International Journal of Epidemiology 2003;32:1089-1097
© International Epidemiological Association 2003
Population Health |
Education, income, and functional limitation transitions among American adults: contrasting onset and progression
1 Policy Research Division, The Population Council, One Dag Hammarskjold Plaza, New York, NY 10017, USA. E-mail: zzimmer{at}popcouncil.org
2 Survey Research Center, Institute for Social Research, University of Michigan, 1355 Institute for Social Research, PO Box 1248, Ann Arbor,MI 48106–1248, USA. E-mail: jimhouse{at}isr.umich.edu
Correspondence: Dr Zachary Zimmer, Population Council, One Dag Hammarskjold Plaza, New York, NY 10017, USA.
Background Although a robust association between socioeconomic status and health has been shown in past research, the processes that explain the connection are not well understood. This paper seeks to advance such understanding in two ways, first by attending to the distinction between onset of a functional health problem and its progression, and second by addressing whether and how education and income relate differently to the onset versus progression of functional health problems.
Methods Data come from the Americans’ Changing Lives survey (n = 3617). The baseline was conducted in 1986 and outcome status measured in 1994. Activity limitations are categorized into none, mild, moderate, severe. Onset is defined as having no limitation at origin and a limitation at outcome. Progression is defined as limitation of a particular severity at origin and improving, staying the same, or getting worse with respect to the severity. Multinomial regressions determine transition probabilities related to onset and progression.
Results Those with higher income and education are less likely to experience an onset. Only income associates with progression. Those with the highest income are most likely to improve and least likely to get worse in comparison to those with the lowest income.
Conclusions Education, being determined early in life and influencing psychosocial mechanisms throughout life, may have a greater impact on prevention of activity and functional disorders. Income’s role may be both as a prevention factor and as a mechanism for management of health problems.
Keywords Social class, activities of daily living, limitation of activity, adults, ageing
Accepted 27 May 2003
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  E Gjonca, F Tabassum, and E Breeze Socioeconomic differences in physical disability at older age J Epidemiol Community Health, November 1, 2009; 63(11): 928 - 935. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. A. Greenfield Felt Obligation to Help Others as a Protective Factor Against Losses in Psychological Well-being Following Functional Decline in Middle and Later Life J Gerontol B Psychol Sci Soc Sci, November 1, 2009; 64B(6): 723 - 732. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Brunner, M. Shipley, V. Spencer, M. Kivimaki, T. Chandola, D. Gimeno, A. Singh-Manoux, J. Guralnik, and M. Marmot Social Inequality in Walking Speed in Early Old Age in the Whitehall II Study J Gerontol A Biol Sci Med Sci, October 1, 2009; 64A(10): 1082 - 1089. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Fuller-Thomson, A. Nuru-Jeter, M. Minkler, and J. M. Guralnik Black--White Disparities in Disability Among Older Americans: Further Untangling the Role of Race and Socioeconomic Status J Aging Health, August 1, 2009; 21(5): 677 - 698. [Abstract] [PDF]
|
|
|
|
 |
|
 M. G. Taylor Timing, Accumulation, and the Black/White Disability Gap in Later Life: A Test of Weathering Research on Aging, March 1, 2008; 30(2): 226 - 250. [Abstract] [PDF]
|
|
|
|
 |
|
 N. E. Basta, F. E. Matthews, M. D. Chatfield, C. Brayne, and MRC-CFAS Community-level socio-economic status and cognitive and functional impairment in the older population Eur J Public Health, February 1, 2008; 18(1): 48 - 54. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Sacker, J. Head, and M. Bartley Impact of Coronary Heart Disease on Health Functioning in an Aging Population: Are There Differences According to Socioeconomic Position? Psychosom Med, February 1, 2008; 70(2): 133 - 140. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Feinglass, S. Lin, J. Thompson, J. Sudano, D. Dunlop, J. Song, and D. W. Baker Baseline Health, Socioeconomic Status, and 10-Year Mortality Among Older Middle-Aged Americans: Findings From the Health and Retirement Study, 1992 2002 J. Gerontol. B. Psychol. Sci. Soc. Sci., July 1, 2007; 62(4): S209 - S217. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. A Freedman and L. G Martin Commentary: Dissecting disability trends--concepts, measures, and explanations Int. J. Epidemiol., October 1, 2006; 35(5): 1261 - 1263. [Full Text] [PDF]
|
|
|
|
|
|
T. Sulander, T. Martelin, P. Sainio, O. Rahkonen, A. Nissinen, and A. Uutela Trends and educational disparities in functional capacity among people aged 65-84 years Int. J. Epidemiol., October 1, 2006; 35(5): 1255 - 1261. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. K. Coppin, L. Ferrucci, F. Lauretani, C. Phillips, M. Chang, S. Bandinelli, and J. M. Guralnik Low Socioeconomic Status and Disability in Old Age: Evidence From the InChianti Study for the Mediating Role of Physiological Impairments J. Gerontol. A Biol. Sci. Med. Sci., January 1, 2006; 61(1): 86 - 91. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. F. Schoeni, L. G. Martin, P. M. Andreski, and V. A. Freedman Persistent and Growing Socioeconomic Disparities in Disability Among the Elderly: 1982-2002 Am J Public Health, November 1, 2005; 95(11): 2065 - 2070. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. S. House, P. M. Lantz, and P. Herd Continuity and Change in the Social Stratification of Aging and Health Over the Life Course: Evidence From a Nationally Representative Longitudinal Study From 1986 to 2001/2002 (Americans' Changing Lives Study) J. Gerontol. B. Psychol. Sci. Soc. Sci., October 1, 2005; 60(suppl_Special_Issue_2): S15 - S26. [Abstract] [Full Text] [PDF]
|
|