多族裔亚裔人群中社区居住的老年人群体中种族/民族和贫困对健康的交叉影响：一项基于人群的研究。
The intersectional effects of ethnicity/race and poverty on health among community-dwelling older adults within multi-ethnic Asian populace: a population-based study.
机构信息
Malaysian Research Institute on Ageing (MyAgeingTM), Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia.
Department of Human Development and Family Studies, Faculty of Human Ecology, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia.
出版信息
BMC Geriatr. 2021 Sep 27;21(1):516. doi: 10.1186/s12877-021-02475-5.
BACKGROUND
Ethnicity/race and poverty are among determinants of health in older persons. However, studies involving intersectional effects of ethnicity/race and poverty on health of older adults within multi-ethnic Asian populace is limited. Hence, this study aimed to examine the intersectional effects of ethnicity/race and poverty on cognitive function, depressive symptoms, and multimorbidity among community-dwelling older adults in Malaysia.
METHODS
Data were obtained from the first wave of a Peninsular Malaysia national survey - "Identifying Psychosocial and Identifying Economic Risk Factor of Cognitive Impairment among Elderly". Log-binomial regression was used to identify intersectional effects and associations between control variables and health outcomes. A comparison between Malay and non-Malay older adults within the same poverty group, as well as hardcore poor and non-hardcore poor older people within the same ethnicity groups, were conducted to understand the intersectional effects of ethnicity/race and poverty on health.
RESULTS
Prevalence of cognitive impairment was highest among hardcore poor Malay group, while the risk of depression and multimorbidity were highest among hardcore poor non-Malays. In the hardcore poor group, Malay ethnicity was associated with higher prevalence of cognitive impairment but lower prevalence of depression risk and multimorbidity. In the Malay group, hardcore poor was associated with higher prevalence of cognitive impairment; however, no association was found between hardcore poor with depression risk and multimorbidity after controlling for covariates.
CONCLUSIONS
Health outcomes of Malaysian older adults differ according to ethnicity and socioeconomic status. Given the importance of demographic characteristics on health outcomes, design of interventions targeting older adults within multi-ethnic settings must address specific characteristics, especially that of ethnicity and sociodemographic status so as to fulfil their needs. Several implications for future practice were discussed.
背景
族裔/种族和贫困是影响老年人健康的因素之一。然而，涉及多族裔亚洲人群中族裔/种族和贫困对老年人健康的交叉影响的研究有限。因此，本研究旨在检验马来西亚社区居住的老年人中族裔/种族和贫困对认知功能、抑郁症状和多种疾病的交叉影响。
方法
本研究数据来自马来西亚半岛全国性调查的第一波数据 - “识别老年人认知障碍的心理社会和经济风险因素”。使用对数二项式回归来识别控制变量与健康结果之间的交叉影响和关联。在同一贫困群体内比较马来裔和非马来裔老年人，以及在同一族裔群体内比较核心贫困和非核心贫困老年人，以了解族裔/种族和贫困对健康的交叉影响。
结果
核心贫困的马来裔老年人认知障碍的患病率最高，而核心贫困的非马来裔老年人抑郁风险和多种疾病的患病率最高。在核心贫困群体中，马来族裔与认知障碍的高患病率相关，但与抑郁风险和多种疾病的低患病率相关。在马来裔群体中，核心贫困与认知障碍的高患病率相关；然而，在控制了协变量后，核心贫困与抑郁风险和多种疾病之间没有关联。
结论
马来西亚老年人的健康结果因族裔和社会经济地位而异。鉴于人口特征对健康结果的重要性，针对多族裔环境中老年人设计的干预措施必须解决特定特征，特别是族裔和社会人口地位特征，以满足他们的需求。本文还讨论了未来实践的几个影响。
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