ICMR - National Institute of Medical Statistics, New Delhi, India.
Indian Council of Medical Research, New Delhi, India.
BMJ Open. 2019 Feb 27;9(2):e022787. doi: 10.1136/bmjopen-2018-022787.
Older adults with adverse socioeconomic conditions suffer disproportionately from a poor quality of life. Stratified by sex, income-related inequalities have been decomposed for functional deficiencies and chronic diseases among older adults, and the degree to which social and demographic factors contribute to these inequalities was identified in this study.
Cross-sectional study.
Data used for this study were retrieved from the WHO Study on Global AGEing and Adult Health Wave 1. A total of 3753 individuals (men: 1979, and women: 1774) aged ≥60 years were found eligible for the analysis.
Instrumental Activity of Daily Living (IADL) deficiency and presence of chronic diseases.
The decomposition method proposed by Adam Wagstaff and his colleagues was used. The method allows estimating how determinants of health contribute proportionally to inequality in a health variable.
Compared with men, women were disproportionately affected by both functional deficiencies and chronic diseases. The relative contribution of sociodemographic factors to IADL deficiency was highest among those with poor economic status (38.5%), followed by those who were illiterate (22.5%), which collated to 61% of the total explained inequalities. Similarly, for chronic diseases, about 93% of the relative contribution was shared by those with poor economic status (42.3%), rural residence (30.5%) and illiteracy (20.3%). Significant difference in predictors was evident between men and women in IADL deficiency and chronic illness.
Pro-poor intervention strategies could be designed to address functional deficiencies and chronic diseases, with special attention to women.
处于不利社会经济条件下的老年人生活质量较差。本研究按性别对与收入相关的功能缺陷和慢性疾病不平等现象进行分层，并确定社会和人口因素对这些不平等现象的贡献程度。
横断面研究。
本研究使用的数据来自世卫组织全球老龄化和成人健康研究第一波。共有 3753 名年龄≥60 岁的个体（男性 1979 名，女性 1774 名）符合分析条件。
日常生活活动能力（IADL）缺陷和慢性疾病的存在。
采用 Adam Wagstaff 及其同事提出的分解方法。该方法可用于估计健康变量的不平等程度与健康决定因素之间的比例关系。
与男性相比，女性在功能缺陷和慢性疾病方面均受到不成比例的影响。社会人口因素对 IADL 缺陷的相对贡献在经济状况较差的人群中最高（38.5%），其次是文盲（22.5%），合计占总不平等的 61%。同样，对于慢性疾病，经济状况较差（42.3%）、居住在农村（30.5%）和文盲（20.3%）的人群约占相对贡献的 93%。在 IADL 缺陷和慢性疾病方面，男性和女性的预测指标存在显著差异。
可以制定扶贫干预策略来解决功能缺陷和慢性疾病问题，特别关注女性。
