Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands.
Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.
Eur J Public Health. 2019 Aug 1;29(4):640-647. doi: 10.1093/eurpub/ckz009.
Previous studies have shown the existence of social inequalities in disability in many European countries. However, it is not clear what factors are associated with these inequalities. The aim of this study was to assess the contribution of behavioral factors, work-related factors and living conditions to educational inequalities in disability.
We pooled data from the seventh wave of the European Social Survey (2014) which included self-reported disability measured with the Global Activity Limitations Indicator for 19 European countries. We used multivariate logistic regression to determine the contributions of behavioral factors, work-related and living conditions to educational inequalities in disability among respondents aged 30-79.
We found that adjusting simultaneously for three groups of determinants (behavioral, work-related and living conditions) reduces the greatest proportion of inequalities in disability in both men and women, in a range >70%. Each group of determinants contributes substantially to explain inequalities in disability.
Inequalities in disability are a major challenge for public health in most European countries. Our findings suggest that these inequalities can be reduced by diminishing inequalities in exposure to well-known health determinants.
先前的研究表明,在许多欧洲国家,残疾存在社会不平等现象。然而,目前尚不清楚哪些因素与这些不平等现象有关。本研究旨在评估行为因素、与工作相关的因素和生活条件对残疾教育不平等的贡献。
我们汇总了来自第七届欧洲社会调查(2014 年)的数据,其中包括来自 19 个欧洲国家的自我报告残疾,使用全球活动限制指标进行测量。我们使用多变量逻辑回归来确定行为因素、与工作相关的因素和生活条件对 30-79 岁受访者残疾教育不平等的贡献。
我们发现,同时调整三组决定因素(行为、与工作相关和生活条件)可降低男性和女性残疾不平等的最大比例,范围在>70%。每个决定因素组都为解释残疾不平等做出了重要贡献。
残疾不平等是大多数欧洲国家公共卫生的主要挑战。我们的研究结果表明,可以通过减少对已知健康决定因素的不平等来减少残疾不平等。