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A higher level of education amplifies the inverse association between income and disability in the Spanish elderly

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Abstract

Background and aims

This paper aims to estimate if the education level modifies the association of income with disability prevalence in the elderly. Education can have a confounding effect on income or interact with it as a health determinant. It is important to analyze the relationship between socio-economic status and disability in older people, because it helps to better understand health inequalities and organize appropriate social policies.

Methods

The study is based on the Survey on Disability, Personal Autonomy and Dependency Situations (Spanish National Statistics Institute). Binary logistic regression models are adjusted (bivariate, adjusted for gender and age, with all variables and with the interaction between income and education levels). A bad adjustment of the model is detected and a scobit link is added, which helps to differentiate disabled and non-disabled individuals better.

Results

People with difficulty in carrying out activities of daily living are much older, frequently women and with low education and income levels. The significant interaction between education level and income means that the odds of being disabled is 43 % less in people of high income compared with people of low income if they are well educated, while it is only 21 %, among those with low education.

Conclusion

A higher education level amplifies significantly the inverse association between income and disability in the Spanish elderly, what suggests that those with higher education will profit more than those with lower education from universal economic benefits policies aimed at the disabled, increasing health inequalities between groups.

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References

  1. Freedman VA, Martin LG (1999) The role of education in explaining and forecasting trends in functional limitations among older Americans. Demography 36:461–473

    Article  CAS  PubMed  Google Scholar 

  2. Marmot M (2002) The influence of income on health: views of an epidemiologist. Health Aff 21:31–46

    Article  Google Scholar 

  3. Mirowsky J, Ross CE (2003) Education, social status, and health. Transaction Books

  4. Ben-Shlomo Y, Kuh D (2002) A life course approach to chronic disease epidemiology: conceptual models, empirical challenges and interdisciplinary perspectives. Int J Epidemiol 31:285–293

    Article  PubMed  Google Scholar 

  5. Ross CE, Wu Cl (1995) The links between education and health. Am Sociol Rev 719–745

  6. Herd P, Goesling B, House JS (2007) Socioeconomic position and health: the differential effects of education versus income on the onset versus progression of health problems. J Health Soc Behav 48:223–238

    Article  PubMed  Google Scholar 

  7. Zimmer Z, House JS (2003) Education, income, and functional limitation transitions among American adults: contrasting onset and progression. Int J Epidemiol 32:1089–1097

    Article  PubMed  Google Scholar 

  8. Schnittker J (2004) Education and the changing shape of the income gradient in health. J Health Soc Behav 45:286–305

    Article  PubMed  Google Scholar 

  9. Guralnik JM, Fried LP, Salive ME (1996) Disability as a public health outcome in the aging population. Annu Rev Public Health 17:25–46

    Article  CAS  PubMed  Google Scholar 

  10. Guralnik JM (2005) The evolution of research on disability in old age. Aging Clin Exp Res 17(3):165–167

    Article  PubMed  Google Scholar 

  11. Instituto Nacional de Estadística (2008) Encuesta sobre Discapacidades, Autonomía personal y situaciones de Dependencia, (Survey on Disability, Personal Autonomy and Dependency Situations). Microdata. http://www.ine.es/prodyser/microdatos.htm

  12. Borrell C, Peiró R, Ramón N et al (2005) Desigualdades socioeconómicas y planes de salud en las comunidades autónomas del Estado español. Gac Sanit 19:277–285

    Article  PubMed  Google Scholar 

  13. Comisión para Reducir las Desigualdades Sociales en Salud en España (2012) Propuesta de políticas e intervenciones para reducir las desigualdades sociales en salud en España. Gac Sanit 26:182–189

    Google Scholar 

  14. Grundy E, Holt G (2001) The socioeconomic status of older adults: how should we measure it in studies of health inequalities? J Epidemiol Community Health 55:895–904

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  15. Abellán A, Esparza C, Castejón P, Pérez J (2011) Epidemiología de la discapacidad y la dependencia de la vejez en España. Gac Sanit 25:5–11

    Article  PubMed  Google Scholar 

  16. Instituto Nacional de Estadística (2011) Encuesta de condiciones de vida. Metodología general. http://www.ine.es/daco/daco42/condivi/ecv_metodo.pdf

  17. Nagler J (1994) Scobit: an alternative estimator to logit and probit. Am J Pol Sci 38:230–255

    Article  Google Scholar 

  18. Avlund K, Damsgaard MT, Osler M (2004) Social position and functional decline among non-disabled old men and women. Eur J Public Health 14:212–216

    Article  PubMed  Google Scholar 

  19. Graciani A, Banegas JR, López-García E, Rodríguez-Artalejo F (2004) Prevalence of disability and associated social and health-related factors among the elderly in Spain: a population-based study. Maturitas 48:381–392

    Article  PubMed  Google Scholar 

  20. Deaton A (2002) Policy implications of the gradient of health and wealth. Health Aff 21:13–30

    Article  Google Scholar 

  21. Herd P, Schoeni RF, House JS (2008) Upstream solutions: does the supplemental security income program reduce disability in the elderly? Milbank Q 86:5–45

    Article  PubMed Central  PubMed  Google Scholar 

  22. Korpi W, Palme J (1998) The paradox of redistribution and strategies of equality: Welfare state institutions, inequality, and poverty in the Western countries. Am Sociol Rev 661–687

  23. Wilkinson RG, Pickett KE (2006) Income inequality and population health: a review and explanation of the evidence. Soc Sci Med 62:1768–1784

    Article  PubMed  Google Scholar 

  24. Rodriguez-Laso A, Abellan A, Sancho M et al (2014) Perceived economic situation, but not education level, is associated with disability prevalence in the Spanish elderly: observational study. BMC Geriatr 14:60

    Article  PubMed Central  PubMed  Google Scholar 

  25. Regidor E, Ronda E, Pascual C et al (2006) Decreasing socioeconomic inequalities and increasing health inequalities in Spain: a case study. Am J Public Health 96:102–108

    Article  PubMed Central  PubMed  Google Scholar 

  26. Jefatura del Estado: Ley 39/2006, de 14 de diciembre, de Promoción de la Autonomía Personal y Atención a las Personas en Situación de Dependencia. http://www.boe.es/boe/dias/2006/12/15/pdfs/A44142-44156.pdf

  27. Sistema para la Autonomía y Atención a la Dependencia, 2011–2014. (System for Autonomy and Care for Dependency. Statistical Information. Monthly reports). http://www.dependencia.imserso.es/dependencia_01/documentacion/estadisticas/est_inf/index.htm

  28. Freedman VA, Martin LG, Schoeni RF, Cornman JC (2008) Declines in late-life disability: the role of early- and mid-life factors. Soc Sci Med 66:1588–1602

    Article  PubMed Central  PubMed  Google Scholar 

  29. Ross CE, Mirowsky J (1999) Refining the association between education and health: the effects of quantity, credential, and selectivity. Demography 36:445–460

    Article  CAS  PubMed  Google Scholar 

  30. Taylor MG (2010) Capturing transitions and trajectories: the role of socioeconomic status in later life disability. J Gerontol B Psychol Sci Soc Sci 65:733–743

    Article  PubMed  Google Scholar 

  31. Skirbekk V, Loichinger E, Weber D (2012) Variation in cognitive functioning as a refined approach to comparing aging across countries. Proc Natl Acad Sci 109:770–774

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  32. Groves RM, Couper MP (1998) Influences of household characteristics on survey cooperation. In: Groves RM, Couper MP (eds) Nonresponse in household interview surveys. John Wiley & Sons, New York, pp 119–154

    Chapter  Google Scholar 

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Acknowledgments

This study was funded by Spanish National Research Council and Matia Instituto Gerontologico.

Conflict of interest

The authors declare that they have no conflict of interest.

Human and Animal Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Author information

Authors and Affiliations

  1. Centre for Human and Social Sciences, Spanish National Research Council, Madrid, Spain

    Antonio Abellán & Rogelio Pujol

  2. Matia Instituto Gerontológico, San Sebastián, Spain

    Ángel Rodríguez-Laso

  3. Statistics Unit, SGAI, Spanish National Research Council, Madrid, Spain

    Laura Barrios

Authors
  1. Antonio Abellán
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  2. Ángel Rodríguez-Laso
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  3. Rogelio Pujol
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  4. Laura Barrios
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Corresponding author

Correspondence to Antonio Abellán.

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Abellán, A., Rodríguez-Laso, Á., Pujol, R. et al. A higher level of education amplifies the inverse association between income and disability in the Spanish elderly. Aging Clin Exp Res 27, 903–909 (2015). https://doi.org/10.1007/s40520-015-0345-0

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  • DOI: https://doi.org/10.1007/s40520-015-0345-0

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