Educational attainment and transitions in functional status among older Taiwanese

Abstract

Despite considerable research examining the influence of socioeconomic status on health, few studies have considered this relationship as it pertains to older adults in non-Western societies. We attempt to ascertain the influence of education on changes in physical functioning in a rapidly developing country. Data come from the 1989 Survey of Health and Living Status of the Elderly in Taiwan and a follow-up interview in 1993 (N = 4,049, age = 60+). Individuals are conceptualized to be in a state of functional independence or functional limitation at the time of origin, based on their ability to perform three physical functioning tasks. The outcome at the follow-up interview is categorized as functionally independent, limited, or dead, allowing for six probabilities, one from each state of origin to each outcome. These are calculated using a multinomial logit model, controlling for other factors often thought to be associated with health transitions. High levels of educational attainment result in a decreased incidence of functional limitation for those originating in a state of independence. Contrary to expectations, however, education has little influence on those who originate functionally limited. Thus, higher education plays a substantial role in primary prevention of morbidity, delaying the onset of disability, but other factors are more important once limitations begin. We speculate on the reasons behind these findings, including that the results may be culturally dependent.

Self-Reported Health Status of Older Adults in Malaysia and Singapore: Evidence from the 2007 Global Ageing Survey

“…Thus, it may be concluded that lower levels of education and unemployment are associated with a higher risk of reporting poor health among older adults in Malaysia and Singapore. It can also be seen from earlier studies that education is negatively related to the risk of the onset of functional limitations (Zimmer et al 1998), and mortality .…”

Facteurs associés à la santé perçue et à la capacité fonctionnelle des personnes âgées dans la préfecture de Bandjoun au Cameroun

“…Du reste, plusieurs études ont constaté, dans divers contextes, des différences marquées dans l'état de santé et l'incapacité des personnes âgées selon le niveau d'instruction et la profession (Zimmer et al, 1998;Robert, 1999). Selon Coburn et Pope (1974), de toutes les variables qui caractérisent le statut socioéconomi-que, c'est habituellement le niveau d'instruction qui présente la plus forte corrélation avec les comportements de santé, devant la profession et le revenu.…”

Neuroendocrine biomarkers, social relations, and the cumulative costs of stress in Taiwan

“…The directionality of ethnicity is unclear. Mainlanders, for instance, have had experiences suggestive of both a less stressful life history (e.g., traditionally holding positions of power) and a more stressful this life history (e.g., living through uncertain and disruptive wartime conditions, leaving behind family in their migration to Taiwan) (Zimmer, Martin, & Lin, 2005;Zimmer et al, 1998). The hypothesized directionality of urban or rural residence is also uncertain, but area of residence is potentially important (Greenhalgh, 1984;Wang, Snyder, & Kaas, 2001;Zimmer, Natividad, Lin, & Chayovan, 2000) and is thus included in the models.…”