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高龄老人在健康和功能方面是否存在教育差异?来自北欧国家的证据。

Are there educational disparities in health and functioning among the oldest old? Evidence from the Nordic countries.

作者信息

Enroth Linda, Veenstra Marijke, Aartsen Marja, Kjær Agnete Aslaug, Nilsson Charlotte Juul, Fors Stefan

机构信息

1Faculty of Social Sciences (Health Sciences) and Gerontology Research Center (GEREC), Tampere University, Tampere, Finland.

2Norwegian Social Research, OsloMet - Oslo Metropolitan University, Oslo, Norway.

出版信息

Eur J Ageing. 2019 Jun 17;16(4):415-424. doi: 10.1007/s10433-019-00517-x. eCollection 2019 Dec.

Abstract

With the ageing of the population and recent pressures on important welfare state arrangements, updated knowledge on the linkage between socioeconomic status and health in old age is pertinent for shedding light on emerging patterns of health inequalities in the Nordic countries. This study examined self-rated health (SRH), mobility and activities of daily living (ADL) according to level of education in the three oldest old age groups 75-84, 85-94, and 95+, in four Nordic countries. Altogether, 6132 individuals from Danish Longitudinal Study of Ageing, Norwegian Life Course, Ageing and Generation study, Swedish Panel Study of Living Conditions of the Oldest Old, the 5-Country Oldest Old (Sweden) and Vitality 90 + Study were analysed. First, associations of education level with SRH, mobility, and ADL were estimated for each individual study by means of age- and gender-adjusted logistic regression. Second, results from individual studies were synthesized in a meta-analysis. Older adults with higher education level were more likely to report good SRH, and they were more often independent in mobility and ADL than those with basic education when all age groups were combined. In mobility and ADL, differences between education groups remained stable across the age groups but for SRH, differences seemed to be weaker in older ages. With only a few exceptions, in all age groups, individuals with higher education had more favourable health and functioning than those with basic education. This study shows remarkable persistence of health and functioning inequalities in the Nordic countries throughout later life.

摘要

随着人口老龄化以及近期重要福利国家安排面临的压力,更新关于老年社会经济地位与健康之间联系的知识,对于阐明北欧国家新出现的健康不平等模式具有重要意义。本研究根据四个北欧国家75 - 84岁、85 - 94岁和95岁及以上三个最年长年龄组的教育水平,考察了自评健康(SRH)、 mobility和日常生活活动(ADL)。总共分析了来自丹麦老龄化纵向研究、挪威生命历程、老龄化与代际研究、瑞典最年长者生活条件面板研究、五国最年长者(瑞典)和活力90 +研究的6132名个体。首先,通过年龄和性别调整后的逻辑回归,对每项个体研究估计教育水平与SRH、mobility和ADL之间的关联。其次,在荟萃分析中综合个体研究的结果。当所有年龄组合并时,教育水平较高的老年人更有可能报告良好的SRH,并且他们在mobility和ADL方面比接受基础教育的人更常具有独立性。在mobility和ADL方面,各年龄组教育水平之间的差异保持稳定,但对于SRH,年龄较大时差异似乎较小。除了少数例外,在所有年龄组中,受过高等教育的个体比接受基础教育的个体具有更有利的健康和功能状况。这项研究表明,北欧国家在整个晚年生活中,健康和功能不平等现象持续显著。

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