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International Journal for Equity in Health
Published in: International Journal for Equity in Health 1/2017

Open Access 01-12-2017 | Research

Gender, childhood and adult socioeconomic inequalities in functional disability among Chinese older adults

Authors: Yaqin Zhong, Jian Wang, Stephen Nicholas

Published in: International Journal for Equity in Health | Issue 1/2017

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Abstract

Background

Gender difference and life-course socioeconomic inequalities in functional disability may exist among older adults. However, the association is less well understood among Chinese older population. The objective is to provide empirical evidences on this issue by exploring the association between gender, childhood and adult socioeconomic inequalities in functional disability.

Methods

Data from the 2013 wave of the China Health and Retirement Longitudinal Study (CHARLS) was utilized. Functional disability was assessed by the activities of daily living (ADL) and instrumental activities of daily living (IADL). Childhood socioeconomic status (SES) was measured by birthplace, father’s education and occupation. Adult SES was measured in terms of education and household income. Multivariate logistic regressions were conducted to assess the association between gender, childhood and adult SES and functional disability.

Results

Based on a sample of 18,448 older adults aged 45 years old and above, our results showed that the prevalence of ADL and IADL disability was higher among women than men, but gender difference disappeared after adult SES and adult health were controlled. Harsh conditions during childhood were associated with functional disability but in multivariate analyses only father’s education was associated with IADL disability (OR for no education = 1.198; 95% CI = 1.062–1.353). Current SES such as higher education and good economic situation are protective factors of functional disability.

Conclusions

Childhood and adult SES were both related to functional disability among older adults. Our findings highlight the need for policies and programs aimed at decreasing social inequalities during childhood and early adulthood, which could reduce socioeconomic inequalities in functional disability in later life.
Literature
1.
2.
York, N. World population ageing, 2002, 1950–2050/. United Nations.
3.
Banister J, Bloom DE, Rosenberg L. Population aging and economic growth in China [M]//the Chinese economy. Palgrave Macmillan UK. 2010:61–89.
4.
Rodrigues MA, Facchini LA, Thumé E, et al. Gender and incidence of functional disability in the elderly: a systematic review [J]. Cadernos De Saúde Pública. 2009;25(Suppl 3):S464–76.CrossRefPubMed
5.
Katz S, Ford AB, Moskowitz RW, et al. Studies of illness in the aged [J]. Jama the Journal of the American Medical Association. 1963;185(12):914–9.CrossRefPubMed
6.
Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. [J]. The Gerontologist. 1969;9(3_Part_1):179–86.CrossRefPubMed
7.
Chan A, Jatrana S. Gender differences in health among older Singaporeans [J]. Int Sociol. 2007;22(4):463–91.CrossRef
8.
Yong V, Saito Y, Chan A. Gender differences in health and health expectancies of older adults in Singapore: an examination of diseases, impairments, and functional disabilities.[J]. J Cross Cult Gerontol. 2011;26(2):189–203.CrossRefPubMed
9.
Grundy E, Glaser K. Socio-demographic differences in the onset and progression of disability in early old age: a longitudinal study [J]. Age Ageing. 2000;29(2):149–57.CrossRefPubMed
10.
Taş Ü, Verhagen AP, Bierma-Zeinstra SMA, et al. Incidence and risk factors of disability in the elderly: the Rotterdam study [J]. Prev Med. 2007;44(3):272–8.CrossRefPubMed
11.
Guerra RO, Alvarado BE, Zunzunegui MV. Life course, gender and ethnic inequalities in functional disability in a Brazilian urban elderly population [J]. Aging Clin Exp Res. 2008;20(1):53–61.CrossRefPubMed
12.
Moffett JA, Underwood MR, Gardiner ED. Socioeconomic status predicts functional disability in patients participating in a back pain trial [J]. Disabil Rehabil. 2009;31(10):783–90.CrossRefPubMed
13.
Fullerthomson E, Nurujeter A, Minkler M, et al. Black–white disparities in disability among older Americans: further untangling the role of race and socioeconomic status [J]. J Aging Health. 2009;21(5):677–98.CrossRef
14.
Alves LC, Leite IC, Machado CJ. Factors associated with functional disability of elderly in Brazil: a multilevel analysis. [J]. Revista De Saúde Pública. 2010;44(3):468.CrossRefPubMed
15.
Liu JF, Chi I, Chen G, et al. Prevalence and correlates of functional disability in Chinese older adults.[J]. Geriatr Gerontol Int. 2009;9(3):253–61.CrossRefPubMed
16.
Hu L, Lv X, Zhou S, et al. Socio-demographic determinants, physical health status, and depression associated with functional limitations among older Chinese adults [J]. Ageing International. 2015;40(4):311–26.CrossRef
17.
Bowen ME, González HM. Childhood socioeconomic position and disability in later life: results of the health and retirement study [J]. American Journal of Public Health. 2010;100(Suppl 1(S1)):S197–203.CrossRefPubMedPubMedCentral
18.
Fujiwara T, Kondo K, Shirai K, et al. Associations of Childhood Socioeconomic Status and Adulthood Height with Functional Limitations among Japanese Older People: Results from the JAGES 2010 Project [J]. J Gerontol A Biol Sci Med Sci. 2014;69(7):852.CrossRefPubMed
19.
Halfon N, Hochstein M. Life course health development: an integrated framework for developing health, policy, and research [J]. Milbank Q. 2002;80(3):433–79.CrossRefPubMedPubMedCentral
20.
Hertzman C. Biological pathways between the social environment and health [J]. Encyclopedia of Environmental Health. 2011;5(3):371–7.CrossRef
21.
Cohen S, Janicki-Deverts D, Chen E, et al. Childhood socioeconomic status and adult health [J]. Ann N Y Acad Sci. 2010;1186(1):37–55.CrossRefPubMed
22.
Haan MN, Alhazzouri AZ, Aiello AE. Life-span Socioeconomic Trajectory, Nativity, and Cognitive Aging in Mexican Americans: The Sacramento Area Latino Study on Aging [J]. J Gerontol B Psychol Sci Soc Sci. 2011;66(Suppl 1(66 Suppl 1)):i102–10.CrossRefPubMed
23.
Ben-Shlomo Y, Mishra G, Kuh D. Life course epidemiology [J]. Int Encyclopedia Soc Behav Sciences. 2003;57(10):778.
24.
Birnie K, Cooper R, Martin RM, et al. Childhood socioeconomic position and objectively measured physical capability levels in adulthood: a systematic review and meta-analysis [J]. PLoS One. 2011;6(1):e15564.CrossRefPubMedPubMedCentral
25.
Yi Z, Gu D, Land KC. The association of childhood socioeconomic conditions with healthy longevity at the oldest-old ages in China. [M]//Issues in childhood social development. Methuen. 2007:497–518.
26.
Wen M, Gu D. The effects of childhood, adult, and community socioeconomic conditions on health and mortality among older adults in China [J]. Demography. 2011;48(1):153–81.CrossRefPubMedPubMedCentral
27.
Zhang Z, Gu D, Hayward MD. Early life influences on cognitive impairment among oldest old Chinese [J]. J Gerontol. 2008;63(1):25–33.CrossRef
28.
Zhao Y, Hu Y, Smith JP, et al. Cohort profile: the China Health and Retirement Longitudinal Study (CHARLS). [J]. Int J Epidemiol. 2014;43(1):61.CrossRefPubMed
29.
Feng Q, Zhen Z, Gu D, et al. Trends in ADL and IADL disability in community-dwelling older adults in shanghai, China, 1998-2008 [J]. J Gerontol. 2013;68(3):476.CrossRef
30.
31.
32.
Manor O, Matthews S, Power C. Dichotomous or categorical response? Analysing self-rated health and lifetime social class [J]. Int J Epidemiol. 2000;29(1):149.CrossRefPubMed
33.
Guralnik JM, Butterworth S, Wadsworth ME, et al. Childhood socioeconomic status predicts physical functioning a half century later.[J]. J Gerontol A Biol Sci Med Sci. 2006;61(7):694–701.CrossRefPubMed
34.
Giskes K, Lenthe FV, Brug HJ, et al. Dietary intakes of adults in the Netherlands by childhood and adulthood socioeconomic position [J]. Eur J Clin Nutr. 2004;58(6):871–80.CrossRefPubMed
35.
Mcveigh JA, Norris SA, Wet TD. The relationship between socio-economic status and physical activity patterns in south African children [J]. Acta Paediatr. 2004;93(7):982–8.CrossRefPubMed
36.
Noronha KV, Andrade MV. Social inequality in health and the utilization of health services among the elderly in Latin America [J]. Rev Panam Salud Publica. 2005;17(5–6):410–8.CrossRefPubMed
37.
Wallace SP, Gutiérrez VF. Equity of access to health care for older adults in four major Latin American cities. [J]. Rev Panam Salud Publica. 2005;17(17):394–409.CrossRefPubMed
38.
Ye L, Waite LJ. The impact of childhood and adult SES on physical, mental, and cognitive well-being in later life [J]. J Gerontol. 2005;60(2):S93–S101.CrossRef
39.
Harper S, Lynch J, Hsu WL, et al. Life course socioeconomic conditions and adult psychosocial functioning [J]. Int J Epidemiol. 2002;31(2):395–403.CrossRefPubMed
40.
Woo J, Kwok T, Sze FK, et al. Ageing in China: health and social consequences and responses [J]. Int J Epidemiol. 2002;31(4):772–5.CrossRefPubMed
41.
Santos JL, Lebrão ML, Duarte YA, et al. Functional performance of the elderly in instrumental activities of daily living: an analysis in the municipality of São Paulo, Brazil [J]. Cadernos De Saúde Pública. 2008;24(4):879.CrossRefPubMed
42.
Sicular T. The challenge of high inequality in China. Inequality in Focus. 2013;2(2):1–5.
43.
World Bank, World Health Organisation; Ministry of Finance; National Health and family planning commission and Ministy of human resources and social security, PRC, 2016, Healthy China: Depening Health Reform in China.
Metadata
Title
Gender, childhood and adult socioeconomic inequalities in functional disability among Chinese older adults
Authors
Yaqin Zhong
Jian Wang
Stephen Nicholas
Publication date
01-12-2017
Publisher
BioMed Central
Published in
International Journal for Equity in Health / Issue 1/2017
Electronic ISSN: 1475-9276
DOI
https://doi.org/10.1186/s12939-017-0662-3

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