 % non-Hispanic African Americans, 8.1 % Latino, and 6.7 % other racial minorities had severe disability. Non-Hispanic African Americans were more likely to have severe disability than were non-Hispanic whites (OR = 1.56, 95 % CI = 1.24, 1.95), and Latinos were less likely to have severe disability (OR = 0.70, 95 % CI = 0.55, 0.90) in the unadjusted model. There was no difference in disability status among non-Hispanic African Americans and non-Hispanic whites after adjusting for socio-economic status.
The study findings highlighted the role of socio-economic characteristics in reducing disparities in disability between non-Hispanic African Americans and non-Hispanic whites. As SES can affect health through a complex interaction of biological, psychological, lifestyle, environmental, social, and neighborhood factors, a multipronged approach that focuses on primary, secondary, and territory prevention of disability is needed.
由于残疾相关的高发病率和死亡率负担，全球将残疾人数用作人口健康状况的指标。本研究的主要目的是使用 2012 年 NHIS 残疾补充数据，并在控制了世卫组织国际功能、残疾和健康分类（WHO-ICF）全面因素清单后，检查残疾方面的种族/民族差异。
采用回顾性横断面研究设计，使用 2012 年全国健康访谈调查（NHIS）中 7993 名年龄在 21 岁以上的个体的数据。残疾是根据 2012 年 NHIS“功能和残疾”补充问卷中与移动、自理和认知相关的一套标准问题来定义的。采用卡方检验和多项逻辑回归来检查种族/民族与残疾之间的关系。
残疾状况存在统计学上显著的种族/民族差异；10.2%的非西班牙裔白人、14.8%的非西班牙裔非裔美国人、8.1%的拉丁裔和 6.7%的其他少数族裔有严重残疾。在未调整模型中，非西班牙裔非裔美国人比非西班牙裔白人更容易出现严重残疾（OR=1.56，95%CI=1.24，1.95），而拉丁裔出现严重残疾的可能性较小（OR=0.70，95%CI=0.55，0.90）。在调整社会经济状况后，非西班牙裔非裔美国人和非西班牙裔白人之间的残疾状况没有差异。
研究结果强调了社会经济特征在减少非西班牙裔非裔美国人和非西班牙裔白人之间残疾差异方面的作用。由于 SES 可以通过生物、心理、生活方式、环境、社会和邻里因素的复杂相互作用影响健康，因此需要采取多管齐下的方法，重点关注残疾的初级、二级和三级预防。
